Retropharyngeal Abscess With Severe Airway Compromise Following Anterior Cervical Spine Surgery: A Case Report.

Anterior cervical corpectomy, discectomy, and fusion are common surgical management options for symptomatic cervical radiculopathy and myelopathy. While these procedures are common and well-tolerated, postoperative complications span from mild dysphasia to airway compromise secondary to retropharyngeal or peri-cervical space abscess. These critical patients require robust airway management, which may entail a multidisciplinary approach or airway management in the operating room.

Small Bowel in Vagina: A Case for Pelvic Exams.

Vaginal cuff dehiscence with small bowel evisceration is a serious but uncommon postoperative complication of total laparoscopic hysterectomies. The severity of surgical site dehiscence can range from small, partial to full-thickness wound dehiscence, manifesting with acute abdominal pain, vaginal bleeding, or discharge, and is often precipitated by sexual intercourse. While imaging, including a pelvic ultrasound and computed tomography (CT), may help in undifferentiated acute abdominal pain, vaginal cuff dehiscence remains a clinical diagnosis found on physical exam.

Native Mitral Valve Infective Endocarditis From Flossing: A Case Report and Emergency Department Management.

Infective endocarditis (IE) is a rare, elusive disease, carrying a 10%-30% mortality. Requiring a high index of suspicion, IE affects damaged native valves and prosthetic valves. While there are a number of inherent risk factors that predispose patients to IE, dental work in the preceding six weeks is often a culprit of disease, colonizing damaged native mitral valves with  species.

Postpartum Bilateral Subdural Hematomas: A Case Report.

Postpartum headache is a common emergency department (ED) complaint in women following delivery. Though the majority of these headaches are due to primary headache disorders or postdural puncture headaches, life-threatening complications can occur. Both postpartum pre-eclampsia can occur as well as hypercoagulable and vascular disorders including stroke, venous sinus thrombosis (VST), and reversible cerebral vasoconstrictive syndrome.

Pediatric Cirrhotic Variceal Bleed Precipitating Diabetic Ketoacidosis.

Cirrhosis and its associated complications such, as variceal bleeding, are rare in children, carrying significant morbidity and mortality. Leading causes of cirrhosis in the pediatric population include infection, neoplasm, and metabolic and genetic disorders, which is in contrast to the adult population. Acute gastrointestinal bleeding, as seen with variceal bleeding, has been previously associated with diabetic ketoacidosis through a multifactorial relationship.

A Tale From the Early Stone Age: Pediatric Ureterolithiasis as Appendicitis Mimic - A Case Report and Management Overview.

Ureterolithiasis in the pediatric population is uncommon and may mimic acute abdomen. While the majority of small stones pass spontaneously, complications may ultimately warrant surgical intervention. As the majority of affected patients have a predisposing condition, targeted therapy with close and consistent follow-up may prevent recurrence, emphasizing timely diagnosis.

Seizure-Associated Takotsubo Cardiomyopathy.

Takotsubo cardiomyopathy (TCOM) is a syndrome characterized by acute systolic dysfunction that can mimic acute coronary syndrome (ACS), usually incited by physical or emotional stress. However, acute neurological dysfunction, including seizures, has been recently described as an additional risk factor for the development of TCOM. This specific case report reviews the pathophysiology of TCOM and its management.

Guanfacine toxic ingestion with subsequent cardiogenic pulmonary edema.

Guanfacine is a central alpha-2 agonist often prescribed for Attention-deficit hyperactive disorder as well as tic disorder, with a usual dose of 1-4 mg per day. Due to its sympatholytic mechanism of action, Guanfacine can cause autonomic instability and hypotension. It can additionally cause cardiac dysfunction to include symptomatic bradycardias and contractility suppression.

A Hard Case to Swallow: Crucifix Esophageal Foreign Body in a Nonverbal Patient.

