Perforation is an exceptionally rare complication of duodenal diverticula and often presents with nonspecific symptoms and signs. We present a case of a perforated duodenal diverticulum diagnosed on computed tomography and successfully repaired with a diverticulectomy.
Medical students planning a residency in emergency med_icine or radiology have little formal instruction in emergency radiology available to them (1). Because the responsibility for immediate pretreatment interpretation of emergency department radiographs often is shared by emergency medicine residents and radiology residents (2), it would seem desirable to provide some formal instruction in emergency radiology early in a physician's training. Therefore, we have suggested that providing an elective in emergency radiology for fourth year medical students is both feasible and beneficial.To address the needs of students planning careers in emergency medicine or radiology, a basic course in emergency radiology has been developed and taught by faculty at the Albert Einstein College of Medicine. Since its inception, we have had numerous requests from students at other institutions, as well as our own, to enroll in this course because of its unique nature and relevance to their field of interest. We conducted a survey to evaluate how many radiology departments aflfiliated with medical schools provide an elective in emergency/trauma radiology to fourth year medical students. An additional purpose was to provide a model for institutions considering the development of programs offering this elective to their medical students.
MATERIALS AND METHODSBeginning in December 1993, an elective in emergency radiology has been offered to fourth year medical students at our institution and to those visiting from other medical schools. The elective consists of a 1-month clerkship at a level I trauma center. An attending radiologist whose area of primary interest is emergency radiology provides ongoing review with the medical students during the day and also reviews the previous night's work in the morning. The scope of instruction is geared toward interpretation of emergency films, special techniques for trauma imaging, and appropriateness of special imaging modalities for emergency room patients.As the elective continues, students are quizzed on each study. They are encouraged to make the appropriate findings and then discuss the differential diagnosis. There is a special emphasis on indications for radiologic assessment, so that unnecessary radiologic examinations may be avoided. The students also are encouraged to observe special procedures performed on patients achnitted through the emergency room (e.g., emergency angiography, computed tomographic scanning, sonography, and nuclear medicine studies).The students are required to attend daily departmental conferences as well as biweekly trauma rounds. These rounds focus on the immediate diagnosis and management of trauma patients brought into the emergency room. There is always an attending emergency radiologist on hand to discuss pertinent findings. In addition, students are requested to refer to basic radiologic literature as special diagnostic problems occur. In the final week, they are quizzed orally on what they have seen. Their grade is based on the result of this quiz and thei...
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