Seventeen-year-old sexually active male with rash Anne Boyd, David Mills, Kristen Hook, Rahul Kaila
DOI: http://dx.doi.org/10.1016/j.ajem.2015.08.043
The American Journal of Emergency Medicine , Vol. 34 , Issue 4 ,
Published online: August 29 2015
x Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a fairly rare but potentially life-threatening adverse drug reaction characterized by rash, fever, lymphadenopathy, hematologic abnormalities, and multiorgan involvement. Pathogenesis of the disease is not fully understood, but proposed mechanisms include drug metabolism defects, human herpesvirus reactivation, and genetic predisposition. Diagnosis and treatment can be difficult or even delayed, as there are no globally accepted diagnostic criteria and those afflicted have nonspecific clinical findings.
Descending necrotizing mediastinitis from upper respiratory infection Kuang-Jui Chang, Wen-Jone Chen, Shey-Ying Chen, Kuang-Chau Tsai, Ang Yuan
DOI: http://dx.doi.org/10.1016/j.ajem.2003.12.016
The American Journal of Emergency Medicine , Vol. 22 , Issue 2 ,
Published in issue: March 2004
Emergency endoscopic decompression of a delayed posttraumatic tension gastrothorax Ausami Abbas, Manish Thakker, Michael Booth, Ian Rechner
DOI: http://dx.doi.org/10.1016/j.ajem.2010.05.019
The American Journal of Emergency Medicine , Vol. 29 , Issue 5 ,
Published online: August 16 2010
x Tension gastrothorax is a rare, potentially life-threatening complication associated with diaphragmatic defects. Most reported cases in the literature have described this condition as a complication of congenital diaphragmatic hernia, in patients with hiatus hernia, or in the postoperative setting. It is an extremely rare complication following diaphragmatic injury and usually manifests as a delayed presentation of an undiagnosed traumatic diaphragmatic hernia. Early diagnosis and differentiation from other conditions that are more commonly associated with “tension” phenomena are essential.
Inhalant abuse of computer cleaner manifested as angioedema Peter C. Kurniali, Letitia Henry, Rita Kurl, Joseph V. Meharg
DOI: http://dx.doi.org/10.1016/j.ajem.2010.12.003
The American Journal of Emergency Medicine , Vol. 30 , Issue 1 ,
Published online: February 4 2011
x Inhalant abuse is the intentional inhalation of chemical vapors or volatile substance to achieve a euphoric effect. Although no statistical data are reported yet, inhalant abuse is potentially life-threatening and has resulted in a wide range of toxic effects such as central nervous system depression, seizures, aspiration, cardiac arrhythmia, asphyxiation, hypoxia, metabolic acidosis, and sudden death among others. We are reporting a 25-year-old white man who was brought to the emergency department after inhaling aerosolized computer-cleaning spray composed of difluoroethane.
An unusual cause of headache and hypertension Hsiang-Ju Hsiao, Ju-Li Lin, Chang-Teng Wu, Jainn-Jim Lin, Shao-Hsuan Hsia
DOI: http://dx.doi.org/10.1016/j.ajem.2012.05.010
The American Journal of Emergency Medicine , Vol. 31 , Issue 1 ,
Published online: August 8 2012
x Children with both headache and hypertension present a relatively rare condition with a broad range of differential diagnoses in pediatric emergency medicine. Some possible diagnoses are potentially life-threatening conditions and merit aggressive evaluation management. We report a case of a 14-year-old girl who presented with headache and hypertension. She responded poorly to medical treatment and subsequently developed anxiety and difficulties with concentration. Three months later, she visited our ophthalmology department because of blurred vision.
