A validation study for a bat-inspired sonar sensing simulator.

Many species of bats rely on echoes to forage and navigate in densely vegetated environments. Foliage echoes in some cases can help bats gather information about the environment, whereas in others may generate clutter that can mask prey echoes during foraging. It is therefore important to study foliage echoes and their role in bat's sensory ecology.

Correction: The Tumbling Bullet: Subacute Intestinal Obstruction due to a Retained Bullet.

[This corrects the article DOI: 10.7759/cureus.9844.

Cardiac Adverse Events With Remdesivir in COVID-19 Infection.

Since December 2019, coronavirus has gradually progressed to a pandemic with no efficacious treatment. Remdesivir is an antiviral medication and inhibitor of viral RNA dependent RNA polymerase with inhibitory action against SARS-CoV virus. Two patients diagnosed with coronavirus infection with worsening respiratory status were initiated with multimodality therapy with antibiotics, steroids and remdesivir.

A Retrospective Study Comparing Radiological to Histopathological Diagnosis After Laparoscopic Cholecystectomy for Suspected Cholecystitis.

Introduction Acute calculus cholecystitis is one of the most common causes of acute abdominal pain in patients presenting to the emergency department, representing a third of all surgical emergency hospital admissions. Laparoscopic surgery is typically performed within 24 to 48 hours of hospital admission. Due to similarities in presentation, it is often difficult to differentiate between biliary colic and acute cholecystitis.

The Role of Minimally Invasive Surgery in Appendectomy Within a Hernia.

We present three cases where an inflamed incarcerated appendix was in a femoral, inguinal, and an umbilical hernia. All three patients underwent an appendectomy laparoscopically. The hernias in two of the patients (femoral and inguinal) were left unrepaired as the primary goal was to relieve the patients' symptoms and achieve source control.

Major Bleed Post Minimally Invasive Surgical Repair of Inguinal Hernia.

At our center, over 200 patients undergo minimally invasive repairs of inguinal hernias every year using a laparoscope and a robotic-assisted technique. In three patients who underwent a minimally invasive procedure for uncomplicated indirect inguinal hernia, the postoperative course was complicated with bleeding and required an exploratory laparotomy. Post-procedure, the patients developed tachycardia and hypotension with a drop in hemoglobin, for which the patients required surgical re-exploration in an emergent fashion.

Overwhelming Post-Splenectomy Infection Syndrome: Variability in Timing With Similar Presentation.

Overwhelming post-splenectomy infection (OPSI) syndrome is a rare and well-known entity that rapidly progresses with poor outcomes. Two patients underwent splenectomy after trauma and later presented with flu-like symptoms and thrombocytopenia, which then progressed to fulminant sepsis and death. The first patient had sepsis 20 days post-splenectomy, and the second patient underwent splenectomy 15 years before presentation.

Gluteal Compartment Syndrome After Prolonged Immobilization in Drug Abusers.

Background There has been an increasing incidence of drug abuse patients presenting with rhabdomyolysis after prolonged immobilization. Our study was to assess etiology and management challenges with patients presenting with gluteal compartment syndrome after drug abuse. Methodology We did a retrospective analysis of five patients who presented with gluteal compartment syndrome secondary to drug abuse over one year.

The Tumbling Bullet: Subacute Intestinal Obstruction due to a Retained Bullet.

A 29-year-old female presented with multiple gunshot wounds to the back and bilateral lower extremities. The patient underwent an exploratory laparotomy with small-bowel resection of two segments with primary stapled anastomosis and partial nephrectomy. The postoperative course showed prolonged intermittent bowel obstruction secondary to the bullet, which lodged in the distal ileum.

Fallopian Tube Tumor Mimicking Primary Gastrointestinal Malignancy.

A 67-year-old female patient positive for a mismatch repair gene mutation and history of serous carcinoma of the fallopian tube presented with a lower gastrointestinal bleed. Clinical workup was suggestive of a primary gastrointestinal malignancy. Pathological review after right hemicolectomy revealed the primary tumor was a fallopian tube carcinoma.

Is It Safe to Perform Lung Surgery During the Coronavirus Pandemic?

Background:  Coronavirus disease (COVID-19) patients are rapidly growing in our community. Patients with compromised lungs and older age are supposedly at high risk of poor outcomes with COVID-19. We aimed to evaluate the COVID-19 impact on lung surgery during this pandemic at our hospital.

Methotrexate for Cornual Ectopic Pregnancy.

A 27-year-old pregnant female presented to the emergency department with pelvic pain and vaginal bleeding. At the time of diagnosis, she had an ectopic pregnancy in the right cornua 4 cm in size with a human chorionic gonadotropin (hCG) value of 14,438 international units per mL. The ectopic pregnancy was initially managed by intramuscular methotrexate.

Appendicitis Caused by Endometriosis Within the Bowel Wall.

Acute appendicitis is one of the most common causes of acute abdominal pain seen in the emergency room. Common etiologies include obstructing appendicolith and lymphoid adenopathy. Appendiceal endometriosis is rare and typically involves the serosal layer.

