A Case of the Incidentally Discovered Pneumomediastinum
Pneumomediastinum… Where is the air coming from? Who do you consult? Are antibiotics and/or surgery needed?
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GI
EM@3AM: Intussusception
A 3-year-old male presents with his mom with chief complaint of vomiting and recurrent abdominal pain. Her son will intermittently cry and refuse to eat, followed by normal activity. His appetite has been decreased. VS are normal. Physical exam reveals a patient who appears stated age, nontoxic, and playful. Your physical exam, including abdomen and GU, is normal. The mom rushes out several minutes later and notifies you that her son is crying and holding his abdomen. What’s the diagnosis, and what’s your next step in your evaluation and treatment?
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EM Boards Survival Guide: Gastrointestinal 1
emDocs will be providing you with must-know items for EM boards and inservice with this new series: EM Boards Survival Guide. Each post will feature several key takeaways on a specific organ system. Our first entry looks at the GI system.
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Sudden Abdominal Pain with a Palpable Mass: Respectus the Rectus
How should you evaluate and manage the patient with possible rectus sheath hematoma? This post from Dr. Baker and Dr. Yang provides you with pearls and pitfalls for this condition.
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EM@3AM: Gastroesophageal Varices
A 57-year-old male presents with hematemesis. He has a history of cirrhosis from alcohol abuse. He appears toxic and is rushed to the resuscitation bay. Initial VS include T 37.2C, HR 122, BP 88/41, RR 24, SpO2 90% RA. What are your next steps, and what is the likely diagnosis?
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Esophageal Perforation: Pearls and Pitfalls for the Resuscitation Room
Esophageal perforation… A rare but deadly diagnosis. Read on for pearls and pitfalls in the evaluation and management of this condition.
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Pancreatitis: Pearls & Pitfalls
Pancreatitis seems straightforward in terms of evaluation, management, and disposition, but recent literature suggests we should make some changes. This post evaluates the ED evaluation and management of pancreatitis.
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EM@3AM: Esophageal Foreign Bodies
A 52-year-old male presents with inability to swallow. He was eating steak one hour ago and swallowed a large piece without chewing. He thinks it is stuck around his upper sternal area. Physical exam reveals a patient who appears uncomfortable, sitting upright, constantly spitting into a bag. You do not see anything in his mouth. What is the next step in your evaluation and treatment?
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EM@3AM: Toxic Megacolon
A 28-year-old male presents with abdominal pain, diarrhea, distension, and fever. He has a history of ulcerative colitis. Vital signs include BP 97/58, HR 121, T 100.9 Oral, RR 24, SpO2 98% on RA. Exam reveals a patient who appears systemically ill, and his abdomen is diffusely tender. His bowel sounds are decreased, but he has no peritoneal findings. KUB shows markedly dilated loops of bowel. What’s the next step in your evaluation and treatment?
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EM@3AM: Small Bowel Obstruction
A 63-year-old female presents with abdominal pain, decreased bowel movements, nausea, three episodes of vomiting, and abdominal distension. She has a history multiple abdominal surgeries. Exam shows abdominal distension and generalized tenderness, but no peritoneal signs. What are your next steps?
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