De Garengeot hernia: the ultrasound and computed tomographic findings in an 81-year-old woman Jianpeng Hao, Junchao Yao, Dawei Guo, Wenyu Sun, Jian Liang, Xiaofeng Jiang
DOI: http://dx.doi.org/10.1016/j.ajem.2013.11.003
The American Journal of Emergency Medicine , Vol. 32 , Issue 5 ,
Published online: November 11 2013
x The presence of appendix within a femoral hernia is a rare condition in an incarcerated femoral hernia. It has a characteristic groin mass, and the diagnosis of appendicitis is mainly made intraoperatively. A specific imaging appearance (ultrasonography, computed tomography [CT]) allows accurate prospective diagnosis. The recognition of this rare femoral hernia helps us to choose appropriate therapeutic approach. We report a case of an 81-year-old woman who present with painful and nonreducible groin mass.
Painful, pigmented lymphadenopathy secondary to decorative tattooing Ishwarya Balasubramanian, John P. Burke, Eoghan Condon
DOI: http://dx.doi.org/10.1016/j.ajem.2013.02.011
The American Journal of Emergency Medicine , Vol. 31 , Issue 6 ,
Published online: May 15 2013
x Pigmented lymph nodes are traditionally associated with melanoma and metastatic malignancy. This report describes the case of 22-year-old white man, who presented with painful right groin lymphadenopathy. Groin ultrasound and computed tomography confirmed an enlarged (2 cm) right inguinal lymph node. Elective excision of this lymph node was conducted due to unresolving pain, and a pigmented node was retrieved. Although a suspicious finding, histologic examination demonstrated black pigment infiltration from a decorative tattoo on the right leg.
Ultrasound diagnosis of occult femoral hernia presenting with intestinal obstruction Te-I Weng, Hsiu-Po Wang, Wen-Jone Chen, Len-Bsu William Chin, Lit-Min Ng
DOI: http://dx.doi.org/10.1053/ajem.2001.24489
The American Journal of Emergency Medicine , Vol. 19 , Issue 4 ,
Published in issue: July 2001
x Femoral hernia is the second most common groin hernia after inguinal hernia.1 Most patients with femoral hernias complain of pain or local discomfort in the groin area, although some patients may have femoral hernias and be asymptomatic. Femoral hernias typically present as a lump in the groin area, which, however, is not required to make this diagnosis.2 Less than two-thirds of femoral hernias are correctly diagnosed before hospital admission, and over 10% are diagnosed only at laparotomy. The challenge to emergency physicians is detection of occult femoral hernia.
Femoral hernia: The dire consequences of a missed diagnosis Gideon P Naude, Sarah Ocon, Fred Bongard
DOI: http://dx.doi.org/10.1016/S0735-6757(97)90184-4
The American Journal of Emergency Medicine , Vol. 15 , Issue 7 ,
Published in issue: November 1997
x Femoral hernia has always presented more difficulty in diagnosis than other external abdominal hernias. The incidence of incarceration and strangulation is higher in our series than the published literature would suggest. A retrospective study was performed at our institution from February 1990 to June 1995. In that period, 22 patients were operated on for femoral hernia. There were 16 women and 6 men, average ages 51 and 48 years, respectively. The men weighed on average 209 lb, and the women, 154 lb.
Acute hemiscrotum due to inguinoscrotal Littre hernia: a case report Murat Akin, Osman Kurukahvecioglu, Tugan Tezcaner, Ahmet Ziya Anadol, Kahraman Onur
DOI: http://dx.doi.org/10.1016/j.ajem.2008.02.023
The American Journal of Emergency Medicine , Vol. 26 , Issue 8 ,
Published in issue: October 2008
x Meckel diverticulum (MD) is the most common congenital anomaly of the gastrointestinal tract that is generally asymptomatic and only manifests in a specific way when complications exist. An unusual complication of MD is known as Littre hernia. It comprises less than 1% of all MD. Littre hernia is the protrusion of an MD through a potential abdominal opening. Usual sites of Littre hernia are right inguinal (50% of cases), umbilical hernia (20%), and femoral hernia (20%). We report a case of Littre hernia in a boy who presented with acute scrotal pain and swelling.
