scholarly journals Bedside Point-of-Care Ultrasound of an Adult with Diffuse Intermittent Abdominal Pain

2020 ◽  
Vol 19 (1) ◽  
pp. 49-51
Author(s):  
Jamaji C Nwanaji-Enwerem ◽  
◽  
Adaira Landry ◽  
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Point Of Care ◽  
Sudden Onset ◽  
Point Of Care Ultrasound ◽  
Intermittent Abdominal Pain ◽  
Obesity Status ◽  
History Of ◽  
History Of Obesity ◽  
New Onset

A 29-year-old woman with a history of obesity status post Roux-en-Y gastric bypass greater than five years prior presented to the emergency department with four hours of sudden-onset stabbing left-sided abdominal pain associated with nausea and non-bloody emesis. She denied melaena and hematochezia, but did report two weeks of diarrhoea that was unchanged with this new onset abdominal pain.

scholarly journals Point-of-care ultrasound for evaluating intra-abdominal calcification in the pediatric emergency department: case series and review of literature

2020 ◽  
Vol 12 (1) ◽  
Author(s):  
Vigil James ◽  
John Samuel ◽  
Chor Yek Kee ◽  
Gene Yong-Kwang Ong
Keyword(s):  
Emergency Department ◽  
Differential Diagnosis ◽  
Abdominal Pain ◽  
Acute Abdominal Pain ◽  
Point Of Care ◽  
Pediatric Population ◽  
Pediatric Emergency ◽  
Point Of Care Ultrasound ◽  
Pediatric Emergency Department ◽  
Wall Calcification

Abstract Background The presence of intra-abdominal calcification in the pediatric population can be due to a wide range of conditions. Calcification in the abdomen can be seen in normal or abnormal anatomical structures. In some patients, abnormal calcification points towards the pathology; whereas in others, calcification itself is the pathology. After a thorough history and clinical examination, point-of-care ultrasound (POCUS) would complement the assessment of acute abdominal pain, based on the list of differentials generated as per the abdominal region. The main objective of this article is to review commonly encountered causes of intra-abdominal calcifications in the pediatric population and help in clinical decision-making in a Pediatric Emergency Department. Case presentation We describe a series of pediatric patients who presented to the Pediatric Emergency Department with acute abdominal pain, in whom point-of-care ultrasound helped expedite the diagnosis by identifying varying types of calcification and associated sonological findings. For children who present to the Pediatric Emergency Department with significant abdominal pain, a rapid distinction between emergencies and non-emergencies is vital to decrease morbidity and mortality. Conclusions In a child presenting to the Pediatric Emergency Department with abdominal pain, POCUS and the findings of calcifications can narrow or expand the differential diagnosis when integrated with history and physical exam, to a specific anatomic structure. Integrating these findings with additional sonological findings of an underlying pathology might raise sufficient concerns in the emergency physicians to warrant further investigations for the patient in the form of a formal radiological ultrasound and assist in the patient's early disposition. The use of POCUS might also help to categorize the type of calcification to one of the four main categories of intra-abdominal calcifications, namely concretions, conduit wall calcification, cyst wall calcification, and solid mass-type calcification. POCUS used thoughtfully can give a diagnosis and expand differential diagnosis, reduce cognitive bias, and reduce physician mental load. By integrating the use of POCUS with the history and clinical findings, it will be possible to expedite the management in children who present to the Pediatric Emergency Department with acute abdominal pain.

scholarly journals Timely Diagnosis of Pneumoperitoneum by Point-of-care Ultrasound in the Emergency Department: A Case Series

2021 ◽  
Vol 5 (4) ◽  
pp. 377-380
Author(s):  
Jung Yum ◽  
Taryn Hoffman ◽  
Leily Naraghi
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Elderly Patients ◽  
Point Of Care ◽  
Case Series ◽  
Point Of Care Ultrasound ◽  
Emergency Physicians ◽  
Hollow Viscus ◽  
Timely Diagnosis ◽  
Life Threatening

