This ultrasound, performed by Dr. Dumerjuste, PGY-1 EM resident at HUM, on a 19 yr old female who presented with fever, right flank pain and right lumbar pain for 5 days. While initially concerned for pyelonephritis, the ultrasound demonstrates a large, well-defined, hypoechoic complex fluid filled structure cleared located within the liver.
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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Dr. Menager, PGY-1 EM resident at HUM, performed this ultrasound on a young woman who presented with dysuria and right-sided constant flank pain. Continue reading
Kanavel’s FOUR signs of flexor tendon sheath infection:
1. Fusiform swelling 2. Finger held in slight flexion 3. Pain with passive extension of the digit 4. Tenderness along the flexor tendon sheath
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
Dr. Duneant, PGY-2 EM resident at HUM, found this clot in the right IJ of a patient in the ICU. The patient had signs and symptoms highly suggestive of a pulmonary embolism however sonographic DVT studies were negative bilaterally. The probe was placed over the right IJ in anticipation of placement of a central line.
With high rates of tuberculosis, we really do see many pericardial effusions that require drainage. In fact, Dr. Plantin performed his second pericardiocentesis on his very next shift! Learn how to perform this procedure now so when the time comes for you to perform it, you will be ready
