Incidental Finding of Inferior Vena Cava Atresia Presenting with Deep Venous Thrombosis following Physical Exertion.

Inferior vena cava atresia (IVCA) is a rare but well described vascular anomaly. It is a rare risk factor for deep venous thrombosis (DVT), found in approximately 5% of cases of unprovoked lower extremity (LE) DVT in patients <30 years of age. Affected population is in the early thirties, predominantly male, often with a history of major physical exertion and presents with extensive or bilateral DVTs.

Impact of Asthma on the Severity of Serious Pneumococcal Disease.

We recently reported an increased risk of serious pneumococcal disease (SPD) in asthmatics. Little is known about the impact of asthma status on the severity of SPD. We compared the severity of serious pneumococcal disease (SPD) between patients with asthma and those without asthma.

Two cases of upper-extremity swelling: Paget-Schroetter syndrome and non-Hodgkin lymphoma.

Two adolescents presented to our emergency department with isolated, acute onset upper-extremity swelling. In their initial emergency department evaluations, both patients were found to have a deep venous thrombosis. Despite their similar presentations, the etiologies of their deep venous thrombosis were very different.

Acute deep vein thrombus due to May-Thurner syndrome.

A 63-year-old white woman with a history of hypertension, hyperlipidemia, hypothyroidism, and transient ischemic attack, on Premarin, presented with a 2-week history of worsening edema and pain on the left side of the lower extremity associated with purplish discoloration and decreased temperature after a prolonged car travel. Physical examination revealed 2+ edema from the midthigh to the toes associated with purpuric discoloration. All arterial pulses were 4+.

Effect of anticoagulant and antiplatelet therapy in patients with spontaneous intra-cerebral hemorrhage: Does medication use predict worse outcome?

Objectives: To assess the impact of anticoagulants and antiplatelet agents on the severity and outcome of spontaneous non-traumatic intra-cerebral hemorrhage (ICH). To evaluate associations between reversal of anticoagulation and mortality/morbidity in these patients.

Methods: Data was collected on a consecutive cohort of adults presenting with ICH to an academic Emergency Department over a 3-year period starting January 2006.

Acute vomiting and mental status changes: a case of acute intraventricular haemorrhage from an optic chiasm tumour.

In this article, we describe a 5- year-old girl who presented to an emergency department with 1 day of vomiting, mental status changes and decreased activity. Imaging studies revealed a mass in the optic chiasm which had haemorrhaged into her ventricles causing acute hydrocephalus. This case highlights the diligence and broad differential one must have when evaluating a child presenting with a sole complaint of vomiting.