Pitfall: Painless ruptured ectopic pregnancy

Images Mark Russel, text Genevieve Carbonatto A 35 year old women  presents to the Emergency Department for a review of a possible ectopic pregnancy. She is 7 weeks pregnant by dates. An outpatient scan was performed the day before for painless vaginal bleeding . It did not show an intrauterine gestational sac. A complex left Read more about Pitfall: Painless ruptured ectopic pregnancy[…]

Assessment of Pericardial effusion

Text and images Genevieve Carbonatto Pericardial effusions are commonplace. A pericardial effusion is not synonomous with pericardial tamponade. Pericardial tamponade is a medical emergency characterised by shock and associated with a number of clinical criteria including Becks triad (hypotension, decreased heart sounds, elevated JVP) pulsus paradoxus ( > 12 mmHg drop in BP on inspiration), Read more about Assessment of Pericardial effusion[…]

Common pitfall – Stones in the gall bladder – Adenomyomatosis

Images Ying Ying Lee, text Genevieve Carbonatto A 44 year old man presents with acute abdominal pain. His pain is mainly epigastric but you are concerned about the possibility of cholecystitis, cholelithiasis or choledocholithiasis. While scanning the patient in the supine position, you think you can see stones in the GB. They do not appear Read more about Common pitfall – Stones in the gall bladder – Adenomyomatosis[…]

Trauma – fractured ribs undiagnosed on chest Xray

Images Roger Burrell, text Genevieve Carbonatto A 54 year old man presents one week after a fall. He is complaining of severe left lower rib pain especially with respiration. His chest Xray looking for rib fractures does not show any fractures, nor is there a pneumothorax or a pleural effusion. On palpation he is tender Read more about Trauma – fractured ribs undiagnosed on chest Xray[…]

Submassive Pulmonary Embolism – a critical care ECHO skill?

Images and Text Genevieve Carbonatto If we consider that there are different levels of expertise in the acquisition of knowledge of echocardiography for the Critical Care Physician, the recognition of acute cor pulmonale which we see with  submassive pulmonary embolus has been described as a Level II skill, level I being the minimal level of Read more about Submassive Pulmonary Embolism – a critical care ECHO skill?[…]

B lines – how best to see them

Thankyou Justin Bowra for this post. Ultrasound for interstitial lung disease and pulmonary oedema Key points • US lets you ‘see the crackles’. The US appearance of crepitations / crackles is called ‘B lines’ (formerly rockets, comets) • Just like crackles, B lines are found in pulmonary oedema and also in pulmonary fibrosis • B Read more about B lines – how best to see them[…]