Pediatric ovarian torsion is a relatively rare occurrence with chances of significant morbidity and possible mortality if not treated emergently.Case Report: In this report, we review a case of pediatric ovarian torsion in a nine-year-old that was difficult to diagnose on initial presentation to the hospital due to various factors, which inevitably led to delayed resolution. Conclusion:We discuss the diagnosis of pediatric ovarian torsion including risk factors, symptoms, imaging modalities, and surgical diagnostics. To improve diagnosis and shorten time to treatment, this case supports the use of laparoscopy for diagnosis of ovarian torsion if indicated by clinical suspicion and supplemental imaging studies.
Mesenteric ischemia is a phenomenon that occurs when arteries supplying the gastrointestinal tract either become narrowed or obstructed, thus reducing or halting downstream perfusion. This case study will explore a case of mesenteric ischemia caused by SMA vasculitis, a nonatherosclerotic abdominal arterial vasculopathy (NAV), in which a 57 y/o woman with history of hyperlipidemia and GERD presented to the ER with chest and upper back pain. Initial work up for MI and PE were inconclusive and the patient was discharged. Patient then returned the next day complaining of chest and additional abdominal pain radiating to her back. An abdominal CTA, venous ultrasound, and MRI revealed findings highly suggestive of ischemia caused by vasculitis of the superior mesenteric artery, for which the patient was treated with tapering prednisone. Evaluation for mesenteric ischemia in patients presenting with nonspecific trunk pain will allow physicians to provide more prompt and catered care. Additionally, with the ubiquity of COVID-19 and its role in downstream inflammatory processes, atypical causes of mesenteric ischemia may be an increasingly important differential to consider.
Achalasia is an esophageal disorder characterized by loss of inhibitory neurons of the myenteric plexus in the lower esophageal sphincter, presenting with dysphagia, chest pain, and regurgitation. Although the etiology of achalasia is unknown, it has been associated with viral infections, and recent studies have noted concurrence of achalasia cases with COVID-19 infection. The case discussed in this report pertains to a 20-year-old female with a recent history of COVID-19 infection and subsequent SARS CoV-2 vaccine administration, presenting to the Emergency Department with a complaint of chest pain and shortness of breath. She was incidentally diagnosed with achalasia, after concern for pulmonary embolism prompted CT angiography of the chest. This case is unique due to the patient’s young age and lack of confounding ongoing medical issues to consider when analyzing disease presentation, as well as its potential link to COVID-19 infection. We hypothesize that SARS-CoV-2 might have caused a deviant immune response in this patient, leading to vagus nerve damage and the development of achalasia. With this case report, we hope to further explore the connection between COVID-19 and achalasia to help guide clinicians to potential viral etiologies of achalasia, allowing them for a prompt and efficient diagnosis and patient management.
A septic embolism occurs when an underlying infection causes a thrombus in a blood vessel to embolize and occlude a different blood vessel in the body. Since the embolus can travel to many different organs and cause ischemia, it can present with different symptoms and can cause life-threatening complications such as a pulmonary embolism. Due to this, it is essential to quickly recognize septic embolism in the Emergency Department and effectively treat the patient. This case report discusses a 47-year-old intravenous drug user male patient who presented with a constant sharp mid-upper back pain, tachycardia, and a heart murmur. This patient was started on IV antibiotics and imaged with a cardiac echo and computed tomography (CT) scan. Eventually, the diagnosis of Methicillin Resistant Staphylococcus aureus (MRSA) septic embolism was confirmed, and the patient was treated effectively with vancomycin. As there are multiple different diagnoses that present in a similar way, such as aortic dissection or bacterial endocarditis, looking at associated symptoms and using imaging can be useful to developing the final diagnosis. CT scans and positron emission tomography (PET) imaging are commonly used imaging techniques that are used to support and confirm the diagnosis of a septic embolism. Effective treatment involves the use of antibiotics (vancomycin, linezolid, and daptomycin) to treat the underlying MRSA infection and supportive care for any additional symptoms that the patient is experiencing. Leaving a patient undiagnosed with a septic embolism is associated with numerous additional complications; thus, it is necessary to quickly diagnose and treat this condition. A thorough examination of this case study will give a unique presentation of MRSA induced septic embolism in hopes of identifying and treating patients with this diagnosis.
Mini ReviewInterposed abdominal compression cardiopulmonary resuscitation, henceforth referred to as IAC-CPR, is an adjunct to standard CPR (S-CPR) according to American Heart Association (AHA) guidelines since 1992. Compared to other CPR adjuncts like high-frequency CPR, Active Compression Decompression CPR (ACD-CPR), vest CPR, mechanical (piston) CPR, Simultaneous Compression Decompression CPR (SCD-CPR), Phased Thoracic Abdominal Compression Decompression CPR (PTACD), and invasive CPR, IAC-CPR is widely accepted to be the least expensive, simplest, and most studied adjunct. IAC-CPR incorporates additional manual rhythmic compression of the region between the umbilicus and xiphoid process of the abdomen during the relaxation, or diastolic,
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.