Clinical Cases

  • Autosomal dominant polycystic disease

    Autosomal dominant polycystic disease

    CASE SUMMARY A 57-year old woman was taken to a community hospital for care following a motor…

  • Autosomal dominant polycystic disease (ADPD)

    Summary:  A 57-year old woman was taken to a community hospital for care following a motor vehicle collision.

  • Nonsurgical pneumoperitoneum

    Summary:  A 56-year-old Caucasian female with multiple falls and ataxia was admitted for exacerbation of multiple sclerosis and placed on high dose steroid therapy. The patient’s past medical history was significant for polycystic kidney disease and a kidney transplant, for which she took cyclosporine as an immunosuppressant. There was no recent history of surgery or endoscopic examination.

    Within 12 hours of admission, the patients developed severe hypoxemia requiring mechanical ventilation. Standard ventilatory therapy was inadequate and the patient required high levels of positive end-expiratory pressure with peak airway pressures exceeding 50 mmHg. On the fifth day of admission, the patient developed crepitus over the anterior chest wall. Chest x-ray confirmed bilateral pneumothoraces, pneumomediastinum, and subcutaneous emphysema (Figure 1). Bilateral chest tubes were placed. The patient’s clinical signs began to deteriorate with radiographic signs of acute respiratory distress syndrome (ARDS).

    The following day, a physical exam revealed abdominal distention, with no rigidity. Pneumoperitoneum and an unknown source of sepsis prompted an exploratory laparotomy. Upon entering the peritoneum a large egress of air was noted. There was no evidence of intraperitoneal fluid. Exploration of all of the hollow organs showed no signs of perforation or signs of inflammatory reaction. Examination of the diaphragm showed no obvious defects. The patient tolerated the procedure well and was returned to the intensive care unit. Over the following days, the patient’s clinical course declined until elective termination of care secondary to cardiorespiratory collapse.

  • Photon-counting digital mammography detects rare breast lesion

    Photon-counting digital mammography detects rare breast lesion

    Adenomyoepithelioma Findings   Screening mammography revealed a 1-cm focal asymmetry with a…

  • Celiac disease

    Celiac disease

    Summary A 41-year-old white woman presented with a 1-day history of fever to 102.6˚F and tenderness…

  • Iatrogenic pulmonary artery pseudoaneurysm

    Iatrogenic pulmonary artery pseudoaneurysm

    Summary An 84-year–old woman presented with hemoptysis during an elective right-heart…

  • Pancreatitis associated with splenic artery pseudoaneurysms

    Summary A 46-year-old man presented with a 5-month history of abdominal pain that had become…

  • Primary epiploic appendagitis

    Summary Case 1: A 41-year-old man presented with sharp pain localized to the left upper quadrant…

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