Case Reports in Emergency Medicine最新文献_第4页

Failure of Nonoperative Management following Angioembolization for Blunt Splenic and Pancreatic Tail Injury. 钝性脾胰尾损伤血管栓塞后非手术治疗的失败。

Case Reports in Emergency Medicine Pub Date : 2020-10-29 eCollection Date: 2020-01-01 DOI: 10.1155/2020/8863885

Kazuhiro Nishida, Tadao Kubota

{"title":"Failure of Nonoperative Management following Angioembolization for Blunt Splenic and Pancreatic Tail Injury.","authors":"Kazuhiro Nishida, Tadao Kubota","doi":"10.1155/2020/8863885","DOIUrl":"https://doi.org/10.1155/2020/8863885","url":null,"abstract":"Background: Over several decades, standard management of blunt spleen injury (BSI) has been changed from operative intervention to the selective operative and nonoperative management (NOM). However, some patient needs laparotomy first. This article describes a case of a BSI patient who failed nonoperative management after angioembolization (AE). Case Presentation. A 58-year-old man fell from his motorcycle and was brought to our hospital. His vital sign was stable after extracellular fluid bolus. A contrast-enhanced computed tomography scan of the abdomen showed AAST grade V spleen injury. AE was performed for the splenic artery, but his systolic blood pressure suddenly dropped under 60 mmHg. The resuscitative endovascular balloon occlusion of the aorta was inserted, and immediate laparotomy was performed. A pancreatic tail injury was detected, and the splenic artery and vein were burst at the pancreatic tail and controlled by hemostatic suture. After splenectomy, a drain was placed at the pancreatic tail and the abdomen was temporally closed. The postoperative course was not remarkable except for abdominal abscess treated with antibiotics, and he was discharged on foot.Conclusion: Although NOM is becoming one of the choices for severe BSI, there will still be a patient who requires surgery. Surgeons should be aware of the mechanism of injury and the limitation of AE as an adjunct to NOM. Patient selection for initial NOM and timing to convert to laparotomy are important.","PeriodicalId":9624,"journal":{"name":"Case Reports in Emergency Medicine","volume":"2020 ","pages":"8863885"},"PeriodicalIF":0.0,"publicationDate":"2020-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/8863885","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38591228","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

Run or Die: A Didactique Case Report of a Rare Cause of Lactic Acidosis in Emergency Medicine. 跑或死:急诊医学罕见原因乳酸性酸中毒的教学病例报告。

Case Reports in Emergency Medicine Pub Date : 2020-10-24 eCollection Date: 2020-01-01 DOI: 10.1155/2020/5671296

Jean-Baptiste Bouillon-Minois, Jeannot Schmidt, Frédéric Dutheil

{"title":"Run or Die: A Didactique Case Report of a Rare Cause of Lactic Acidosis in Emergency Medicine.","authors":"Jean-Baptiste Bouillon-Minois, Jeannot Schmidt, Frédéric Dutheil","doi":"10.1155/2020/5671296","DOIUrl":"https://doi.org/10.1155/2020/5671296","url":null,"abstract":"Introduction: Acidosis with traumatic brain injury is a common and serious cause of consciousness disorders in emergency medicine. Extreme acidosis is significantly associated with high mortality (more than 67% if pH levels are under 7). Case Presentation. We describe the case of a 23-year-old man with unknown medical history who was found near the entrance of the emergency department sweat with a tachypnea (55 per minute), a lot of blood around him, and confused. The initial hypothesis was a hemorrhagic shock after a fight, but he did not have any hemodynamic trouble. The initial venous gazometry showed a major lactic acidosis (pH less than 6,8, HCO3 incalculable and lactate up to 20 mmol/L). A Focused Assessment with Sonography in Trauma-echography (FAST-echo) and secondly a body-tomodensitometry were conducted and did not reveal any anomaly. The team was now thinking that the patient situation was caused by an epileptic seizure (association of lactic acidosis and confusion), and the bleed was a consequence of the head trauma. The patient was treated only by NaCl 0,9%. One hour after his admission, the tachypnea began to decrease and he could speak and explain what was happen. He had to run as fast as possible to escape to a fight. The last gazometry, realized 2 hours after his admission, finds a normal pH at 7,35, HCO3 24,5 mmol/L and lactate 2,6 mmol/L. He was authorized to going home.Conclusion: We report here a rare case of major lactic acidosis in emergency medicine caused by a supramaximal effort.","PeriodicalId":9624,"journal":{"name":"Case Reports in Emergency Medicine","volume":"2020 ","pages":"5671296"},"PeriodicalIF":0.0,"publicationDate":"2020-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/5671296","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38582543","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: 1