Amyand hernia: a case of an unusual inguinal herniace Gerard S. Doyle, Christy McCowan
DOI: http://dx.doi.org/10.1016/j.ajem.2007.10.028
The American Journal of Emergency Medicine , Vol. 26 , Issue 5 ,
Published in issue: June 2008
x Amyand hernia, named for the first person to describe an inguinal hernia containing the vermiform appendix, is an uncommon variant of an inguinal hernia. Presence of the appendix in the sac complicates the management of inguinal hernias. The appendix may be more prone to rupture when contained within a hernia sac, and herniation of an inflamed appendix into the scrotum can mimic an acute scrotum. A 50-year-old man presented with right lower quadrant abdominal pain associated with chills and anorexia.
Inguinal hernias: room for a better understanding Charles A Perrott
DOI: http://dx.doi.org/10.1016/j.ajem.2003.09.007
The American Journal of Emergency Medicine , Vol. 22 , Issue 1 ,
Published in issue: January 2004
x Inguinal hernias are a common problem but often present with diagnostic dilemmas, in part as a result of the complex anatomy of the region. A simplified analogy is put forward in the hope of increasing the understanding of the anatomy and some guidance given in an endeavor to differentiate direct and indirect hernias, with significance to their possible complication rates.
Retroperitoneal hematoma after manual reduction of indirect inguinal hernia Xiequn Xu, Tao Hong, Binglu Li, Wei Liu, Chaoji Zheng, Xiaodong He
DOI: http://dx.doi.org/10.1016/j.ajem.2013.02.023
The American Journal of Emergency Medicine , Vol. 31 , Issue 7 ,
Published online: April 22 2013
x This report presents the case of a 59-year-old man with sudden severe pain in the right lower abdomen after manually reducing the right indirect inguinal hernia who had bilateral indirect inguinal hernia for 5 years. A subsequent contrast computed tomography scan with contrast of the abdomen and pelvis revealed a significant extensive retroperitoneal hematoma at the abdomen and pelvis of the right side. There was contrast leaked out, which was suspected from inferior epigastric artery. He underwent successful laparotomy.
Intrathoracic stomach presenting as acute tension gastrothorax Scott C Tadler, John H Burton
DOI: http://dx.doi.org/10.1016/S0735-6757(99)90089-X
The American Journal of Emergency Medicine , Vol. 17 , Issue 4 ,
Published in issue: July 1999
x Total intrathoracic stomach creating pulmonary and hemodynamic compromise is a rare life-threatening complication in patients with hiatal hernia. The presentation and clinical course of this condition are discussed. Physicians should consider this entity in patients presenting with apparent tension pneumothorax without history or other evidence of trauma or positive pressure ventilation who do not respond to standard interventions.
Retroperitoneal hematoma as a complication of coronary angiography and stenting Boris V Lubavin
DOI: http://dx.doi.org/10.1016/j.ajem.2004.02.025
The American Journal of Emergency Medicine , Vol. 22 , Issue 3 ,
Published in issue: May 2004
Ruptured abdominal aortic aneurysm presenting as bilateral symptomatic inguinal hernias Lee W. Shockley
DOI: http://dx.doi.org/10.1016/0735-6757(91)90224-8
The American Journal of Emergency Medicine , Vol. 9 , Issue 5 ,
Published in issue: September 1991
“Asymptomatic” hyponatremia Joseph Varon, Marc S. Nelson
DOI: http://dx.doi.org/10.1016/0735-6757(91)90223-7
The American Journal of Emergency Medicine , Vol. 9 , Issue 5 ,
Published in issue: September 1991
Acute abdominal pain in an elderly woman Carol F. McCammon
DOI: http://dx.doi.org/10.1053/ajem.2001.9262
The American Journal of Emergency Medicine , Vol. 19 , Issue 3 ,
Published in issue: May 2001
x Herniation of abdominal viscera may present as an internal process as in inguinal or femoral hernias, or externally as in cases of rectal prolapse, cystocele or enterocele, or prolapse of the uterus. The most common presentation in women is femoral hernia, yet in unusual circumstances external herniation of abdominal viscera may occur through a weakened vaginal wall. This has been seen in association with previous vaginal surgery, obstetrical trauma, or forceful coitus.1-8 This case shows an unusual case of external herniation caused by the use of pessaries in the treatment of cystocele and rectocele.
Lateral abdominal wall hematoma due to tear of internal abdominal oblique muscle in a patient under warfarin therapy Chi-Ming Tai, Kao-Lang Liu, Chieh-Chang Chen, Jaw-Town Lin, Hsiu-Po Wang
DOI: http://dx.doi.org/10.1016/j.ajem.2005.04.013
The American Journal of Emergency Medicine , Vol. 23 , Issue 7 ,
Published in issue: November 2005
x Abdominal pain is a common problem in the ED. Abdominal wall hematoma is a rare cause of acute abdominal disorders and may be misdiagnosed from other causes of abdominal pain. We present a patient who visited our ED because of acute left flank and left lower abdominal pain. In the present case, the ultrasonography (US) and computed tomography (CT) showed not only the hematoma but also the muscular defect of left internal abdominal oblique muscle which suggested the bleeder. Angiography showed active extravasation from left deep circumflex iliac artery, and N -butyl cyanoacrylate glue embolization was performed successfully.
