While nonocclusive mesenteric ischemia (NOMI) has been reported in a significant percentage of adults who were resuscitated after cardiac arrest, it is rare in children. This report presents the first known Japanese case of pediatric NOMI after return of spontaneous circulation following cardiac arrest. A 16-month-old boy experienced cardiac arrest due to asphyxiation from foreign bodies in the airway. After receiving 10 doses of adrenaline, with a maximum arrest time of 95 minutes, the patient achieved return of spontaneous circulation. However, 40 hours after onset, the patient developed NOMI, resulting in refractory hypotensive shock with decreased blood pressure, distended abdomen, and increased intravesical pressure. The patient was successfully rescued with two laparotomies and was discharged. Although NOMI is uncommon in children, appropriate treatment can be lifesaving.
Citations
Citations to this article as recorded by
Intestinal necrosis due to nonocclusive mesenteric ischemia in a child with Mycoplasma pneumoniae pneumonia: a case report Xuejing Li, Tingting Lin, Ken Chen, Danli Wang, Jiahui Yu, Lei Wu, Lanfang Tang BMC Infectious Diseases.2025;[Epub] CrossRef
Bentazone is a widely used herbicide considered a moderate hazard. Fatalities associated with its use are rare, with deaths reported only after intake of ≥200 mL. In some studies, bentazone intoxication is accompanied by generalized rigidity. Malignant hyperthermia is a pharmacogenetic disease that presents a hypermetabolic response to anesthetic gases or depolarizing muscle relaxants due to calcium channel dysfunction. The classic symptoms of malignant hyperthermia include hyperthermia and muscle rigidity. We report the case of a 65-year-old man who died 4 hours after presenting to the emergency department after ingesting approximately 75 mL of Basagran M60 (bentazone 33.6%, 25.2 g). This is the smallest dose (364 mg/kg) reported in a fatal case to date. Electrocardiogram changes, including QRS widening and QT prolongation, were present, and hypocalcemia was confirmed. We propose that bentazone intoxication causes patient deterioration by a mechanism similar to that of malignant hyperthermia.
In a case of contrast media-induced anaphylactic shock managed with epinephrine, a 57-year-old male patient developed lactic acidosis without cardiogenic shock or global hypoperfusion, highlighting epinephrine’s potential to trigger lactic acidosis. Despite the previous management of similar reactions with antihistamines and corticosteroids, this case required intensive care unit admission and emergency intervention for alarmingly high lactate level. The rapid resolution of acidosis following epinephrine discontinuation underscores the need for careful monitoring and consideration of alternative vasopressor strategies in severe anaphylaxis, illustrating the complex relationship between epinephrine’s metabolic effects and anaphylaxis-induced tissue hypoperfusion.
Citations
Citations to this article as recorded by
Lactate in Anaphylaxis: 100 Years On Elena Borzova, Bernhard F. Gibbs Sports Medicine.2025; 55(9): 2091. CrossRef
This case concerns a 59-year-old male patient with a medical history of hypertension, chronic renal insufficiency, and autoimmune pancreatitis secondary to immunoglobulin G4 (IgG4)-related disease, who was on chronic steroid treatment. The patient experienced acute onset of lightheadedness, a tingling sensation in both hands, and jaw tightness after masturbating. He was found to have type A aortic dissection. This is the first case of its kind to document an atypical, painless aortic dissection presentation in a patient with IgG4-related disease. This piece explores how the fibroinflammatory sequelae of IgG4-related disease can result in aortic manifestations and discusses the importance of considering a broader differential including aortic syndrome when encountering patients presenting with atypical symptoms
Airway foreign body (FB) removal is challenging and a time-limited and lifesaving procedure. Herein, we report successful removal of a life-threatening FB in the subglottic airway in an infant by physically forcing the FB further into the distal airway to block one lung and save the other. A 12-month-old boy presented in the emergency department with choking. Upon arrival, his mental status was alert. However, respiratory failure rapidly progressed and respiratory arrest occurred. We attempted to move the FB distally by pushing the endotracheal tube as deep as possible and inserting the stylet further. The patient was successfully resuscitated, and bronchoscopic FB removal was performed. The patient was discharged without respiratory or neurologic sequelae.
