A 35-year-old man presented with left side abdominal cramps and bloody stools that persisted for 1 week. Physical examination revealed a body temperature of 38.5 °C (101.3 °F), normoactive bowel sounds, and left lower quadrant tenderness. A standing abdominal radiograph showed a nonspecific small bowel gas pattern and a smooth radiolucent descending colon without haustration (Figure 1),…

A 72-year-old man presented to the emergency department with urinary retention and increasing abdominal pain hours after undergoing transurethral resection of a bladder tumor. His initial blood pressure was 146/104 mmHg, and his pulse rate was 97 beats/min. He had abdominal distension and diffuse tenderness. His potassium level was 6.1 mEq/L, and his serum creatinine level was 2.78 mg/dL,…

A 6-week-old female infant presented to the emergency department with labial swelling. Her past medical history was unremarkable. Examination revealed a palpable 2-cm, nonreducible mass in the left labia majora without overlying skin changes or tenderness. Her vital signs were within normal age-adjusted limits. Ultrasound examination of the labia was performed (Figures 1 and 2).

An 81-year-old man presented to the emergency department with 4 hours of continuous chest pain. The ECG showed atrial fibrillation and acute extensive anterior myocardial infarction. His blood pressure was 95/69 mm Hg and pulse rate was 110 beats/min. Emergency laboratory testing showed an elevated brain natriuretic peptide level (783.0 pg/mL) and troponin I level of 41.2 ng/mL. Emergency…

A 90-year-old woman with hypertension and a previous gastric ulcer presented to the emergency department with sudden-onset, sharp, diffuse abdominal pain. She was drowsy and afebrile, with a pulse rate of 65 beats/min and blood pressure of 86/46 mm Hg. On palpation, the abdomen was diffusely tender. Her hemoglobin level was 11.4 g/dL and serum lactate level was 4.4 mmol/L. Abdominal point-of-care…

A 46-year-old woman presented to our emergency department (ED) with 3 weeks of abdominal bloating and discomfort, anorexia, neck swelling, scleral icterus, generalized muscle aches, and a dry cough. The patient had returned from visiting family in West Africa 1 month before. Her only medical history was an exploratory laparoscopy with unilateral salpingectomy for an ectopic pregnancy more than 20…

An otherwise healthy 20-year-old man presented to the emergency department with a large painful right shoulder mass. The mass had been present since birth but had recently increased in size, causing severe pain, worse with shoulder abduction. On physical examination, the patient was afebrile and a large, lobulated, maroon, soft tissue mass was present, extending from the supraclavicular fossa to…

An 82-year-old man was brought to the hospital after syncope. He complained of malaise, dizziness, diarrhea, and a painful left upper quadrant mass that had grown during an uncertain period (Figure 1). The patient had no significant medical history; however, he was a heavy smoker and drinker. Laboratory studies revealed iron-deficiency anemia and increased C-reactive protein level. Abdominal…

A 32-year-old woman presented to the emergency department (ED) with 1 hour of right upper extremity pain, swelling, and discoloration. The swelling and discoloration started on waking, but she had been experiencing right upper extremity pain for the previous 2 weeks, for which she had a negative ultrasonographic result initially. The patient was previously healthy and engaged in yoga often. Her…