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CT Abdomen and Pelvis - Hollow Viscus
It's weird how you get runs of patients in the ED. Some days it seems like it's nothing but wall-to-wall low risk chest pain, altered mental status, or back pain. Today (and a lot of other days), it's abdominal pain. Scanning the board you see seemingly nothing but Level 3 acuity patients with the chief complain of "Abdominal pain." Out of the scores of patient's, you seen so far, the last 2 worry you the most:
Andrea is a very pleasant 20 year old student from a local college. She came in after having symptoms of right lower quadrant pain over the course of the past 8-12 hours. She didn't recall any migratory symptoms but does endorse a lack of appetite, nauseousness, 2 episodes of vomiting (started after the pain), and steadily worsening pain.
Vascular Ultrasound - Aorta & Lower Extremity Veins
It's a frosty Easter morning and the ED is "q!&%t," all except for the 2 patient's turned over to you by the night ranger. You greet the first patient, a 75 yo M complaining of flank pain - probably a kidney stone you think to yourself as you walk in to the room. Walking into the room, you see the patient rolling around on the stretcher (as one would expect from those with a stone jammed in the UVJ), but something about his presentation strikes you as odd - a bit of diaphoresis, clammy pale skin. It could just be pain, but the specter of a ruptured abdominal aortic aneurysm still looms large in your differential diagnosis. You quickly exit the room, grab the ultrasound machine and head back in to take a look at his aorta...
Soft Tissue Neck Radiographs
The soft-tissue neck radiograph can be an extremely useful tool in a variety of clinical situations. These include: epiglottitis, croup, retropharyngeal abscesses, and localization of airway foreign bodies.
However, like any diagnostic tool, the soft tissue neck x-ray’s usefulness depends on knowledge of the relevant anatomy — particularly the normal size and appearance of various airway structures — as well as a systematic approach to each radiograph. We will discuss both the anatomy and radiographic approach in this blog post.