J Emerg Med
-
Case Reports
Effective treatment of hereditary angioedema with fresh frozen plasma in an emergency department.
Hereditary angioedema (HAE) is a rarely seen disorder of C1 inhibitor (C1-INH) deficiency usually manifested by non-pruritic swelling of the skin. Acute exacerbations are not sensitive to conventional medications, and C1-esterase inhibitor concentrates are recommended as the first-line therapy. However, fresh frozen plasma is the main treatment alternative in many centers due to the lack of C1-esterase inhibitor concentrates. In this report, we present 3 patients with acute exacerbations of hereditary angioedema who were effectively and safely treated with fresh frozen plasma.
-
Rupture of the urinary collecting system associated with peripelvic extravasation of the urine is an unusual condition and commonly associated with obstructing calculus. We report a patient, recently given chemotherapy due to lymphoma, with acute abdomen symptoms. ⋯ Diagnosis was suspected on serial ultrasonography, and confirmed by computed tomograhy. Diagnosis, follow-up, and therapeutic approach are discussed.
-
We sought to determine whether post-reduction radiographs add clinically important information to what is seen on pre-reduction X-rays in Emergency Department (ED) patients with anterior shoulder dislocations. In this prospective, observational study, clinicians recorded preliminary pre-reduction and post-reduction X-ray readings on patients with shoulder dislocations. The films were subsequently reviewed by a blinded attending radiologist. ⋯ In conclusion, although the majority (62.5%) of fractures associated with shoulder dislocations are seen on pre-reduction radiographs, more than one-third (37.5%) of fractures may be visible only on post-reduction X-rays. None of the fractures missed on pre-reduction X-rays changed patient management in the ED. There were no persistent shoulder dislocations found on post-reduction films.