Emergency radiology
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Emergency radiology · Oct 2006
Case ReportsSplenic rupture following colonoscopy: two cases with CT findings.
Splenic injury following colonoscopy is extremely rare. We report a 75-year-old woman and a 35-year-old woman who presented to the emergency room with left upper quadrant and left shoulder pain following colonoscopy. ⋯ One patient was successfully managed conservatively, and one patient needed emergent open splenectomy. The possibility of splenic injury should be considered in post-colonoscopy patients with left upper quadrant or left shoulder pain.
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Emergency radiology · Oct 2006
Impact of bedside right upper quadrant ultrasonography on radiology imaging.
Many Emergency Departments (ED) use emergency ultrasonography of the right upper quadrant (RUQ) to capture images of the gallbladder in patients with suspected gallstones. It is unclear what impact this practice has on additional imaging performed by radiology. Patients were enrolled 24 h a day by ED residents and attending physicians who have completed an educational program in limited RUQ ultrasound. ⋯ One hundred forty-nine (70%) clinical and 29 (20.7%) teaching ultrasounds had additional imaging. The average time to follow up imaging after discharge from the ED was 8.51 days. Most patients receiving emergency ultrasound of their RUQ had follow-up imaging by radiology.
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Emergency radiology · Oct 2006
Increasing utilization of computed tomography in the adult emergency department, 2000-2005.
This study aims to characterize changes in computed tomography (CT) utilization in the adult emergency department (ED) over a 5-year period. CT scans ordered on adult ED patients from July 2000 to July 2005 were analyzed in five groups: head, cervical spine, chest, abdomen, and miscellaneous. ED patient volume and triage acuity scores were determined. ⋯ ED CT utilization has increased at a rate far exceeding the growth in ED patient volume. This presumably reflects the improved utility of CT in diagnosing serious pathology, its increased availability, and a desire on the part of physicians for diagnostic certainty. Whether this increase in utilization results in improved patient outcomes is at present unclear and deserves additional study.
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The purpose of this study is to characterize the caliber of the normal appendix and the effect of luminal content on appendiceal diameter in adults using thin section intravenous (IV) contrast enhanced multidetector-row computed tomography (MDCT). A retrospective review was conducted using the MDCT datasets from 82 adults being screened as potential renal donors. The four-channel CT technique included IV contrast and 1-mm collimation. ⋯ Chart notes from within 24 h of the MDCT confirmed no signs or symptoms of appendicitis in cases that demonstrated any CT finding suspicious for appendicitis. In this healthy, adult population, the collapsed appendix measured up to 7 mm at MDCT. Air distention of the lumen results in a wider diameter, up to 10 mm.
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Emergency radiology · Sep 2006
Case ReportsSplenic rupture after diagnostic colonoscopy: a case report.
Colonoscopy is a commonly used diagnostic and therapeutic procedure. Splenic injury or rupture after this procedure is rare. We report a case of splenic rupture and hematoma in a middle-aged man who presented with symptoms of worsened anemia after diagnostic colonoscopy.