ABSTRACT
Introduction: Cerebral air embolisms are a rare but potentially devastating event where air enters the vascular system. Although commonly associated with intravascular catheters, they can arise from a variety of mechanisms including endoscopic procedures. Case Report: We report the case of a 90-year-old woman who presented with focal neurologic deficits due to an air embolism after undergoing an esophagogastroduodenoscopy. Conclusion: Cerebral air embolisms should be considered in patients who present to the emergency department with acute neurologic changes, especially after an endoscopic procedure.
ABSTRACT
Introduction: Acute aortic syndrome (AAS) includes the disease processes of aortic dissection, penetrating atherosclerotic ulcer, and intramural hematoma. This case demonstrates an atypical presentation of the disease and offers approaches to potentially prevent missed diagnoses. Case Report: An 87-year-old female with hypertension and Alzheimer's dementia presented to the emergency department with stable vital signs and a chief complaint of throat pain. Initial work-up was significant for ischemia on electrocardiogram and elevated troponin. Computed tomography of the soft tissue neck revealed evidence of a ruptured aorta. Conclusion: Aortic rupture is a fatal complication of AAS. In an elderly patient with a history of hypertension, ischemic changes on electrocardiogram, and nonspecific pain, AAS should be on the emergency physician's differential even in the setting of a benign or limited history and exam.
ABSTRACT
CASE PRESENTATION: A 65-year-old male with schizophrenia and intellectual disability ingested what was reported to be two AA batteries, prior to a scheduled magnetic resonance imaging (MRI) study. He developed severe abdominal pain and presented to the emergency department the following day with hypovolemic/septic shock. General surgery retrieved two metal sockets and a clevis pin from the stomach prior to surgical repair of a gastric perforation. This case highlights a rare yet critical outcome of ingesting ferromagnetic foreign bodies prior to an MRI study. DISCUSSION: Medical literature on this subject is scarce as indwelling metal foreign bodies are a contraindication to obtaining an MRI. Yet some patients with indwelling metallic foreign bodies proceed with MRI studies due to either challenges in communication such as age, psychiatric/mental debility, or unknowingly having an indwelling metal foreign body. In this case, the patient surreptitiously ingested metal objects prior to obtaining an MRI.