Thyroid rupture secondary to blunt neck trauma Yih-Liang Sow, Nora Abdul Aziz, Khoon-Leong Ng
DOI: http://dx.doi.org/10.1016/j.ajem.2012.12.005
The American Journal of Emergency Medicine , Vol. 31 , Issue 4 ,
Published online: February 11 2013
x Rupture of the thyroid gland is uncommon in cases of blunt neck trauma. We report a case of thyroid rupture after a motor vehicle accident in a patient without a preexisting goiter. He presented with a painful anterior neck swelling associated with dysphagia and hoarseness of voice. Computed tomographic scans showed lacerations of the right thyroid lobe and isthmus with features suggestive of slow active bleeding. Neck exploration was subsequently performed, and a ruptured right thyroid lobe was found with ongoing venous hemorrhage.
Spontaneous hepatic rupture caused by hemolysis, elevated liver enzymes, and low platelet count syndrome Je Sung You, Yong Eun Chung, Hyun Soo Chung, Youngseon Joo, Sung Phil Chung, Hahn Shick Lee
DOI: http://dx.doi.org/10.1016/j.ajem.2013.12.001
The American Journal of Emergency Medicine , Vol. 32 , Issue 6 ,
Published online: December 11 2013
x The causes of hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome or hepatic hemorrhage as a serious complication of HELLP are not known. Although spontaneous hepatic rupture associated with HELLP syndrome is a rare complication of pregnancy, hepatic rupture results in life-threatening complications. The cornerstone of prognosis is early diagnosis. Hepatic rupture in HELLP syndrome should be considered a differential diagnosis in pregnant patients with sudden onset of abdominal pain or hypotension.
A life-threatening complication of warfarin therapy in ED: diffuse alveolar hemorrhage Emin Uysal, Erdem Çevik, Süleyman Solak, Yahya Ayhan Acar, Mustafa Yalimol
DOI: http://dx.doi.org/10.1016/j.ajem.2013.12.022
The American Journal of Emergency Medicine , Vol. 32 , Issue 6 ,
Published online: December 16 2013
x Warfarin have some serious adverse effects, and bleeding is one of the most serious and frequent of them. In this case report, we present the diffuse alveolar hemorrhage case as a rare and life-threatening complication of warfarin.
Delayed massive hemothorax complicating simple rib fracture associated with diaphragmatic injury Chin-Li Chen, Yeung-Leung Cheng
DOI: http://dx.doi.org/10.1016/j.ajem.2013.12.060
The American Journal of Emergency Medicine , Vol. 32 , Issue 7 ,
Published online: January 9 2014
x Traumatic hemothorax is potentially life threatening. Rib fractures are the commonest injury after chest trauma, which accounts for 10% of patients after trauma. A delayed massive hemothorax after simple rib fracture is rare. The possibility of delayed sequelae after chest trauma should be considered, and patients should be informed of this possibility. We present a case of this uncommon situation with delayed massive hemothorax caused by simple fracture of the lower ribs. Admission should be considered for close observation when presenting with fracture of the lower ribs because of the possibility of diaphragmatic injury or intra-abdominal injury, even if a simple rib fracture is found initially.
Life-threatening bleeding from gastrointestinal stromal tumor: successful embolization with subsequent laparoscopic surgery Yen-Wei Huang, Fu-Yuan Siao, Hsu-Heng Yen
DOI: http://dx.doi.org/10.1016/j.ajem.2014.02.024
The American Journal of Emergency Medicine , Vol. 32 , Issue 9 ,
Published online: February 26 2014
x Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract that originate from the interstitial cells of Cajal. The stomach and the small bowel are the 2 primarily involved sites. The symptoms of GIST depend on their size and location of the tumors. Common symptoms include abdominal pain, a palpable mass, and/or gastrointestinal bleeding. However, acute gastrointestinal bleeding from GIST is rare and, generally, requires emergency surgery. Here, we report an 86-year-old man with lung cancer who was presented to our emergency department with hypovolemic shock from a gastric GIST.
