Clinical Practice and Cases in Emergency Medicine最新文献_第3页

A Split from Traditional Orbital Compartment Syndrome Intervention: Case Report of Vision-saving Vertical Lid Split Procedure. 脱离传统眶间室综合征的干预：挽救视力的垂直眼睑分裂术1例报告。

Clinical Practice and Cases in Emergency Medicine Pub Date : 2026-08-01 DOI: 10.5811/cpcem.52953

Hannah Chason, Barret Zimmerman, Andrew Jenzer, David Fay, Julia Elpers

{"title":"A Split from Traditional Orbital Compartment Syndrome Intervention: Case Report of Vision-saving Vertical Lid Split Procedure.","authors":"Hannah Chason, Barret Zimmerman, Andrew Jenzer, David Fay, Julia Elpers","doi":"10.5811/cpcem.52953","DOIUrl":"10.5811/cpcem.52953","url":null,"abstract":"Introduction: Many emergency physicians will never perform a lateral canthotomy and cantholysis, and one-third of those who try will be unsuccessful at relieving the pressure that threatens permanent vision loss. This procedure is notoriously difficult and rare, but a recently proposed alternative-the vertical lid split-may be simpler and more effective.Case report: We report the case of a 35-year-old woman with motor vehicle collision-related orbital trauma who presented to a community emergency department. Initially, she had intact vision and extraocular movements. Imaging showed a comminuted inferior orbital blowout fracture with retrobulbar hemorrhage, and the transfer process was initiated. However, after coughing she developed vision loss and elevated intraocular pressure. Lateral canthotomy and cantholysis was performed for suspected orbital compartment syndrome but did not fully address the elevated pressures or restore vision. The emergency physician then performed a vertical lid split procedure, which fully restored vision and normalized pressures.Conclusion: To the best of our knowledge, this is the first case report of orbital compartment syndrome to be treated with vertical lid split, and the first case report of any full-thickness eyelid incision technique being used for salvage of an unsuccessful lateral canthotomy and cantholysis; the result was excellent.","PeriodicalId":31975,"journal":{"name":"Clinical Practice and Cases in Emergency Medicine","volume":"10 3","pages":"269-272"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13517972/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148833048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Retained Stingray Barb in the Sole of the Foot. 脚底残留的黄貂鱼倒刺。

Clinical Practice and Cases in Emergency Medicine Pub Date : 2026-08-01 DOI: 10.5811/cpcem.63973

So Sakamoto

{"title":"Retained Stingray Barb in the Sole of the Foot.","authors":"So Sakamoto","doi":"10.5811/cpcem.63973","DOIUrl":"10.5811/cpcem.63973","url":null,"abstract":"Case presentation: A 46-year-old woman presented to the emergency department after stepping on an object while playing in shallow seawater. Examination revealed a barbed foreign body protruding from the plantar aspect of the left foot. Plain radiography demonstrated that the retained stingray barb had fragmented into three pieces within the soft tissue. Because deeper extension was a concern, computed tomography was additionally obtained to better assess the depth and extent of penetration. The fragments were removed through staged incisions, and repeat radiography confirmed complete extraction. The wound was irrigated, a Penrose drain was placed, and levofloxacin was prescribed at discharge.Discussion: Stingray injuries are among the most common marine vertebrate envenomations and should not be regarded as simple puncture wounds when retained foreign body is suspected. This case highlights that even when a stingray barb is externally obvious, internal fragmentation may alter procedural planning. Radiography can reveal retained fragments, and additional imaging may be useful when injury depth is uncertain.","PeriodicalId":31975,"journal":{"name":"Clinical Practice and Cases in Emergency Medicine","volume":"10 3","pages":"426-428"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13517998/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148833074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Clinical Practice and Cases in Emergency Medicine Pub Date : 2026-08-01 DOI: 10.5811/cpcem.53200

