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emDOCs Podcast – Episode 66: NSTI Pearls and Pitfalls Part II

Today's podcast covers part II of necrotizing soft tissue infection pearls and pitfalls on imaging and management with Jess Pelletier. Jess is an emergency medicine physician and Education Fellow at Washington University School of Medicine. This second part looks at imaging and management of NSTI.


EM@3AM: Sigmoid Volvulus

A 75-year-old male with 4 days of abdominal distention, constipation, and decreased PO intake due to nausea. He reports that his symptoms are worse after eating or drinking and that he is able to pass gas but has not had a bowel movement in the past 4 days.  On initial presentation to the ED, he appears anicteric while his abdomen is soft, non-tender, but massively distended asymmetrically with no bowel sounds heard on auscultation. What is the most likely diagnosis?