Eric Chavis, MD
A 58 year old man with a history of stage IV pancreatic adenocarcinoma, currently on chemotherapy, presents with chief complaint of RLQ abdominal pain. He appears in severe pain as you enter the room and his abdomen appears disteneded and stretched tight. Small bowel obstruction? you think as you approach the bedside. Not so fast!
72 yo M w/ PMHx of HTN, HLD, CKD (not on dialysis), DM and CAD presents to the ED with scrotal pain x 1 week. He is concerned that he has an "abcess" and wanted to be checked. A CT is done and shown below. What's the diagnosis? (scroll down for answer)
Answer: Fournier's Gangrene
A 27 yo M with a PMHx of osteosarcoma s/p R hip disarticulation and numerous lung metastases s/p L upper lobe wedge resection (1 year prior) presents to ED with DOE and "abnormal findings on outpatient CT scan." On ED arrival he is tachycardic w/ HR 135, RR is 18 and SpO2 is 93% on RA. On exam he has diminished but present breath sounds bilaterally. A CXR is obtained and shown below. What's the diagnosis? (scroll down for answer)
You are on your critical care rotation helping take care of multiple ventilated patients. At the end of your night shift, one of the respiratory therapists comes up to you and says, “Hey, the new ABG just came back. It is 7.25/52/70/24 .” What do these numbers mean and what can you do to help?