Ming-Tse Tsai

Spontaneous rupture of an ovarian artery aneurysm.

Spontaneous rupture of an ovarian artery aneurysm is rare and is thought to be related to pregnancy or uterine fibroids. A patient without fibroids presented with extreme pain during normal menstruation. Ruptured ovarian artery aneurysm should be suspected in a multiparous woman with flank or abdominal pain and peritoneal signs.

Isolated traumatic pancreatic rupture.

Traumatic pancreatic rupture is associated with high morbidity and mortality. The diagnosis is difficult and usually accompanied with other injuries. We reported a 17-year-old adolescent boy who experienced this disease alone. The diagnosis was first suspected in ultrasonography and then confirmed by computed tomography. Endoscopic retrograde pancreatography showed his pancreatic duct was patent. He made an uneventful recovery after 10 days of hospitalization. Ultrasonography is well known for detecting the presence of hemoperitoneum in blunt abdominal trauma. Furthermore, it can be applied to the assessment of patients with posttraumatic abdominal pain. It provides a real-time, noninvasive, and inexpensive means for screening this kind of patients.

Isolated gallbladder hematoma after a blunt abdominal trauma: case report

Background Sonography has played an important role on detection of intraabdominal injuries with a sensitivity of 86%, a specificity of 98%, and an accuracy of 97% [1]. Negative predictive value achieved about 98% [1]. However, gallbladder injury is rare with incidence around 2.1% [2,3] in blunt abdominal trauma [2], and commonly associated with the solid organ injury or abdominal vascular injury [4]. Isolated gallbladder injury were very few[3] including traumatic cholecystitis, gallbladder tear, and gallbladder perforation ...etc. Ultrasound is very sensitive to gallbladder disease. We presented a rare case of isolated gallbladder hematoma after a blunt abdominal trauma which diagnosis by Focused Gallbladder ultrasound.

Nasal septal abscess diagnosed by ultrasound

A 77-year-old healthy woman was referred to our hospital due to nasal pain for 2 weeks. She denied nasal trauma in recent months. The local physical finding showed a bulging nasal septum. Ultrasonography applied transversely on the patient’s nose showed a heterogeneous 1-centimeter-in-diameter mass, which was further confirmed by computed tomography. The abscess was drained and the bacteriological cultures revealed viridans streptococci. Follow-up ultrasonography 2 weeks later showed nostrils without septal mass. Nasal septal abscess is uncommon. Usually it is secondary to nasal trauma. There are other less common causes like sinusitis or dental infections.1 Immunocompromised status should be considered if there is no history of nasal trauma.2 If left untreated, there are risks of intracranial complications and facial deformity. The reported pathogens include bacteria and fungi, among which viridans streptococci are the most common. Proper management requires prompt diagnosis, adequate surgical drainage, and antibiotics to prevent the potentially dangerous spread of infection and the development of severe functional and cosmetic sequelae. Ultrasonography was regarded as an efficient diagnositic tool in practice currently. In the field of otorhinolaryngology, it is applied in several diseases such as sinusitis, peritonsillar abscess or lymphadenitis. With ultrasonography, physicians can assess this disease quickly and treat it promptly.

Emphysematous pyelonephritis with flank rash.

A previously healthy 56-year-old woman visited our emergency department because of fever, left flank rash for 5 days. Upon arrival, her vital signs were as followings: heart rate 98/min, body temperature 36.8°C and blood pressure 118/58 mmHg. Physical examinations revealed an erythematous patch over the left flank area and left flank knocking pain. Laboratory data showed increased white blood cell (WBC) counts (17 890/μl) and urinalysis showed pyuria (numerous …

Crampy left upper quadrant pain in a 26-year-old male

A 26-year-old man presented with left upper quadrant abdominal pain for 1 week. The character of the pain was intermittent, cramping in …