Emergency Medicine and Surgery

Acquired haemophilia is a rare autoimmune condition with an annual incidence of one per million. It is more common in the elderly and is associated with the presence of anti-factor VIII IgG antibodies. Most cases are idiopathic but there are also known associations with malignancy, other autoimmune diseases and drug interactions. As aging itself is not a cause of changes...
(Vol 15 p 4-6, Emergency Medicine and Surgery; Haematology: 14 May 2015)
The case of a young man who presented in the emergency department complaining of sudden onset of cough, fever and haemoptysis is described. Chest ultrasonography rapidly diagnosed an acute respiratory distress syndrome picture, which was confirmed on computed tomography. This allowed prompt management of the patient. Blood cultures yielded Streptococcus pyogenes and...
(Vol 14 p 1-5, Critical care; Emergency medicine; Infection and immunity: 29 March 2014)
With the advent of modern techniques including the widespread use of gastric endoscopy, benign gastric lesions are diagnosed more frequently and can be characterized by means of biopsy. Of all gastric tumours, less than 5% are benign and 90% of these are polyps. The treatment options for benign gastric tumours vary from mucosal resection to limited gastric...
(Vol 13 p 17-22, Emergency medicine and surgery; Gastroenterology; General surgery: 26 April 2013)
A patient was admitted and diagnosed as acute pancreatitis of obscure aetiology. Laboratory investigations and radiological studies failed to reveal the underlying cause. A worm was pulled out of the nasogastric tube by the patient. In a modern society and in developed hospital settings, is it possible that we are missing, or underdiagnosing what we once regarded as...
(Vol 12 p 49-55, Emergency Medicine and Surgery; Gastroenterology; General Surgery: 23 October 2012)
We present a case of an uncommon viral myopericarditis in a 19-year-old man with chest pain. Electrocardiographic abnormalities and elevated cardiac enzymes were present. Myopericarditis of unknown origin was diagnosed following cardiac magnetic resonance imaging. During admission, the patient developed tonsillitis and serology tests confirmed an acute Epstein–Barr viral...
(Vol 12 p 40-43, Cardiology; Emergency Medicine: 10 August 2012)
We report a case of an 85-year-old lady with repeated hospital admissions secondary to presumed urosepsis with blood cultures positive for Escherichia coli. Chest radiographs during the final admission had changed dramatically and computed tomography scan of the aorta confirmed mycotic thoracic aortic aneurysm.
(Vol 12 p 27-31, Emergency Medicine; Infection and immunity; Vascular surgery: 6 August 2012)
This is a rare case of freezing of the corneas in extremely cold conditions. A large proportion of the worlds’ population inhabits areas where frequent exposure to subzero temperatures is common. Early recognition, appropriate referral and treatment of frozen corneas may help to minimize any potential complications that can develop later on, as well as reduce pain and...
(Vol 12 p 6-9, Emergency Medicine and Surgery; Occupational Health; Ophthalmology: 19 January 2012)
Chronic hypokalaemia often remains a diagnostic challenge, especially in young women without hypertension. A concealed diuretic abuse should be suspected, especially in young women with eating disorders. This case describes a woman with chronic hypokalaemia in whom a thorough medical history and proper laboratory tests were essential to early and accurate diagnosis.
(Vol 11 p 53-55, Acute Medicine; Nephrology; Psychiatry: 18 July 2011)
We describe a case of very late stent thrombosis (ST) in a patient presenting with hematemesis while taking aspirin and oral anticoagulation therapy (OAC). This case shows that the management of patients with an indication for OAC who undergo percutaneous coronary intervention with drug-eluting stent (DES) implantation is challenging because of the need to balance the...
(Vol 11 p 48-52, Cardiology; Emergency Medicine; Gastroenterology; Haematology; Histopathology; Pathology: 18 July 2011)