Citations
Citations to this article as recorded by
Do We Actually Help Choking Children? The Quality of Evidence on the Effectiveness and Safety of First Aid Rescue Manoeuvres: A Narrative Review Jakub R. Bieliński, Riley Huntley, Cody L. Dunne, Dariusz Timler, Klaudiusz Nadolny, Filip Jaskiewicz Medicina.2024; 60(11): 1827. CrossRef
Hyperbaric oxygen therapy (HBOT) has garnered significant attention as a therapeutic modality with potential benefits across a variety of medical conditions, ranging from wound healing and ischemic conditions to neurologic disorders and radiation-induced tissue damage. HBOT involves the administration of 100% oxygen at higher-than-atmospheric pressures, which increases the amount of oxygen dissolved in body fluids and tissues. Those elevated oxygen levels are proposed to facilitate tissue repair, reduce inflammation, and promote angiogenesis. This case report presents a compelling instance of the usefulness of HBOT in promoting skin perfusion and healing following peripheral tissue injury caused by administration of inotropic and vasopressor agents to a septic shock patient.
Citations
Citations to this article as recorded by
Hyperbaric oxygen therapy in inflammatory bowel disease: Current evidence and research progress Zhe-Heng Li, Wen-Song Ge World Chinese Journal of Digestology.2026; 34(3): 236. CrossRef
Hyperbaric oxygen therapy in managing fingertip injury after the thenar and V—Y flap procedure: A case series Mendy Hatibie Oley, Maximillian Christian Oley, Albertus Djarot Noersasongko, Yudhaputra Setiadhi, Vania Sukarno, Muhammad Faruk International Journal of Surgery Case Reports.2025;[Epub] CrossRef
In a prehospital setting, the narrow therapeutic window of epinephrine necessitates its cautious administration to avoid anaphylaxis. In this case, a 46-year-old man presented severe anaphylactic symptoms. Following the standard protocol, the emergency medical technician (EMT) administered intramuscular epinephrine; however, symptoms persisted. Under the oversight of the emergency medical services (EMS) medical director, an additional intravenous bolus of epinephrine was administered, unfortunately leading to atrial fibrillation. This case underscores the potential risks of intravenous epinephrine, which is not typically recommended for anaphylaxis without continuous monitoring. Since 2019, Korea has initiated a pilot program to expand the EMT scope of practice, which gives them the authority to administer epinephrine for anaphylaxis. The ultimate decision regarding epinephrine use for anaphylaxis, emphasizing patient safety, rests with the EMS medical director. Proper training for EMTs, coupled with the EMS medical director’s comprehensive knowledge and meticulous protocol adherence, can ensure patient safety and optimal outcomes.
Citations
Citations to this article as recorded by
Oral Cephalosporin-Induced Anaphylaxis Presenting With Severe Tachycardia: A Case of Microdosed Epinephrine Over Standard Protocols Anupama R S, Rohan Krishna NK, Sathya Lakshmi Mekkoth, N Sridhara, Shivaraj K Cureus.2025;[Epub] CrossRef
Atrial Fibrillation in a Young Healthy Adult: A Case Report From Anaphylaxis to Arrhythmia Louis A Enchill, Eugene K Yeboah, Sergei Klokov, Ogheneakpobor E Ubogun, Suchith B Suresh Cureus.2025;[Epub] CrossRef
Symptomatic urolithiasis is a common cause of emergency department visits, with noncontrast computed tomography considered the imaging gold standard. According to the current guidelines, point-of-care ultrasound (POCUS) is limited to evaluating hydronephrosis as a secondary sign of acute ureteral stones. However, the use of POCUS to detect ureteral stones may lead to decreased radiation to the patient and a more rapid diagnosis. This case series describes 10 patients with suspected symptomatic urolithiasis who were diagnosed accurately by emergency physicians using POCUS to detect obstructive ureteral stones. In three of the cases, POCUS significantly changed the patient’s management. This article also describes the proper techniques for the emergency physician to learn to master POCUS for ureteral stone detection.
