Question 1 : A patient presents with RIF pain. Discuss the ultrasound technique for this complaint and US findings of appendicitis and Crohn’s disease

Possible Differential diagnoses include Appendicitis Terminal ileitis Intussusception Crohn’s disease Abscesses Mesenteric adenitis Diverticulitis Caecal carcinoma Infectious colitis Hernias (inguinal/femoral/surgical/ventral) Vascular causes (AAA/ iliac aneurysms) Testicular (tortion/ epididimitis) Gyne/obstetric (ectopic, hydrosalpinx/ovarian cyst rupture/ endometriosis) Biliary colic Renal colic, UTI Psoas abscess Herpes Zoster Ascites/ free fluid/ pancreatitis US technique Examine the patient first in the Read more about Question 1 : A patient presents with RIF pain. Discuss the ultrasound technique for this complaint and US findings of appendicitis and Crohn’s disease[…]

Lung ultrasound for pulmonary embolism

Images Edward Christian Text Genevieve Carbonatto A 65 year old man presents to the Emergency Department with a 1 week of cough and left sided chest pain. The pain is intermittent but worse at night when lying down. It is not exacerbated by activity. The patient  is experiencing shortness of breath when the chest pain Read more about Lung ultrasound for pulmonary embolism[…]

Pitfall : Retroverted uterus

Images and text Genevieve Carbonatto A 32 year old lady presents with PV spotting. She is thought to be 8 weeks pregnant. A point of care transabdominal scan is performed in the Emergency Department. This is her transverse scan of the pelvis The bladder is empty. There appears to be no gestational sac This is Read more about Pitfall : Retroverted uterus[…]

Giant retroperitoneal haematoma

Images and text Genevieve Carbonatto An 88 year old woman presents to ED from a nursing home hypotensive. She has recently been admitted to hospital with pneumonia, CCF, AF and bilateral below knee DVT’s. She was discharged on warfarin. She is generally feeling tired, has abdominal pain and is vomiting coffee ground vomit. On examination, Read more about Giant retroperitoneal haematoma[…]

Dilated CBD, pancreatic carcinoma

Images and text Kezia Mansfield and Olga Gaitsgory An 84 year old woman presents to the  emergency department with a week of nausea, anorexia and general malaise, without abdominal pain. She has a past history insulin dependent diabetes, GORD and osteoarthritis. It was noted on examination that she was moderately jaundiced, with a non tender abdomen. Read more about Dilated CBD, pancreatic carcinoma[…]

Acute vs Chronic Hydronephrosis

Text and Images Oli Gaitsgory and Kezia Mansfield Clinical presentation: A 70 year old man with a background of metastatic colorectal cancer presents to the Emergency Department. He has a known large pelvic mass causing L ureteric obstruction, with a L ureteric stent in situ. He presents with 1 week of confusion and fevers. His blood Read more about Acute vs Chronic Hydronephrosis[…]

Eyeballing LV function : Test yourself

Gollum, Wellington Airport, Weta Studios Estimating ejection fraction (EF) can be done by eyeballing LV contraction on ECHO. This requires some skill and expertise. A very basic assessment in the Emergency department requires a parasternal long axis (PLAX), a parasternal short axis (PSAX) and a 4 chamber view (4CV). What are we looking for ? Read more about Eyeballing LV function : Test yourself[…]

Cholecystitis : Full house

Images Victoria Bond Text Genevieve Carbonatto A 42 year old lady presents to the Emergency Department with RUQ pain. She has had episodes of cholelithiasis in the past. She is mildly tender in her RUQ. A point of care ultrasound is performed along with the history and examination. This is her ultrasound Note the GB Read more about Cholecystitis : Full house[…]