scholarly journals Suprapubic Catheter Migration: A Review of a Rare Complication

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Amr Elmoheen ◽  
Mahmoud Saqr ◽  
Waleed Salem ◽  
Khalid Bashir ◽  
Ayman Hagras
Keyword(s):  
Ureteral Obstruction ◽  
Point Of Care ◽  
Rare Complication ◽  
Urethral Injury ◽  
Unusual Complication ◽  
Point Of Care Ultrasound ◽  
Suprapubic Catheter ◽  
Catheter Migration ◽  
Pelvicalyceal System

Background. Suprapubic catheter migration to the vesicoureteral junction is an unusual complication, causing an obstruction that led to hydronephrosis and dilation of the pelvicalyceal system. Case presentation. A 30-year-old man with a suprapubic catheter (SPC) that was inserted one month before this current Emergency Department (ED) visit had severe left flank pain for 48 hours. The SPC was inserted in the context of urethral injury after falling astride. Point-of-Care Ultrasound (POCUS) showed a semifilled urinary bladder and moderate hydronephrosis on the left side. A computed tomography scan (CT scan) of the abdomen was performed and showed migration of the suprapubic catheter’s tip into the left vesicoureteral junction, causing ureteral obstruction dilation of the ipsilateral pelvicalyceal system. The suprapubic catheter was changed in the ED, causing relief of symptoms, and the patient was referred to the urology department for follow-up. It was uneventful on the follow-up from the SPC clinic. Conclusions. This case report describes a rare complication of migration of the suprapubic catheter to the vesicoureteral junction causing acute ureteral obstruction and hydronephrosis.

scholarly journals Pyogenic Flexor Tenosynovitis as a Rare Complication of Dyshidrotic Eczema

2020 ◽  
Vol 4 (2) ◽  
pp. 174-177
Author(s):  
Waroot Nimjareansuk ◽  
Michael Rosselli
Keyword(s):  
Point Of Care ◽  
Rare Complication ◽  
Middle Finger ◽  
Unusual Complication ◽  
Point Of Care Ultrasound ◽  
Emergency Case ◽  
Deep Wound ◽  
Dermatological Disease ◽  
Pyogenic Flexor Tenosynovitis ◽  
Flexor Tenosynovitis

Introduction: Pyogenic flexor tenosynovitis is an unusual complication of dyshidrotic eczema. The diagnosis has traditionally been made by Kanavel’s signs. Point-of-care ultrasound can be a useful adjunct in the diagnosis of this surgical emergency. Case Report: We report the case of a 23-year-old male who presented with right middle finger pain and swelling and an overlying eczematous rash. The use of point-of-care ultrasound was performed to aid in the diagnosis of pyogenic flexor tenosynovitis. An incision and drainage was performed with deep wound cultures positive for Staphylococcus aureus. Discussion: The presentation of pyogenic flexor tenosynovitis with underlying concomitant dermatological disease can complicate this challenging diagnosis. Point-of-care ultrasound can be an effective adjunct in revealing pyogenic flexor tenosynovitis rather than relying solely on the classical Kanavel’s signs, leading to earlier treatment. Conclusion: Our case demonstrates that point-of-care ultrasound can be a rapid and effective tool for the diagnosis of pyogenic flexor tenosynovitis in the setting of superimposed dermatological diseases.

scholarly journals Case Series of Bedside Renal Cell Carcinoma Detected by Point-of-Care Ultrasound in the Ambulatory Setting

2020 ◽  
Vol 11 ◽  
pp. 215013272091627
Author(s):  
Gayatri Setia ◽  
Ilan Kedan
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Point Of Care ◽  
Case Series ◽  
Smoking History ◽  
Point Of Care Ultrasound ◽  
Gross Hematuria ◽  
The Right

