The ability of renal ultrasound and ureteral jet evaluation to predict 30-day outcomes in patients with suspected nephrolithiasis J. Matthew Fields, Jonathan I. Fischer, Kenton L. Anderson, Alessandro Mangili, Nova L. Panebianco, Anthony J. Dean
DOI: http://dx.doi.org/10.1016/j.ajem.2015.07.014
The American Journal of Emergency Medicine , Vol. 33 , Issue 10 ,
Published online: July 16 2015
x We sought to identify findings on bedside renal ultrasound that predicted need for hospitalization in patients with suspected nephrolithiasis.
Sepsis-associated takotsubo cardiomyopathy can be reversed with levosimendan Marios Karvouniaris, John Papanikolaou, Demosthenes Makris, Epameinondas Zakynthinos
DOI: http://dx.doi.org/10.1016/j.ajem.2011.02.030
The American Journal of Emergency Medicine , Vol. 30 , Issue 5 ,
Published online: May 2 2011
x Sepsis is a stressful physical condition, and at the acute phase, overstimulation of the sympathetic nervous system may occur; these events have the potential to induce cardiomyopathy. Takotsubo cardiomyopathy (TTC) is a form of catecholamine-induced cardiomyopathy, which occurs very rarely in sepsis. However, TTC management in critically ill patients with sepsis may be challenging because the use of exogenous catecholamines for circulatory support might augment further TTC. Herein, we report a rare case of TTC after urosepsis; and we point out that cardiac function may improve after catecholamine withdrawal and the application of calcium channel sensitizer levosimendan.
Contrast-enhanced ultrasound as imaging technique for patients with acute flank pain into the ED Marco Fiore, Lorenzo Andreana
DOI: http://dx.doi.org/10.1016/j.ajem.2015.11.020
The American Journal of Emergency Medicine , Vol. 34 , Issue 2 ,
Published online: November 9 2015
x We read with great interest the case report recently published on the American Journal of Emergency Medicine by Gun et al [1] describing 2 patients admitted to the emergency department (ED) because of acute flank pain, who were diagnosed renal infarction with contrast-enhanced computed tomography (CT).
Table of Contents
DOI: http://dx.doi.org/10.1016/S0735-6757(15)00714-7
The American Journal of Emergency Medicine , Vol. 33 , Issue 10 ,
Published in issue: October 2015
What do we miss without contrast in patients with flank pain? Cem Gun, Hasan Aldinc, Serpil Yaylaci, Tansu Gudelci, Ozgur Karcioglu
DOI: http://dx.doi.org/10.1016/j.ajem.2015.09.002
The American Journal of Emergency Medicine , Vol. 34 , Issue 4 ,
Published online: September 9 2015
x Flank pain is a common complaint in the emergency department, and the most frequent cause of flank pain is urolithiasis. Spontaneous renal artery dissection and renal artery thrombosis are rare causes of abdominal pain which can result in renal parenchymal injury. They are mostly difficult to diagnose and treat in the emergency setting. The present report describes 2 patients admitted to the emergency department because of acute flank pain who were diagnosed with renal infarction.
Effect of advanced age and vital signs on admission from an ED observation unit Jeffrey M. Caterino, Emily M. Hoover, Mark G. Moseley
DOI: http://dx.doi.org/10.1016/j.ajem.2012.01.002
The American Journal of Emergency Medicine , Vol. 31 , Issue 1 ,
Published online: March 2 2012
x The primary objective was to determine the relationship between advanced age and need for admission from an emergency department (ED) observation unit. The secondary objective was to determine the relationship between initial ED vital signs and admission.
Ultrasound detection of obstructive pyelonephritis due to urolithiasis in the ED Jennifer Carnell, Jason Fischer, Arun Nagdev
DOI: http://dx.doi.org/10.1016/j.ajem.2010.07.006
The American Journal of Emergency Medicine , Vol. 29 , Issue 7 ,
Published online: October 11 2010
x Identifying acute pyelonephritis (APN) with early obstructive uropathy is clinically important in the emergency department (ED) because obstructive urolithiasis is an independent risk factor for inpatient death, prolonged hospitalization, and failure of outpatient APN therapy. Furthermore, diagnosis of an early obstructive uropathy can be difficult when based solely on clinical findings. Clinicians may assume the cause of the patient's symptoms to be APN alone, without considering the concurrent presence of an obstructing stone.