William Dean, James Dean, Hady Lichaa, Christopher Wilbert

{"title":"Entrectinib-related Myocarditis Causing a Triangular QRS-ST-T Waveform Electrocardiographic Pattern: A Case Report.","authors":"William Dean, James Dean, Hady Lichaa, Christopher Wilbert","doi":"10.5811/cpcem.53200","DOIUrl":"10.5811/cpcem.53200","url":null,"abstract":"Introduction: Entrectinib is a kinase inhibitor used in ROS1-positive non-small cell lung carcinoma. Cardiovascular toxicity is rare, with only one prior report of myocarditis related to entrectinib use. The triangular QRS-ST-T waveform electrocardiographic pattern is a ST-elevated myocardial infarction equivalent and is rarely associated with myocarditis.Case report: A 42-year-old male with metastatic non-small cell lung carcinoma presented with presyncope, palpitations, and dyspnea three days after initiating entrectinib. Electrocardiograph (ECG) revealed a \"shark-fin\" T-wave morphology with diffuse ST elevation, QTc prolongation, and elevated troponin. ST-elevated myocardial infarction protocol was initiated with tenecteplase, heparin, clopidogrel, and aspirin. Left heart catheterization was normal. The ECG showed an ejection fraction of 20-25% with global hypokinesis. Myocarditis with heart failure associated with entrectinib use was suspected. Cardiac magnetic resonance imaging confirmed myopericarditis with subsequent recovery of ejection fraction to 57%. The patient was discharged after five days with complete recovery.Conclusion: This is the second reported case of myocarditis associated with entrectinib use and the second documented case of myocarditis presenting with a T-wave ECG pattern. Clinicians should be aware that entrectinib is associated with early-onset myocarditis and that the T-wave pattern, while strongly correlated to occlusive myocardial infarction, may rarely occur in myocarditis. Prompt recognition is critical to avoid mismanagement.","PeriodicalId":31975,"journal":{"name":"Clinical Practice and Cases in Emergency Medicine","volume":"10 3","pages":"333-335"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13518043/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148832888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Magnetic Mishaps-Small Bowel Obstruction Caused by Ingested Magnets Complicated by Appendicitis: A Case Report. 磁性事故-误食磁铁致小肠梗阻并阑尾炎1例报告。

Clinical Practice and Cases in Emergency Medicine Pub Date : 2026-08-01 DOI: 10.5811/cpcem.49053

Seth Ball, Marissa Wierzbicki

{"title":"Magnetic Mishaps-Small Bowel Obstruction Caused by Ingested Magnets Complicated by Appendicitis: A Case Report.","authors":"Seth Ball, Marissa Wierzbicki","doi":"10.5811/cpcem.49053","DOIUrl":"10.5811/cpcem.49053","url":null,"abstract":"Introduction: Magnet ingestions are a growing pediatric emergency due to the use of widely available stronger magnets in toys. A legislative ban briefly reduced injuries, but cases rose after its reversal in federal court. Magnet ingestions are resulting in increasing morbidity and mortality, specifically due to bowel obstruction and perforation.Case report: We present a complex case involving a child with global developmental delay presenting to the emergency department for evaluation of abdominal pain. While the initial evaluation focused on working up appendicitis, which he was found to have, he was also found to have ingested multiple magnets causing small bowel obstruction and perforation.Conclusion: This case highlights the need for emergency physicians to maintain a high level of suspicion when evaluating pediatric patients with abdominal pain, especially those with developmental delay. It also encourages parental education and further advocacy to help stem the increase in pediatric morbidity and mortality resulting from the ingestion of magnets.","PeriodicalId":31975,"journal":{"name":"Clinical Practice and Cases in Emergency Medicine","volume":"10 3","pages":"324-327"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13517997/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148833065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Recurrence of Guillain-Barré Syndrome Is not Uncommon, and a Relapse May Require More Aggressive Treatment than the Original Condition. guillain - barr<s:1>综合征的复发并不罕见，复发可能需要比原始情况更积极的治疗。

Clinical Practice and Cases in Emergency Medicine Pub Date : 2026-08-01 DOI: 10.5811/cpcem.63037

Josef Finsterer

引用次数: 0

Novel Technique in Performing Ocular Ultrasound in Trauma: A Case Series. 在外伤中进行眼部超声的新技术：一个病例系列。

Clinical Practice and Cases in Emergency Medicine Pub Date : 2026-08-01 DOI: 10.5811/cpcem.48653

