All posts by cameronks

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Video/Image of the Week – Trauma?

A 2 yo male was brought to the HUM ED for fever and facial swelling that began 4 days prior after a fall while playing.  On exam, the patient had swelling of the scalp and right frontal region and was unable to open his right eye.
The EM docs obtained the following x-ray during the workup and were concerned for child abuse due to findings on the bilateral collar bone:
Are these findings the result of past trauma??
No!  This was not a case of child abuse.  While multiple unexplained fractures in young children should raise suspicion of child abuse, these findings are the result of normal ossification of the clavicles, and in this case, trauma was a distraction from the real disease process that needed to be addressed:  a scalp abscess.



Video of the Week: Intussusception

This ultrasound was performed by Dr. Menager, PGY-1 EM resident at HUM, on a 9 month old male with 9 days of abdominal pain and blood diarrhea.  The study nicely demonstrates the “target sign,” the classic sonographic finding for intussusception.

Of note, this bedside study was performed in the PEDIATRICS ward.   The patient did receive an ultrasound in the ED which did not show intussusception.   At that time, the patient had intermittent pain.  He was placed on ceftriaxone for presumed bacterial enterocolitis however his pain and bloody diarrhea continued and he was eventually admitted.  On the ward, the patient continued to have pain and Dr. Menager, who was on his pediatrics rotation, cleverly decided to repeat the ultrasound study leading to the correct diagnosis.  The patient was then taken to the operating room where the diagnosis of intussusception was confirmed and the appropriate treatment provided.   GREAT WORK!


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Large Volume Pericardiocentesis

Dr. Menager, PGY-1 EM resident performed this ultrasound on a 47 yr old man complaining of shortness of breath over the last month, worsening in the last day,  associated with increasing lower extremity edema.

PERIOCARDIOCENTESIS PERFORMED – 1500cc removed from pericardium

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