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Abdominal/Gastroenterology

Hydropic Gallbladder. CT Coronal Unannotatd. JETem 2025

A Case Report of Hydropic Gallbladder Presenting as Right Lower Quadrant Abdominal Pain

Savannah Tan, MD*, Zoe Adams, BA^, Scott Rudkin, MD, MBA* and Danielle Matonis, MD*

DOI: https://doi.org/10.21980/J8DD26 Issue 10:2 No ratings yet.
Computed tomography (CT) of the abdomen and pelvis with contrast was ordered, and general surgery was consulted for the initial working diagnosis of acute appendicitis. However, the CT scan resulted with findings of a markedly distended gallbladder measuring approximately 14.5 x 4 centimeters (cm) with marked gallbladder wall thickening (magenta) and pericholecystic fat stranding (cyan). The appendix was not dilated and had no inflammatory changes or edema. Follow-up right upper quadrant ultrasound confirmed the diagnosis of acute cholecystitis.
Visual EMAbdominal/GastroenterologyCurrent IssueInfectious Disease

A Simulation and Small-Group Pediatric Emergency Medicine Course for Generalist Healthcare Providers: Gastrointestinal and Nutrition Emergencies

Adeola Adekunbi Kosoko, MD*, Alicia E Genisca, MD^, Nicholas A Peoples, MSc, MA†, Connor Tompkins†, Ryan Sorensen† and Joy Mackey, MD**

DOI: https://doi.org/10.21980/J8WH2K Issue 9:4 No ratings yet.
The aim of this curriculum is to increase learners’ proficiency in identifying and stabilizing acutely ill pediatric patients with gastrointestinal medical or surgical disease or complications of malnutrition. This module focuses on the diagnosis and management of gastroenteritis, acute bowel obstruction, and deficiencies of feeding and nutrition. The target audience for this curriculum is generalist physicians and nurses in limited-resource settings.
Abdominal/GastroenterologyCurriculaPediatrics
Adult Intussusception. CT Axial Unannotated. JETem 2024

Telescoping into Adulthood: A Case Report of Intussusception in an Adult Patient

Neena Joy, DO*, and Laura Kolster, DO*

DOI: https://doi.org/10.21980/J8Q06C Issue 9:2 No ratings yet.
Computed tomography imaging of the abdomen and pelvis with intravenous and oral contrasts was obtained. In the axial view, one will see a concentric ring formed by layers of bowel, mesenteric vessels, and fat (red arrow and circle); this is the equivalent of the ultrasonographic “target sign.” The inner ring (blue arrow) represents the lead point causing telescoping of the bowel. One can see that the proximal bowel is dilated (yellow arrow). In the coronal view, one can see an obstructive mass, also known as the lead point (red arrow), located in the lumen of the descending colon. Located proximal to the lead point are dilated loops of bowel with edematous changes and fat stranding (pink circle). The proximal portion of the bowel will take on a concentric appearance with the telescoping loop of bowel.
Abdominal/GastroenterologyVisual EM

An Appy That Needs Epi: An Atypical Presentation of Anaphylaxis

Ryan O’Neill, MD*, Cyrus Adeli, BA, CHSE^, and  Christopher E San Miguel, MD, MEd* 

DOI: https://doi.org/10.21980/J80H14 Issue 9:1 No ratings yet.
At the conclusion of the simulation, learners will be able to: 1) demonstrate ability to efficiently review patient records to optimize patient care and identify relevant details to current presentation, 2) rapidly assess a patient when there is a change in clinical status, 3) recognize the need to start resuscitative fluids for undifferentiated hypotension, 4) identify anaphylaxis, 5) demonstrate the medical management of anaphylaxis, 6) utilize the I-PASS framework to communicate with the inpatient team during the transition of care.
Abdominal/GastroenterologyDermatologySimulation
Colocolic Intussusception. Abdominal Ultrasound Unannotated. JETem 2024

Case Report of a Child with Colocolic Intussusception with a Primary Lead Point

Ethan Lee, BS*, Jeremy Lins, MD^, Chelsea Cosand, MD^, Mary Jane Piroutek, MD† and Tommy Y Kim, MD*^

