Browse
Submit Data
Databases
API
Help

Dataset Information

0 Views

0 Connections

0 Citations

0 Reanalyses

0 Downloads

Omics score: 0

Ureteral Stone Mimics Appendicitis: A Point-of-care Ultrasound Case Report.

ABSTRACT:

Introduction

Abdominal pain is a common complaint in the emergency department. Point-of-care ultrasound (POCUS) is a rapid modality to evaluate for the etiology.

Case report

A teenage male presented with symptoms concerning for appendicitis. POCUS revealed a non-peristalsing, non-compressible, tubular structure containing an echogenic stone. This was determined to be a ureteral stone within a dilated ureter, not appendicitis.

Conclusion

We propose a syndromic sonographic approach to right lower quadrant pain (RLQ) that includes the gallbladder, right kidney, bladder, and right adnexa, in addition to RLQ landmarks. This case emphasizes the value of such an approach to avoid diagnostic error.

SUBMITTER: Shavor C

PROVIDER: S-EPMC7676809 | biostudies-literature | 2020 Nov

REPOSITORIES: biostudies-literature

ACCESS DATA

Json Xml

Publications

Ureteral Stone Mimics Appendicitis: A Point-of-care Ultrasound Case Report.

Shavor Cindy C Pagenhardt Justine J Sun YuanYuan Y Kraft Clara C End Bradley B Minardi Joseph J

Clinical practice and cases in emergency medicine 20201101 4

<h4>Introduction</h4>Abdominal pain is a common complaint in the emergency department. Point-of-care ultrasound (POCUS) is a rapid modality to evaluate for the etiology.<h4>Case report</h4>A teenage male presented with symptoms concerning for appendicitis. POCUS revealed a non-peristalsing, non-compressible, tubular structure containing an echogenic stone. This was determined to be a ureteral stone within a dilated ureter, not appendicitis.<h4>Conclusion</h4>We propose a syndromic sonographic ap ...[more]

PMID: 33217271

Similar Datasets

Appendicitis Diagnosed by Emergency Physician Performed Point-of-Care Transvaginal Ultrasound: Case Series.

Project description:Lower abdominal pain in females of reproductive age continues to be a diagnostic dilemma for the emergency physician (EP). Point-of-care ultrasound (US) allows for rapid, accurate, and safe evaluation of abdominal and pelvic pain in both the pregnant and non-pregnant patient. We present 3 cases of females presenting with right lower quadrant and adnexal tenderness where transvaginal ultrasonography revealed acute appendicitis. The discussion focuses on the use of EP- performed transvaginal US in gynecologic and intra-abdominal pathology and discusses the use of a staged approach to evaluation using US and computed tomography, as indicated.

| S-EPMC3789895 | biostudies-literature

Point-of-Care Ultrasound to Diagnose Molar Pregnancy: A Case Report.

Project description:Molar pregnancies are rare complications that can have potentially devastating effects, including neoplastic disease. Given the potential for malignant conversion, proper diagnosis of molar pregnancy is crucial. This case demonstrates the utility of point-of-care ultrasound (POCUS) for molar pregnancy in the emergency department (ED). The patient was a 43-year-old G8P1, 8-week-pregnant female who presented to the emergency department for evaluation of abdominal pain. Her physical exam was notable for abdominal tenderness and a normal pelvic exam. Evaluation included basic labs with a quantitative serum beta human chorionic gonadotropin (βhCG), urinalysis, and vaginal wet mount. Her results were unremarkable with the exception of elevated βhCG to 83,000 mIU/mL. A transabdominal POCUS was performed which showed a heterogeneous mass with several anechoic areas, concerning for a molar pregnancy. Patient was seen by obstetrics and gynecology (OB-GYN) and a transvaginal ultrasound showed similar findings. Dilation and evacuation were performed approximately 5 hours after initial diagnosis on POCUS. Use of POCUS was crucial for expedient diagnosis and appropriate treatment in this patient, highlighting the utility of POCUS for pregnant patients in the ED.TopicsMolar pregnancy, gestational trophoblastic disease, hydatidiform mole, point of care ultrasound.

| S-EPMC10332747 | biostudies-literature

Accuracy of Point-of-care Ultrasound in Diagnosing Acute Appendicitis During Pregnancy.

Project description:IntroductionAcute appendicitis is the most common non-obstetrical surgical emergency in pregnancy. Ultrasound is the imaging tool of choice, but its use is complicated due to anatomical changes during pregnancy and depends on the clinician's expertise. In this study, our aim was to investigate the diagnostic accuracy of point-of-care ultrasound (POCUS) in suspected appendicitis in pregnant women.MethodsWe conducted a retrospective analysis of all pregnant women undergoing POCUS for suspected appendicitis between June 2010-June 2020 in a tertiary emergency department. The primary outcome was to establish sensitivity, specificity, and likelihood ratios of POCUS in diagnosing acute appendicitis, overall and for each trimester. We used histology of the appendix as the reference standard in case of surgery. If appendectomy was not performed, the clinical course until childbirth was used to rule out appendicitis. If the patients underwent magnetic resonance imaging (MRI), we compared readings to POCUS.ResultsA total of 61 women were included in the study, of whom 34 (55.7%) underwent appendectomy and in 30 (49.2%) an acute appendicitis was histopathologically confirmed. Sensitivity of POCUS was 66.7% (confidence interval [CI] 95% 47.1-82.7), specificity 96.8% (CI 95% 83.3-99.9), and positive likelihood ratio 20.7. Performance of POCUS was comparable in all trimesters, with highest sensitivity in the first trimester (72.7%). The MRI reading showed a sensitivity of 84.6% and a specificity of 100%. In the four negative appendectomies a MRI was not performed.ConclusionPoint-of-care ultrasound showed a high specificity and positive likelihood ratio in diagnosing acute appendicitis in pregnant women in all trimesters with suspected appendicitis. In negative (or inconclusive) cases further imaging as MRI could be helpful to avoid negative appendectomy.

