Ruptured Ovarian Artery Aneurysm in a Postmenopausal Female: Case Report
Clinical Practice and Cases in Emergency Medicine
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3d ago
Introduction: Ovarian artery aneurysm is a rare diagnosis, primarily associated with late pregnancy and the postpartum period. It can cause life-threatening hemorrhage when ruptured. Even more rare are ovarian artery aneurysms in postmenopausal women. Case Report: We present a case of a postmenopausal female presenting to the emergency department with flank pain. Point-of-care ultrasound showed free fluid in the abdomen. She was diagnosed with an ovarian artery aneurysm on computed tomography angiography and treated successfully with embolization. Conclusion: Ruptured ovarian artery aneurysm is ..read more
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Defibrillator Lead Perforation Leading to Concerning Electrocardiogram Findings: Case Report
Clinical Practice and Cases in Emergency Medicine
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3d ago
Introduction: Implantable cardioverter-defibrillator (ICD) lead perforation through the myocardium may result in chest pain and electrocardiogram (ECG) changes concerning for ST-segment elevation myocardial infarction. The clinical context of the ECG aids in appropriate management. Case Report: We report the case of a 71-year-old woman experiencing chest pain after an ICD placement two weeks earlier. On presentation, she exhibited ST-segment elevation on her ECG. Computed tomography confirmed ICD lead migration. The patient’s hemodynamics were normal, and she was discharged home after a five-day ..read more
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Permissive Hypotension in a Patient with Severe Hypernatremia: A Case Report
Clinical Practice and Cases in Emergency Medicine
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3w ago
Introduction: Severe hypernatremia is a critical situation, and when coupled with intravascular depletion and hypotension can create a treatment dilemma. Case Report: We present the case of a medically complex patient who had gradually worsening alteration of mental status and mean arterial pressures in the 50s on presentation to the emergency department. Conclusion: Final diagnoses included severe hypernatremia and hypovolemic shock secondary to poor oral intake. We used judicious fluid repletion with gradual improvement in sodium levels and permissive hypotension to avoid rapid osmotic shifts ..read more
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Using Point-of-care Ultrasonography to Diagnose Traumatic Arthrotomy of the Knee: A Case Series
Clinical Practice and Cases in Emergency Medicine
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1M ago
Introduction: Accurate diagnosis of traumatic arthrotomy of the knee (TAK) is critical for patients presenting to the emergency department (ED) to ensure timely treatment. Current diagnostic modalities including plain radiography, computed tomography (CT), and the saline load test (SLT) have advantages and disadvantages. Point-of-care-ultrasonography (POCUS) offers a possible timely, low-cost, and efficient alternative method of diagnosing TAK. In this case series we present three cases where POCUS was used to diagnose TAK in the ED. Case Series: Three patients in their early 20s presented to t ..read more
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Transcatheter Arterial Embolization for Atraumatic Splenic Rupture in TEE-negative Endocarditis: A Case Report
Clinical Practice and Cases in Emergency Medicine
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1M ago
Introduction: Spontaneous splenic rupture is an extremely rare complication of infective endocarditis. Case Report: We present a case of a 56-year-old immunocompetent female with porcine bioprosthetic mitral valve replacement, automated implanted cardioverter-defibrillator, and atrial fibrillation on apixaban who was found to have in-hospital atraumatic splenic rupture complicating infective endocarditis with Haemophilus parainfluenza. The rupture was treated successfully by endovascular embolization. Usual treatment with six weeks of antibiotics provided durable cure without further complication ..read more
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Acute Abdominal Pain and a Whirlpool Sign on Computerized Tomography: A Case Report
Clinical Practice and Cases in Emergency Medicine
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1M ago
Introduction: Mesenteric volvulus is a rare cause of abdominal pain and bowel obstruction in elderly patients. When a mesenteric volvulus occurs in adult patients, the symptoms are often non-specific, which contributes to delays in diagnosis. Case Report: We present a case of a 75-year-old female who presented with non-specific abdominal pain. The rare whirlpool sign on computed tomography identified a mesenteric volvulus as the cause of small bowel obstruction. She was taken to the operating room and, after successful resection of the small bowel, she recovered and ultimately was discharged home ..read more
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Diabetic Ketoalkalosis: A Case Report
Clinical Practice and Cases in Emergency Medicine
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1M ago
Introduction: Diabetic ketoacidosis (DKA) is a common diagnosis in the emergency department (ED). However, one must consider other causes for acid-base disturbances when the pattern is not consistent with typical presentation. Case Report: A 52-year-old female with a history of insulin-dependent diabetes mellitus type 2 presented to the ED with abdominal pain, nausea, and vomiting for three days. Her diagnostic workup revealed diabetic ketoacidosis but with concurrent metabolic alkalosis. Standard treatment for DKA was initiated, and there was improvement of her mentation and resolution of met ..read more
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CPC-EM Full-Text Issue
Clinical Practice and Cases in Emergency Medicine
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1M ago
CPC-EM Full-Text Issue ..read more
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Buprenorphine for High-dose Tramadol Dependence: A Case Report of Successful Outpatient Treatment
Clinical Practice and Cases in Emergency Medicine
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2M ago
Buprenorphine for High-dose Tramadol Dependence: A Case Report of Successful Outpatient Treatment ..read more
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Complications of Bacterial Keratitis Impacted by Social Determinants of Health: A Case Report
Clinical Practice and Cases in Emergency Medicine
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2M ago
Introduction: The emergency department commonly evaluates eye pain and vision loss. Typically, these conditions can be managed outpatient; however, delays can lead to advanced pathology. Case Report: A 48-year-old homeless male presented with left-eye vision loss and pain. His exam revealed monocular decreased visual acuity, corneal ulcer, and hypopyon. The patient was diagnosed with bacterial keratitis and admitted for treatment but left against medical advice. He returned and was admitted for further treatment but was lost to follow-up thereafter. Conclusion: Our case features complicated ba ..read more
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