Background: Kidney and renal pelvic cancer was the sixth most common cancer in men and 10th most common in women in the United States in 2018. Renal cell carcinoma (RCC), accounts for 86% of malignancies of the kidney. RCC patients are often asymptomatic; up to 25-30% have metastases at diagnosis. Few present with the triad of gross hematuria, flank pain, and abdominal mass. In RCC patients, 36% had 2 symptoms of the triad, and 60% had gross hematuria as 1 symptom. Point-of-care ultrasound (POCUS) offers a way to identify clinically meaningful anatomic abnormalities. This case series presents 3 patients in whom routine POCUS examination performed in an outpatient cardiology clinic found asymptomatic renal masses, resulting in surgical resection and cure of early-stage RCCs. Case Presentation: Patient 1: 54-year-old female with hypertension (HTN). Two solid masses were identified with POCUS in the right kidney. Patient 2: 63-year-old male with coronary artery disease (CAD) and HTN was seen at an 8-month follow-up visit. A 6-cm mass was identified in the left kidney. Patient 3: 69-year-old male with CAD, HTN, and smoking history seen at 5-month follow-up visit. A 3-cm mass in the right kidney was identified. Conclusions: Incorporating POCUS into the routine physical examination in the ambulatory care setting may improve rates of detection and increase the pretest probability of identifying renal pathology with formal imaging studies. With minimal clinician training, earlier and increased detection of asymptomatic RCC may result in improved patient survival.

scholarly journals Point-of-care ultrasound by the pediatrician in the diagnosis and follow-up of community-acquired pneumonia

2020 ◽  
Author(s):  
Manuel Sobrino Toro ◽  
José Luis Vázquez Martínez ◽  
Ricardo Viana Falcão ◽  
Arnaldo Prata-Barbosa ◽  
Antonio José Ledo Alves da Cunha
Keyword(s):  
Point Of Care ◽  
Community Acquired Pneumonia ◽  
Point Of Care Ultrasound

Diffuse Sterile Corneal Infiltration: An Unusual Complication Post Collagen Cross-linkage

2015 ◽  
Vol 4 (3) ◽  
pp. 115-119 ◽  
Author(s):  
Ritu Arora ◽  
Sonal Dangda
Keyword(s):  
Visual Acuity ◽  
Rare Complication ◽  
Cross Linking ◽  
Unusual Complication ◽  
Topical Steroids ◽  
Poor Vision ◽  
Corneal Clouding ◽  
Cross Linkage

ABSTRACT Purpose Presenting the course of visually disabling corneal infiltration post uneventful collagen cross-linking (CXL) in a 23 years old male with bilateral keratoconus. Methods A 23 years old male with bilateral keratoconus underwent cross-linking of left eye with indigenous 0.1% riboflavin dye and 370 nm ultraviolet A irradiation. This patient had an uneventful successful cross-linking performed in right eye 6 months prior with good recovery of vision to LogMAR (6/9 Snellen). Results Patient developed diminution of vision, along with redness of eye, photophobia and watering on 3rd day after uneventful cross-linkage. Examination revealed very poor vision; diffuse corneal clouding with multiple superficial stromal infiltrates and incomplete corneal epithelization. A provisional diagnosis of infective keratitis was made, in situ bandage contact lens (BCL) removed and subjected to culture. Intensive fortified topical antibiotics were initiated and steroids withheld. After complete corneal re-epithelization on 6th day, the infiltrations did not decrease in either intensity or number. Response to antibiotics being inadequate, an immune etiology was suspected and full strength topical steroids reinstituted which resulted in slow resolution of infiltration over a 10 weeks period. Last follow-up at 9 months post-CXL, revealed a diffuse stromal haze with unaided visual acuity of LogMAR 0.8 6/36 and best-corrected visual acuity (BCVA) of 0.3 (6/12) with use of a rigid gas permeable lens. Conclusion Sterile infiltration post-CXL requiring intense topical steroids is a rare complication of CXL and needs to be differentiated from infective keratitis. How to cite this article Bhattacharyya M, Singh K, Mutreja A, Dangda S, Arora R. Diffuse Sterile Corneal Infiltration: An Unusual Complication Post Collagen Cross-linkage. Int J Kerat Ect Cor Dis 2015;4(3):115-119.

scholarly journals Intensive point-of-care ultrasound training with long-term follow-up in a cohort of Rwandan physicians

2016 ◽  
Vol 21 (12) ◽  
pp. 1531-1538 ◽  
Author(s):  
Patricia C. Henwood ◽  
David C. Mackenzie ◽  
Joshua S. Rempell ◽  
Emily Douglass ◽  
Damas Dukundane ◽  
...  
Keyword(s):  
Point Of Care ◽  
Point Of Care Ultrasound ◽  
Long Term Follow Up

scholarly journals Orthopaedic residents demonstrate retention of point of care ultrasound knowledge after a brief educational session: a quasi experimental study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Samuel Larrivée ◽  
Robyn Rodger ◽  
Patricia Larouche ◽  
Jeff Leiter ◽  
Tomislav Jelic ◽  
...  
Keyword(s):  
Test Scores ◽  
Orthopaedic Surgery ◽  
Online Survey ◽  
Point Of Care ◽  
Interdisciplinary Approach ◽  
Comfort Level ◽  
Point Of Care Ultrasound ◽  
Significant Drop ◽  
Written Test

