European journal of emergency medicine : official journal of the European Society for Emergency Medicine
-
Foreign body ingestion in children is a common presenting complaint to the emergency department. Although the majority of ingested foreign bodies pass through the gastrointestinal tract unaided, some children will require either non-surgical or surgical intervention. Retained oesophageal foreign bodies may cause a multitude of problems, including mucosal ulceration, inflammation or infection, and more seriously paraoesophageal or retropharyngeal abscess formation, mediastinitis, empyema, oesophageal perforation and aorta-oesophageal fistula formation. ⋯ Such complications following foreign body ingestion in children are rare but potentially fatal. A high index of suspicion must be maintained in young children presenting with a possible history of foreign body ingestion as a delayed diagnosis may lead to significant morbidity and mortality. We review the literature surrounding paediatric retropharyngeal abscesses and mediastinitis.
-
Peritonism is a finding that leads to a more cautious approach in the emergency department management of abdominal pain. This study examined whether peritonism assessment using inspiration, expiration and cough tests was associated with the patient's clinical management. ⋯ These peritonism tests represent a simple investigation, and are significantly associated with admission when all three tests are positive. They seem to be a clinical predictor of cases in which continuing assessment was required, and may be useful as a departmental 'safety net' in the management of abdominal pain.
-
The combined clinical and biochemical profile of diabetic ketoacidosis, hyperglycemic hyperosmolar non-ketotic syndrome, complicated by acute pancreatitis, in an 11-year-old with established insulin-dependent diabetes mellitus, is presented. The management requires diligent correction of dehydration and hyperglycemia, while monitoring neurological status and blood chemistry. It is imperative to monitor and avoid potentially fatal complications of the combined entity, namely, cerebral edema, thromboembolism, acute respiratory distress syndrome and rhabdomyolysis. Excluding acute pancreatitis in the face of persistent abdominal pain in this setting is emphasized.
-
This report highlights the uncommon disease of Langerhans cell histiocytosis in the context of nontraumatic back pain. Langerhans cell histiocytosis has a broad range of presentations and should be borne in mind in many differential diagnoses in the emergency and general practice setting. Back pain in children, contrary to back pain in adults, is frequently the result of a treatable organic pathology and should be assessed thoroughly before a diagnosis of nonspecific or mechanical back pain is made.
-
The aim of the study was to evaluate the effects of different resuscitation solutions on wound healing in an animal model of sublethal hemorrhagic shock. ⋯ It can be concluded that resuscitation with modified fluid gelatin may have detrimental effects on wound healing in an experimental model of sublethal hemorrhagic shock.