Citations
Citations to this article as recorded by
Correlation between expulsion rate of distal ureteric calculus up to 8mm in size with CRP level, WBC count and Neutrophil percentage Dr. Amit Singh, Dr. Ashok Yadav, Dr. Anish Ahemad Dinkum Journal of Medical Innovations.2024; 3(5): 358. CrossRef
Extracorporeal membrane oxygenation (ECMO) has been increasingly employed in the emergency department for patients with a potentially reversible cause of cardiac arrest. We present the case of a young female patient with an in-hospital cardiac arrest who was found to have severe right heart strain on point-of-care ultrasound (POCUS), suggesting a massive pulmonary embolism. Rapid bedside diagnosis using ultrasound expedited bedside cannulation and initiation of ECMO as a bridge to surgical thrombectomy, and ultimately the patient survived with full neurologic function. With its ready availability and increasing acceptance by consultants, POCUS should be incorporated into cardiac arrest algorithms as the standard of care to rule in thrombotic and obstructive causes of cardiac arrest.
Citations
Citations to this article as recorded by
Artificial intelligence-based evaluation of carotid artery compressibility via point-of-care ultrasound in determining the return of spontaneous circulation during cardiopulmonary resuscitation Subin Park, Hee Yoon, Soo Yeon Kang, Ik Joon Jo, Sejin Heo, Hansol Chang, Jong Eun Park, Guntak Lee, Taerim Kim, Sung Yeon Hwang, Soyoung Park, Myung Jin Chung Resuscitation.2024; 202: 110302. CrossRef
Highly malignant electroencephalogram (EEG) patterns (including suppressed background and burst suppression) refer to a poor neurological outcome in cardiac arrest patients, but some of those patients may show a good neurological outcome. This is the first report that details the reason for their uncommon survival despite highly malignant EEG patterns after cardiac arrest. The brain cortical activities in very elderly patients (who are vulnerable to the usual sedative doses) showed a suppressed background and burst suppression but resulting in a good neurological outcome. The mean suppression rates from their EEGs were 100% and 68.4%, respectively, and a normal pattern was completely restored after the sedatives had affected their brain waves for 12 hours. It was speculated that sedatives given at an ordinary dose may negatively affect the brain’s cortical activity in elderly patients who demonstrate a good neurological outcome. When appropriate doses of sedatives are used, highly malignant EEG patterns in very elderly patients should be carefully interpreted for early neuroprognostication.
Citations
Citations to this article as recorded by
Interactions Between Depression, Alcohol Intake, and Smoking on the Risk of Acute Coronary Syndrome Eujene Jung, Hyun Ho Ryu, Young Ju Cho, Byeong Jo Chun Psychiatry Investigation.2024; 21(1): 1. CrossRef
In emergency departments, many drugs, fluids, and materials for medical examinations and treatment are typically administered to patients intravenously. One of the most common complications of the intravenous bolus or infusion of drugs is extravasation injuries. These injuries may cause certain morbidities for the patient, increase the cost of treatment, and prolong hospital stays. At the same time, these injuries also carry medicolegal risks for health personnel. Furosemide is a potent diuretic that is commonly used in emergency departments for volume overload conditions. To the best of our knowledge, there have been no cases reported in the literature of furosemide-induced extravasation injury with subsequent compartment syndrome that has required surgical intervention. Presented herein is the case of a 70-year-old female patient who was administered intravenous furosemide from the dorsum of the left hand and whose extravasation injury progressed to compartment syndrome requiring an emergency fasciotomy.
We report a case of an 83-year-old male patient with massive tuberculous pleural effusion. Percutaneous drainage was performed following a diagnosis of tuberculous pleurisy. Fifteen minutes into the procedure, the patient’s condition deteriorated suddenly, necessitating mechanical ventilatory support. A chest radiograph performed after intubation showed partial collapse of the affected lung with pneumothorax. Despite sufficient air drainage and lung expansion, the patient’s oxygen demand remained high. A repeat chest radiograph performed 30 minutes after chest tube insertion revealed partial expansion of the affected lung and severe infiltrative patterns in the unaffected lung, suggesting contralateral reexpansion pulmonary edema.
