Aortic dissection presenting as a stroke: a case report.

Aortic dissection is an uncommon yet frequently fatal illness. Patients generally present with tearing chest pain with possible acute hemodynamic instability. Hence, early diagnosis and intervention is critical for survival. This is a case of a 62-year-old male who was transferred to our emergency department for severe chest pain, left side hemiplegia, left hemianopsia, left facial weakness, suggesting a right-sided stroke. A chest computed tomography angiogram showed an extensive circumferential aortic dissection of the intimal layer involving the great vessels. Antiplatelet medications were withheld, nicardipine was started, and the cardiothoracic surgeon was consulted. There was no indication for surgery, and patient was admitted to the intensive care unit. We highlight here the importance of considering an aortic dissection in patients who present with neurological symptoms and an acute history of tearing chest pain.

Diphenhydramine induced acute dystonia: a case report.

Acute dystonia has notably been a challenge in the emergency unit. Drug-induced dystonia is reported in a limited number of cases in the literature. Rarely, diphenhydramine was found to be the culprit. We report the case of a 25-year-old female patient who developed an acute dystonic reaction following the administration of 25 mg of intravenous diphenhydramine as a treatment for an allergic reaction. The patient was given 5 mg diazepam, admitted for monitoring, and discharged home. Diphenhydramine-induced acute dystonia is a user drug-induced threatening reaction that warrants further investigation on the metabolism of these drugs and the contributing phenotypes to this adverse reaction.

Laparoscopic Adnexal Detorsion in a 20-Week Pregnant Patient: A Case Report and Literature Review.

Adnexal torsion is a cause of severe pelvic pain in reproductive aged women and during pregnancy. Adnexal torsion occurs when there is a complete turn of the ovary, tube, or both resulting in impaired blood flow to the ovary. The diagnosis of adnexal torsion is sometimes challenging due to the enlarged effect of the uterus, the displacement of abdominal and pelvic structures and the nonspecific symptoms in pregnancy. Therefore, prompt diagnosis is essential for better maternal and neonatal outcomes. The gold standard for confirmation and treatment of ovarian torsion is surgery. Laparoscopy and Laparotomy are surgical options with defined risks and benefits. Therefore, choosing the best surgical technique and surgical procedure are of utmost importance to decrease the chances of adverse events intra and postoperatively. Little literature exists regarding the laparoscopic approach of an ovarian torsion during the second trimester. Our case is a 20-week pregnant patient who had a 1080 degree rotation of the left adnexa. She required laparoscopy for adnexal detorsion and had good intraoperative, postoperative, maternal, and neonatal outcomes following management.