Abstract Background Musculoskeletal point of care ultrasound (MSK POCUS) has many uses for orthopaedic surgeons, but orthopaedic trainees are rarely exposed to this modality. The purpose of this project was to assess the usefulness in clinical education of a newly implemented MSK POCUS course in an orthopaedic surgery program. Methods An MSK POCUS course for orthopaedic surgery residents was developed by an interdisciplinary team. Online videos were created to be viewed by residents prior to a half-day long practical course. An online survey covering the level of training of the resident and their previous use of ultrasound (total hours) was completed by the participants prior to the course. Resident’s knowledge acquisition was measured with written pre-course, same-day post-course and six-month follow-up tests. Residents were also scored on a practical shoulder examination immediately after the course and at six-month follow-up. Changes in test scores between time points were evaluated using Wilcoxon signed-rank tests. Results Ten orthopaedic surgery residents underwent the MSK POCUS curriculum. Pre-course interest in MSK-POCUS was moderate (65%) and prior exposure was low (1.5 h mean total experience). Written test scores improved significantly from 50.7 ± 17.0% before to 84.0 ± 10.7% immediately after the course (p < 0.001) and suffered no significant drop at 6 months (score 75.0 ± 8.7%; p = 0.303). Average post-course practical exam score was 78.8 ± 3.1% and decreased to 66.2 ± 11.3% at 6 months (p = 0.012). Residents significantly improved their subjective comfort level with all aspects of ultrasound use at 6 months (p = 0.007–0.018) but did not significantly increase clinical usage frequency. Conclusion An MSK POCUS curriculum was successfully developed and implemented using an interdisciplinary approach. The course succeeded in improving the residents’ knowledge, skills, and comfort with MSK POCUS. This improvement was maintained at 6 months on the written test but did not result in higher frequency of use by the residents.

scholarly journals Migration of the Anterior Spinal Rod to the Right Thigh, a Rare Complication of Anterior Spinal Instrumentations: A Case Report and a Literature Review

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Camino Willhuber Gaston ◽  
Taype Zamboni Danilo ◽  
Carabelli Guido ◽  
Barla Jorge ◽  
Sancineto Carlos
Keyword(s):  
Rare Complication ◽  
Spinal Instrumentation ◽  
Unusual Complication ◽  
Anterior Fusion ◽  
Long Term Follow Up ◽  
The Right ◽  
Rod Migration ◽  
Surgical Treatments

Posterior and anterior fusion procedures with instrumentation are well-known surgical treatments for scoliosis. Rod migration has been described as unusual complication in anterior spinal instrumentations; migration beyond pelvis is a rare complication. A 32-year-old female presented to the consultant with right thigh pain, rod migration was diagnosed, rod extraction by minimal approach was performed, and spinal instrumentation after nonunion diagnosis was underwent. A rod migration case to the right thigh is presented; this uncommon complication of spinal instrumentation should be ruled out as unusual cause of sudden pain without any other suspicions, and long-term follow-up is important to prevent and diagnose this problem.

scholarly journals A Case Report: Point-of-care Ultrasound in the Diagnosis of Post-Myocardial Infarction Ventricular Septal Rupture

2020 ◽  
Vol 4 (3) ◽  
pp. 407-410
Author(s):  
Andrew Portuguese ◽  
Khaled Abdulla ◽  
Michael Vornovitsky ◽  
John DeAngelis
Keyword(s):  
Myocardial Infarction ◽  
Case Report ◽  
Point Of Care ◽  
Rare Complication ◽  
Artery Bypass ◽  
Heart Catheterization ◽  
Point Of Care Ultrasound ◽  
Mechanical Complication ◽  
Ventricular Septal Rupture ◽  
First Case