Out-of-hospital cardiac arrest in pregnancy is extremely rare. In this case report, a 43-year-old female patient at 24.0 weeks of gestation collapsed outside her home after cardiac arrest. The paramedics performed cardiopulmonary resuscitation with defibrillation for ventricular fibrillation. Spontaneous circulation was achieved after 19 minutes. The fetus was stable during postarrest care. The patient exhibited high blood pressure with seizure-like symptoms for 2 days afterwards, which resolved with magnesium sulfate. She gradually recovered and returned to her daily activities while on treatment with beta blockers for cardiomyopathy and premature ventricular contractions until delivery. At 37.2 weeks of gestation, she underwent elective Cesarean section under spinal anesthesia. The baby weighed 2.55 kg and did not present with any complications. Here, we report a case of successful full-term delivery in a patient who underwent cardiopulmonary resuscitation for sudden cardiac arrest during the second trimester of pregnancy.
Citations
Citations to this article as recorded by
Maternal Cardiac Arrest in Severe Preeclampsia at 34 Weeks: Successful Resuscitation, Perimortem Cesarean Section, and Dual Survival Pankaj Deori, Habib Md R Karim, Sekhar J Sharma, Himangshu Malakar, Suvan K Chowdhury , Sristi Kumari, Daisy Hazarika, Namitha M Lal, Rohit Sasidharan Cureus.2025;[Epub] CrossRef
Low back pain is one of the most common presenting complaints in the emergency department, and a plain radiograph of the lumbar spine is usually the first diagnostic modality. The ivory vertebra sign refers to the radiological appearance of a smooth, white ivory-like appearance of the affected single vertebra or multiple vertebral bodies. It is sometimes the initial radiologic manifestation of a variety of infectious, neoplastic, or metabolic diseases. Subsequent computerized tomography and magnetic resonance imaging are generally indicated to characterize the details, as well as look for other occult lesions. It is therefore important for emergency physicians to be aware of this, as this will aid in the appropriate evaluation and rapid diagnosis of the underlying disorder.
Citations
Citations to this article as recorded by
Ivory Vertebra Phenomenon as a Sign of Metastatic Dissemination in Pancreatobiliary Neoplasia: A Case Report and Literature Review Madalena Santos, Mafalda Pinho, Joana Gouveia, Mariana Sousa, Lígia Peixoto Cureus.2025;[Epub] CrossRef
The use of extracts from the hawthorn plant as cardiovascular agents dates back to the 1st century; recently, they have also been made available online as weight loss aids. Herein, we present a case of intentional intoxication with hawthorn root extract (HRE) in an adult patient that resulted in death. A 20-year-old female patient, who was clinically diagnosed with depression, developed hypotension, bradycardia, and depressed consciousness after ingestion of this extract. An electrocardiogram recorded a sinus arrest with a slow nodal rhythm, which rapidly deteriorated, leading to cardiac arrest. This case report illustrates the potentially fatal consequences of HRE for which the constituents have not yet been characterized. All physicians, especially those in the emergency department, should be aware of the dangerous, even potentially fatal interactions of HRE with prescription medications.
Citations
Citations to this article as recorded by
When herbal supplements cause heart problems: Clinical case report and forensic toxicological analysis Theresa Theuer, Katrin Faber, Lisa Oberli, Thomas Schweingruber, Marie-Alice Fraiture, Nancy Roosens, Adrian Kindler, Alain Rudiger, Roman Leist, Celine Vanhee Toxicology Reports.2026; 16: 102239. CrossRef
Interactions Between Depression, Alcohol Intake, and Smoking on the Risk of Acute Coronary Syndrome Eujene Jung, Hyun Ho Ryu, Young Ju Cho, Byeong Jo Chun Psychiatry Investigation.2024; 21(1): 1. CrossRef
A case report of cardiac glycoside-like intoxication following reported exposure to tejocote Mounir Contreras Cejin, Jason D. Vadhan, Kelsey Martin, Kapil Sharma, Mengchen Cao Medical Reports.2024; 6: 100080. CrossRef
Analysis of Adverse Reactions Associated with the Use of Crataegus-Containing Herbal Products Herman J. Woerdenbag, Melissa Ursidae, Corine Ekhart, Martina Schmidt, Annabella Vitalone, Florence P. A. M. van Hunsel Pharmaceuticals.2024; 17(11): 1490. CrossRef
First
Prev