A Case of an 80-Year-Old Man with Empyema and Psoas Abscess. 80岁男性脓胸及腰肌脓肿1例。

Case Reports in Emergency Medicine Pub Date : 2020-10-24 eCollection Date: 2020-01-01 DOI: 10.1155/2020/8895785

Mikio Sakurai, Hiroki Nagasawa, Ikuto Takeuchi, Youichi Yanagawa

{"title":"A Case of an 80-Year-Old Man with Empyema and Psoas Abscess.","authors":"Mikio Sakurai, Hiroki Nagasawa, Ikuto Takeuchi, Youichi Yanagawa","doi":"10.1155/2020/8895785","DOIUrl":"https://doi.org/10.1155/2020/8895785","url":null,"abstract":"An 80-year-old man with flu symptoms collapsed at his house and had a backache worsened over time. His family called for an ambulance. On arrival, chest X-ray showed reduced permeability of the right lung field, and truncal computed tomography (CT) suggested right multilobular empyema and right iliopsoas abscess. A blood test showed an acute inflammatory response. The patient underwent right small thoracotomy for empyema and ultrasonic-guided drainage for the right iliopsoas abscess and started the administration of antibiotics. We started the administration of doripenem by intravenous drip and then deescalated to ampicillin based on the culture results. Streptococcus intermedius was cultured from all sites. Following these treatments for three months, his general condition improved. We herein report a unique case of complicated empyema and iliopsoas abscess in which a favorable outcome was obtained by an appropriate diagnosis and treatment. Reports of multiple abscesses have been increasing recently because of the growing geriatric population and aging-related complications. It is important to search the whole body to detect multiple abscesses in cases where an abscess is detected at a single site.","PeriodicalId":9624,"journal":{"name":"Case Reports in Emergency Medicine","volume":"2020 ","pages":"8895785"},"PeriodicalIF":0.0,"publicationDate":"2020-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/8895785","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38582544","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: 4

Survival after Aluminum Phosphide Poisoning in Pregnancy. 妊娠期磷化铝中毒后的存活率。

Case Reports in Emergency Medicine Pub Date : 2020-09-28 eCollection Date: 2020-01-01 DOI: 10.1155/2020/2785425

Adnane Lahlou, Mohammed Sidayne, Saïd Benlamkaddem, Mohamed Adnane Berdaï, Mustapha Harandou

引用次数: 2

Liquorice Intoxication Can Lead to Cardiac Arrest! 甘草中毒可导致心脏骤停!

Case Reports in Emergency Medicine Pub Date : 2020-09-21 eCollection Date: 2020-01-01 DOI: 10.1155/2020/3727682

Rachid Attou, Sébastien Redant, Patrick M Honore, Thierry Preseau, Philippe Hantson, David De Bels

引用次数: 2

Severe Hypermagnesemia with Normal Renal Function Can Improve with Symptomatic Treatment. 严重高镁血症伴肾功能正常，经对症治疗可改善。

Case Reports in Emergency Medicine Pub Date : 2020-07-14 eCollection Date: 2020-01-01 DOI: 10.1155/2020/2918249

Yoshiaki Ishida, Akihiko Tabuchi

{"title":"Severe Hypermagnesemia with Normal Renal Function Can Improve with Symptomatic Treatment.","authors":"Yoshiaki Ishida, Akihiko Tabuchi","doi":"10.1155/2020/2918249","DOIUrl":"https://doi.org/10.1155/2020/2918249","url":null,"abstract":"Hypermagnesemia is a rare disorder and commonly occurs in patients with renal dysfunction. Supportive therapy for hypermagnesemia consists of administration of high-volume fluids, calcium preparation, diuretics, and, in severe cases, hemodialysis. Few reports have described severe hypermagnesemia patients with normal renal function who improved without hemodialysis. A 56-year-old woman presented with a history of constipation in spite of taking constipation medicine, including MgO. She was brought to our emergency department due to vomiting and diffuse distension of the abdomen. Sudden vomiting, weakness, and lower level of consciousness occurred during examination. Her blood pressure dropped to 77/34 mmHg, and deep tendon reflexes of the limbs disappeared. Abdominal computed tomography showed bowel distension with wall edema, and biochemical testing showed serum Mg at 13.5 mg/dl. She was diagnosed with severe hypermagnesemia associated with intestinal obstruction and administered intravenous loop diuretics and calcium preparation in addition to high volumes of normal saline. As the serum Mg level steadily declined, her level of consciousness returned to usual. This case suggests that severe hypermagnesemia can occur in patients with normal renal function and constipation under MgO. Severe hypermagnesemia with normal renal function can improve with symptomatic treatment without hemodialysis.","PeriodicalId":9624,"journal":{"name":"Case Reports in Emergency Medicine","volume":"2020 ","pages":"2918249"},"PeriodicalIF":0.0,"publicationDate":"2020-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/2918249","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38220103","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: 1

