COVID-19 associated spontaneous hemorrhagic cholecystitis

Hemorrhagic cholecystitis is a rare disorder associated with considerable morbidity and mortality. The clinical presentation of hemorrhagic cholecystitis is non-specific and imaging findings can be difficult to accurately interpret without a high level of suspicion. Most recent reports of hemorrhagic cholecystitis have been associated with concurrent therapeutic anticoagulation. Here, we report imaging findings of a case of acute, spontaneous hemorrhagic cholecystitis in a 67-year-old male patient admitted for hypoxic respiratory failure secondary to COVID-19 pneumonia. © 2022

Virtual student-transplant patient interactions empower patients and enhance student transplantation knowledge

Presenter: Taylor Coe MD ;Massachusetts General Hospital Background: Exposure to organ transplantation and donation is limited in undergraduate medical education. Additionally, due to the COVID-19 pandemic, transplant patients are increasingly isolated because of their immunosuppressed state. To address this, we paired medical students with transplant recipients or donors for semi-structured, virtual encounters and studied the impact on both students and patients. Methods: Kidney or liver transplant recipients and donors were recruited by their medical team and paired with students for virtual visits via telephone or video-conferencing. Participants were briefed on the purposes and boundaries of the interactions, and a discussion guide focused the conversation on the patient’s personal experience. Separate focus groups were conducted with three groups of students and two groups of patients. The survey responses and focus group discussions were deidentified and analyzed using a constant comparative method. Results: 23 medical students on their surgery clerkship and 15 patients participated in virtual encounters. All encounters lasted more than 30 minutes, with 36% lasting greater than one hour. Students described how the encounters changed their perceptions of transplant-related relationships, including a deeper understanding of how recipients relate to living donors and the families of deceased donors and the multidisciplinary care relationships between patients and providers. Student perceptions of organ donation were also altered, including their ability to counsel patients, willingness to donate and confidence in speaking to friends and patients about organ donation. Patients derived personal benefit from these encounters as a chance to reflect and process their transplant experience, describing them as cathartic and personally illuminating. Additionally, patients appreciated the opportunity to educate students about donation and transplantation, subsequently helping them develop into more compassionate, empathetic physicians. Conclusion: Utilizing virtual non-medical visits between medical students and transplant patients is a feasible, well-received and effective method for students to learn about organ transplantation, donation and the multidisciplinary nature of transplant care. Additionally, these encounters provide an opportunity for patients to process their transplant experience and embrace their role as a teacher. Ultimately, this novel program demonstrates that virtual student-patient interactions are a useful approach to engage patients and a unique way to teach medical students about transplantation and donation principles.