Hannah Chawang, Sanjeev Bhoi, Vineeth Chandran, Anmol Chanda, Anand Kumar Das

{"title":"Novel Technique in Performing Ocular Ultrasound in Trauma: A Case Series.","authors":"Hannah Chawang, Sanjeev Bhoi, Vineeth Chandran, Anmol Chanda, Anand Kumar Das","doi":"10.5811/cpcem.48653","DOIUrl":"10.5811/cpcem.48653","url":null,"abstract":"Introduction: Ocular ultrasound is highly effective for diagnosing traumatic eye injuries such as retinal detachment, vitreous hemorrhage, foreign bodies, and retrobulbar hematomas. However, it is contraindicated in cases of suspected globe rupture, as applying external pressure to the eye could cause further damage. When globe injury is clinically suspected, computed tomography is typically used to confirm the diagnosis. However, delays can occur if other life-threatening injuries require immediate attention or there are long wait times. We propose a novel method for performing ocular ultrasound in such cases-the modified water bath technique-which allows for the diagnosis of globe rupture upon the patient's arrival in the emergency department.Case series: We present five cases where the modified water bath technique was used. A glove partially filled with saline is prepared and gently placed on the affected eye while the patient lies supine. A small amount of gel is applied to a high-frequency linear probe, which is then positioned transversely on the glove. An ocular scan is then conducted in dual mode to compare both eyes.Conclusion: This method produces clear, well-defined images and offers the advantage of being performed bedside immediately. This eliminates diagnostic delays and allows for prompt initiation of treatment. Additionally, the high-quality images provided by this technique can be used to diagnose other eye emergencies through ultrasound.","PeriodicalId":31975,"journal":{"name":"Clinical Practice and Cases in Emergency Medicine","volume":"10 3","pages":"232-237"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13518040/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148833092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Adult Intussusception and Ischemic Bowel Potentially Associated with CurQD Supplementation: A Case Report of A Diagnosis Driven by Point-of-care Ultrasound. 成人肠套叠和缺血性肠可能与CurQD补充相关：一个由即时超声诊断的病例报告。

Clinical Practice and Cases in Emergency Medicine Pub Date : 2026-08-01 DOI: 10.5811/cpcem.61903

Andrew Parambath, Bobby Patel, Timothy J Batchelor, Nicholas Geoffrey Ashenburg, Terence Lee Ahern

{"title":"Adult Intussusception and Ischemic Bowel Potentially Associated with CurQD Supplementation: A Case Report of A Diagnosis Driven by Point-of-care Ultrasound.","authors":"Andrew Parambath, Bobby Patel, Timothy J Batchelor, Nicholas Geoffrey Ashenburg, Terence Lee Ahern","doi":"10.5811/cpcem.61903","DOIUrl":"10.5811/cpcem.61903","url":null,"abstract":"Introduction: Adult ileocolic intussusception is rare and typically associated with a pathological lead point. Diagnosis can be challenging in the emergency department (ED), particularly when initial vital signs and laboratory studies are reassuring. Point-of-care ultrasound (POCUS) may allow for earlier recognition and expedited management.Case report: A woman with ulcerative colitis presented to the ED with abrupt, severe, waxing-and-waning abdominal pain. Initial vital signs and lab studies were normal. Bedside POCUS performed at the point of maximal tenderness revealed a target sign in the right mid-abdomen, prompting concern for intussusception. This finding was used to advocate for urgent surgical evaluation and expedited computed tomography of the abdomen and pelvis, which confirmed ileocolic intussusception with early distal small-bowel obstruction and no identifiable mass. Despite reassuring objective data, the patient's persistent severe pain and serial examinations raised concern for evolving ischemia. Following continued emergency physician advocacy, the patient was admitted for operative management. Diagnostic laparoscopy was converted to open laparotomy, during which manual reduction and right hemicolectomy were performed for an ischemic, near-perforated colon, followed by creation of an end ileostomy and mucus fistula. The patient recovered well postoperatively. She had been taking curcumin-qing dai (CurQD) for ulcerative colitis, a supplement with rarely reported associations with intussusception.Conclusion: This case highlights the value of emergency POCUS in identifying high-risk abdominal pathology, the importance of early surgical involvement despite reassuring initial tests, and a potential supplement-associated risk factor in patients with inflammatory bowel disease.","PeriodicalId":31975,"journal":{"name":"Clinical Practice and Cases in Emergency Medicine","volume":"10 3","pages":"341-344"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13517988/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148833105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Retrograde Intubation in a Severe Fixed Spinal Deformity: A Case Report. 逆行插管治疗严重脊柱固定畸形1例。

Clinical Practice and Cases in Emergency Medicine Pub Date : 2026-08-01 DOI: 10.5811/cpcem.50583

