RESUMO
Dislocations of the shoulder are the most common joint dislocations seen in the emergency department, and complications of shoulder dislocations are more frequent than is generally believed. It is vital that emergency physicians have current knowledge of complications associated with shoulder dislocations because of their important role in recognition and prevention. Delayed recognition of complications can have an impact on the long-term outcome of patients. Prompt recognition and follow-up are essential. Most references address reduction methods rather than recognition of specific complications. Emergency physicians have few opportunities to update their knowledge of complications of shoulder dislocations. This article briefly reviews mechanisms of shoulder dislocation and discusses complications in light of the mechanisms of injury.
Assuntos
Serviço Hospitalar de Emergência , Luxação do Ombro/complicações , Fenômenos Biomecânicos , Humanos , Doenças do Sistema Nervoso Periférico/etiologia , Prognóstico , Recidiva , Lesões do Manguito Rotador , Fraturas do Ombro/etiologia , Doenças Vasculares/etiologiaAssuntos
Antidepressivos de Segunda Geração/efeitos adversos , Triazóis/efeitos adversos , Adulto , Antidepressivos de Segunda Geração/administração & dosagem , Antidepressivos de Segunda Geração/uso terapêutico , Depressão/tratamento farmacológico , Overdose de Drogas , Feminino , Humanos , Piperazinas , Triazóis/administração & dosagem , Triazóis/uso terapêuticoRESUMO
Skin necrosis is an uncommon complication of warfarin (Coumadin; Dupont Pharma, Wilmington, DE) therapy. The presentation may mimic other disorders. This article reports a case of a 72-year-old woman who presented to the emergency department complaining of swelling and ecchymosis to her left breast and right foot. The patient had been hospitalized for coronary artery bypass grafting, and had been discharged from the hospital earlier that day. This article reviews the pathophysiology and clinical features of warfarin-induced skin necrosis.
Assuntos
Anticoagulantes/efeitos adversos , Doenças Mamárias/induzido quimicamente , Doenças Mamárias/patologia , Serviços Médicos de Emergência , Dermatoses do Pé/induzido quimicamente , Dermatoses do Pé/patologia , Pele/efeitos dos fármacos , Pele/patologia , Varfarina/efeitos adversos , Idoso , Diagnóstico Diferencial , Feminino , Humanos , NecroseRESUMO
Acute myocardial infarction associated with ventricular septal defect (VSD) occurs infrequently. When a patient with an acquired VSD presents to the emergency department (ED), prompt recognition is required because definitive treatment can greatly decrease mortality. We present the case of a 75-year-old woman with an acute myocardial infarction and a new heart murmur. The diagnosis of acquired VSD was made by echocardiography in the ED, and emergency surgical correction was arranged.
Assuntos
Sopros Cardíacos/diagnóstico , Ruptura do Septo Ventricular/diagnóstico , Doença Aguda , Idoso , Ecocardiografia Doppler em Cores , Eletrocardiografia , Serviço Hospitalar de Emergência , Feminino , Sopros Cardíacos/etiologia , Humanos , Infarto do Miocárdio/complicações , Ruptura do Septo Ventricular/etiologia , Ruptura do Septo Ventricular/cirurgiaRESUMO
A 67-year-old female presented to the Emergency Department with a several hour history of severe pain in the left upper quadrant. A computed tomographic study (CT scan) of the abdomen demonstrated a splenic infarct. The patient was subsequently found to have a patent foramen ovale, with a small right-to-left shunt. This patient's splenic infarct is considered to be embolic in etiology, either from the patent foramen ovale or severe atherosclerotic disease. Patients with left upper quadrant pain who do not have the etiology differentiated by initial testing should be considered to have the potential for splenic infarction. This case illustrates the uncommon occurrence of splenic infarction, presenting as left upper quadrant pain.