Introduction: Pneumoperitoneum is a life-threatening diagnosis that requires timely diagnosis and action. We present a case series of patients with perforated hollow viscus who were accurately diagnosed by emergency physicians using point-of-care ultrasound (POCUS) while in the emergency department (ED). Case Series: Three elderly patients presented to the ED with the complaints of syncope, abdominal pain with constipation, and unresponsiveness. The emergency physicians used POCUS to diagnose and then expedite the necessary treatment. Conclusion: Point-of-care ultrasound can be used by emergency physicians to diagnose pneumoperitoneum in the ED.

scholarly journals Point-of-care Ultrasound Diagnosis of Emphysematous Cholecystitis

2020 ◽  
Vol 4 (1) ◽  
pp. 107-108
Author(s):  
Fadwa Al Hammadi ◽  
Rasha Buhumaid
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Mortality Rate ◽  
Physical Examination ◽  
Acute Cholecystitis ◽  
Point Of Care ◽  
Point Of Care Ultrasound ◽  
Emphysematous Cholecystitis ◽  
Biliary Pathology ◽  
Biliary Ultrasound

A 49-year-old male presented to the emergency department with abdominal pain and generalized weakness. The physical examination was positive for right upper quadrant tenderness and positive Murphy’s sign. Point-of-care biliary ultrasound revealed signs of emphysematous cholecystitis. Emphysematous cholecystitis is a rare biliary pathology with a high mortality rate. It differs from acute cholecystitis is many ways. It has unique ultrasound characteristics. This case highlights the use of point-of-care ultrasound to diagnose a rare biliary condition.

scholarly journals Point-of-Care Ultrasound May Be Useful for Detecting Pediatric Intussusception at an Early Stage

2020 ◽  
Author(s):  
Jeong-Yong Lee ◽  
Jung Heon Kim ◽  
Seung Jun Choi ◽  
Jong Seung Lee ◽  
Jeong-Min Ryu
Keyword(s):  
Abdominal Pain ◽  
Early Stage ◽  
Point Of Care ◽  
Abdominal Mass ◽  
Pediatric Emergency ◽  
Symptom Duration ◽  
Point Of Care Ultrasound ◽  
Bloody Stool ◽  
Emergency Physicians ◽  
Intermittent Abdominal Pain

Abstract Background: This study aimed to verify the usefulness of point-of-care ultrasound (POCUS) performed by pediatric emergency physicians for detecting intussusception at an early stage. Methods: This retrospective study included 1-month- to 6-year-old children with clinically suspected intussusception, who underwent POCUS in the pediatric emergency department between December 2016 and February 2018. The criteria for performing POCUS were set to broader standards: presenting any one of intermittent abdominal pain/irritability or bloody stool, or ≥2 symptoms among nonspecific abdominal pain/irritability, abdominal mass/distension, vomiting, or lethargy. POCUS results were interpreted and categorized as “negative” or “suspicious,” and a radiologist performed confirmatory ultrasound in “suspicious” cases. Results: We analyzed 575 POCUS scans from 549 patients (mean age, 25.5 months). Among the 92 “suspicious” cases (16.0%), 70 (12.2%) were confirmed to have intussusception. POCUS showed 100% sensitivity, 95.6% specificity, and 97.8% accuracy. Patients with confirmed intussusception were mainly diagnosed in the early stages, with a mean symptom duration of 11.7 hours, and most patients (97.1%) were treated successfully via air enema reduction. Compared to the non-intussusception group, the intussusception group had more intermittent abdominal pain ( P < 0.001), but less vomiting ( P = 0.001); the other clinical features showed no intergroup differences. Conclusion: POCUS performed using the criteria set to broader standards by pediatric emergency physicians may be useful for detecting intussusception at an early stage, which may present with obscure clinical symptoms.

scholarly journals Point-of-Care Ultrasound May Be Useful for Detecting Pediatric Intussusception at an Early Stage

2019 ◽  
Author(s):  
Jeong-Yong Lee ◽  
Jung Heon Kim ◽  
Seung Jun Choi ◽  
Jong Seung Lee ◽  
Jeong-Min Ryu
Keyword(s):  
Abdominal Pain ◽  
Early Stage ◽  
Point Of Care ◽  
Abdominal Mass ◽  
Pediatric Emergency ◽  
Symptom Duration ◽  
Point Of Care Ultrasound ◽  
Bloody Stool ◽  
Emergency Physicians ◽  
Intermittent Abdominal Pain

