J Emerg Med
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Choriocarcinoma is an aggressive malignant tumor. It commonly invades the uterus, causing necrosis and hemorrhage through vascular invasion. Metastasis is also common, with the main areas affected being the lung, brain, liver, pelvis, vagina, spleen, intestine, and kidney. ⋯ Gestational choriocarcinoma with metastasis to the eye is a rare disease and a rare cause of exudative retinal detachment. In general, metastatic choriocarcinoma is highly curable with chemotherapy. However, metastasis to the eye, regardless of the type of tumor, portends a poor prognosis.
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Perforated jejunal diverticulitis is an unusual entity that can present with acute abdominal pain. Due to the non-specific clinical findings, this condition is rarely diagnosed clinically. ⋯ This case report demonstrates the utility of CT in accurately diagnosing this unusual entity that frequently perplexes clinicians.
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Pulmonary vein thrombosis is a rare and potentially life-threatening condition. Reported cases of pulmonary vein thrombosis commonly occur as a complication of pulmonary surgery. There is a paucity of literature describing its clinical manifestations and non-operative causes. ⋯ Large hiatal hernias may be a nidus for pulmonary vein thrombosis, a potential source of left-sided emboli.
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Pediatric trauma patients pose a diagnostic challenge to physicians. Computed tomography (CT) imaging identifies life-threatening injuries quickly and efficiently. CT radiation dose in pediatric trauma patients is a concern. ⋯ Pediatric blunt trauma patients receive a major radiation burden in their initial evaluation. Patients who are transferred from an outside facility endure an even higher dose of radiation.
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Children with cyanotic congenital heart disease (CCHD) are living longer and presenting to the Emergency Department (ED) in larger numbers. A greater understanding of their diagnoses and appropriate management strategies can improve outcomes. ⋯ A cardiac cause of fever in CCHD patients is rare. Because of limited cardiopulmonary reserve, they might require supplemental oxygen, intravenous fluids, and hospital admission.