1/64. Upper airway obstruction.A large number of diseases may present with respiratory distress. In adults, upper airway obstruction (UAO) is relatively rare. Consequently, UAO may initially be overlooked in the differential diagnosis of the dyspneic patient. Because it may progress rapidly, delays or errors in diagnosis can be critical. During an eight-month period in one emergency department, seven adult patients with potentially life-threatening diseases of the upper airway were seen. To reacquaint physicians with the syndrome of mechanical obstruction of large airways, several illustrative cases are presented and the syndrome is discussed.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/64. A new hazard for windsurfers: needlefish impalement.Marine-related injuries and envenomations are common to the coastal physician. Needlefish injuries, which occur almost exclusively in the Indo-Pacific region, have not previously been reported along the Atlantic seaboard. This case report describes a penetrating injury to the lower extremity from a needlefish. Treatment is guided by general resuscitative procedures as well as antibiotic therapy directed against infections unique to the marine environment.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
3/64. Hypopharyngeal perforation from a swallowed fork: a brief report and comment.Hypopharyngeal perforations are usually seen as a complication of endotracheal intubation by less experienced physicians in emergency situations. The site most commonly perforated is the pharynx, posterior to the cricopharyngeal muscle; the second most common site is the pyriform sinus. We report here an unusual cause of hypopharyngeal perforation from a swallowed plastic fork in a psychiatric patient.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
4/64. Retained digital foreign body after a pellet gun injury.A symptomatic foreign body embedded in the human body can be a frustrating problem for physician and patient alike. A unique case of a retained foreign object resulting from a pellet gun injury has been presented. Although the course of treatment in this case was uncomplicated, it is important to understand the complexities of the human body's response to foreign bodies.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
5/64. Complete intrusion of a maxillary right primary central incisor.This clinical article presents a rare presentation of complete intrusion of a maxillary right primary central incisor. Routine examination of a 29-month old female patient revealed an intrusion injury where the primary central incisor was displaced through the floor of the nasal cavity. The traumatic impaction was erroneously diagnosed as an avulsion injury by the attending emergency room physician and later discovered by the dental team during routine care. The injury was documented with radiographs. The intruded incisor was removed through the right naris utilizing general anesthesia to manage behavior and surgical access. This article emphasizes the importance of radiographs and demonstrates the need to involve the dental professional in initial assessment of dental trauma.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
6/64. Urethrocutaneous fistula due to a retained ring of condom.Hidden foreign bodies have been described as a rare cause of both strangulation of the glans penis and urethrocutaneous fistula. We present the case of a 30-year-old man who developed a urethrocutaneous fistula and penile shaft necrosis after a condom broke during intercourse. Neither the patient nor several physicians could identify the retained ring of condom, which had been buried under newly epithelialized skin. He underwent removal of the foreign body under general anesthesia, followed 5 months later by a formal urethrocutaneous fistula repair.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
7/64. Localization, detection and guided removal of soft tissue in the hands using sonography.Penetrating wounds and lacerations are frequent pathologies treated in the emergency room. The management of hand trauma represents a large part of the work in any surgical practice. Although x-rays are routinely taken, numerous foreign bodies remain undetected, and the wounds are just locally debrided and the lacerations sutured. Unfortunately, as not all foreign bodies are radio-opaque, the radiography results may appear normal, but the patient fails to recover. patients complaining of persistent wound tenderness were sent for ultrasound investigations, and foreign bodies were detected. Had ultrasonography been carried out initially in the emergency room, the correct diagnosis would have been made, and the sonographic equipment could have helped to guide the physician in his attempt to remove the foreign body. Usually, in response to continued pain, an ultrasound investigation is ordered, and the pathology becomes apparent. A number of examples are briefly described in order to highlight the present inadequacies. It is suggested that hospital administrators consider the need to provide ultrasonographic services as an integral facility of the emergency room.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
8/64. Delayed presentation of transorbital intracranial pen.A 13 year old Fijian boy sustained a stab wound to the left orbit 3 years ago. It was not appreciated by the treating physicians in fiji that the plastic pen had crossed from the left orbit, through the nose, right orbit and right optic nerve, into the right middle cranial fossa and lodged in the right temporal lobe and that the pen remained in situ for the past 3 years. The boy presented to australia with a discharge from the entry wound in his left lower eyelid. The retained foreign body was not detected on computed tomography imaging, but was detected on subsequent magnetic resonance image. A combined neurosurgery/plastic surgery craniofacial approach was undertaken with successful complete removal of the retained pen, and preservation of vision in his only seeing eye.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
9/64. High-pressure injection injuries to the hand.High-pressure injection injury hides the true extent of the lesions behind an apparent small and harmless puncture of the finger or the hand. Through clinical description, we wish to point out the need for prompt treatment to avoid mutilating and function-threatening complications. We wish to outline the role of the emergency physician who must be aware of the incidence of high-pressure injection injury and become accustomed to early referral to a surgeon, experienced in extensive surgical exploration, removal of foreign bodies, and rehabilitation. The open-wound technique gives the best results. We also point out that failure to refer may become an increasing focus of negligence claims.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
10/64. The child with persistent cough.Coughing is a healthy reflex. Causes of a cough can vary from minor upper respiratory illnesses to malignancy. When a child's cough continues for weeks, parents worry. Primary care providers must decide when reassessment is needed and if a vigorous workup and referral to a pulmonologist are required. The above discussion should assist these physicians.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
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