Delayed presentation of esophageal foreign bodies places patients at high risk for esophageal perforation and infection. In nonverbal patients as well as children and adults with other concomitant illnesses, it is important to consider a broad differential diagnosis for presentations with upper respiratory complaints. The authors present a case of a nonverbal, elderly woman who presented after several days of mild, dry cough and was ultimately found to have a large esophageal foreign body that had been present for an unclear amount of time.

Hide and Seek: Intermittent Preexcitation Wolff-Parkinson-White Syndrome Case Report and Management Overview.

Wolff-Parkinson-White (WPW) syndrome is an uncommon form of cardiac preexcitation due to an underlying structural accessory pathway, which may lead to potentially lethal arrhythmias. Classic electrocardiogram (ECG) findings of WPW include short PR interval, slurred upstroke of the QRS complex, and prolonged QRS duration. However, in intermittent preexcitation, a rare variant in contrast to continuous preexcitation, these findings are not always present, thus masking a diagnosis of WPW syndrome.

An Atypical Presentation of Spontaneous Coronary Artery Dissection.

Spontaneous coronary artery dissection is a rare form of acute coronary syndrome (ACS) resulting from tears in the coronary vessel lumen leading to myocardial ischemia. Historically, younger to middle-aged Caucasian females without traditional risk factors for ACS are most commonly affected. The authors present the case of an African American female with numerous traditional ACS risk factors who presented to the emergency department with chest pain.

Necrotic Fibroid Mimicking Ovarian Torsion in a Second Trimester of Pregnancy.

Uterine fibroids are incredibly common, benign smooth muscle tumors which range in severity of symptoms from asymptomatic to debilitating. While pain is frequently a symptom, degeneration and necrosis of uterine fibroids can rarely present as acute abdomen. The authors present the case of a pregnant female at 19 weeks' gestation, whose clinical and radiographic presentation mimicked that of ovarian torsion, ultimately requiring exploratory laparoscopy for definitive diagnosis.

Subdural Empyema in an Immunocompetent Active Duty Soldier: A Case Report.

Intracranial subdural empyema is a rare clinical entity with incidence estimates of 0.1 per 100,000 people. The condition is most often the sequela of a primary infection elsewhere and carries a high morbidity and mortality.

Adult Small Bowel Intussusception and Resolution Captured on Pelvic Ultrasound.

While abdominal pain is one of the leading causes for ED visits, intestinal intussusception is an infrequent etiology in adults. We present the case of a 22-year-old woman with five days of left lower quadrant abdominal pain with initial workup investigating for a genitourinary source utilizing pelvic ultrasound which revealed small bowel-small bowel intussusception. During the study, resolution of the intussusception correlated temporally with the patient's symptoms.

Pulsatile Mass: Ruptured Common Femoral Artery Pseudoaneurysm with Active Extravasation.

Delayed rupture of a pseudoaneurysm represents an extremely rare and life-threatening complication of endovascular, radiographic, and cardiac procedures. We discuss a case of a 69-year-old man with delayed rupture of a known left common femoral artery pseudoaneurysm, highlighting the importance of rapid recognition, to include the use of point of care ultrasound, if available. Computed tomographic angiography allows for better anatomic characterization and aids in operative planning, which is the mainstay of treatment.

Cardiac Tamponade in an 18-year-old Male with Undiagnosed Systemic Lupus Erythematosus.

Systemic lupus erythematosus (SLE) is a multisystem, autoimmune condition of extremely variable presentation and prognosis. While pericardial effusion is a common disease sequela, subsequent tamponade is a rare, potentially fatal complication. We present the case of an 18-year-old, previously healthy male who presented to the emergency department with a chief complaint of abdominal pain and hematochezia.

Reduce torques and stick the landing: limb posture during landing in toads.

A controlled landing, where an animal does not crash or topple, requires enough stability to allow muscles to effectively dissipate mechanical energy. Toads (Rhinella marina) are exemplary models for understanding the mechanics and motor control of landing given their ability to land consistently during bouts of continuous hopping. Previous studies in anurans have shown that ground reaction forces (GRFs) during landing are significantly higher compared with takeoff and can potentially impart large torques about the center of mass (COM), destabilizing the body at impact.