Static winging of the scapula is a rare diagnosis. It may be caused by pathology of the scapula or the chest wall. Solitary osteochondroma of the scapula is one of the rare causes and may present an initial diagnostic difficulty. We present a case of an 18-year-old man who presented with non-specific pain in his right shoulder following a fall. Initial examinations and...
(Vol 10 p 86-88, Emergency Medicine; Trauma; Orthopaedics: 22 October 2010)
Lateral abdominal wall haematoma following blunt trauma can be a life-threatening condition and requires prompt diagnosis and treatment. We present the imaging findings and treatment modalities used for a young man presenting to the emergency department with abdominal pain and bruising.
(Vol 9 p 33-37, Accident and Emergency Medicine and Surgery (including Trauma), Radiology, Vascular Surgery: 17 November 2009)
Compartment syndrome is a potentially limb- and life-threatening clinical entity resulting from elevated intra-compartmental pressures. A high clinical suspicion is paramount in diagnosis since full recovery is time-sensitive. We present a unique case of chronic myelomonocytic leukemia-induced (CMML) compartment syndrome which illustrates the importance of quick diagnosis...
(Vol 8 p 31-34, Accident and Emergency Medicine and Surgery (including Trauma); Orthopaedic Surgery; Vascular Surgery: 1 October 2008)
We report the case of a healthy 44-year-old gentleman who sustained bilateral patellar tendon rupture while jumping on a trampoline. Although this kind of injury has been reported in the literature previously, it is extremely rare in healthy individuals. We believe it is the first documented case associated with the use of a trampoline.
(Vol 7 p 70-74, Accident and emergency medicine and surgery (including trauma); Orthopaedic surgery: 20 November 2007)
A 60-year-old woman attended A&E following an unwitnessed ‘collapse query cause’. Over 4 months she recalled involuntary movement of her eyes and head to the left and, on one occasion, complete rotation of her body. She had subtle neurological signs. Imaging identified the cause of these adversive seizures.
(Vol 7 p 61-63, Accident and Emergency Medicine and Surgery (including Trauma); Neurology; Neuroradiology; Neurosurgery: 13 June 2007)
Hereditary angioedema (HAE) is an infrequent disorder characterised by abnormalities in the levels and/or function of complement C1 esterase inhibitor (C1 INH). Clinical manifestations of HAE are due to recurrent episodic swelling of the subcutaneous or submucosal tissue. When swelling involves the gastrointestinal mucosa, patients may present with nausea, vomiting,...
(Vol 7 p 29-35, Accident and Emergency Medicine, Surgery (including Trauma): 28 March 2007)
Penetrating traumatic laryngeal–pharyngeal injuries are relatively rare and traumatic injuries to the epiglottis are extremely rare. The incidence varies between countries. Most of these cases are dealt with by ear, nose and throat specialists, and trauma surgeons deal with such trauma when concomitant injury is present. In our institution laryngeal–pharyngeal trauma...
(Vol 6 p 8-10, Emergency medicine, Trauma: 25 May 2006)
Musculoskeletal injuries following low voltage electrocution are extremely rare. We present the case of a 54-year-old gentleman who had an accident while working with 240-volt live wires. The absence of any associated trauma should not rule out the presence of scapular fractures in such cases.
(Vol 4 p 10-12, Orthopaedics, Emergency medicine: May 2004)
Hydatid disease, caused by the cestode Echinococcus, is common in Mediterranean regions. Depending on its size, an intact cyst may be ‘silent’ or may compress adjacent organs, causing symptoms. The cystic stage of Echinococcus granulosus is commonly located in the liver, which frequently results in a long symptom-free period [1]. Rupture of a hydatid cyst commonly gives...
(Vol 2 p 17-20, Emergency Medicine: April 2002)


Frank Cross
Consultant Vascular and General Surgeon
The London Clinic, UK


Neil Barnes
Consultant Physician
Barts Health NHS Trust, London, UK
Ali Jawad
Professor of Rheumatology
Barts Health NHS Trust, London, UK

Join our newsletter

* indicates required

view counter
view counter
view counter
view counter
view counter