J Emerg Med
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Giant hydronephrosis is a relatively rare condition caused by obstruction of the renal collecting system that can present with a great number of different types of abdominal signs and symptoms. ⋯ Giant hydronephrosis is a rare potential cause of abdominal pain, particularly in the context of a patient with known nephrolithiasis, structural urologic abnormalities, or malignancy.
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Blunt laryngeal trauma frequently takes place in the setting of more significant injuries. In the setting of multiple injuries or, more importantly, as an isolated event, missed injuries to the laryngotracheal complex can have devastating results. More importantly, underestimation of the severity of injury can result in an airway that becomes quite difficult to manage. However, early recognition and management of laryngotracheal injuries can result in minimal morbidity and the need for minimal long-term intervention. ⋯ Expedient evaluation, treatment, and management of blunt laryngeal trauma results in favorable outcomes. Awareness of the potential for significant injury in the presence of benign examination based on the history of injury and confirmed by radiographic or endoscopic evaluation is paramount. Although minimal findings on examination and stable patients in the setting of blunt trauma to the neck may be as innocuous as it seems, the severity of injury may "lie beneath."
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Mental illness affects 8% of the population. The early identification and treatment of mental illness can reduce the progression and complications of the illness. ⋯ The idea that the ED is a good place to identify undiagnosed mental health illnesses was confirmed. The use of an independent test such as the MINI was also shown to be useful to aid the emergency physician in identifying undetected mental illnesses.
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The presurgical diagnosis of foreign body (FB)-induced bowel perforation is exceedingly difficult. Perforation most commonly occurs in the ileocecal region and typically mimics diagnoses more common to the right lower quadrant (RLQ), including appendicitis and diverticulitis. ⋯ This represents a rare case of small bowel perforation secondary to fish bone ingestion that was managed non-operatively without complication.