Disseminated Kaposi's sarcoma-a missed diagnosis.

BACKGROUND: Kaposi's sarcoma is significantly prevalent among men infected with the human immunodeficiency virus, accounting for >90% of all cases. The early presentation of KS typically involves mucocutaneous lesions and lymphadenopathy, and more advanced disease can affect the lungs and other organs. OBJECTIVE: Our aim was to remind emergency physicians to remain suspicious of clinical presentations despite previous diagnoses or patient statements, particularly in patients with risk factors. CASE REPORT: We present a case of a young man having skin lesions and respiratory problems remaining undiagnosed, despite, and possibly due to, multiple recent physician contacts. CONCLUSIONS: Respiratory illnesses are common presentations in the emergency department and are typically benign and attributed to viral causes. However, the emergency physician must always be on the look out for more dangerous causes of respiratory complaints, especially in patients with risk factors and in those found to be refractory to recent treatment for more common illnesses.

Pancreaticoduodenal artery aneurysm associated with median arcuate ligament syndrome.

Aneurysm of the pancreaticoduodenal artery arcade has a well-documented association with occlusion of the celiac axis. The etiology of celiac occlusion is most commonly atherosclerotic disease. Occlusion or severe stenosis of the celiac artery secondary to a median arcuate ligament is less frequently encountered, and symptoms can be vague or completely lacking. We present a case of an asymptomatic 25-year-old woman who, in the course of being evaluated as a potential donor for living-related kidney transplantation, underwent a computed tomography angiography (CTA) scan that revealed an aneurysm of the pancreaticoduodenal artery. The aneurysm, as well as severe compression of the celiac axis by the median arcuate ligament, was confirmed by catheter angiography. The patient underwent successful endovascular coil embolization of the aneurysm. In our review of the existing medical literature, our patient is the youngest reported case of pancreaticoduodenal aneurysm caused by median arcuate ligament syndrome.

Rare cause of knee pain after martial arts demonstration: a case report.

BACKGROUND: Patellar dislocations are a commonly treated injury in the Emergency Department (ED), with a majority of cases involving lateral subluxation of the patella outside of the joint space. Intra-condylar dislocations of the patella are rare. Of the two types of axis rotation, vertical and horizontal, the vertical occurs five times less frequently. These injuries most often undergo open reduction or, at best, closed reduction under general anesthesia. OBJECTIVES: To remind Emergency Physicians to consider this injury in any patient with severe knee pain and limited mobility, even with a history that is lacking significant trauma. CASE REPORT: We present a case of intra-condylar patellar dislocation with vertical axis rotation. CONCLUSION: This injury is no longer primarily attributed to the young and, barring fracture, closed reduction in the ED should be considered.