Effect of time delays for appendectomy as observed on computed tomography in patients with noncomplicated appendicitis Maru Kim, Seong-Taek Oh
DOI: http://dx.doi.org/10.1016/j.ajem.2015.10.009
The American Journal of Emergency Medicine , Vol. 34 , Issue 2 ,
Published online: October 12 2015
x Delaying appendectomy is a controversial issue. This study aimed at identifying the effect of time delays in surgery, especially for patients with noncomplicated appendicitis on computed tomography (CT).
Diagnosis and disposition are changed when board-certified emergency physicians use CT for non-traumatic abdominal pain Aaron Nathan Barksdale, Jeff Lee Hackman, Monica Gaddis, Matt Christopher Gratton
DOI: http://dx.doi.org/10.1016/j.ajem.2015.07.082
The American Journal of Emergency Medicine , Vol. 33 , Issue 11 ,
Published online: August 4 2015
x To determine the effect of abdominal computed tomographic (CT) scan results on diagnosis and disposition of patients with non-traumatic abdominal pain who were evaluated by board-certified emergency physicians (EPs).
Computed tomography is not justified in every pediatric blunt trauma patient with a suspicious mechanism of injury Yehuda Hershkovitz, Itai Zoarets, Albert Stepansky, Eran Kozer, Zahar Shapira, Baruch Klin, Ariel Halevy, Igor Jeroukhimov
DOI: http://dx.doi.org/10.1016/j.ajem.2014.04.024
The American Journal of Emergency Medicine , Vol. 32 , Issue 7 ,
Published online: April 21 2014
x Computed tomography (CT) has become an important tool for the diagnosis of intra-abdominal and chest injuries in patients with blunt trauma. The role of CT in conscious asymptomatic patients with a suspicious mechanism of injury remains controversial. This controversy intensifies in the management of pediatric blunt trauma patients, who are much more susceptible to radiation exposure. The objective of this study was to evaluate the role of abdominal and chest CT imaging in asymptomatic pediatric patients with a suspicious mechanism of injury.
Could contrast-enhanced CT detect STEMI prior to electrocardiogram? Chadi Sabbagh, Mayda Rahi, Maria Baz, Fadi Haddad, Omar Helwe, Noel Aoun, Tony Ibrahim, Lynn Abdo
DOI: http://dx.doi.org/10.1016/j.ajem.2014.06.039
The American Journal of Emergency Medicine , Vol. 33 , Issue 1 ,
Published online: July 1 2014
x We present here a case in which contrast-enhanced computed tomography (CT) was the first diagnostic tool to detect myocardial hypoperfusion in a patient with atypical symptoms and normal electrocardiogram (ECG) on admission. An ST-segment elevation was detected thereafter on a second ECG realized several minutes after CT with raised troponin levels. Percutaneous coronary intervention was performed after failure of thrombolysis and confirmed occlusion of the left anterior descending artery. Further studies are needed to evaluate the role of high-resolution contrast-enhanced CT with or without coronary angiography in the workup of suspected myocardial infarction in the setting of a normal ECG.
Computed tomography scan as a diagnostic tool for supraglottitis in adults Tian-Hoe Tan, Chien-Chin Hsu, Yu-Ying Liao, Kuo-Tai Chen
DOI: http://dx.doi.org/10.1016/j.ajem.2014.06.016
The American Journal of Emergency Medicine , Vol. 32 , Issue 10 ,
Published online: June 20 2014
x The diagnostic criterion standard for supraglottitis is direct visualization of the supraglottic area during laryngoscopic examination [1]. It requires special equipment and personnel who are familiar with operating a laryngoscope; either of which is accessible 24 hours a day in most emergency departments (EDs). Therefore, patients suspected of acute supraglottitis are usually referred for diagnoses, which increase the chance of a futile referral and of disastrous airway obstruction during transportation.
Dual-source computed tomography may define cardiac contusion in patients with blunt chest trauma in ED Mucahit Emet, Murat Saritemur, Bayram Altuntas, Leyla Karaca, Fatih Mehmet Sari, Yasin Bilgin, Mecit Kantarci, Sahin Aslan
DOI: http://dx.doi.org/10.1016/j.ajem.2014.12.059
The American Journal of Emergency Medicine , Vol. 33 , Issue 6 ,
Published online: December 31 2014
x We report a 20-year-old woman with blunt chest trauma because of a motor vehicle injury who has traumatic asphyxia and hypotension. The diagnosis of blunt cardiac injury was put by using dual-energy computed tomography in the emergency department because other laboratory and imaging modalities were useless. After hospitalization in intensive care unit, she was treated with supportive and antiedema therapy. The patient was extubated on the fifth day and discharged on the ninth day without any sequel.
