Figure 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 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 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 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 MoreOn April 23, 1986, a 3-year-old girl was brought to our institution after a 1.5-ton truck ran over her left lower limb. She suffered a floating knee injury with fractures at the supracondylar level of the femur and middle third of the tibia. An above the knee and near-total amputation was sustained at the supracondylar […]
Read MoreA 51-year-old right-handed man presented to the clinic with a 3-year history of worsening swelling of the left wrist associated with pain and numbness in the fingers. His medical history included type 2 diabetes and human immunodeficiency virus infection; he was adherent to an antiretroviral therapy regimen and his CD4 cell count was 357 per […]
Read MoreA 19-year-old woman (gravida 0, para 0) presented to the emergency department with severe abdominal pain that had started 9 hours earlier. On examination, the abdomen was soft and nondistended without guarding, but rebound tenderness was present in the suprapubic and left iliac fossa regions. A urine test for beta human chorionic gonadotropin was negative. […]
Read MoreCase Presentation A 38-year-old male, a chronic alcoholic who committed an attempt of suicide, was presented to the emergency department of the University Hospital “St. George”- Plovdiv. On initial presentation, the patient was in a prone position, awake, oriented, and hemodynamically stable (blood pressure 140/90 mmHg and heart rate 92 bpm). The external examination revealed […]
Read MoreA 19-year-old man presented to the dermatology clinic with a 3-month history of an enlarging ulcer on the dorsal aspect of the right hand and multiple tender subcutaneous nodules on the right forearm and elbow. Five months earlier, the patient had traveled to Ecuador, where he had worked at an organic produce farm. On physical […]
Read MorePatient is a 30-year-old male who presented to the ED from the field with extensive facial trauma secondary to a firework blast to the face. His airway was secured immediately upon arrival due to an altered mental status with a GCS of 3 and poor oxygenation. A glidescope intubation with a size 7 tube was […]
Read MoreA 6-year-old female patient with a low socioeconomic status, with an incomplete immunization schedule according to her age (only one dose of pentavalent vaccine and rotavirus had been applied). She began her clinical presentation 11 days prior to hospital admission, after having a sharp slice of wood on her right arm. She went to the […]
Read More