Ogilvie syndrome: a potentially life-threatening phenotype of immobilization hypercalcemia Wei-Chi Tsai, Tzu-Yi Chuang, Mei-Chen Chen, Jui-Chang Chen, Yu-Tzu Tsao
DOI: http://dx.doi.org/10.1016/j.ajem.2013.12.056
The American Journal of Emergency Medicine , Vol. 32 , Issue 7 ,
Published online: January 6 2014
x Ogilvie syndrome, also known as acute colonic pseudo-obstruction , is characterized by the clinical presentation and imaging evidence of acute colonic obstruction in the absence of a mechanical cause. Several comorbidities and serious associated medical or surgical conditions have been described to be relevant to this syndrome. In general, a preferred initial management with favorable treatment outcomes is virtually to correct underlying disorders. Although disrupted electrolyte homeostasis may induce impaired colonic motility, hypercalcemia secondary to immobilization as a major culprit in this syndrome has rarely been studied.
Subject Index
DOI: http://dx.doi.org/10.1016/S0735-6757(15)00997-3
The American Journal of Emergency Medicine , Vol. 33 , Issue 12 ,
Published in issue: December 2015
Pseudolithiasis after recent use of ceftriaxone: an unexpected diagnosis in a child with abdominal pain Julius Z.H. von Martels, Evelien K. Van de Meeberg, Mirjam Holman, Jack J.M. Ligtenberg, Jan C. ter Maaten
DOI: http://dx.doi.org/10.1016/j.ajem.2013.04.022
The American Journal of Emergency Medicine , Vol. 31 , Issue 8 ,
Published online: June 28 2013
x Ceftriaxone is a widely prescribed third-generation broad spectrum cephalosporin, often used for treatment of severe bacterial infections in children. It is known that ceftriaxone can cause sonographic biliary abnormalities in children. However, in only a minority of these cases, it will be accompanied with the clinical relevant symptoms and biochemical abnormalities seen in gallbladder disease. Ceftriaxone-associated cholelithiasis has a highly reversible nature and is thus called pseudolithiasis.
Large left upper quadrant mass Amy A. Ernst, Steve J. Weiss, David A. Wachter, Michael D. Stifelman
DOI: http://dx.doi.org/10.1016/j.ajem.2010.06.011
The American Journal of Emergency Medicine , Vol. 29 , Issue 6 ,
Published online: August 16 2010
x Causes of left upper quadrant (LUQ) masses include spleen, colonic, pancreatic, and renal etiologies. Emergency department (ED) ultrasound can help differentiate the cause. In this article, we present the case of a 53-year-old female attending Emergency Medicine physician diagnosed with a large palpable LUQ mass. The mass was noted after an episode of moderate nausea and mild LUQ, left lower quadrant, and flank pain. The pain and nausea resolved the following day. The mass was palpable about 10 cm below the left costal margin and was thought initially to be the spleen.
Complications of percutaneous procedures Esther H. Chen, Alexander Nemeth
DOI: http://dx.doi.org/10.1016/j.ajem.2010.05.010
The American Journal of Emergency Medicine , Vol. 29 , Issue 7 ,
Published online: August 5 2010
x Minimally invasive percutaneous procedures are increasingly being performed by both interventional radiologists and noninterventionalists. Patients with postprocedural issues will likely present to the emergency department for evaluation and treatment. This review focuses on the evaluation and management of the complications of common percutaneous procedures.
The prevalence and implications of incidental findings on ED abdominal CT scans Wells A. Messersmith, David F.M. Brown, Michael J. Barry
DOI: http://dx.doi.org/10.1053/ajem.2001.27137
The American Journal of Emergency Medicine , Vol. 19 , Issue 6 ,
Published in issue: October 2001
x We reviewed reports from 321 consecutive emergency department (ED) noncontrast, helical “renal stone” abdominal CT scans obtained at a single medical center between April 1996 to June 1997 for incidental findings. Incidental findings were common (45% of scans), and approximately half were rated of “moderate” or “serious” concern by 2 independent reviewers (kappa = 0.72). ED records indicated that only 21% of incidental findings were documented, and only 11 (18%) of cases with findings of “moderate/severe” concern had evidence of follow-up on hospital chart review.
Does diagnosis change as a result of repeat renal colic computed tomography scan in patients with a history of kidney stones? Adam Goldstone, Andrew Bushnell
DOI: http://dx.doi.org/10.1016/j.ajem.2008.11.024
The American Journal of Emergency Medicine , Vol. 28 , Issue 3 ,
Published online: October 26 2009
x We sought to determine the incidence of alternative diagnosis in patients with a history of kidney stones who experience recurrent symptoms and undergo repeat computed tomography (CT) imaging at their return to the emergency department (ED).
