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Dilemmas: The Art of Medicine

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Hot Seat #222: Just Swell

Case by Nikki Animasaun, CNH PEM Fellow 15 yo previously healthy M presenting with chronic penile and scrotal swelling. Patient has been having swelling without pain for the past few months. The swelling has increased gradually over the past 2-3 months. He went to his PMD today due to having blisters on the scrotum that […]

Hot Seat #221: Making The Breast Choices

Case by Brandon Kappy MD, CNH PEM Fellow A 35-day-old female presents to the ED with what Mom describes as a “right-sided chest rash.” Mom states that she noticed the mild erythema around 2 days ago when she was breastfeeding the infant. Since then, Mom believes that it has become moderately more erythematous, though no […]

Hot Seat #220: High-Risk Blue or High-Risk BRUE?

Case by Richmond Castillo, CNH PEM Fellow A 14 day old ex-35 weeker M was in his usual state of health until today at 1pm. He was sleeping and suddenly started crying and turned purple. Parents also reported he was cold, limp, and stopped breathing for a short time (parents unsure how long) and then […]

Hot Seat #219: Denouement

This week we highlight the case of a well-appearing child who presents with intermittent bilious emesis. The crux of the decision centered around the appropriate imaging when there is concern about malrotation with volvulus but an upper GI is unavailable. Junior learners preferred a CT abdomen with contrast whereas senior learners preferred an abdominal ultrasound. […]

Hot Seat #219: Gut-sy Decisions

Case by Brandon Ho, CNH PEM Fellow It is a wonderful Saturday evening in the ED when an 11-month-old female presents with 3 days of projectile vomiting after every feed. Vomiting occurs 4-5 times a day and is described as occasionally yellow-green. Parents note that her stomach is very hard after feeding but becomes soft […]