The American journal of emergency medicine
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Case Reports
More than just gastritis: An unusual presentation of strangulated transmesenteric hernia in a pediatric patient.
Internal hernias are a rare occurrence, reported in only 0.2-0.9% of the general population, and predominantly occur in adult patients as postsurgical complications. However, internal hernias can occur in pediatric patients, typically due to herniation of bowel through congenital mesenteric defects, and are associated with high rates of strangulation or volvulus (up to 30-40%) in this population. ⋯ She ultimately went on to have ultrasound and then CT imaging that revealed a high grade bowel obstruction due to an internal hernia from a mesenteric defect for which she required emergent resection of 119 cm of necrotic bowel. Ultimately this case illustrates a fairly benign presentation of a rare etiology of pediatric vomiting and abdominal pain that if left undetected could prove fatal, and is therefore essential for the emergency clinician to consider on the differential for vomiting and nonspecific abdominal pain in the pediatric patient.
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With a steady rise in the number of urgent care centers in the United States and the establishment of urgent care medicine as a specialty, research in the field is likely to emerge. ⋯ Based on our sample, published research in the field of urgent care medicine has evolved. By describing current trends, we hope that clinicians and researchers continue to advance the field by developing high quality research, including prospective, multi-institutional/center studies involving both clinical and non-clinical topics.