CT

A Case Report of a Transected Carotid Artery Caused by a Stab Wound to the Neck

Jennifer Roh, MD^*and Kylie Prentice, BS^*

DOI: https://doi.org/10.21980/J8BP8M Issue 6:1 No ratings yet.

The post intubation chest x-ray (CXR) showed severe rightward displacement of the trachea (purple arrow). The computed tomography angiogram (CTA) showed transection of the left common carotid artery (LCCA), extensive neck hematoma without extravasation and severe tracheal deviation to the right (blue arrow). The intravenous (IV) contrasted chest computed tomography (CT) image showed a lateral contrast projection from the aortic arch at the level of the isthmus (green and pink arrows). There were no other significant injuries reported on the CT scans of the chest, abdomen and pelvis.

Posterior Sternoclavicular Dislocation: A Case Report

Stephanie Songey, DO^*, Christopher Goodwill, DO^* and Kimberly Sokol, MD, MS, MACM^*

DOI: https://doi.org/10.21980/J8363Q Issue 6:1 No ratings yet.

Chest X-ray revealed an inferiorly displaced right clavicle at the right sternoclavicular joint (blue arrow). A computed tomography angiogram (CTA) of the chest was therefore obtained and revealed a right posterior sternoclavicular dislocation with resultant compression of the left brachiocephalic vein (purple arrow). Even though the right clavicle is displaced, the anatomy of the brachiocephalic vein is such that it is positioned to the right of midline, placing the left brachiocephalic vein posterior to the right clavicle. The right brachiocephalic and common carotid artery were normal in appearance. The CTA also revealed a comminuted fracture of the left anterior second rib at the costochondral junction that had not been previously seen on the x-ray.

Orthopedics Trauma Visual EM

Necrotizing Fasciitis and Mediastinitis after Wisdom Tooth Extraction: A Case Report

Jennifer Edwards, MD^*, Ryan Fisher, MD^* and Amrita Vempati, MD^*

DOI: https://doi.org/10.21980/J8XW7KIssue 5:4 No ratings yet.

Computer tomography (CT) imaging of soft tissues of the neck and of the chest/abdomen/pelvis revealed extensive swelling and subcutaneous air (see red arrows) on the left side of the face and neck extending to the left shoulder, as well as parapharyngeal/retropharyngeal spaces and posterior/superior mediastinum.

Infectious Disease Visual EM

Adult Clavicular Fracture Case Report

Jessica L Sea, PhD^*, Nadia Zuabi, MD^* and Alisa Wray, MD, MAEd^*

DOI: https://doi.org/10.21980/J8FM0TIssue 5:4 No ratings yet.

The patient's chest and clavicular radiographs showed a comminuted displaced acute fracture of the right mid-clavicle (green, blue, yellow). The clavicular fracture was also visible on the chest computed tomography (CT). The remainder of his trauma workup was negative for acute findings.

Orthopedics Trauma Visual EM

A Case Report of Ogilvie’s Syndrome in a 58-year-old Quadriplegic

Rosie Kumar, BS^*, Brett Cowan, MD^*, Daniel Quesada, MD^* and Sage Wexner, MD^*

DOI: https://doi.org/10.21980/J82922 Issue 5:4 No ratings yet.

Plain radiograph of the patient's abdomen revealed a gaseous distention of the colon. This is demonstrated as noted in the abdominal x-ray as gaseous distention, most notably in the large bowel (arrows) including the rectal region (large circle). Follow up computed tomography (CT) scan affirmed severe pancolonic gaseous distention measuring up to 11.2 cm, compatible with colonic pseudo-obstruction as noted by the large red arrows. No anatomical lesion or mechanical obstruction was observed, as well as no evidence of malignancy or other acute process.

Abdominal/Gastroenterology Visual EM

Cecal Volvulus Diagnosed with a Whirl Sign: A Case Report

Gregory K Sun, DO^* and Brian Walsh, MD^*

DOI: https://doi.org/10.21980/J8XM05 Issue 5:4 No ratings yet.

The CT image demonstrates a “whirl sign” (red arrow) which is indicative of a volvulus. This image occurs when bowel, mesentery and vasculature rotate around a transition point causing an image similar to a hurricane on a weather map. When seen on a CT scan, a whirl sign suggests a high likelihood of either a closed loop bowel obstruction or volvulus in the cecum, sigmoid or midgut. In any of the cases, seeing a whirl sign strongly increases the need for emergent surgical management.

Abdominal/Gastroenterology Visual EM

Case Report of Spontaneous Thyroid Hemorrhage Following LMA Insertion

Gregory Podolej, MD^* and Gary Bhagat, MD^*

DOI: https://doi.org/10.21980/J8XP8W Issue 5:3 No ratings yet.

Two photographs of patients neck, both showcasing no obvious erythema, bruising, or swelling which is noteworthy because there is potential for airway compromise but there was nothing visible to indicate that on exam. CTA of neck showing thyroid nodule and potential thyroid hemorrhage (outlined in orange) on the left without evidence of airway compromise at the time of CT scan. Official read by attending radiologist states there is a “heterogeneous left thyroid nodule measuring 3 cm. Findings are suggestive of multinodular goiter with possible acute hemorrhage. Adjacent tract of soft tissue stranding in the anterior left neck with mild adjacent fascial thickening. This could represent small amount of hemorrhage or could be inflammatory.”

Endocrine Visual EM

Caught on CT! The Case of the Hemodynamically Stable Ruptured Abdominal Aortic Aneurysm

Matthew Patrick Weber, MS, BS^* and Megan Stobart-Gallagher, DO^*

DOI: https://doi.org/10.21980/J8B07B Issue 5:3 No ratings yet.

The associated images demonstrate the transverse, sagittal, and coronal views of a 6.8 cm infrarenal ruptured AAA continuous with a 4 cm right common iliac aneurysm (transverse, sagittal and coronal). Active hemorrhage was seen contained within the aortic wall, and retroperitoneal bleeding can be appreciated with asymmetric enlargement of the left psoas muscle (coronal - red arrow).1 Plaque and calcifications with a residual opacified true lumen is also present (transverse – red star, sagittal – red arrow). Known as the tangential calcium sign, this is a common radiologic finding of AAAs.2

Cardiology/Vascular Visual EM

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 No ratings yet.

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.

Neurology Cardiology/Vascular Visual EM

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 No ratings yet.

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.

Trauma Neurology Visual EM