Shrirang Joshi, Shreesha Nayak, Soubhik Chakraborty, Hardeep Kaur, Naazia Siddiqua, Sanjeev Bhoi

{"title":"Retrograde Intubation in a Severe Fixed Spinal Deformity: A Case Report.","authors":"Shrirang Joshi, Shreesha Nayak, Soubhik Chakraborty, Hardeep Kaur, Naazia Siddiqua, Sanjeev Bhoi","doi":"10.5811/cpcem.50583","DOIUrl":"10.5811/cpcem.50583","url":null,"abstract":"Introduction: Retrograde intubation is a seldom used but valuable technique in managing difficult airways, especially in resource-limited settings when advanced equipment is unavailable or ineffective.Case report: We report the case of a 64-year-old male with advanced ankylosing spondylitis and severe cervicothoracolumbar kyphosis who presented with altered mental status and respiratory distress. Extreme fixed cervical flexion, markedly restricted mouth opening, and an inaccessible anterior neck rendered direct laryngoscopy, video laryngoscopy, fiberoptic intubation, and surgical airway approaches unfeasible. Retrograde nasotracheal intubation was successfully performed, resulting in airway stabilization and hemodynamic improvement.Conclusion: This case highlights retrograde intubation as a lifesaving low-technology technique in complex anatomic and physiologic airways, demonstrating its continued relevance under the updated Difficult Airway Society 2025 guidelines.","PeriodicalId":31975,"journal":{"name":"Clinical Practice and Cases in Emergency Medicine","volume":"10 3","pages":"288-290"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13517978/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148833113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Blunt Thoracic Aortic Injury Presenting as Hemodynamically Stable: A Case Report. 钝性胸主动脉损伤表现为血流动力学稳定1例报告。

Clinical Practice and Cases in Emergency Medicine Pub Date : 2026-08-01 DOI: 10.5811/cpcem.53232

Joseph Knudsen, Stephen Lucas, James Mangano

{"title":"Blunt Thoracic Aortic Injury Presenting as Hemodynamically Stable: A Case Report.","authors":"Joseph Knudsen, Stephen Lucas, James Mangano","doi":"10.5811/cpcem.53232","DOIUrl":"10.5811/cpcem.53232","url":null,"abstract":"Introduction: Blunt thoracic aortic injury is a rare but potentially fatal consequence of motor vehicle collisions. While commonly associated with hemodynamic instability, some cases present with normal vital signs, delaying diagnosis and treatment. We present the case of a 42-year-old unrestrained backseat passenger who sustained a blunt thoracic aortic injury following a motor vehicle collision and underwent emergent endovascular repair. This case emphasizes the critical role of early imaging and multidisciplinary coordination in the management of high-risk trauma patients.Case report: A 42-year-old female presented to the emergency department (ED) following a high-risk motor vehicle collision. She was an unbelted passenger in a vehicle traveling at approximately 35 miles per hour that collided with a telephone pole. The patient was unconscious at the scene but regained consciousness en route. Upon arrival at the ED she was alert, oriented, and hemodynamically stable. Her vital signs were as follows: blood pressure, 107/58 millimeters of mercury; heart rate, 62 beats per minute; respiratory rate, 18 breaths per minute; and oxygen saturation, 100% on room air. Physical examination revealed anterior chest wall tenderness but no signs of respiratory distress. Imaging revealed a high-grade blunt thoracic aortic injury with a left-sided hemothorax. The patient underwent emergent thoracic endovascular aortic repair and remained hemodynamically stable throughout hospitalization.Conclusion: Blunt thoracic aortic injury can present with hemodynamic stability despite its life-threatening nature. This case highlights the necessity of early imaging and multidisciplinary coordination in optimizing outcomes for high-risk trauma patients.","PeriodicalId":31975,"journal":{"name":"Clinical Practice and Cases in Emergency Medicine","volume":"10 3","pages":"336-340"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13517990/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148832524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Clinical Application of Intravenous Lipid Emulsion Therapy in Cocaine-associated Cardiac Arrest: A Case Report. 静脉脂质乳剂治疗可卡因相关性心脏骤停1例

Clinical Practice and Cases in Emergency Medicine Pub Date : 2026-08-01 DOI: 10.5811/cpcem.50763

Ryan Offman, Sarah K Baribeau

引用次数: 0