Visual EM

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Post-Coital Sudden Cardiac Arrest Due to Non-Traumatic Subarachnoid Hemorrhage—A Case Report

Vinson Vong, MD*, John Costumbrado, MD, MPH*, Daniel Ng, MD* and Brandon Phong^

DOI: https://doi.org/10.21980/J8663N Issue 5:3[mrp_rating_result]
The electrocardiogram demonstrated sinus tachycardia with ST segment elevation in lead aVR (black arrows) and diffuse ST depressions concerning for possible ST elevation myocardial infarction (STEMI). Given the events reported and the patient’s neurologic exam without sedation, non-contrast CT of the head was ordered; imaging showed evidence of a large subarachnoid hemorrhage, mostly at the level of the Circle of Willis (black arrow) concerning for an aneurysmal bleed as well as mild generalized white matter density suggestive of cerebral edema.
NeurologyCardiology/VascularVisual EM
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A Case Report of Epidural Hematoma After Traumatic Brain Injury

Ronald Goubert, BS*, Alisa Wray, MD, MAEd* and Danielle Matonis, MD

DOI: https://doi.org/10.21980/J8R059 Issue 5:3[mrp_rating_result]
Non-contrast CT head demonstrated a right sided EDH (red arrow) with overlying scalp hematoma, left-sided subdural hematoma (blue arrow), and bilateral subarachnoid hemorrhages. No skull fractures were noted.
TraumaNeurologyVisual EM
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A Case Report on Miliary Tuberculosis in Acute Immune Reconstitution Inflammatory Syndrome

Erica Concors, MD*, Hamid Ehsani-Nia, DO* and Michael Mirza, MD*

DOI: https://doi.org/10.21980/J81H02 Issue 5:3[mrp_rating_result]
A portable single-view radiograph of the chest was obtained upon the patient’s arrival to the ED resuscitation bay that showed diffuse reticulonodular airspace opacities (red arrows) seen throughout the bilateral lungs, concerning for disseminated pulmonary tuberculosis. Subsequently, a computed tomography (CT) angiography of the chest was obtained which again demonstrates this diffuse reticulonodular airspace opacity pattern (red arrows).
Infectious DiseaseRespiratoryVisual EM
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Loose PEG Tube Leading to Peristomal Leakage and Peritonitis

Connie Au, BS and Toby Myatt, MD

DOI: https://doi.org/10.21980/J8HS7T Issue 5:2[mrp_rating_result]
Frontal chest X-ray showed a large radiolucent area (pink highlighted area) underneath the diaphragm (yellow line) and on top of the liver (blue highlighted area) and spleen (green highlighted area) suggestive of pneumoperitoneum possibly caused by gastrointestinal perforation. This large radiolucent area can also be seen underneath the diaphragm in the lateral view chest X-ray. Computed tomography (CT) was not performed due to his physical exam findings and the significant positive findings on chest X-ray. Surgery was consulted and patient was taken emergently to the operating room.
Abdominal/GastroenterologyVisual EM
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Rapid Airway Narrowing Associated with Hodgkin’s Lymphoma

Luke Hoffmann, BS* and Toby Myatt, MD*

DOI: https://doi.org/10.21980/J86D3Q Issue 5:2[mrp_rating_result]
Neck X-ray showed nonspecific significant prevertebral soft tissue swelling at the level of the cervical spine, with associated apparent thickening of the epiglottis (yellow arrow), diffuse soft tissue swelling of the neck (red arrows) and tracheal airway narrowing (light blue arrow). The computed tomography imaging of the neck was significant for multiple conglomerating pathological lymph nodes with a significant mass effect (orange arrows) compressing the right internal jugular vein (green arrow).
Hematology/OncologyRespiratoryVisual EM
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Fitz Hugh Curtis Case Report

Savannah Loehr, BS* and Cindy Bitter, MD, MPH, MA^

DOI: https://doi.org/10.21980/J82K9G Issue 5:2[mrp_rating_result]
A sagittal view from computed tomography (CT) of the abdomen and pelvis demonstrated fat stranding beneath the inferior margin of the liver (outlined in red). The axial view showed fat stranding adjacent to the ascending colon without significant colon wall thickening (arrow). Fat stranding can occur as a hazy increased attenuation (brightness) or a more distinct reticular pattern.
Ob/GynInfectious DiseaseVisual EM
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Ascending Thoracic Aortic Dissection: A Case Report of Rapid Detection Via Emergency Echocardiography with Suprasternal Notch Views

Brandon Backlund, MD*, Anastasia Kendrick-Adey, MD*, Rachel Harper, MD* and Martin Makela, MD*

DOI: https://doi.org/10.21980/J8WW6WIssue 5:2[mrp_rating_result]
Video of parasternal long-axis bedside transthoracic echocardiogram: The initial images showed grossly normal left ventricular function, and no pericardial effusion or evidence of cardiac tamponade. However, the proximal aorta beyond the aortic valve was poorly-visualized in this window.
Cardiology/VascularUltrasoundVisual EM
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Hemorrhagic Renal Cyst

Mary Rometti, MD*, Christopher Bryczkowski, MD*and Michael Rohinton Mirza, MD*

DOI: https://doi.org/10.21980/J8C92V Issue 5:1[mrp_rating_result]
Bedside renal ultrasound demonstrated a right renal cyst with echogenic debris consistent with a hemorrhagic cyst (red arrow).  In addition, a computed tomography (CT) scan of the abdomen and pelvis revealed a 4mm non-obstructing right renal stone and bilateral renal cysts. The CT also confirmed the ultrasound finding of a right renal cyst with mild perinephric stranding possibly consistent with a hemorrhagic cyst.
Renal/ElectrolytesAbdominal/GastroenterologyVisual EM