In December 2012, a 35-year-old Berber man, without any past medical history, presented to our Emergency Department with incomplete amputation of his penis after being assaulted by an unknown actor who cut off his penis using a shaving blade 3cm distal from the mons pubis. A physical examination did not show any other remarkable finding. […]
Read MoreThe hand of an infant girl who was born at 24 weeks of gestation and weighed 540 g (1 lb 3 oz) at birth is shown. The infant was found to have jejunal atresia on the sixth day of life and underwent a small-bowel resection with primary anastomosis. She recovered from the surgical procedure, was […]
Read MoreFigure 1 A 30-year-old man with the acquired immunodeficiency syndrome (CD4 cell count, 14 per cubic millimeter) presented with a six-month history of enlarging facial lesions. The lesions had not responded to a six-week course of oral acyclovir (800 mg five times a day). The patient had no history of herpes or any other opportunistic infections. […]
Read MoreFigure 1 A 54-year-old man was struck by lightning and was initially stuporous. The emergency medical team found him conscious and in sinus rhythm, with normal vital signs and numbness and paresthesia of the left shoulder, flank, and leg. On his arrival at the emergency department, he felt well, and an examination revealed a fern-leaf pattern […]
Read MoreFigure 1 A 45-year-old man with autosomal dominant polycystic kidney disease presented to the urology clinic for consideration of bilateral nephrectomy as treatment for severe abdominal pain and distention. Magnetic resonance imaging of the abdomen (Panel A) demonstrated profound enlargement and complete replacement of the liver (top arrow) and kidneys (lower arrows) by cysts. A bilateral […]
Read MoreA 46-year-old farmer presented to the emergency department 3 hours after his penis was bitten by a snake while he was urinating in an open field. The snake was identified by the patient as “gunas,” which is the local name of the Levantine viper (Macrovipera lebetina). Physical examination revealed stable vital signs, with a grossly […]
Read MoreA 60-year-old man presented to clinic with concerns about the cosmetic results of previous surgery. During childhood he had had an alkali burn of the esophagus that resulted in complete esophageal stenosis. In 1962, when he was 7 years of age, an esophagogastric bypass was performed by means of subcutaneous colonic interposition that involved the […]
Read MoreA 48-year-old man presented with a 2-month history of abdominal discomfort and lethargy. Physical examination revealed pallor, and results from laboratory studies showed mild anemia (hemoglobin level, 9.2 g per deciliter [normal, 12 to 15 g per deciliter]). Colonoscopy revealed a proglottid from a tapeworm in the rectosigmoid colon, and gastroduodenoscopy identified its location in […]
Read MoreA 71-year-old man presented to the emergency department with a 2-day history of fever and excruciating pain in his left hand that had developed 12 hours after eating raw seafood. He had a history of type 2 diabetes mellitus and hypertension and was undergoing hemodialysis for end-stage renal disease. At the time of presentation, hemorrhagic […]
Read MoreAmputation below the knee in the men’s operating theater at St. Thomas’s Hospital, London, late eighteenth/early nineteenth century (artist unknown). A Petit’s screw tourniquet is in use, and the patient is held on a firm table in a semi-seated position by assistants, perhaps to promote fainting more readily. The surgeon adopts a tour de maître […]
Read MoreIgor Khomenko,1Vitalii Shapovalov,2Ievgen Tsema,1,3Georgii Makarov,1Roman Palytsia,1Ievgen Zavodovskyi,3Ivan Ishchenko,1Andrii Dinets,3 and Vladimir Mishalov3 The patient was a 22-year-old male soldier who received severe injury in the battlefield area next to the village of Krasnohorivka in the Donetsk oblast of Ukraine. On December 16, 2016, the patient received multifragmental combined with thoraco-abdominal injuries as a result of shelling from […]
Read MoreIf you visit the Gordon Museum at Guy’s Hospital in London, you’ll see a small bladder stone—no bigger than 3 centimetres across. Besides the fact that it has been sliced open to reveal concentric circles within, it is entirely unremarkable in appearance. Yet, this tiny stone was the source of enormous pain for 53-year-old Stephen […]
Read MoreAn 81-year-old man with hypertension presented to the emergency department with pain and swelling of the left thigh and lower leg that had developed during the previous several hours. He had no history of recent surgery or trauma and no known personal or family history of clotting disorders. The left lower leg was tender, cold, […]
Read MoreA 48-year-old man presented to the ophthalmology clinic with a 1-week history of pain, double vision, and blurred vision in his left eye. The symptoms started after he was struck in the eye by a retracting rubber bungee cord that he was using to secure goods onto a motorcycle. Physical examination revealed bruising of the […]
Read MoreA 60 year-old man sustained severe facial injury after a car accident. He was conscious at admission and had a laceration on his right fronto-temporal area. On ophthalmologic examination, the right eye was normal with 20/20 vision and only had echymosis on right lower lid. Visual acuity of the left eye was no light perception […]
Read MoreA 26-year-old previously healthy man presented to the emergency department with a 3-day history of fever, dry cough, and nonpruritic rash. A physical examination was notable for crackles on the left side of the chest and a macular, targetoid rash on his hands and feet, including the palms and soles. A radiograph of the chest […]
Read MoreA 52-year-old man presented to the emergency department with painless, bloody tears from both eyes. The bleeding had begun spontaneously approximately 2 hours earlier, had lasted a few minutes, and had recurred just before presentation. He reported no orbital, ocular, or nasal trauma and no history of bloody tears, epistaxis, gingival bleeding, or easy bruising. […]
Read MoreA 17-year-old boy presented to the emergency department with pain and swelling in his jaw 2 hours after an e-cigarette exploded during use. The patient was in a hemodynamically stable condition and had no respiratory distress. He had a circular puncture to the chin, extensive lacerations in his mouth, multiple disrupted lower incisors, and bony […]
Read More