scholarly journals Adrenocortical Carcinoma Discovered with Point-of-care Ultrasound

2021 ◽  
Vol 5 (4) ◽  
pp. 482-484
Author(s):  
Mark McIntyre ◽  
Michael Prats
Keyword(s):  
Lower Extremity ◽  
Adrenocortical Carcinoma ◽  
Point Of Care ◽  
Cystic Mass ◽  
Obstructive Nephropathy ◽  
Point Of Care Ultrasound ◽  
Lower Extremity Edema ◽  
Important Diagnostic Tool ◽  
Rare Malignancy ◽  
The Right

Case Presentation: A 34-year-old woman presented to the emergency department with bilateral lower extremity edema and shortness of breath. She had been seen by her primary care provider. Lab work and a follow-up with endocrinology had been unrevealing. Using point-of-care ultrasound we identified a cystic mass in the right upper quadrant prompting further imaging. Discussion: Abdominal and pelvic computed tomography confirmed a mass in the right posterior liver, which was later identified as an adrenocortical carcinoma. Ultrasound is an important diagnostic tool in the setting of lower extremity edema and can be used to assess for heart failure, liver failure, obstructive nephropathy, venous thrombosis, and soft tissue infection. In this case, ultrasound helped expedite the diagnosis and treatment of a rare malignancy.

scholarly journals Man With Bilateral Leg Swelling

2019 ◽  
Vol 3 (4) ◽  
pp. 451-452
Author(s):  
Jake Toy ◽  
Alexander Garrett ◽  
Yiju Liu
Keyword(s):  
Emergency Department ◽  
Lower Extremity ◽  
Tumor Thrombus ◽  
Inferior Vena ◽  
Point Of Care ◽  
Vena Cava ◽  
Point Of Care Ultrasound ◽  
Heterogeneous Structure ◽  
Lower Extremity Edema ◽  
Primary Renal Cell Carcinoma

A 52-year-old man without known medical history presented with painful, progressive, bilateral lower extremity edema over a two-week period. An abdominal exam noted a firm left upper quadrant mass. Emergency department (ED) point-of-care ultrasound (POCUS) revealed a hyperechoic, heterogeneous structure in the inferior vena cava that was determined to represent a tumor thrombus extending from a primary renal cell carcinoma. This case demonstrates how POCUS was valuable in rapidly diagnosing this rare cause of lower extremity edema and its usefulness in directing the initial ED management of this patient.

scholarly journals Early Detection of Post-Endarterectomy Complication by Point-of-Care Ultrasound

Reports ◽  
2021 ◽  
Vol 4 (3) ◽  
pp. 21
Author(s):  
Bo-Ku Chen ◽  
Po-Wei Chiu ◽  
Chih-Hao Lin
Keyword(s):  
Femoral Artery ◽  
Point Of Care ◽  
Postoperative Bleeding ◽  
External Iliac Artery ◽  
Common Femoral Artery ◽  
Atheromatous Plaque ◽  
Point Of Care Ultrasound ◽  
Related Complication ◽  
Contrast Extravasation ◽  
The Right

Endarterectomy is an effective intervention to remove the atheromatous plaque in the inner lining of the artery, aiming to revascularize the occluded/stenosed vessel in patients with peripheral arterial occlusive disease (PAOD). The most common wound-related complication is postoperative bleeding, followed by infection, hematoma, and seroma. However, hematoma complications with air surrounded have rarely been reported in clinical cases. Case presentation: A 90-year-old female patient visited our emergency department because of a rapidly growing hematoma with pulsatile bleeding over her right groin area. She had received bilateral percutaneous transluminal angioplasty with endarterectomy for PAOD one month prior. A point-of-care ultrasound revealed a large hypoechoic mass, with a dirty shadow on the right groin area. Computed tomography angiography showed a hematoma over her right femoral region, with free air surrounding the right femoral artery. Angiography revealed an irregular shaped lesion on the right femoral artery without contrast extravasation. The patient was diagnosed with right-femoral post-endarterectomy infection with infected hematoma, with the inclusion of air. She underwent urgent excision and repair of the right femoral artery infectious lesion, debridement of the infectious hematoma and stenting of the right external iliac artery, common femoral artery and superficial femoral artery.

scholarly journals Life after a point-of-care ultrasound course: setting up the right conditions!

