Hopefully you've checked out part 1, part 2, and part 3. Though ileocolic is the most common type - small bowel-small bowel occur as well. Generally they present with similar symptoms (intermittent colicky pain etc,.). They are also diagnosed similarly with ultrasound being the best study, but CTs can show them too. They are more likely to reduce spontaneously if: They are [...]
Hopefully you've checked out part 1 and part 2 - Let's now shift the focus to the treatment. Nonoperative reduction OK, so you made the diagnosis of ileocolic intussusception - so let's fix this problem. The current standard is nonoperative reduction using pneumatic pressure - the Air Contrast Enema. Some facilities use hydrostatic pressure with barium, normal saline or water soluble [...]
Welcome to part 2 of the intussusception series - check out part 1 here. Let's suppose that you work in a place without 24 hour ultrasound, and you get a toddler that is having intermittent episodes of belly pain. You think she has intussusception. You recall that there are some X-ray findings that can help make you feel better about [...]
Ah, intussusception, the Mississippi (at least in terms of spelling) of medicine. For my latest series I thought I'd look into this common diagnosis in the Peds ED. Is it really that common? Well, it is the #1 cause of intestinal obstruction in children 6 months to 36 months. So, its got that going for it, which is nice. 60% [...]
A 14 month old male stuck a fork in an outlet. It made a big spark and he cried. The wall looks a little toasted, but the boy appears to be doing fine. Mom "just wanted him checked out." Is he OK? Yes - If he looks good in the ED then he'll look good later for the most part. [...]
Many of you might be familiar with 3D printers. According to the scion of knowledge Wikipedia "additive manufacturing or 3D printing is a process of making a three-dimensional solid object of virtually any shape from a digital model. 3D printing is achieved using an additive process, where successive layers of material are laid down in different shapes. 3D printing is also considered distinct from traditional machining techniques, which mostly rely [...]
Kids accidentally ingest medicines. In the Peds ED we are rightfully worried about opiates, BP meds, acetaminophen, and diabetes drugs (among many others) but we shouldn't overlook the potential dangers that come with iron ingestion. Let's take a look shall we? Why do humans need iron? Iron is a part of lots and lots of proteins and enzymes especially hemoglobin, [...]
Welcome to a new recurring feature on the PEM Blog. I'll be highlighting some straightforward clinical cases and reviewing diagnosis and treatment. [divider scroll_text=""] The mother of 3 year old girl is concerned because she saw blood in her underpants. The patient complains of no pain. Examination shows the following This is what the mom saw What [...]
The Case A 14 year old male was tackled while playing football and has pain along the angle of his jaw. He can open and close his mouth without pain. He does have pain to palpation along the body of the mandible adjacent to 2nd/3rd left inferior molars. There are no loose teeth and he feels that they are in normal [...]
Here's a follow up to my earlier post on QR codes. What if there was a way to gain useful feedback on urine samples without going to the doctor's office? Pixie Scientific is developing diapers with embedded urinalysis strips that link to an iPhone app. In a recent article on Gizmodo developers stated that "each smart diaper has a QR code [...]