Computed tomography scan is superior to x-ray plain film in the diagnosis of gastrointestinal tract perforation Yang Li, Junmin Song, Nan Lin, Chuang Zhao
DOI: http://dx.doi.org/10.1016/j.ajem.2014.08.048
The American Journal of Emergency Medicine , Vol. 33 , Issue 3 ,
Published online: August 26 2014
x Gastrointestinal (GI) tract perforation is one of the most severe acute abdomens. In clinical practice, abdominal x-ray plain film remains the first-line diagnostic modality for this entity. A proportion of the perforated patients, however, do not exhibit a classic x-ray sign: free air at the subphrenic area. This insufficiency can bring difficulties to the diagnosis, delay appropriate treatments, and even cause lethal consequences. We describe herein a case of GI tract perforation, which was not detected by the abdominal x-ray plain film initially.
Benefits of CT tractography in evaluation of anterior abdominal stab wounds Tamer Ertan, Yusuf Sevim, Talha Sarigoz, Omer Topuz, Baki Tastan
DOI: http://dx.doi.org/10.1016/j.ajem.2015.05.018
The American Journal of Emergency Medicine , Vol. 33 , Issue 9 ,
Published online: May 29 2015
x The study aimed to identify the presence of peritoneal penetration in management of anterior abdominal stab wound by using computed tomography (CT) tractography.
Variation in use of all types of computed tomography by emergency physicians Matthew B. Levine, Andrew B. Moore, Chris Franck, Jie Li, Damon R. Kuehl
DOI: http://dx.doi.org/10.1016/j.ajem.2013.07.003
The American Journal of Emergency Medicine , Vol. 31 , Issue 10 ,
Published online: September 3 2013
x Variation in computed tomography (CT) use between emergency medicine (EM) physicians may delineate appropriate or inappropriate use. We hypothesize that variation in all types of CT use exists between providers and their use in patients with common chief concerns. We determine EM physicians' variability in CT use of all types and whether high use in one area predicts use of other CT types.
Effects of pain severity and CT imaging on analgesia prescription in acute appendicitis Daniel D. Singer, Henry C. Thode Jr., Adam J. Singer
DOI: http://dx.doi.org/10.1016/j.ajem.2015.09.015
The American Journal of Emergency Medicine , Vol. 34 , Issue 1 ,
Published online: September 25 2015
x Previously, analgesics were avoided in suspected appendicitis to avoid masking the diagnosis. We determined use of analgesia in patients with appendicitis to determine recent trends over time and explore predictors of use of analgesia.
Emergent CT findings of impending cardiac arrest: a report of 4 cases Sun Hwa Hong, Eun-Young Kang, Sik Huh, Hwan-Seok Yong, Yoon Kyung Kim, Ok Hee Woo, Tae-Seok Seo
DOI: http://dx.doi.org/10.1016/j.ajem.2012.10.028
The American Journal of Emergency Medicine , Vol. 31 , Issue 3 ,
Published online: January 24 2013
x We report CT findings of 4 patients who experienced sudden cardiac arrest. The CT features documented in our cases include dense opacification of the right heart and major systemic veins, venous layering of contrast material and blood, densely opacified parenchyma in the right hepatic lobe, decreased enhancement of the abdominal organ, dense pulmonary artery, contrast pooling in dependent lungs, and contrast stasis in pulmonary veins. Familiarity with characteristic CT findings of impending cardiac arrest is essential for immediate cardiopulmonary resuscitation.
What is the clinical significance of chest CT when the chest x-ray result is normal in patients with blunt trauma? Bory Kea, Ruwan Gamarallage, Hemamalini Vairamuthu,, Jonathan Fortman, Kevin Lunney, Gregory W. Hendey, Robert M. Rodriguez
DOI: http://dx.doi.org/10.1016/j.ajem.2013.04.021
The American Journal of Emergency Medicine , Vol. 31 , Issue 8 ,
Published online: June 24 2013
x Computed tomography (CT) has been shown to detect more injuries than plain radiography in patients with blunt trauma, but it is unclear whether these injuries are clinically significant.
It is not contrast media: CT imaging appearance of intra-arrest transnasal evaporative cooling Sonja Gordic, Peter Gerstl, Martin Brueesch, Hatem Alkadhi
DOI: http://dx.doi.org/10.1016/j.ajem.2012.10.030
The American Journal of Emergency Medicine , Vol. 31 , Issue 3 ,
Published online: February 4 2013
x Foreign material in the upper digestive tract might be a serious, potentially life-threatening condition. Although commonly found objects are solid and include bones, glass, dental prostheses, needles, and coins, liquid foreign material is less often encountered. We report a case of a patient who had cardiac arrest and who was cooled with an evaporative coolant after successful resuscitation for inducing hypothermia in the prehospital period. On admission, head and neck computed tomography (CT) revealed hyperdense fluid in the pharynx and in paranasal sinuses, causing confusion to emergency physicians, anesthesiologists, and radiologists alike.