Necrotizing painful skin lesion after a mosquito bite in healthy elderly woman: Case report Mauro Giordano, Tiziana Ciarambino, Cecilia Politi, Caterina Aurilio, Giuseppe Paolisso
DOI: http://dx.doi.org/10.1016/j.ajem.2014.02.028
The American Journal of Emergency Medicine , Vol. 32 , Issue 9 ,
Published online: February 26 2014
x Pseudomonas aeruginosa (PA) is a gram-negative bacillus capable of producing infections, which usually occur in hospital environment. Cutaneous manifestations represent a wide spectrum of pathologic entities, ranging from minor skin lesions to necrotizing skin infection and to potentially life-threatening PA septicemia. The pathogenesis of PA infections must be understood in the context of its role as an opportunistic pathogen. In particular, it rarely causes disease in healthy patients because of its low virulence.
Veno-venous extracorporeal membrane oxygenation therapy of a severely injured patient after secondary survey M.C. Stoll, F. Rademacher, K. Klak, J. Strauch, T.A. Schildhauer, J. Swol
DOI: http://dx.doi.org/10.1016/j.ajem.2014.03.039
The American Journal of Emergency Medicine , Vol. 32 , Issue 10 ,
Published online: April 2 2014
x Thoracic injury following a major trauma can be life threatening. Veno-venous extracorporeal membrane oxygenation (vv-ECMO) can be used as a support to mechanical ventilation when acute respiratory distress syndrome is present. We report the case of an 18-year-old male driver who strayed from the road and fell 15 m into a backyard by landing on the roof of its car. The injury severity score was 51 for his pattern of injuries (hemopneumothorax left, sternum fracture, pneumothorax right, pneumomediastinum, intracerebral bleeding, scalping injury occipital, fracture of the ninth thoracic vertebral body, and complete paraplegia).
Life-threatening hemothorax due to azygos vein rupture after chest compression during cardiopulmonary resuscitation Euiseok Yang, WonJoon Jeong, JunWan Lee, SeungWhan Kim
DOI: http://dx.doi.org/10.1016/j.ajem.2014.04.019
The American Journal of Emergency Medicine , Vol. 32 , Issue 11 ,
Published online: April 18 2014
x Hemothorax is not an uncommon cardiopulmonary resuscitation (CPR)–related complication. But hemothorax related to azygos vein injury (AVI) is a rare condition following blunt chest trauma, with no report of CPR-related AVI in the literature. We present a case of azygos vein rupture in a middle-aged woman after repeated chest compression during 1 hour of CPR. She eventually presented with massive hemothorax due to azygos vein rupture diagnosed by computed tomography (CT). When faced with a patient with massive hemothorax after chest compression, azygos vein rupture should be considered as a complication.
Commentary on: Severe manifestations of coricidin intoxication William V. Bobo, Robert B. Fulton
DOI: http://dx.doi.org/10.1016/j.ajem.2004.09.011
The American Journal of Emergency Medicine , Vol. 22 , Issue 7 ,
Published in issue: November 2004
Pelvic ectopic kidney with acute pyelonephritis: wolf in sheep's clothing Yu-Tzu Tsao, Shih-hua Lin, Yuh-Feng Lin, Pauling Chu
DOI: http://dx.doi.org/10.1016/j.ajem.2007.08.023
The American Journal of Emergency Medicine , Vol. 26 , Issue 4 ,
Published in issue: May 2008
x The differential diagnosis of right lower quadrate pain at the emergency department is quite perplexing. We describe a 38-year-old woman presenting with characteristic clinical and laboratory features of ruptured appendicitis with severe sepsis. However, contrast-enhanced computed tomography scan of the abdomen established the diagnosis of pelvic ectopic kidney with acute pyelonephritis. Antibiotic treatment eventually achieved satisfactory resolution without compromise of renal function. It is should be addressed that, even with the advent of modern imaging modalities, there can be a diagnostic pitfall in general practice when managing right lower quadrate pain in patients with typical presentations of acute appendicitis without sonographic evidence, as illustrated in this case.