DOI: https://doi.org/10.21980/J8564Q Issue 9:1 No ratings yet.
On the initial ED visit, an abdominal ultrasound (US) was ordered which showed the classic intussusception finding of a target sign (yellow arrow), or concentric rings of telescoped bowel, on the transverse view of the left lower quadrant (LLQ).
Visual EMAbdominal/GastroenterologyPediatrics
Point Of Care Ultrasound Use for Detection of Multiple Metallic Foreign Body Ingestion. US. JETem 2023

Point-Of-Care Ultrasound Use for Detection of Multiple Metallic Foreign Body Ingestion in the Pediatric Emergency Department: A Case Report

Sarah Bella, DO*, Joseph Heiney, MD* and Amy Patwa, DO^ 

DOI: https://doi.org/10.21980/J83D2D Issue 8:4 No ratings yet.
Bedside POCUS was performed on the patient’s abdomen using the curvilinear probe. The left upper quadrant POCUS image demonstrates multiple hyperechoic spherical objects with shadowing and reverberation artifacts concerning multiple foreign body ingestions. Though the patient and mother initially denied knowledge of foreign body ingestion, on repeated questioning after POCUS findings, the patient admitted to his mother that he ate the spherical magnets he received for his birthday about one week ago. The patient swallowed these over the course of two days. The presence of multiple radiopaque foreign bodies was confirmed with an abdominal X-ray.
UltrasoundAbdominal/GastroenterologyPediatricsVisual EM
Creative Commons images

Imaging Findings of Small Bowel – Diverticulitis: A Case Report

Albert Zhou, MD*, Sarah Bella, DO*, and Amy Patwa, DO*

DOI: https://doi.org/10.21980/J8F078 Issue 8:1 No ratings yet.
Bedside ultrasound was performed and showed thickened bowel wall (orange marker), fat enhancement (green marker), and phlegmonous structure with central echogenicity (yellow marker). Imaging of the abdomen and pelvis with CT showed marked wall thickening and inflammatory change involving a 7.0cm segment of the distal/terminal ileum suspicious for severe ileitis with phlegmon and microabscess on the coronal image (yellow arrow). Additonally, the transverse images show a small rim-enhancing focus within this region of inflammation measuring up to 1.4cm which could represent microabscess (yellow arrow). Diagnosis of diverticulitis by ultrasound is made by identifying the following findings: colon wall thicker than 5mm, fat enhancement, evidence of abscess, visualized diverticuli, air artifacts suggesting diverticuli, and tenderness with compression of the probe.6 Diagnosis of diverticulitis by CT is made by identifying the following findings: colonic wall thickening, pericolic fat stranding, abscess formation and enhancement of the colonic wall. Often, these signs are associated with an identifiable inflamed diverticulum.7
Abdominal/GastroenterologyVisual EM
Creative Commons images

Mushroom for Improvement Case Report: The Importance of Involving Mycologists

Gary Bhagat, MD*, Marit Tweet, MD^ and Steven Aks, MD^†

DOI: https://doi.org/10.21980/J8ZW7W Issue 7:4 No ratings yet.
The mushroom displayed here is large and lacks any gills. Small puffball mushrooms can resemble young immature button top Amanita type mushrooms. Opening the Amanita mushroom should reveal apparent gills and quickly differentiate the two- -the puffball mushroom should have a white interior without gills.
Abdominal/GastroenterologyToxicologyVisual EM

Massive Upper Gastrointestinal Bleeding

Eytan Shtull-Leber, MD, MSCR*, Amrita Vempati, MD^, Geoff Comp, DO^ and Aneesh T Narang, MD*

DOI: https://doi.org/10.21980/J8W93W Issue 7:1 No ratings yet.
By the end of this simulation, learners will be able to: 1) manage a hypotensive patient with syncope and hematemesis, 2) pharmacologically manage an acute UGIB addressing the various causes, 3) recognize worsening clinical status and intervene by performing difficult airway management, 4) place a gastroesophageal balloon tamponade device.
Abdominal/GastroenterologyLectures
Creative Commons images

Case Report: It’s a Small Whirl Afterall

Lisa M Schwartz, MD*, Ryan M Perdomo, MD* and Jason An, MD*

DOI: https://doi.org/10.21980/J83S8G Issue 7:1 No ratings yet.
The CT imaging of the abdomen and pelvis demonstrated multiple loops of dilated small bowel with a whirl sign (red arrow) within the mid abdomen and a transition point (green arrow), suspicious for closed loop bowel obstruction and internal hernia.
Abdominal/GastroenterologyVisual EM
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