The American journal of emergency medicine
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Bowel obstruction is rare in pregnancy, and delay in recognition can lead to serious maternal and fetal complications. Most reported causes of bowel obstruction in pregnancy (adhesions, intussusception, hernia, and carcinoma) require surgical intervention. Sigmoid volvulus is an acute surgical cause that can now be managed successfully without surgery. We report the case of 33-year-old lady who presented with a sigmoid volvulus that was successfully managed with urgent endoscopic decompression.
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Acute lingual abscess is a rare yet life-threatening clinical entity. Lingual abscess must be appropriately diagnosed and treated in the emergency department to avoid acute airway compromise. A 68-year-old woman on immunomodulatory medication for rheumatoid arthritis presented to the emergency department with left facial pain and swelling. ⋯ Intravenous antibiotics are the primary treatment modality, with consideration given to adjunctive surgical drainage. We present this case to increase awareness surrounding this diagnosis among emergency physicians. Spontaneous lingual abscess should be considered in immunocompromised patients who present to the emergency department with tongue pain and edema even in the absence of lingual trauma.
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Case Reports
De Garengeot hernia: the ultrasound and computed tomographic findings in an 81-year-old woman.
The presence of appendix within a femoral hernia is a rare condition in an incarcerated femoral hernia. It has a characteristic groin mass, and the diagnosis of appendicitis is mainly made intraoperatively. A specific imaging appearance (ultrasonography, computed tomography [CT]) allows accurate prospective diagnosis. ⋯ We report a case of an 81-year-old woman who present with painful and nonreducible groin mass. The ultrasonography and CT characteristic imaging features successfully diagnosed de Garengeot hernia. To our knowledge, this is the first description of a combination of CT and ultrasound in the preoperative diagnosis.
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Prone ventilation is usually used for severe acute respiratory distress syndrome. We applied an alternative method to prone position. ⋯ Respiratory mechanics work to improve oxygenation almost as same as the mechanism proposed for prone position without any major adverse effects and serious complications. We suggest a larger randomized study to determine the efficacy and also to find out the optimum weight required to compress the chest.
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Individuals who live and work in the Southeastern coastal range of the 3 US crocodilian carnivores, American alligators, American crocodiles, and caiman, understand the risks of reptile-human encounters. Individuals who live in other parts of the country maybe exposed through contact with exotic pets at private homes, small menageries, or petting zoos or from escaped or abandoned animals. ⋯ The emergency management of large crocodilian injuries is similar to that of other major trauma; however, providers also must take into consideration the significant crush component potentially inflicted by the tremendous bite power and shaking inflicting during attacks by these large reptiles, appropriate antibiotic coverage for less common organisms that inhabit their mouths, and management of possible psychological distress, including posttraumatic stress disorder produced by such an unusual attack. Emergency physicians should support the development of a readily available national database of scientifically collect information on attacks to inform appropriate care and support efforts to explore responsible measures that the USDA Animal and Plant Health Inspection Service and other appropriate local, state, and federal agencies can take to ensure ethical and biologically sustainable management of our large reptiles, which also helps to ensure the safety of the public.