Unusual Delayed Complication of Pacemaker Leads.

We present three patients who complained of chest pain secondary to displaced pacemaker leads. They underwent evaluation in the emergency room multiple times for chest pain. Imaging was useful to diagnose misplaced ventricular leads of the pacemaker.

Ogilvie Syndrome Following an Inflatable Penile Implant.

A 59-year-old male patient presented with Ogilvie syndrome which developed after inflatable penile prosthesis placement. The patient presented to the emergency room three days after having an inflatable penile prosthesis with complaints of obstipation. A trial of conservative measures failed, and because of the development of peritonitis, the patient underwent a right hemicolectomy with a loop ileostomy.

Vascular Shunt for Small Vessel Trauma in a Polytrauma Patient.

A 15-year-old male patient presented with multiple gunshot injuries. The patient underwent emergency lifesaving exploratory laparotomy and subsequently needed repair of his left upper limb ulnar artery injury. A shunt helped restore blood flow to the hand in a setting of damage control surgery in an exsanguinating patient with an ulnar artery injury having a massive disruption.

Pelvic Rectal Stercoral Perforation Resulting in Diffuse Pneumatosis.

An 83-year-old woman with oral corticosteroid use for chronic autoimmune conditions presented with abdominal pain and constipation for the previous seven days. CT of the abdomen and pelvis revealed a large fecaloma with diffuse pneumatosis involving the retroperitoneum, subcutaneous tissue, and mediastinum. An emergent exploratory laparotomy revealed perforation of the rectum below the peritoneal reflection into the retroperitoneum.

Bleeding After a Single Dose of Ketorolac in a Postoperative Patient.

A 74-year-old male patient with extensive cardiac history and hepatitis on apixaban and clopidogrel presented with adhesive small bowel obstruction. The patient underwent an exploratory laparotomy and adhesiolysis for small bowel obstruction. On postoperative day 6, after a single dose of ketorolac, the patient had an intra-abdominal bleed requiring exploratory laparotomy and washout.

Laparoscopic Approach for Gallstone Ileus in Geriatric Patients.

We report two patients who presented with small bowel obstruction secondary to gallstones in the ileum. Both patients were geriatric women with multiple comorbidities. The first patient was a 73-year-old woman who presented with a gallstone eroding and obstructing the duodenum (Bouveret's syndrome) secondary to gallbladder cancer with diffuse metastatic spread to the liver.

Delayed Presentation of Foot Compartment Syndrome.

A 30-year-old male after consuming alcohol and drugs lost consciousness and passed out in his bathroom. After 10 hours, he was found immobilized stuporous on his bathroom floor and brought by emergency service to the emergency room. He was found to have compartment syndrome of the right lower limb and underwent emergency fasciotomy of three compartments of the thigh and four compartments of the leg.

Isolated Injury to Prepuce After Motor Vehicle Collision.

A four-year-old male restrained passenger in the rear seat was in a motor vehicle collision. He had pain and swelling in the tip of the penis with the inability to micturate. The patient on evaluation had an isolated injury of the prepuce.

Idiopathic Pneumatosis of Small Bowel and Bladder.

An 81-year-old woman presented with multiple episodes of loose bowel movements. CT scan of the abdomen and pelvis revealed pneumatosis cystoides intestinalis and asymptomatic emphysematous cystitis. The patient had an extensive workup with no obvious identified pathology to explain diffuse pneumatosis of the small bowel and bladder.

Rectus Sheath Hematoma Causing Bladder Outlet Obstruction.

A 93-year-old woman on Coumadin with history of atrial fibrillation and chronic obstructive pulmonary disease (COPD) presented with urinary retention for one day. Computed tomography (CT) of abdomen and pelvis demonstrated grade 3 rectus sheath hematoma (RSH), with the hematoma dissecting between the transversalis fascia and muscle into the prevesical space. The large-sized hematoma caused compression at the bladder outflow tract causing urinary retention.

Fulminant Ischemic Pancolitis: A Severe Variant of Ischemic Colitis.

We present the case of a 75-year-old female with abdominal pain and a sudden change in mental status. She progressed rapidly with manifestations of acidosis without episodes of bloody bowel movements or diarrhea. The patient underwent emergent exploratory laparotomy, and a diagnosis of fulminant ischemic pancolitis was made with visual confirmation of infarcted colon from cecum to proximal rectum leading to subtotal colectomy and ileostomy.

Transdiaphragmatic-pericardial Hernia: Case Report of an Unusual Condition Managed by Utilization of a Robotic Surgical System.

Transdiaphragmatic hernia via the central tendon in the pericardium is a rare entity. Most often, these hernias are acquired and related to the iatrogenic creation of a transdiaphragmatic-pericardial defect. We would like to present a case of a 62-year-old male who presented with acute chest pain and was diagnosed to have a transdiaphragmatic-pericardial hernia on computed tomography.