Myocardial hypoperfusion on conventional contrast computed tomography Shing Ching, Tak Shun Chung
DOI: http://dx.doi.org/10.1016/j.ajem.2015.07.072
The American Journal of Emergency Medicine , Vol. 33 , Issue 10 ,
Published online: July 29 2015
x Abstract
Association of physician risk tolerance with ED CT use for isolated dizziness/vertigo patients Fu-Jen Cheng, Chien-Hung Wu, Yuan-Jhen Syue, Pai-Chun Yen, Kuan-Han Wu
DOI: http://dx.doi.org/10.1016/j.ajem.2014.07.022
The American Journal of Emergency Medicine , Vol. 32 , Issue 10 ,
Published online: July 30 2014
x Dizziness/vertigo is one of the most common principal complaints in the emergency department (ED) [1], accounting for 2.5% of all ED presentations [2]. Although the most common causes of dizziness/vertigo are benign, potential life-threatening stroke especially cerebellar or brain stem infarction should be considered in the differential diagnosis because isolated dizziness without other concurrent neurologic symptoms can be the sole presentation of these conditions [3-5]. Noncontrast brain computed tomography (CT) provides the necessary information for emergency management of most patients with suspected stroke and is the most commonly used brain imaging method in EDs [6].
Outcomes of warfarinized patients with minor head injury and normal initial CT scan Beng Leong Lim, Charmaine Manauis, Marxengel L. Asinas-Tan
DOI: http://dx.doi.org/10.1016/j.ajem.2015.09.009
The American Journal of Emergency Medicine , Vol. 34 , Issue 1 ,
Published online: September 18 2015
x We investigated delayed outcomes of patients with minor head injury, warfarin, and a normal initial head computer tomographic (CT) scan finding.
Correlation of optic nerve sheath diameter measurements by computed tomography and magnetic resonance imaging Hossein Kalantari, Rajnish Jaiswal, Isaac Bruck, Hussein Matari, Farzaneh Ghobadi, Jeremy Weedon, Getaw Worku Hassen
DOI: http://dx.doi.org/10.1016/j.ajem.2013.07.028
The American Journal of Emergency Medicine , Vol. 31 , Issue 11 ,
Published online: September 19 2013
x Traditionally, intracranial pressure is measured by direct ventriculostomy, which is invasive. Noninvasive measures such as bedside ultrasound and magnetic resonance imaging have been advocated and utilized recently to assess the intracranial pressure. The role of this study is to determine the degree of agreement between measurements of the optic nerve sheath diameter by computed tomography (CT) and magnetic resonance imaging (MRI).
CT versus grayscale rib series for the detection of rib fracture Harun Gunes, Elif Nisa Unlu, Ayhan Saritas
DOI: http://dx.doi.org/10.1016/j.ajem.2015.07.061
The American Journal of Emergency Medicine , Vol. 33 , Issue 10 ,
Published online: July 29 2015
x In an article published in the April issue of your journal, Park et al [1] assessed the utility of inverted grayscale rib series (RS) in detecting rib fractures, and they found out that “inverted grayscale RS are not superior to conventional x-rays in detecting rib fractures but using both sets of images improved diagnostic sensitivity and accuracy among less experienced readers like medical students and junior EM residents”.
Ischemic stroke with left hemiparesis or shock should be evaluated by computed tomography for aortic dissection Shunsuke Tanoue, Youichi Yanagawa
DOI: http://dx.doi.org/10.1016/j.ajem.2011.03.018
The American Journal of Emergency Medicine , Vol. 30 , Issue 5 ,
Published online: November 18 2011
x An 82-year-old woman with consciousness disturbance, left hemeparesis, and dysarthria was discovered at home by her family and was transported to a hospital. On arrival, she remained in a sleepy and disorientated and shock state. She complained of nausea but no chest or back pain. She obtained stable circulation after infusion. Her chest roentgen results showed widening of the mediastinum and the existence of a separation of the intimal calcification from the outer aortic soft tissue border, thus suggesting a Stanford A–type aortic dissection.
Alvarado score: can it reduce unnecessary CT scans for evaluation of acute appendicitis? Piyaporn Apisarnthanarak, Voraparee Suvannarerg, Poompis Pattaranutaporn, Aphinya Charoensak, Steven S. Raman, Anucha Apisarnthanarak
DOI: http://dx.doi.org/10.1016/j.ajem.2014.11.056
The American Journal of Emergency Medicine , Vol. 33 , Issue 2 ,
Published online: December 3 2014
x The objective of the study is to assess the utility of Alvarado score in the diagnosis of acute appendicitis and the utility of computed tomographic (CT) scan for evaluation of acute appendicitis when stratified by Alvarado scores.
