Diagnostic ultrasonography for peripheral vascular emergencies

Vascular Ultrasound

Vascular point-of-care ultrasound is a useful tool for emergency department (ED) clinicians to evaluate lower extremity pain and swelling. It can quickly and safely detect deep vein thrombosis, a serious condition that can lead to pulmonary embolism and post-thrombotic syndrome as well as diagnose pseudoaneurysm, hematoma, and acute arterial occlusion, a vascular emergency that requires urgent surgical intervention. Point-of-Care Ultrasound can be a useful tool for the evaluation of ED patients with vascular emergencies.

Arterial Thrombosis Diagnosed With Point-of-Care Ultrasound

Acute arterial thrombosis is a rare but dangerous condition that requires rapid diagnosis and treatment to reduce the risk of amputation. SARS-CoV-2 is associated with an increased risk of arterial thrombosis. Point-of-care ultrasound (POCUS) can facilitate rapid bedside evaluation for both venous and arterial thrombosis and expedite treatment in these time-sensitive diagnoses. Although POCUS diagnosis of venous thrombosis is well studied, few cases of POCUS diagnosis of arterial thrombosis have been reported. We present a case in which acute SARS-CoV-2-associated arterial and venous thromboses were diagnosed at the bedside utilizing POCUS, which led to expedited operative management and limb preservation.

Diagnosis of Internal Jugular Vein Septic Thrombophlebitis by Point-of-Care Ultrasound

ABSTRACT

Septic thrombophlebitis represents a rare but serious collection of diseases, which carry a high risk of morbidity and mortality requiring prompt and aggressive treatment. Diagnosis centers on identification of thrombus along with clinical and microbiologic data. We present a case where point-of-care ultrasound was used to diagnose septic thrombophlebitis of the internal jugular vein and expedite appropriate therapy. We further review the technique and literature for ultrasound diagnosis of venous thrombosis and associated thrombophlebitis.

Bothrops atrox Snakebite: How a Bad Decision May Lead to a Chronic Disability: A Case Report

Snakebites are a neglected and underestimated global health hazard. In the Brazilian Amazon, Bothrops snakebites are the most prevalent and may lead to severe complications. Here we describe a severe case of Bothrops atrox snakebite that, owing to delayed medical assistance, presented with renal and respiratory failure, compartment syndrome, and tissue necrosis. After several fasciotomy surgeries, the patient survived; however, he showed significant functional disability. Prompt management of snake envenomation would aid in the early diagnosis of local and systemic complications and, consequently, would result in a better functional outcome with improved quality of life.