Aortic graft in hollow viscus Sun Hwa Lee, Yoon Hee Choi
DOI: http://dx.doi.org/10.1016/j.ajem.2015.06.060
The American Journal of Emergency Medicine , Vol. 34 , Issue 3 ,
Published online: June 25 2015
x Secondary aortoenteric fistulas (AEFs) and aortic graft infection are relatively rare but fatal complications of aortic surgery. A 77-year-old man had a 1-week history of fever and abdominal pain with right inguinal area swelling. The patient's medical history included hypertension, aortobifemoral bypass grafting due to right iliac artery, and superficial femoral artery occlusion. Abdominopelvic computed tomography revealed the presence of an aortic graft in the hollow viscus. Although there have been several reports of secondary AEF, there have been few reports of an aortic graft in a hollow viscus.
Use of emergency ultrasound in a rural ED with limited radiology services Matthew Lyon, Michael Blaivas, Larry Brannam
DOI: http://dx.doi.org/10.1016/j.ajem.2004.05.007
The American Journal of Emergency Medicine , Vol. 23 , Issue 2 ,
Published in issue: March 2005
x Disparity in healthcare delivered to patients seen in emergency departments (EDs) comes in many forms. Studies have suggested differences in care based on ethnicity and education [1]. Inequities in healthcare occur in other specialties as well, such as the discrepancies in rates of revascularization attempts in women and men with myocardial infarction [2]. Medical care may also differ based on geography. For example, access to mammography for women living in remote areas differs significantly from that available to women in suburban areas [3].
Dissecting abdominal aortic aneurysm in a young man: an uncommon presentation of abdominal pain Lawrence M. Linett
DOI: http://dx.doi.org/10.1016/j.ajem.2005.02.007
The American Journal of Emergency Medicine , Vol. 23 , Issue 3 ,
Published in issue: May 2005
x Aortic dissection results from an intimal tear that allows blood to penetrate the wall of the aorta. Patients, typically males over the age of fifty with a history of hypertension, usually present with sudden onset of severe chest pain. An unusual presentation of a dissecting aortic aneurysm as a cause of abdominal pain in a 32-year-old male is discussed. Although a relatively uncommon cause of abdominal pain, it is important to keep this entity on the list of differential diagnoses and adequately rule it out before discharge from the emergency department.
Spermatic cord injury associated with blunt trauma Akira Takasu, Kentarou Morita, Naoyuki Kaneko, Toshihisa Sakamoto, Yoshiaki Okada
DOI: http://dx.doi.org/10.1016/j.ajem.2005.02.053
The American Journal of Emergency Medicine , Vol. 23 , Issue 6 ,
Published in issue: October 2005
x Spermatic cord injury due to blunt trauma is an entity rarely encountered in clinical practice, and it may be mainly characterized by the onset of severe pain, swelling, or hematoma in the groin area. We present a case of a fresh spermatic cord injury caused by blunt trauma, which was correctly diagnosed after a surgical exploration.
Angiographic embolization in chest wall hematoma due to handlebar injury—a rare case report Po-Chin Yu, Tzu-Hsien Yang, Abhishek Katakwar, Yu-Jen Cheng, Po-Chih Chang
DOI: http://dx.doi.org/10.1016/j.ajem.2015.02.054
The American Journal of Emergency Medicine , Vol. 33 , Issue 9 ,
Published online: March 6 2015
x We report a woman presenting with an expanding chest wall hematoma after handlebar injury. Computed tomography identified a right anterior-upper chest wall hematoma with extension to right shoulder and upper extremity. Moreover, an enhancing spot within the hematoma was identified, favoring a pseudoaneurysm. The right axillary arterial angiography revealed a pseudoaneurysm at the branch of right anterior humeral circumflex artery. Patient underwent angiographic embolization with subsequent surgical drainage and made a full recovery.
Table of Contents
DOI: http://dx.doi.org/10.1016/S0735-6757(08)00301-X
The American Journal of Emergency Medicine , Vol. 26 , Issue 5 ,
Published in issue: June 2008