| S-EPMC9683773 | biostudies-literature

Infected Urachal Cyst Masquerading as Acute Appendicitis on Point-of-care Ultrasound.

Project description:Case presentationA seven-year-old male presented to the pediatric emergency department with one day of abdominal pain. His physical exam was significant for rebound, guarding, and tenderness in the right lower quadrant, and his labs demonstrated a leukocytosis. Both a point-of-care ultrasound and radiology-performed ultrasound were concerning for acute appendicitis with a periappendiceal abscess, but on emergent laparoscopy the patient was found to have an infected urachal cyst.DiscussionInfected urachal remnants are a rare but important cause of pediatric abdominal pain. In this case, inflammation surrounding the patient's midline urachal cyst triggered a serositis that involved the appendix and pulled the cyst to the right. This created a clinical and radiologic presentation similar to appendicitis. This atypical presentation of an already rare anomaly highlights the importance of maintaining a broad differential during the work-up of pediatric abdominal pain.

| S-EPMC9197745 | biostudies-literature

Paradoxical venous air embolism detected with point-of-care ultrasound: a case report.

Project description:Venous air embolism (VAE) is an uncommon event consistent in the entrainment of air from any communication between the environment and the venous vasculature that could occur during central venous catheter (CVC) manipulation, and might trigger circulatory shock within minutes depending on the amount of air embolized. We present a case of a critical care patient who presented sudden clinical hemodynamic deterioration after the removal of central venous catheter. Hemodynamic evaluation with point-of-care ultrasound (POCUS) showed bubbles in both right and left heart cavities wherewith air embolism facilitated by heart septal defect was suspected. Therefore, the patient was reintubated, supported with vasopressors and a new CVC was inserted to proceed with air aspiration. Shortly after, the patient's hemodynamic status improved in terms of vital signs stabilization. 6 h after the event with optimal perfusion markers and diminished sedation, the patient showed left hemiparesis therefore a cerebral magnetic resonance (MRI) was also performed showing hyperintensity in the right precentral gyrus, so ischemic stroke without hemorrhagic transformation diagnosis was made, because of paradoxical embolism. This case report demonstrates the value of POCUS application as a diagnostic tool in the hemodynamically unstable patient.

| S-EPMC9116074 | biostudies-literature

Laparoscopic removal of a giant middle ureteral stone: A case report and review of literature.

Project description:Giant ureteral calculi stones defined as larger than 5 cm in length or circumference. Although many giant ureteral stones have been reported, the laparoscopic removal of these stones is rare. A 45-year-old male patient presented to our clinic with right flank pain and discomfort from 6 months ago. Abdominopelvic computed tomographic scan showed a giant left middle ureteral stone. On the first stage laparoscopic ureter lithotomy was performed with 3 ports and the stone was extracted from 12 mm port successfully. We used transperitoneal laparoscopic approach in the full lateral decubitus position. three trocars were placed: one camera 11-mm port was placed at the level of the umbilicus on the lateral border of the rectus muscle, a 5-mm port was placed in the midline below the umbilicus, and a 12-mm port was at the superior border of the rectus muscle. The extracted stone size was 6.5*1.7 cm with 33 gm in weight. Due to the advantages of laparoscopic ureter lithotomy in giant ureteral stones and its feasibility to perform in a single session, we could suggest this minimally invasive treatment as a first choice in this group of patients.

| S-EPMC7593261 | biostudies-literature

Necrotizing fasciitis following gastrostomy tube placement, detected by point-of-care ultrasound, case report.

Project description:IntroductionNecrotizing fasciitis is a recognized rare complication of gastrostomy tube replacement, but if it occurs and is not discovered early, a lethal outcome is possible.Case presentationWe present a woman in her 80s who was known to have chronic atrial fibrillation with ischemic heart disease. She was fed through percutaneous endoscopic gastrostomy after brain injury. Erythema was observed around the stoma of the gastrostomy tube, which was later removed, and erythema extended to the left anterior abdomen. The patient was diagnosed with cellulitis. Point-of-care ultrasound examination suspected necrotizing fasciitis and, confirmed later by computerized tomography of the abdomen. The case was managed surgically.DiscussionPatients with a high clinical suspicion of necrotizing fasciitis should undergo early surgical debridement with antibiotic administration. Necrotizing fasciitis starts with a clinical picture indistinguishable from other skin infections, such as cellulitis, and imaging modalities are important for confirmation and early diagnosis. We present a case of necrotizing fasciitis after gastrostomy tube replacement for which point-of-care ultrasound played a pivotal role in confirming the diagnosis early.ConclusionPoint-of-care ultrasound is a useful adjunct tool for clinical evaluation and assessment in diagnosing early critically ill patients with life-threatening necrotizing infections.

| S-EPMC10563042 | biostudies-literature

A Case Report on Distinguishing Emphysematous Pyelitis and Pyelonephritis on Point-of-care Ultrasound.