Introduction: Ventricular septal rupture (VSR) is a rare complication of ST-elevation myocardial infarction (STEMI), typically discovered post-revascularization. Case report: We present the first case of VSR detected on point-of-care ultrasound (POCUS) in the emergency department immediately prior to emergent angiography, with management positively affected by this discovery. The VSR was quickly confirmed via right heart catheterization. Subsequently, hemodynamic stability was achieved using an intra-aortic balloon pump. A delayed surgical VSR repair, with concomitant coronary artery bypass grafting, was implemented for definitive management. Conclusion: This case highlights the utility of POCUS in a STEMI patient with a suspected mechanical complication.

scholarly journals Splenic Injury Following Colonoscopy: A Case Report

2021 ◽  
Vol 5 (4) ◽  
pp. 499-501
Author(s):  
Jason Wang ◽  
Heesun Choi ◽  
John Ashurst
Keyword(s):  
Case Report ◽  
Splenic Injury ◽  
Point Of Care ◽  
Rare Complication ◽  
Point Of Care Ultrasound ◽  
Intravenous Contrast ◽  
Active Extravasation ◽  
History Of ◽  
Grade Ii ◽  
Abdominal Examination

Introduction: Colonoscopy is a commonly performed outpatient procedure with a low risk of complications. The most common complications seen in the postoperative period include hemorrhage and perforation. Infrequently, splenic injury can occur. Case Report: A 72-year-old male presented with a one-day history of left upper quadrant pain following colonoscopy. During the procedure he had two polyps removed along the transverse colon near the splenic flexure. There were no complications during the procedure or in the immediate post-operative period. On presentation to the emergency department, abdominal tenderness was present in the left upper quadrant without rebound, rigidity, or guarding. Point-of-care ultrasound of the abdomen demonstrated mixed hypoechoic densities confined to the splenic capsule, and computed tomography of the abdomen and pelvis with intravenous contrast noted a grade II/III splenic laceration without active extravasation. The patient was admitted for serial abdominal examination and labs. Conclusion: Splenic injury following colonoscopy is a rare complication of colonoscopy. Emergency providers should be aware of this possible complication, and acute management should include basic trauma care and consultation for possible intervention, if warranted.

Diagnostic Accuracy of Point-of-Care Ultrasound Integrated into Clinical Examination for Acute Diverticulitis: A Prospective Multicenter Study

2020 ◽  
Author(s):  
Peiman Nazerian ◽  
Chiara Gigli ◽  
Emilia Donnarumma ◽  
Ersilia de Curtis ◽  
Andrea Bribani ◽  
...  
Keyword(s):  
Ct Scan ◽  
Point Of Care ◽  
Acute Diverticulitis ◽  
Final Diagnosis ◽  
Complicated Diverticulitis ◽  
Point Of Care Ultrasound ◽  
Sonographic Assessment ◽  
The One ◽  
Low Sensitivity

Abstract Purpose Diverticulitis is a common cause of abdominal pain and CT scan is commonly used for its diagnosis in the emergency department (ED). The diagnostic performance of point-of-care ultrasound (POCUS) integrated into a clinical exam for diverticulitis is still not established. We evaluate the accuracy of clinical-sonographic assessment for the diagnosis of diverticulitis and whether POCUS could improve the selection of patients needing CT scan for complicated diverticulitis. Materials and Methods This is a multicentric observational study involving adult patients suspected of having diverticulitis presenting at 4 EDs. 21 sonographer physicians were asked to diagnose diverticulitis and complicated diverticulitis based on clinical-sonographic assessment. The final diagnosis was established by two reviewers, blinded to POCUS, based on data collected during the one-month follow-up comprehensive CT scan. Results Among 393 enrolled patients, 218 (55.5 %) were diagnosed with diverticulitis and 33 (8 %) had complicated diverticulitis. The time to diagnosis by the sonographer physicians was shorter compared to standard care (97 ± 102 vs. 330 ± 319 minutes, p < 0.001). Clinical-sonographic assessment showed optimal sensitivity (92.7 %) and specificity (90.9 %) for diverticulitis. However, the sensitivity (50 %) for complicated diverticulitis was low. The sonographer physician would have proceeded to CT scan in 194 (49.4 %) patients and the CT scan request compared to the final diagnosis of complicated diverticulitis demonstrated 94 % sensitivity. Conclusion Clinical-sonographic assessment is rapid and accurate for the diagnosis of diverticulitis. Even if POCUS has low sensitivity for complicated diverticulitis, it can be used to safely select patients needing CT.

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