A Case of Exertional Heat Stroke Complicated by Hypoxic Hepatitis. 劳累性中暑合并缺氧性肝炎1例。

Case Reports in Emergency Medicine Pub Date : 2020-03-30 eCollection Date: 2020-01-01 DOI: 10.1155/2020/8724285

Bertram K Woitok, Shawki Bahmad, Gregor Lindner

引用次数: 0

Behcet's Disease with Upper GI Bleeding. 白塞氏病伴上消化道出血。

Case Reports in Emergency Medicine Pub Date : 2020-03-17 eCollection Date: 2020-01-01 DOI: 10.1155/2020/2983209

Melaku Getachew, Nebiyou Seyoum, Finot Debebe

引用次数: 1

Hypercalcemia-Induced ST-Segment Elevation Mimicking Acute Myocardial Injury: A Case Report and Review of the Literature. 高钙血症诱导st段抬高模拟急性心肌损伤1例报告及文献复习。

Case Reports in Emergency Medicine Pub Date : 2020-03-16 eCollection Date: 2020-01-01 DOI: 10.1155/2020/4159526

Ashraf Abugroun, Aneesh Tyle, Farah Faizan, Michael Accavitti, Chaudhary Ahmed, Theodore Wang

{"title":"Hypercalcemia-Induced ST-Segment Elevation Mimicking Acute Myocardial Injury: A Case Report and Review of the Literature.","authors":"Ashraf Abugroun, Aneesh Tyle, Farah Faizan, Michael Accavitti, Chaudhary Ahmed, Theodore Wang","doi":"10.1155/2020/4159526","DOIUrl":"https://doi.org/10.1155/2020/4159526","url":null,"abstract":"ST-segment elevation in absence of acute coronary syndrome can be seen in multiple conditions, including acute pericarditis and coronary vasospasm, but it is rarely seen with severe hypercalcemia. The authors present a case of an 81-year-old female with a history of stage 4 squamous cell cancer of the lung, who presented to the emergency room with profound fatigue, weakness, anorexia, and drowsiness two weeks after her first chemotherapy cycle. Additionally, she had complaints of right-sided chest pain associated with worsening shortness of breath, as well as right arm numbness. An EKG obtained on arrival to the hospital showed diffuse ST-segment elevation (leads V3-V6, I, II, III, and aVF). Basic lab work found a calcium level of 20.4 mg/dl with elevated parathyroid hormone-related protein (PTHrP) of 135 pg/ml. Troponin I remained within normal limits. Serial EKS obtained during the patient's hospitalization demonstrated resolution of the ST elevation as calcium level normalized. This case emphasizes the importance of hypercalcemia as a differential diagnosis for ST-segment elevation and QT shortening when acute coronary syndrome is not present. Awareness of these EKG changes is critical for early diagnosis, recognition, and appropriate treatment.","PeriodicalId":9624,"journal":{"name":"Case Reports in Emergency Medicine","volume":"2020 ","pages":"4159526"},"PeriodicalIF":0.0,"publicationDate":"2020-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/4159526","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37808970","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: 5

Carbamazepine Toxicity Masquerading as Complex Febrile Seizures in a Pediatric Patient. 卡马西平毒性伪装成复杂热性癫痫患儿。

Case Reports in Emergency Medicine Pub Date : 2020-03-16 eCollection Date: 2020-01-01 DOI: 10.1155/2020/1790310

Richard J Chen, Muhammad Ershad, Maricel Dela Cruz, Ahmed Mamdouh Taha Mostafa

引用次数: 2