Abdominal/Gastroenterology

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Perianal Abscess

Luke Walls-Smith, BS* and Jonathan Peña, MD*

DOI: https://doi.org/10.21980/J8QP81Issue 3:1[mrp_rating_result]
Computed Tomography (CT) of the Pelvis with intravenous (IV) contrast revealed a 5.7 cm x 2.4 cm air-fluid collection in the right perianal soft tissue along the right gluteal cleft, with surrounding fat stranding, consistent with a perianal abscess with cellulitis.
Abdominal/GastroenterologyInfectious DiseaseVisual EM
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An Elderly Male with Amyand’s Hernia

Saema Said, MD* and Roozbeh Houshyar, MD^

DOI: https://doi.org/10.21980/J80D13 Issue 2:4[mrp_rating_result]
Ultrasound of the right scrotum shows a right inguinal hernia with an air-containing loop of bowel (white arrow) and a non-compressible appendix (yellow arrow). Coronal and axial views of abdomen-pelvis CT show a right inguinal hernia containing a loop of small bowel (white arrow) and appendix (yellow arrow).
Abdominal/GastroenterologyVisual EM
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Pediatric Esophageal Foreign Body

Samer Assaf, MD* and Ryan Gibney, BS*

DOI: https://doi.org/10.21980/J8GD1F Issue 2:4[mrp_rating_result]
A radiopaque foreign body was visualized in the proximal esophagus at the thoracic inlet on the chest and neck radiographs. The foreign body appeared to be metallic with visualized concentric rings consistent with a coin.
Abdominal/GastroenterologyPediatricsVisual EM
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Bedside Ultrasound for the Diagnosis of Small Bowel Obstruction

Alexander Anshus, BS* and Maili Alvarado, MD^

DOI: https://doi.org/10.21980/J86W6PIssue 2:4[mrp_rating_result]
The POCUS utilizing the low frequency curvilinear probe demonstrates fluid-filled, dilated bowel loops greater than 2.5cm with to-and-fro peristalsis, and thickened bowel walls greater than 3mm, concerning for SBO. 
Abdominal/GastroenterologyVisual EM
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Choledocholithiasis

Jonathan Peña, MD*

DOI: https://doi.org/10.21980/J8Q62X Issue 2:3[mrp_rating_result]
Computed tomography (CT) was significant for two large gallstones measuring 1.1 centimeters impacted at the level of the pancreatic head with associated common bile duct (CBD) dilatation.
Abdominal/GastroenterologyVisual EM
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Volvulus

Sari Lahham, MD, MBA*, Kathryn Bennett, BS* and Mohammad Helmy, MD†

DOI: https://doi.org/10.21980/J8JH0Q Issue 2:3[mrp_rating_result]
Upright and supine frontal radiographs of the abdomen demonstrate gas dilation of the large bowel from the level of the cecum to the sigmoid colon with air fluid levels (yellow arrows). There is a swirled configuration of the distal descending to sigmoid colon indicating the level of the volvulus (dashed yellow line) and giving rise to the classic “coffee bean” sign (dotted white tracing). Note the elevated left hemidiaphragm on the upright view reflecting abdominal distention with increased intra-abdominal pressure (red arrow).
Abdominal/GastroenterologyVisual EM
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Esophageal Perforation

Valentina Park, BS* and Jason Mefford, MD^

DOI: https://doi.org/10.21980/J8K91B Issue 2:3[mrp_rating_result]
History of present illness: A 51-year-old male with history of gastroesophageal reflux disease status post multiple endoscopies presented to the emergency department with severe abdominal pain. Paramedics reported the patient appeared diaphoretic on arrival and maintained stable vital signs during transit. The patient reported taking Prilosec that morning before eating breakfast, after which he felt like something was stuck in
Abdominal/GastroenterologyVisual EM
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Perforated Gastric Ulcer with Intra-abdominal Abscess

Leslie Palmerlee, MD, MPH*, Scott Mackey, DO* and Michael Petrauskis, MD, MEd*

DOI: https://doi.org/10.21980/J82H0C Issue 2:3[mrp_rating_result]
Bedside ultrasound revealed a large volume of free fluid in the right upper quadrant and in the pelvis. The fluid appeared complex with multiple septations. Its appearance was not consistent with ascites or acute intra-abdominal free fluid due to striations and pockets.
Abdominal/GastroenterologyVisual EM
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Bowel Perforation complicating an incarcerated inguinal hernia

Adam Sigal, MD* and Jamie Slotkin, DO^

DOI: https://doi.org/10.21980/J8D30BIssue 2:2[mrp_rating_result]
The AP and lateral pelvis x-rays revealed two sewing needles, 60 mm in length, within the soft tissue over the anterior right lower hemipelvis. In addition, the AP view showed emphysema involving the right hemiscrotum (arrow), concerning for perforated bowel.
Abdominal/GastroenterologyVisual EM
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A Toddler with Abdominal Pain and Emesis

Saema Said, BS* and Kevin Koenig, MD*

DOI: https://doi.org/10.21980/J8XW2P Issue 2:2[mrp_rating_result]
In the long axis video, the appendix appears as an enlarged, non-compressible, blind-ending tubular structure (white arrow) with distinct appendiceal wall layers and lack of peristalsis. In the short axis video, the appendix appears as a target sign (yellow arrow) between the abdominal and psoas muscles. The maximal outer diameter (MOD) measures 11.8mm and the appendix wall measures 0.17mm. There is trace adjacent free fluid and echogenic periappendiceal fat. Transverse axis video and image (red arrow) demonstrate that the appendix is not compressible. These findings are consistent with acute appendicitis.
Abdominal/GastroenterologyInfectious DiseasePediatricsUltrasoundVisual EM