The disappearing act: case of a migrating left renal vein stent.

INTRODUCTION: Nutcracker syndrome (NS) is a rare condition in which the abdominal aorta and superior mesenteric artery compress the left renal vein (LRV). One treatment option is the placement of an endovascular stent into the LRV, which carries the risk of stent migration. CASE REPORT: A 30-year-old female with NS status-post LRV stenting 6 months prior presented to the emergency department with suprapubic pain. An incidental finding on abdominal computed tomography scan noted interval removal of LRV stent, which had not been surgically removed. A subsequent chest radiograph showed the stent lodged in the left pulmonary artery. DISCUSSION: To our knowledge, this is the first documented case of LRV stent migration to the pulmonary artery. This case demonstrates the importance of physician awareness of stent migration as a potential complication after stent placement, and careful review of all imaging findings, even if unrelated to the chief complaint.

A rare life-threatening complication of acute mastoiditis: Case report and literature review.

Severe complications may not always present with "classic" signs and symptoms. In the setting of recent mastoiditis, complications including cerebral venous sinus thrombosis, skull base osteomyelitis, and retropharyngeal abscess should be considered, particularly with persistent or worsening symptoms. A broad differential can lead to prompt diagnosis and treatment, thereby reducing the likelihood of morbidity and mortality.

Accuracy of Weight Estimation Using the Broselow Tape in a Peruvian Pediatric Population.

Introduction The Broselow tape (BT) is a useful pediatric tool for weight estimation and dosing reference during emergency care. Many accuracy studies have been performed for various countries and regions of the world but there is very little information for Latin American countries. The primary objective of the study was to assess the accuracy of the BT in a Peruvian pediatric population. Methods This was a retrospective cross-sectional study of 1,160 children aged two to 19 years from three outpatient clinics in La Libertad, Lima, and Iquitos, Peru. Patient height and weight were measured and compared with the weight and color zone generated by the 2017 edition of the BT. Accuracy was estimated by statistical comparison of mean absolute percent differences, error within 10% (EW10), and color zone agreement. Results Comparison of mean differences between measured weight (MW) and estimated BT weight shows that the BT underestimates actual weight for all color zones in this population. Likewise, the Bland-Altman plot of agreement between estimated and measured weights shows an overall underestimation, or bias, equal to 1.60 kg. The overall percent difference was -7.84% with differences gradually increasing for weights over 10 kg. In terms of accuracy, the overall error within 10% was 62.8%. Conclusion The BT underestimates the actual weight of Peruvian pediatric patients in all color categories, particularly in children with higher body mass indexes. Underestimation of weight may lead to the use of non-therapeutic medication doses or incorrect equipment sizes and, subsequently, ineffective resuscitation.