RESUMO
Magnets are among the most dangerous foreign objects that a child can ingest. If more than one magnet is ingested, the attraction between loops of the bowel can bring adjacent loops closer together, leading to perforation, obstruction, or fistulization. Pediatric magnet ingestion patients often require endoscopic or surgical intervention to retrieve the objects and repair the damage created by the magnets. Due to the risks of surgical intervention, management is done with strict adherence to the rare earth magnet ingestion algorithm. We highlighted a pediatric case of multiple magnet ingestion, and the steps that were taken to manage the patient. Our case highlights the potential for complications and the importance of adherence to the management algorithm in these patients. Epidemiology, mechanisms, algorithms, and outcomes for pediatric magnet ingestion patients were discussed.
RESUMO
A 30-year-old female with a history of multiple cesarean sections presents to the emergency department with several months of right lower quadrant abdominal pain only associated with her menstrual cycles. CT abdomen and pelvis with contrast was remarkable for an abdominal wall mass that likely represented an endometrioma, and she was subsequently discharged with pain medications and conservative treatment. However, three months later, she returned to the ED, because her pain was unbearable and refractory to medical management. Interventional radiology was consulted for percutaneous biopsy of the soft tissue mass located in her rectus abdominus muscle. Following the procedure, the patient was started on ORILISSA® (elagolix), the first FDA-approved oral treatment for the management of severe pain associated with endometriosis. We highlight an interesting case of post-cesarean section abdominal wall endometrioma implantation and describe the patient's clinical course and disease management. The radiographic features of the mass are described and proposed mechanisms for the development of an abdominal wall endometrioma following a C-section is discussed.
RESUMO
Traumatic injury to the mediastinum can damage critical surrounding structures, including the pericardium, aorta, and bronchial tree. We highlight a miraculous case of a 13-year-old female with no past medical history who presented to the emergency department after being impaled in the chest by a metal fence post. After median sternotomy, the foreign object was removed, and the patient fortunately recovered with no permanent sequelae. The radiographic features of the injury are described, and potential unseen cardiovascular and respiratory complications are discussed.