Heterotopic pregnancy presenting with acute left chest pain Fikret Bildik, Ahmet Demircan, Ayfer Keles, Aydan Biri, Emine Bildik, Gul Pamukcu
DOI: http://dx.doi.org/10.1016/j.ajem.2007.12.013
The American Journal of Emergency Medicine , Vol. 26 , Issue 7 ,
Published in issue: September 2008
x Heterotopic pregnancy is the simultaneous existence of intrauterin and ectopic gestations. Heterotopic pregnancy is an extremely rare entity in natural cycle; however, it is increasing due to widespread use of assisted reproductive techniques. Early diagnosis and intervention are crucial in avoiding short- and long-term morbidity and mortality. Unfortunately, early diagnosis is often difficult due to the presence of intrauterin pregnancy that impedes the diagnosis and early treatment for ectopic component.
Pharyngitis followed by hypoxia and sepsis: Lemierre syndrome Frederick W. Fiesseler, Peter B. Richman, Renee L. Riggs
DOI: http://dx.doi.org/10.1053/ajem.2001.24507
The American Journal of Emergency Medicine , Vol. 19 , Issue 4 ,
Published in issue: July 2001
x —Symptoms of pharyngitis are a frequent presenting complaint of emergency department (ED) patients. The majority of these cases are caused by viral pathogens. Thus, it is generally accepted that antibiotics are not warranted in most adult patients with sore throats. On the other hand, complications of withholding antibiotics, although infrequent, can lead to life-threatening consequences.
Successful transcatheter lumbar arterial embolization of traumatic hemothorax Masakazu Nabeta, Osamu Takasu, Keita Tashiro, Toshio Morita, Atsuo Nakamura, Asako Kuhara, Masamichi Koganemaru, Toshi Abe, and others
DOI: http://dx.doi.org/10.1016/j.ajem.2015.11.034
Publication stage: In Press Corrected Proof
The American Journal of Emergency Medicine
Published online: November 18 2015
x Traumatic hemothorax associated with the lumbar artery is extremely rare. In addition to tube thoracostomy, active hemostatic intervention is necessary in life-threatening massive hemothorax cases. Here we report a case of hemothorax resulting from a lumbar arterial injury accompanied by vertebral fracture, which was successfully treated with transcatheter lumbar arterial embolization.
Isolated testicular pain mimicking ruptured abdominal aortic aneurysm in a nonagenarian Susanne Regus, Hendrik Apel, Peter Dankerl, Werner Lang
DOI: http://dx.doi.org/10.1016/j.ajem.2015.01.038
The American Journal of Emergency Medicine , Vol. 33 , Issue 8 ,
Published online: January 30 2015
x Ruptured abdominal aortic aneurysm commonly presents as acute abdominal or lower back pain and hemodynamic instability. We discuss the case of a 90-year-old patient who presented to the emergency unit with a 3-day history of left testicular pain. Ultrasound scan demonstrated and a computed tomography scan confirmed a 6 cm in diameter ruptured abdominal aortic aneurysm with enlargement and hematoma of the left psoas muscle causing the symptoms. This atypical presentation highlights the need for clinical vigilance and emergency physician–performed ultrasound scan in the older patients with seemingly benign testicular symptoms.
Acute airway compromise due to ruptured inferior thyroid artery aneurysm Zerrin Ozergın Coskun, Özcan Yavaşi, Tugba Durakoglugil, Ozlem Celebi Erdivanli, Abdulkadir Ozgur, Suat Terzi, Engin Dursun
DOI: http://dx.doi.org/10.1016/j.ajem.2015.01.049
The American Journal of Emergency Medicine , Vol. 33 , Issue 8 ,
Published online: February 2 2015
x A cervical hematoma secondary to the spontaneous rupture of an aneurysm is an uncommon but catastrophic life-threatening condition because it can potentially obstruct the airway. Inferior thyroid artery aneurysm and rupture is a very rare clinical entity and only a limited number of cases have been reported in the literature. In this article, we present the case of a female patient who suffered from a rapidly enlarging cervical mass followed by a rapid onset of dyspnea as a result of rupture of an inferior thyroid artery aneurysm.
