J Emerg Med
-
The yield of blood cultures is approximately 10%. This could be caused by inaccurate prediction of patients with bloodstream infection (BSI). ⋯ SIRS is an adequate predictor of BSI. By contrast, biochemical parameters were not useful as predictors of BSI.
-
Medical and surgical problems associated with rectal foreign bodies are rare. Although most rectal foreign bodies can be removed without subsequent sequelae, they pose significant risk of infection. ⋯ Rectal foreign bodies can cause Fournier gangrene. A close observation and follow-up is important after removal of rectal foreign bodies.
-
Compartment syndrome of the foot is a rare but life- and limb-threatening condition that is often difficult to diagnose. The common signs and symptoms of compartment syndrome are pain out of proportion to the injury, pain with passive stretch of the compartment, paresis, paresthesias, and often, intact pulses. Foot compartment syndrome is often caused by traumatic injuries, and the clinical presentation may be confusing in this setting. The foot contains nine compartments, which should all be assessed for elevated compartment pressures. Definitive management is fasciotomy. Prompt recognition, diagnosis, and treatment are essential to prevent devastating complications. ⋯ Foot compartment syndrome is a surgical emergency that can be difficult to diagnose. Early diagnosis with compartment pressure measurements is crucial, as definitive management with fasciotomies can prevent long-term sequelae.
-
Case Reports
Bilateral subdural hematoma after inadvertent dural puncture during epidural analgesia.
Post-dural puncture headache (PDPH) is typically a benign complication of dural puncture that is clinically diagnosed. It commonly presents as a throbbing and positional headache that occurs 24-48 h after dural puncture. Subdural hematomas, if unrecognized, may occur as a rare and life-threatening complication of dural puncture. ⋯ Patients with unremitting PDPH should prompt the clinician to suspect the development of subdural hematoma as a potential life-threatening complication of an otherwise benign condition.
-
The rapid development of ascites in a patient without known liver disease is an uncommon occurrence in the Emergency Department. Initial stabilization may include therapeutic peritoneal lavage to reduce diaphragmatic pressure and halt the progression of respiratory compromise. In the absence of liver disease, the differential diagnosis should include a search for malignancy, which has been reported to account for up to 10% of all cases of newly diagnosed ascites. ⋯ Rapidly progressing ascites may be the sole presenting symptom of metastatic gastrointestinal carcinoma.