Pulmonary hypertension in a child

  Images Juan Chiang A 13 year old girl presents to the Emergency Department after a syncopal event at school. This was not associated with prior chest pain or SOB. This is her first syncopal event. ECG Chest Xray A point of care ultrasound is performed. The following clip shows her PLAX view followed by Read more about Pulmonary hypertension in a child[…]

VSD in a 3 month old

Images Hanaho Imamura, text Genevieve Carbonatto A 3 month old girl is brought into the Emergency department. Her parents state that she has become more unsettled recently, not feeding as well and  appearing to be more short of breath with feeding. She is not settling with feeding, requiring to be fed every 2 hours and Read more about VSD in a 3 month old[…]

Coarctation of the aorta in a neonate

Images Chris Harrington, text Genevieve Carbonatto A 11 day old presents to the Emergency department in acute respiratory distress. His mother states that his SOB has increased markedly over the past 24 hours.  While on the way to hospital he has an episode of tachypnea  cyanosis and not breathing for 5 seconds. He has been Read more about Coarctation of the aorta in a neonate[…]

Intussusception in a 6 year old

Images and text Genevieve Carbonatto A 6 year old girl presents to the Emergency department with dysuria and abdominal pain. The symptoms have been  intermittent until the morning of the presentation when the symptoms were constant and also associated with a left sided limp. She is unwilling to weight bear on her left leg. She Read more about Intussusception in a 6 year old[…]

Internal hernia

Ultrasound images Sanjay Ramrakha. Text Genevieve Carbonatto and Katherine Bennett The Emergency department gets a pre arrival call from a GP. He is sending in a sick looking 10 year old who has been vomiting overnight. He thinks this may be gastro On arrival a pale, mottled, barely responsive child is wheeled into the resuscitation Read more about Internal hernia[…]

Imperforate hymen : Haematometrocolpus

Images by Genevieve Carbonatto  This 11 year old presented with severe abdominal pain. On examination she had a distended tender abdomen.  She was initially thought to be in urinary retention. She was catheterised but had very little urine in her bladder. Her ultrasound shows a distended uterus from  haematometrocolpus due to an imperforate hymen. The Read more about Imperforate hymen : Haematometrocolpus[…]

2 year old, ruptured appendix

Images Genevieve Carbonatto Severely unwell febrile 2 year old presenting with abdominal tenderness and rebound Features of appendicitis Thickened appendix Faecolith Free fluid in RLQ indicating rupture incompressible ” creeping fat” hyperechoic mesentary Incompressible appendix. a complex structure abuts the appendix ? abscess . Appendicolith appears just at the end of the clip with free Read more about 2 year old, ruptured appendix[…]

Gallstones in 4 month old

Images and text by Genevieve Carbonatto and Jeremy Fry Name changed to protect patient confidentiality. Sam was 4 months old when he was brought by his parents to the ED. He presented with acute onset of crying and distress which awoke him from sleep. He was grunting and drawing his knees up to his chest. He Read more about Gallstones in 4 month old[…]