Small Bowel Obstruction Key Concepts Small bowel obstruction (SBO) is a common clinical condition accounting for 2% of patients presenting to the emergency department with abdominal pain, leading to an estimated 300,000 hospitalizations annually in the United States. The most…
Key Concepts Acute pancreatitis represents a wide spectrum of disease, ranging from mild to severe life-threatening disease with a mortality rate as high as 30%. The most common causes of acute pancreatitis are gallstones and chronic alcohol consumption. Acute pancreatitis…
Key Concepts Viral Hepatitis The clinical presentation of viral hepatitis is highly variable, and many cases may be asymptomatic, particularly in children. Hepatitis A is transmitted through oral fecal spread, whereas hepatitis B and C are spread through parenteral or…
Key Concepts Dysphagia Dysphagia can be caused by obstructive lesions (e.g., esophageal neoplasm), motility disorders (e.g., achalasia), or neuromuscular disorders that can be vascular (e.g., cerebral vascular accident), immunologic (e.g., myasthenia gravis, multiple sclerosis [MS]), infectious (e.g., botulism), or metabolic…
Key Concepts Hallmarks of deep venous thrombosis (DVT) include unilateral limb pain and swelling, though these findings can be subtle and nonspecific. Patients with low pretest probability (PTP) can have DVT ruled out in the ED with a negative D-dimer…
Key Concepts Acute arterial occlusion is a limb-threatening emergency requiring early anticoagulation and Fogarty catheter embolectomy. The clinical diagnosis is based on some variant of the five Ps: pain, pallor, pulselessness, paresthesias, and paralysis. Confirmatory tests are unnecessary and increase…
Key Concepts A ruptured abdominal aortic aneurysm (AAA) should be considered in any patient with otherwise unexplained abdominal or back pain. The complete triad of pain, hypotension, and a pulsatile mass may not be present. In a patient with an…
Key Concepts Aortic dissection most commonly presents as abrupt, sharp, severe pain maximally intense at onset in the chest or back. There may be various seemingly unconnected associated symptoms due to altered blood pressure or insufficiency of disparate vascular beds.…
Key Concepts Elevated blood pressure with or without associated symptoms is exceedingly common in the emergency department (ED). A true hypertensive emergency is defined by the presence of acute target organ damage (TOD) and is distinct from other clinical presentations.…
Key Concepts Infectious endocarditis (IE) is more often caused by Staphylococcus species than Streptococcus, and increasingly occurs in elderly, recently hospitalized patients, those with prosthetic valves and intra-cardiac devices, and in patients who inject opioids. IE should be considered in…