The use of intravenous ketorolac for the treatment of renal colic in the emergency department L.Scott Larsen, Alan Miller, John R. Allegra
DOI: http://dx.doi.org/10.1016/0735-6757(93)90123-S
The American Journal of Emergency Medicine , Vol. 11 , Issue 3 ,
Published in issue: May 1993
x The objective of this study was to report the authors' experience using intravenous ketorolac (Syntex Laboratories, Palo Alto, CA) as an analgesic in the treatment of renal colic in a convenience sample at three suburban community hospital emergency departments. Twenty-five patients with renal colic were participants. Pregnant women, patients with a history of renal or hepatic impairment, bleeding diathesis, active peptic ulcer disease, or hypersensitivity to aspirin or nonsteroidal antiinflammatory drugs (NSAID) were excluded.
The use of abdominal computed tomography in older ED patients with acute abdominal pain Fredric M. Hustey, Stephen W. Meldon, Gerald A. Banet, Lowell W. Gerson, Michelle Blanda, Lawrence M. Lewis
DOI: http://dx.doi.org/10.1016/j.ajem.2005.02.021
The American Journal of Emergency Medicine , Vol. 23 , Issue 3 ,
Published in issue: May 2005
x The objectives of this study were to determine the prevalence of use of abdominal computed tomography (CT) in older ED patients with acute nontraumatic abdominal pain, describe the most common diagnostic CT findings, and determine the proportion of diagnostic CT results. This was a prospective, observational, multicenter study of 337 patients 60 years or older. History was obtained prospectively; charts were reviewed for radiographic findings, dispositions, diagnoses, and clinical course, and patients were followed up at 2 weeks for additional information.
Hematuria as an indicator for the presence or absence of urinary calculi Yair Safriel, Ajay Malhotra, Salvatore J Sclafani
DOI: http://dx.doi.org/10.1016/S0735-6757(03)00158-X
The American Journal of Emergency Medicine , Vol. 21 , Issue 6 ,
Published in issue: October 2003
x The purpose of this study was to determine whether the presence of hematuria or its absence can predict the presence or absence of urinary calculi as determined by computed tomography (CT) scan in patients presenting to the ED with acute abdominal colic. We reviewed the urine analysis and CT scans of all patients presenting to the ED over a 12-month period with acute colic and a clinical suspicion of urinary calculi. Urine samples were drawn on arrival in the ED before CT scanning. Two hundred seventy-seven patients were included in the study.
An unusual presentation of renal infarction Anthony Napoli
DOI: http://dx.doi.org/10.1016/j.ajem.2004.06.003
The American Journal of Emergency Medicine , Vol. 22 , Issue 5 ,
Published in issue: September 2004
Idiopathic ovarian vein thrombosis: a rare cause of abdominal pain Basem F. Khishfe, Anna Sankovsky, Isam Nasr
DOI: http://dx.doi.org/10.1016/j.ajem.2015.09.022
The American Journal of Emergency Medicine , Vol. 34 , Issue 5 ,
Published online: September 20 2015
x Ovarian vein thrombosis (OVT) is a rare but potentially serious condition that affects mostly postpartum women. It has also been associated with other conditions, such as pelvic inflammatory disease, malignancy, sepsis, inflammatory bowel disease, and recent pelvic or abdominal surgery. It is critical to recognize and treat this condition as early as possible to avoid the potential complications of the thrombosis and adverse sequelae such as infection and sepsis. We report a case of idiopathic OVT in a previously healthy premenopausal woman presenting with sudden onset groin pain.
Pericarditis as initial manifestation of proximal aortic dissection in young patients Suchdeep Raj Bains, Anita Kedia, Carlos A. Roldan
DOI: http://dx.doi.org/10.1016/j.ajem.2007.05.018
The American Journal of Emergency Medicine , Vol. 26 , Issue 3 ,
Published in issue: March 2008
x Pericarditis was the primary manifestation of aortic dissection in these 2 young men. Both patients had no phenotypic characteristics of Marfan or Ehlers-Danlos syndrome. These patients had pleuritic chest pain and characteristic electrocardiographic changes consistent with pericarditis. However, timely performed transthoracic echocardiograms revealed proximal aortic dissection with hemopericardium noted at surgery in both cases. Although the sensitivity of transthoracic echocardiogram for proximal aortic dissection is approximately 60%, certain findings can alert the physician to the possibility of aortic dissection.