Abstract Background: This study aimed to verify the usefulness of point-of-care ultrasound (POCUS) performed by pediatric emergency physicians for detecting intussusception at an early stage. Methods: This retrospective study included 1-month- to 6-year-old children who underwent POCUS for the detection of intussusception in the pediatric emergency department between December 2016 and February 2018. The criteria for performing POCUS were set to lower standards wherein POCUS was performed in the presence of any one of the following symptoms: intermittent abdominal pain, bloody stool, ≥2 causes of nonspecific abdominal pain, abdominal mass, vomiting, or lethargy. POCUS results were interpreted and categorized as “negative” or “suspicious,” and a radiologist performed confirmatory ultrasound in “suspicious” cases. Results: We analyzed 575 POCUS scans from 549 patients (mean age, 25.5 months). Among the 92 “suspicious” cases (16.0%), 70 (12.2%) were confirmed to have intussusception. POCUS showed 100% sensitivity, 95.6% specificity, and 97.8% accuracy. Patients with confirmed intussusception were mainly diagnosed in the early stages, with a mean symptom duration of 11.7 hours, and most patients (97.1%) were treated successfully via air enema reduction. Compared to the non-intussusception group, the intussusception group had more intermittent abdominal pain (P < 0.001), but less vomiting (P = 0.001); the other clinical features showed no intergroup differences. Conclusion: POCUS performed using the criteria set to lower standards by pediatric emergency physicians may be useful for detecting intussusception at an early stage, which may present with obscure clinical symptoms.

Case Report: A cardiac mass diagnosed using Point-of-care ultrasound in a dyspneic patient. An integrated ultrasound examination of lung-heart-Inferior Vena Cava

POCUS Journal ◽  
2017 ◽  
Vol 2 (3) ◽  
pp. 20-21 ◽  
Author(s):  
Maria Viviana Carlino, MD ◽  
Costantino Mancusi, MD ◽  
Alfonso Sforza, MD ◽  
Giorgio Bosso, MD ◽  
Valentina Di Fronzo, MD ◽  
...  
Keyword(s):  
Emergency Department ◽  
Heart Rate ◽  
Inferior Vena Cava ◽  
Inferior Vena ◽  
Point Of Care ◽  
Vena Cava ◽  
Point Of Care Ultrasound ◽  
Bundle Branch Block ◽  
History Of ◽  
Time Of Admission

A 74-year-old woman with history of hypertension presented to the Emergency Department (ED) with severe resting dyspnea and swelling in the feet, ankles and legs. She was on treatment with furosemide and a beta blocker. At the time of admission blood pressure was 145/88 mmHg, heart rate (HR) 99 bpm, regular, oxygen saturation was 89% (FiO2 21%) and respiratory rate was 17 breaths/min. Abbreviation List AST: Aspartate aminotransferase ED: Emergency Department GFR: Glomerular Filtration Rate HCC: Hepatocellular Carcinoma HF: Heart Failure HR: Heart rate IVC: Inferior vena cava LAFB: Left anterior fascicular block LV: Left ventricle NT-pro-BNP: N-Terminal pro-Brain Natriuretic peptide POCUS: Point-of-care ultrasound RA: Right atrium RBB: Right bundle branch block RV: Right ventricle TS: Tricuspid stenosis

scholarly journals Point-of-care Ultrasound Detection of Cataract in a Patient with Vision Loss: A Case Report

2020 ◽  
Vol 4 (3) ◽  
pp. 355-357
Author(s):  
Kyle Dornhofer ◽  
Marawan Alkhattabi ◽  
Shadi Lahham
Keyword(s):  
Emergency Department ◽  
Case Report ◽  
Vision Loss ◽  
Point Of Care ◽  
Point Of Care Ultrasound ◽  
Cataract Formation ◽  
Ocular Ultrasound ◽  
History Of

Background: Point-of-care ocular ultrasound in the emergency department (ED) is an effective tool for promptly evaluating for several vision-threatening etiologies and can be used to identify more slowly progressing etiologies as well, such as cataract formation within the lens. Case Report: A 62-year-old female presented to the ED with a two-day history of painless vision loss of the left eye as well as reduced vision for the prior 30 days. Conclusion: Point-of-care ultrasound was performed and showed calcification of the lens consistent with cataract.

