[NEJM临床医学影像]:Alpha1-抗胰蛋白酶缺乏已关闭评论
IMAGES IN CLINICAL MEDICINE
Alpha1-Antitrypsin Deficiency
José Maria Hernández Pérez
N Engl J Med Published August 17, 2024
DOI: 10.1056/NEJMicm2403183
A 60-year-old woman with a 15-pack-year smoking history was referred to the pulmonology clinic owing to several years of dyspnea on exertion. She had quit smoking at 43 years of age. Her father had died from emphysema. Her oxygen saturation was 93% while she was breathing ambient air. Physical examinatio...
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[Intensive Care Med重症影像]: FDG PET/CT鉴别机械通气患者的肺炎与肺不张已关闭评论
Imaging in Intensive Care Medicine
Published: 19 June 2024
18F-fluorodeoxyglucose positron emission tomography/computed tomography differentiates between pneumonia and atelectasis in a mechanically ventilated patient
Intensive Care Med (2024). https://doi.org/10.1007/s00134-024-07505-5
Differentiation between atelectasis and pneumonia in critically-ill patients can be challenging on regular computed tomography (CT). In this image the additional value of...
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[NEJM临床医学影像]:坏死性软组织和咽后间隙感染及纵隔炎已关闭评论
IMAGES IN CLINICAL MEDICINE
Necrotizing Soft-Tissue and Retropharyngeal Space Infections and Mediastinitis
Martin A. Gomez, Beatriz Mejia
N Engl J Med 2024;391: e5
DOI: 10.1056/NEJMicm2312959
A 50-year-old man with no known medical history presented to the emergency department with a 3-day history of tooth and jaw pain on the left side, fever, and shortness of breath. He lived in a rural area and had never visited a physician or dentist. Physical examin...
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[NEJM临床医学影像]:气道中的硬币已关闭评论
A Coin in the Airway
Victor Bor-Chang Hsue, Vijay Patel
N Engl J Med 2024; 390: e33
DOI: 10.1056/NEJMicm2312266
A healthy 14-year-old boy presented to the emergency department with a 6-hour history of hoarseness and difficulty swallowing after having accidentally swallowed a coin. On physical examination, the patient was breathing comfortably without stridor or drooling. Radiographs of the chest (Panel A, posteroanterior view) and ...
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[NEJM临床医学影像]:免疫性血小板减少患者的自发性口腔紫癜已关闭评论
IMAGES IN CLINICAL MEDICINE
Spontaneous Oral Purpura in Immune Thrombocytopenia
Jakob L. Drivenes, Anette Bygum
N Engl J Med 2024; 390:1029DOI: 10.1056/NEJMicm2312260
A 76-year-old man presented to the dermatology clinic with a 2-day history of blood-filled blisters on the tongue. The lesions had appeared suddenly without antecedent trauma. He reported no other bleeding symptoms. The physical examination was notable for multiple hemorrhagic bullae on the t...
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[NEJM临床医学影像]:绿色的透析流出液以及血浆已关闭评论
IMAGES IN CLINICAL MEDICINE
Green Dialysis Effluent and Plasma
Bao-ping Xu, Xiao-tao Wang
N Engl J Med 2024; 390:e27DOI: 10.1056/NEJMicm2311085
A 72-year-old man with end-stage kidney disease who began receiving continuous renal-replacement therapy in the intensive care unit (ICU) was noted to have green-colored dialysis effluent and plasma. Seven hours earlier, the patient had presented to the emergency department with a gastrointestinal perforation. An e...
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[NEJM临床医学影像]:缩窄性心包炎已关闭评论
IMAGES IN CLINICAL MEDICINE
Constrictive Pericarditis
Meghan Nahass, John Kassotis
N Engl J Med 2023; 389:2087DOI: 10.1056/NEJMicm2301671
A 69-year-old woman presented to the emergency department with a 3-year history of dyspnea on exertion. She had a history of focal pleural plaques that had been attributed to asbestos exposure that occurred during her work at an insulation-manufacturing company. Physical examination was notable for signs of volume overlo...
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[NEJM临床医学影像]:横向白甲症(米氏线)已关闭评论
IMAGES IN CLINICAL MEDICINE
Transverse Leukonychia (Mees’ Lines)
Annabel M. Follows, George A. Follows
N Engl J Med 2023; 389:e48DOI: 10.1056/NEJMicm2304533
A 30-year-old man presented to the hematology clinic with a 4-month history of white lines across his fingernails. Five months before presentation, he had received a diagnosis of primary mediastinal large B-cell lymphoma and began to receive systemic chemotherapy. The nail changes had first appeared mi...
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[NEJM临床医学影像]:静脉胸廓出口综合征已关闭评论
IMAGES IN CLINICAL MEDICINE
Venous Thoracic Outlet Syndrome
Sang Jun Park, Hyun Jin Cho
N Engl J Med 2023; 389:e32DOI: 10.1056/NEJMicm2301198
A 36-year-old woman was referred to the thoracic surgery clinic after she had presented with a 3-week history of swelling and bluish discoloration of the left arm and hand that occurred when she raised her arms (Panel A). The symptoms started after she had spent 10 days typing at a desk. Computed tomography of the ch...
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[JAMA临床挑战]:70岁女性患者出现腹痛及低血压(答案)已关闭评论
Abdominal Pain and Hypotension in a 70-Year-Old Woman
Educational ObjectiveBased on this clinical scenario and the accompanying image, understand how to arrive at a correct diagnosis.
Case
A 70-year-old woman with hypertension, atrial fibrillation, congestive heart failure, and gallstones presented to the emergency department with 3 days of nausea, vomiting, and abdominal pain. She reported no hematemesis, hematochezia, or melena and had no history of abdominal s...
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