CT

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Renal Infarction from Type B Aortic Dissection

Marit Tweet, MD* and James Roy Waymack, MD*

DOI: https://doi.org/10.21980/J8HG9G Issue 2:3[mrp_rating_result]
Initial abdominal images demonstrated a dissection flap; therefore, a CTA of the chest was also obtained. These images revealed a Stanford type B aortic dissection beginning just distal to the left subclavian artery and extending to the origin of the inferior mesenteric artery. The right renal artery arose from the true lumen of the dissection while the left renal artery arose from the false lumen. This case is interesting as imaging shows the lack of perfusion to the left kidney, residing in the retroperitoneum, which correlates with her non-descript abdominal and left flank pain.
Cardiology/VascularRenal/ElectrolytesVisual 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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Globe Rupture

Reid Honda, MD*

DOI: https://doi.org/10.21980/J8N91Z Issue 2:3[mrp_rating_result]
The patient’s computed tomography (CT) head demonstrated a deformed left globe, concerning for ruptured globe. The patient had hyperdense material in the posterior segment (see green arrow), consistent with vitreous hemorrhage. CT findings that are consistent with globe rupture may include a collapsed globe, intraocular air, or foreign bodies.
OphthalmologyVisual EM
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Ectopic Kidney

John Costumbrado, MD, MPH*, Reid Honda, MD^ and Eric McCoy, MD, MPH^

DOI: https://doi.org/10.21980/J89058 Issue 2:3[mrp_rating_result]
CT of the abdomen and pelvis revealed a normal left kidney and an ectopic, malrotated right kidney located in the pelvis (see white arrow).
Renal/ElectrolytesVisual EM
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Ruptured Abdominal Aortic Aneurysm

Jessica Andrusaitis, BS, MS* and Jonathan Peña, MD*

DOI: https://doi.org/10.21980/J8FP6SIssue 2:3[mrp_rating_result]
CTA demonstrated a ruptured 7.4 cm infrarenal abdominal aortic aneurysm with a large left retroperitoneal hematoma.
Cardiology/VascularVisual EM
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Open Pneumothorax

Bart Paull, MD*, Zachary Jarou, MD* and David Richards, MD*

DOI: https://doi.org/10.21980/J88036 Issue 2:3[mrp_rating_result]
A large chest wound was clinically obvious. A chest radiograph performed after intubation showed subcutaneous emphysema, an anterior rib fracture, and a right-sided pneumothorax. He was then taken to the operating room for further management.
TraumaRespiratoryVisual EM
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Dense MCA Sign

Richard J Chen, MD* and Grant Wei, MD*

DOI: https://doi.org/10.21980/J8CS66Issue 2:3[mrp_rating_result]
A non-contrast computed tomography (CT) scan showed a hyperdensity along the right middle cerebral artery (MCA) consistent with acute thrombus. The red arrow highlights the hyperdensity in the annotated image.
NeurologyVisual EM
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Acute, massive pulmonary embolism with right heart strain and hypoxia requiring emergent tissue plasminogen activator (TPA) infusion

Jonathan Patane, MD* and Wirachin Hoonpongsimanont, MD*

DOI: https://doi.org/10.21980/J84K5K Issue 2:2[mrp_rating_result]
CT angiogram showed multiple large acute pulmonary emboli, most significantly in the distal right main pulmonary artery (image 1 and 2). Additional pulmonary emboli were noted in the bilateral lobar, segmental, and subsegmental levels of all lobes. There was a peripheral, wedge-shaped consolidation surrounded by groundglass changes in the posterolateral basal right lower lobe that was consistent with a small lung infarction (image 3).
Cardiology/VascularRespiratoryVisual EM