The American journal of emergency medicine
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Case Reports
Congenital diaphragmatic hernia with gastric volvulus presenting as an acute tension gastrothorax.
This report describes a 3-month-old infant with acute severe respiratory distress in whom a diagnosis of congenital diaphragmatic hernia with tension gastrothorax and gastric volvulus was made. A review of the pathophysiology, clinical presentation, differential diagnosis, diagnostic evaluation, and treatment of congenital diaphragmatic hernia is presented.
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Training programs in bedside ultrasound for emergency physicians often encounter considerable resistance, partly because of concern that the number of radiology-interpreted studies ordered from the ED may decrease. This study attempted to determine the effect of instituting an ED training program in ultrasound on the ordering of formal studies from a department of radiology. ⋯ The number of formal studies significantly increased after institution of the training program, both in terms of absolute numbers (annual mean 181 v 95, P < .001) and as a percentage of all outpatient sonograms ordered at the institution (9.8% v 5.1%, P < .001). Introduction of a teaching program in emergency ultrasound appears to increase utilization of formal ultrasound services, at least during the training period.
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A rare case is presented of intercondylar dislocation of the patella with vertical axis rotation. The injury was the result of blunt trauma directed to the lateral border of the patella. The patient presented with the knee locked in full extension and with a vertical ridge-shaped deformity caused by the medial border of the patella facing anteriorly. Reduction was accomplished under intravenous conscious sedation by manipulation.
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Letter Case Reports
Elbow dislocation complicated by brachial artery laceration.