2020 ◽  
Vol 12 (1) ◽  
Author(s):  
T. J. Olgers ◽  
N. Azizi ◽  
H. R. Bouma ◽  
J. C. ter Maaten
Keyword(s):  
Point Of Care ◽  
Point Of Care Ultrasound ◽  
The Right

scholarly journals Point-of-Care Ultrasound-Directed Evaluation of Elbow Effusion

2019 ◽  
Vol 3 (3) ◽  
pp. 286-288
Author(s):  
Peter Patitsas ◽  
Richard Davis ◽  
Robert Strony
Keyword(s):  
Emergency Department ◽  
Best Practices ◽  
Point Of Care ◽  
Robotic Prostatectomy ◽  
Point Of Care Ultrasound ◽  
Prolonged Hospital Stay ◽  
Ultrasound Guided ◽  
The Right ◽  
Department Evaluation ◽  
Prolonged Hospital

A 53-year-old male presented with pain in the right elbow that was sudden in onset and progressively worsening over approximately eight hours. The pain was exacerbated with any movement of the elbow. Of note, he had been recently admitted for robotic prostatectomy and had a prolonged hospital stay requiring a course of antibiotics. This case report details the emergency department evaluation of septic arthritis of the elbow with a focus on best practices for ultrasound- guided elbow arthrocentesis.

scholarly journals Functioning Adrenocortical Carcinoma with Extension upto the Right Atrium Producing Cushing's Syndrome

2013 ◽  
Vol 3 ◽  
pp. 32 ◽  
Author(s):  
Santosh Kumar ◽  
Gautam R. Choudhary ◽  
Arawat Pushkarna
Keyword(s):  
Inferior Vena Cava ◽  
Cushing’S Syndrome ◽  
Adrenocortical Carcinoma ◽  
Right Atrium ◽  
Inferior Vena ◽  
Vena Cava ◽  
Cushing's Syndrome ◽  
Curative Therapy ◽  
Rare Malignancy ◽  
The Right

Adrenocortical carcinoma (ACC) is a rare malignancy with poor prognosis. Surgery is the only curative therapy available and overall 5-year survival for patients who undergo a complete resection is 32% to 48%. They are known to produce intravascular invasion and into the inferior vena cava (IVC) and in rare cases they may reach the right atrium. We report a case of functioning ACC extending into the inferior vena cava and right atrium in a female with Cushing's syndrome.

scholarly journals Case Series of Bedside Renal Cell Carcinoma Detected by Point-of-Care Ultrasound in the Ambulatory Setting

2020 ◽  
Vol 11 ◽  
pp. 215013272091627
Author(s):  
Gayatri Setia ◽  
Ilan Kedan
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Point Of Care ◽  
Case Series ◽  
Smoking History ◽  
Point Of Care Ultrasound ◽  
Gross Hematuria ◽  
The Right

Background: Kidney and renal pelvic cancer was the sixth most common cancer in men and 10th most common in women in the United States in 2018. Renal cell carcinoma (RCC), accounts for 86% of malignancies of the kidney. RCC patients are often asymptomatic; up to 25-30% have metastases at diagnosis. Few present with the triad of gross hematuria, flank pain, and abdominal mass. In RCC patients, 36% had 2 symptoms of the triad, and 60% had gross hematuria as 1 symptom. Point-of-care ultrasound (POCUS) offers a way to identify clinically meaningful anatomic abnormalities. This case series presents 3 patients in whom routine POCUS examination performed in an outpatient cardiology clinic found asymptomatic renal masses, resulting in surgical resection and cure of early-stage RCCs. Case Presentation: Patient 1: 54-year-old female with hypertension (HTN). Two solid masses were identified with POCUS in the right kidney. Patient 2: 63-year-old male with coronary artery disease (CAD) and HTN was seen at an 8-month follow-up visit. A 6-cm mass was identified in the left kidney. Patient 3: 69-year-old male with CAD, HTN, and smoking history seen at 5-month follow-up visit. A 3-cm mass in the right kidney was identified. Conclusions: Incorporating POCUS into the routine physical examination in the ambulatory care setting may improve rates of detection and increase the pretest probability of identifying renal pathology with formal imaging studies. With minimal clinician training, earlier and increased detection of asymptomatic RCC may result in improved patient survival.

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