Case Report: The Value of Vigilance and Iterative Evaluations with an Uncooperative Patient in the Emergency Department

Discussion A Flexible and Vigilant Approach: The initial presenting information from EMS could have led to anchoring bias. A flexible approach led to new information, which led to interative testing. Iterative physical examination. There are cases, as seen in this case report, where the physical examination was unreliable or even impossible. Iterative evaluations ultimately led to appropriate imaging and accurate diagnosis. Iterative testing: In the case presented, the radiologist reported a finding as being present on a prior CXR; however, given the patient’s clinical presentation, further imaging studies were necessary

Celiac Artery Aneurysm: A Rare Cause of Abdominal Pain

Celiac artery aneurysm is a very rare vascular lesion accounting for only 5.1% of all splanchnic artery aneurysms. Etiology for celiac artery aneurysm includes, but not limited to, infectious diseases, atherosclerosis, trauma, congenital conditions such as median arcuate ligament syndrome and iatrogenic causes. Etiology for abdominal pain is extensive. Patients should be evaluated for both intra-abdominal and extra-abdominal causes for pain, as presentations of a different pathophysiology vary widely. CT scan has become a mainstay part of the work for abdominal pain in the Emergency department, and often elicit pathologies that would otherwise be missed on blood work and other imaging modalities. Although rare, celiac artery aneurysm carries a high mortality rate if ruptured and therefore surgical repair is definitive care plan. Surgical repair maybe either via endovascular approach or via open surgical repair of the aneurysm preferably via prosthetic grafts

Case Report: Ocular Capsaicin Toxicity with Chemosis from Jalapeño Peppers

A 42 year old female presented to an Emergency Department (ED) with the abrupt onset of left eye pain, tearing and eye redness of a one hour duration. Her symptoms were due to ocular toxicity from contact exposure to capsicum, through preparation of Jalapeño peppers