Wei Ven Chin, MD MRCP; Mae Jane Khaw, MD MRCP – Gas-forming pyogenic liver abscess (GFLPA) carries a high mortality rate. Early identification of the source of infection in sepsis results in better survival. Bedside point of care ultrasound (POCUS) can be used to help localize a source of infection. A 59-year-old man presented with systemic inflammatory response syndrome (SIRS) and was diagnosed with GFLPA on the initial encounter via clinical assessment and POCUS examination.
Eric Scheier, MD; Benjamin Taragin, MD – Studies of pediatric appendicitis treated conservatively show a considerable rate of recurrence. Point of care ultrasound (POCUS) imaging at our facility is routinely performed for abdominal pain and may be more likely than radiology-performed ultrasound to encounter cases that then self-resolve. We present a case series collected from a POCUS quality assurance review from 2019 through 2022.
Kandria Ledesma, MD; Joseph Kim, MD; Allison Cohen, MD; Nicholas Bielawa, PA-C; Mathew Nelson, DO – Ischemic colitis is the most common form of gastrointestinal ischemia [1]. The diagnosis of ischemic colitis is made by clinical data and computed tomography (CT) imaging of the abdomen and pelvis [1]. While colonoscopy is considered the gold standard for diagnosis, this is not performed in the emergency department (ED) [2]. Few studies have been performed to describe the sonographic findings of ischemic colitis using point of care ultrasound (POCUS). We report a case that highlights the sonographic findings of ischemic colitis in a patient who had two separate visits to the ED, showcasing the utility of POCUS in making this diagnosis.
Eric Scheier, MD – Studies have demonstrated the high sensitivity and specificity of pediatric emergency department (PED) point of care ultrasound (POCUS) in the evaluation of testicular torsion. Rarely, testicular torsion may present with intact blood flow. Here, we present a case series of four children with testicular torsion confirmed intraoperatively, who had intact blood flow on POCUS.
Jenniffer Katherine Guío Rodríguez, MD; Jenny del Pilar Rico Mendoza, MD; Elkin René Barrios Peralta, MD – Using point of care ultrasound (POCUS) to evaluate patients with syncope in the emergency department facilitates the timely diagnosis of life-threatening pathologies. Case: A 56-year-old woman presented to the emergency department of a hospital in Bogotá, Colombia, for a syncopal episode. Vital signs, physical examination, electrocardiogram, and routine laboratory tests were normal. Cardiac POCUS was performed, which identified an echogenic mass located in the left atrium, measuring 35x28mm, which in left atrial systole appeared to occupy the entire chamber.
R. Haridian Sosa Barrios; V. Burguera Vion; E. Casillas Sagrado; D. Villa Hurtado; S. Jiménez Álvaro; I. Martín Capón; M. Fernández Lucas; Maite E. Rivera Gorrín – Renal artery stenosis of the kidney allograft is an infrequent finding, as is mechanical kinking of the artery. The right renal artery’s greater length in comparison to the vein, limited space within the iliac fossa, and post-operative shifting in graft components all increase the likelihood of kinking. Renal artery stenosis and kinking can either coexist or kinking can result in stenosis. Nevertheless, since both these abnormalities can be corrected with timely treatment, early diagnosis is crucial to prevent permanent to the renal allograft.
Angelina Voronina; Nachele Aurelien; Edward Bergin; Paula Roy-Burman – Paracentesis is a procedure routinely performed at the bedside in the evaluation and management of ascites. While point of care ultrasound (POCUS) assistance during paracentesis is known to reduce the risk of procedure-related complications, intraprocedural POCUS to overcome commonly occurring issues, such as obstructed flow through the centesis catheter, remain poorly described.
David Jerome; Matthew Stacey; Joseph Newbigging – An 81-year-old man presented to urgent care for assessment of an area of erythema and tenderness on his right thigh after recent travel to Belize. Point of care ultrasound (POCUS) revealed a hyperechoic structure with acoustic shadowing in the subcutaneous tissue. Colour Doppler assessment of the structure produced a twinkle artifact. The structure was removed and pathology identified the object as a Dermatobia hominis larva (human botfly).
Takaaki Mori, MD, MRCPCH, MSc; Sung Shin Teng, MBBS, MRCPCH, FAMS – A previously healthy, 4-year-old boy visited our emergency department due to chest pain after a fall from a skate scooter. Physical examination revealed tenderness over the sternal body. Point of care ultrasound (POCUS) of the sternum demonstrated a discontinuation of a hyperechoic structure of the sternal cortex, suggesting a sternal fracture.
David J. McCreary, MBBS MRCPCH PgC US; Alex White, MBBS – A 2-year-old girl presented to the Paediatric Emergency Department following an unwitnessed injury to her left arm while playing at nursery limiting further examination. On assessment she was reluctant to use her left arm and further examination was difficult. In cases of unwitnessed and undifferentiated elbow injuries point of care ultrasound (POCUS) can be used to evaluate for elbow joint effusion, fracture, or radial head subluxation, also known as nursemaid’s elbow.