scholarly journals Man with sudden upper abdominal pain

2018 ◽  
Vol 26 (2) ◽  
pp. 130-131
Author(s):  
Hung-Lin Hsu ◽  
Wei-Jing Lee
Keyword(s):  
Abdominal Pain ◽  
Epigastric Pain ◽  
Point Of Care ◽  
Systemic Disease ◽  
Poor Response ◽  
Sudden Onset ◽  
Point Of Care Ultrasound ◽  
Endovascular Stent ◽  
Endovascular Stent Placement ◽  
Upper Abdominal

A 52-year-old man without systemic disease presented to the emergency department with sudden-onset epigastric pain for 2 h. He had vomiting for several times without fever, diarrhea, or recent abdominal trauma. Point-of-care ultrasound revealed flap in the superior mesenteric artery. Percutaneous endovascular stent placement was arranged due to refractory upper abdominal pain and poor response to medical treatment.

scholarly journals Point-of-Care Ultrasound May Be Useful for Detecting Pediatric Intussusception at an Early Stage

2020 ◽  
Author(s):  
Jeong-Yong Lee ◽  
Jung Heon Kim ◽  
Seung Jun Choi ◽  
Jong Seung Lee ◽  
Jeong-Min Ryu
Keyword(s):  
Abdominal Pain ◽  
Early Stage ◽  
Point Of Care ◽  
Abdominal Mass ◽  
Pediatric Emergency ◽  
Symptom Duration ◽  
Point Of Care Ultrasound ◽  
Bloody Stool ◽  
Emergency Physicians ◽  
Intermittent Abdominal Pain

Abstract Background: This study aimed to verify the usefulness of point-of-care ultrasound (POCUS) performed by pediatric emergency physicians for detecting intussusception at an early stage. Methods: This retrospective study included 1-month- to 6-year-old children with clinically suspected intussusception, who underwent POCUS in the pediatric emergency department between December 2016 and February 2018. The criteria for performing POCUS were set to broader standards: presenting any one of intermittent abdominal pain/irritability or bloody stool, or ≥2 symptoms among nonspecific abdominal pain/irritability, abdominal mass/distension, vomiting, or lethargy. POCUS results were interpreted and categorized as “negative” or “suspicious,” and a radiologist performed confirmatory ultrasound in “suspicious” cases. Results: We analyzed 575 POCUS scans from 549 patients (mean age, 25.5 months). Among the 92 “suspicious” cases (16.0%), 70 (12.2%) were confirmed to have intussusception. POCUS showed 100% sensitivity, 95.6% specificity, and 97.8% accuracy. Patients with confirmed intussusception were mainly diagnosed in the early stages, with a mean symptom duration of 11.7 hours, and most patients (97.1%) were treated successfully via air enema reduction. Compared to the non-intussusception group, the intussusception group had more intermittent abdominal pain ( P < 0.001), but less vomiting ( P = 0.001); the other clinical features showed no intergroup differences. Conclusion: POCUS performed using the criteria set to broader standards by pediatric emergency physicians may be useful for detecting intussusception at an early stage, which may present with obscure clinical symptoms.

Case Report: When all claims that it is necrotizing fasciitis but Point of care ultrasound (POCUS) proves the opposite!

POCUS Journal ◽  
2018 ◽  
Vol 3 (1) ◽  
pp. 13-14
Author(s):  
Hadiel Kaiyasah, MD, MRCS (Glasgow), ABHS-GS ◽  
Maryam Al Ali, MBBS
Keyword(s):  
Emergency Department ◽  
Critical Care ◽  
Case Report ◽  
Soft Tissue ◽  
Necrotizing Fasciitis ◽  
Soft Tissue Infection ◽  
Critical Care Unit ◽  
Point Of Care ◽  
Point Of Care Ultrasound ◽  
Soft Tissue Infections

Soft tissue ultrasound (ST-USS) has been shown to be of utmost importance in assessing patients with soft tissue infections in the emergency department or critical care unit. It aids in guiding the management of soft tissue infection based on the sonographic findings.

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