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Facial Fracture Induced Periorbital Emphysema
DOI: https://doi.org/10.21980/J8F05HPhysical exam showed marked left palpebral subcutaneous crepitus, as well as bulbar and palpebral conjunctival bulging. Visual acuity was normal with intact extraocular movements, and normal pupillary exam. Computed tomography (CT) imaging of the face was obtained and revealed multiple displaced fractures involving the left orbital floor and zygomatic arch associated with moderate periorbital and postseptal extraconal gas, resulting in orbital proptosis.
Fournier Gangrene
DOI: https://doi.org/10.21980/J89626The computed tomography (CT) of the abdomen and pelvis revealed significant subcutaneous gas tracking along the perineum and right gluteal region (orange outline) into the scrotum with associated scrotal edema (yellow arrow) and subcutaneous inflammatory fat stranding of 0.92 cm (red arrow) consistent with Fournier’s gangrene. There is early fluid loculation along the right medial gluteal cleft of 5.85 cm (green arrow) without a sizeable drainable abscess seen.
Foreign Body in Maxillary Sinus: A Rare Case of Chronic Rhinosinusitis
DOI: https://doi.org/10.21980/J85H09Computed tomography (CT) sinus with contrast demonstrated complete opacification of left paranasal sinuses and nasal cavity, and a linear radiopacity within the left maxillary sinus consistent with a foreign body. There were additional left facial subcutaneous radiopaque opacities.
Brief Review of Intussusception Diagnosis and Management
DOI: https://doi.org/10.21980/J81P7FThe patient’s abdominal ultrasound revealed intussusception in the right upper abdominal quadrant. The transverse ultrasound view showed a “doughnut sign” (dashed yellow line), telescoping bowel (yellow arrow), and invaginated hyperechoic mesenteric fat with crescent configuration (dashed orange line). The sagittal ultrasound view demonstrated the intussusception formed by the outer recipient bowel loop (yellow arrows), invaginated hyperechoic mesenteric fat (orange asterisks), and telescoping bowel centrally (red arrow).
Corneal Rust Ring
DOI: https://doi.org/10.21980/J8X067The photograph reveals a limbic metallic foreign body with a surrounding corneal rust ring (arrow) in the three o’clock position of the left cornea.
Cauliflower Ear Secondary to a Chronic Auricular Hematoma
DOI: https://doi.org/10.21980/J8S63XOn exam, the patient has a gross deformity to the left pinna that was not painful to touch or fluctuant. Findings and history are consistent with cauliflower ear, secondary to a chronic auricular hematoma.
Sialadenitis
DOI: https://doi.org/10.21980/J8NH0NThe computed tomography (CT) scan demonstrates prominent enlargement and heterogeneous enhancement of the right submandibular gland (single large arrow) compatible with sialadenitis. There is no evidence of a sialolith or obstruction on the CT. There is associated edema (two small arrows) of the right submandibular space, parapharyngeal space and anterior right neck with partial effacement of the right vallecula and right pyriform sinus.
Clinical Evaluation and Management of Pediatric Pericarditis
DOI: https://doi.org/10.21980/J8HP85An electrocardiogram (ECG) was concerning for ST segment elevation in leads II, III, aVF, and V4, with subtle ST elevations in V5 and V6 (see black arrows). There is also ST segment depression in aVL (see blue arrows).
Point-of-care Ultrasound for the Diagnosis of Ovarian and Fallopian Tube Torsion
DOI: https://doi.org/10.21980/J8D06KThe ultrasound video clip demonstrates a transverse view of the pelvis using the endocavitary probe. The bladder can be seen on the anterior portion of the scan (yellow arrow), while the uterus with an intrauterine pregnancy is visible posteriorly (blue arrow). The thickened appearance of the uterine wall is also indicative of pregnancy. A large, anechoic cystic structure measuring approximately 5 cm is seen in the vicinity of the patient’s left adnexa (pink arrow), which raises concerns for ovarian torsion.
Subcutaneous Emphysema After Chest Trauma
DOI: https://doi.org/10.21980/J8864NPlain film anteroposterior (AP) radiography of the chest shows left-sided subcutaneous emphysema (red arrow) with overlapping muscle striations of the pectoralis major (green arrow). After chest tube placement (blue arrow), AP chest radiography shows persistent left-sided subcutaneous emphysema (red arrow). CT of the chest shows pneumomediastinum (blue arrow), left apical pneumothorax (pink arrow), and subcutaneous emphysema (red arrow) at the level of T2. At the level of T6, rib fractures can be visualized on the CT (yellow arrow). At the level of T8, left sided pneumothorax is also seen (pink arrow) as the absence of lung tissue on CT.