Project description:IntroductionPoint-of-care ultrasound (POCUS) in the emergency department (ED) is being performed with increasing frequency. The objective of this study was to demonstrate how utilization of POCUS can help the emergency physician recognize emphysematous pyelitis (EP) and emphysematous pyelonephritis (EPN).Case reportA 60-year-old female presented to the ED with normal vital signs and intermittent left-sided flank pain that radiated to her groin. She also had a history of obstructive nephrolithiasis. Within 20 minutes of arrival she became febrile (101.2°Fahrenheit), tachycardic (114 beats per minute), tachypneic (21 breaths per minute), and had a blood pressure of 114/82 millimeters mercury. POCUS was conducted revealing heterogeneous artifact with "dirty shadowing" within the renal pelvis, which was strongly suggestive of air. The emergency physician ordered a computed tomography (CT) to confirm the suspicion for EP and started the patient on broad-spectrum antibiotics. The CT showed a 1.3-centimeter calculus and hydronephrosis with foci of air. The patient received intravenous antibiotics and had an emergent nephrostomy tube placed. Urine cultures tested positive for pan-sensitive Escherichia Coli. Urology was consulted and a repeat CT was obtained to show correct drainage and decreased renal pelvis dilation.ConclusionDistinctly different forms of treatment are used for EP and EPN, despite both having similar pathophysiology. In EP, air can be seen in the renal pelvis on POCUS, as in this case study, which distinguishes it from EPN. In the case of our patient, the use of POCUS was useful to aid in rapid differentiation between EP and EPN.

| S-EPMC7872620 | biostudies-literature

Case Report: Diagnosis of Late Spontaneous Intraocular Lens Dislocation on Point-of-care Ultrasound.

Project description:IntroductionSpontaneous intraocular lens (IOL) dislocation is a rare, but serious, complication following cataract surgery.Case reportWe report a case of patient with a remote history of cataract surgery presenting to the emergency department with monocular blurred vision. Ocular point-of-care ultrasound (POCUS) facilitated diagnosis of a late spontaneous IOL dislocation.DiscussionProsthetic IOL dislocations are being reported with increasing frequency. Prompt recognition of IOL dislocation is essential to prevent secondary complications, including acute angle-closure glaucoma and retinal detachment, which can result in permanent vision loss.ConclusionPoint-of-care ultrasound is a rapid, noninvasive imaging modality for early detection of IOL dislocation to help guide management, improve patient outcomes, and mitigate long-term sequelae.

| S-EPMC8373180 | biostudies-literature

Using Point-of-Care Ultrasound to Expedite Diagnosis of Necrotizing Fasciitis: A Case Report.

Project description:It is vital that all emergency medicine physicians (EP) are able to perform and evaluate point-of-care ultrasound (POCUS) images when a patient's presentation is concerning for necrotizing fasciitis (NF). We present a case of a 69-year-old man who had initially presented to an outside hospital with testicular edema and difficulty urinating. Consultative ultrasound was interpreted as a hydrocele and bilateral scrotal pearls but failed to identify the sonographic hallmarks of NF (subcutaneous thickening, free fluid, and subcutaneous air). Computed tomography (CT) performed several hours later re-demonstrated free air and fascial thickening in the scrotum prompting transfer to our hospital for a higher level of care. Upon arrival to our emergency department (ED) POCUS showed extensive free air with shadowing, thickened subcutaneous tissue, and fluid collections. The patient was immediately evaluated by general surgery and urology, who took him to the operating room for debridement. This case highlights the challenges EP face when assessing patients with NF. Early-on, clinical findings can be subtle and easily missed. POCUS can aid in the diagnosis of this time-dependent disease process. Therefore, it is paramount that EPs look for and recognize characteristic sonographic findings present in NF to improve the accuracy and timeliness of the diagnosis.TopicsPoint-Of-Care Ultrasound, necrotizing fasciitis.

| S-EPMC10332782 | biostudies-literature

OmicsDI is part of the ELIXIR infrastructure

OmicsDI is an Elixir interoperability service. Learn more ›

Tweets

OmicsDI Databases

PRIDE
PeptideAtlas
MassIVE
JPOST Repository
Physiome Model Repository

EGA
EVA
ENA
LINCS
PAXDB
Cell Collective

MetaboLights
Metabolomics Workbench
MetabolomeExpress
GNPS
BioModels
FAIRDOMHub

ArrayExpress
dbGaP
ExpressionAtlas
GEO
NODE

Information

Databases
Help
API
Contact us
Code on GitHub
Terms of use
Submit Data