Severe reflux #Esophagitis | Figure 1

JLandyMD
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Severe reflux #Esophagitis

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A 38-year-old female presented to an emergency department after feeling a sharp, painful sensation in her throat following ingestion of a lamb casserole. The pain was worse on swallowing and radiated to the right chest and between her shoulder blades. Examination was unremarkable, the patient’s voice remained unchanged, and there was no abnormality on fiberoptic nasendoscopy.
A diagnosis of an ingested foreign body was proposed. A chest and lateral neck x-ray showed no evidence of a foreign body but a CT showed a bony foreign body within the thoracic oesophagus at the level of the azygos vein located 2 mm from the aortic arch. It measured 20×21 mm and was stretching the lumen of the oesophagus but there was no evidence of perforation or vascular injury.
A rigid oesophagoscopy was performed under general anaesthesia with support from on-site cardiothoracic surgeons and a cardiac anaesthetist given the possibility of severe haemorrhage. A 40-cm rigid oesophagoscope was passed into the upper oesophagus atraumatically where the bone was visualised at 22 cm from the upper incisors. No recent or active bleeding was seen. Grasping forceps were used under direct vision and the bone was gently dislodged from the wall of the oesophagus and removed in its entirety without excessive traction required. A small mucosal tear on removal of the bone occurred with a small amount of blood.

36 yof with the hx of ulcerative colitis came in with few weeks hx of abdominal cramps, bloating and bleeding with bowel movement. Colonscopy showed active inflammation in rectosigmoid area and internal hemorrhoids. Pt was advised to continue lialda and use rowasa enema daily before bedtime to reduce the inflammation.

71M presents to ED with generalized weakness in the setting of persistent N/V that has been ongoing for 2.5 weeks. He reports that he has not been "unable to hold down food or liquor" for this period. Denies abd pain, CP, SOB, fever, sick contacts, or GU Sx. PMHx: HTN, alcohol abuse. Image 1 initial EKG, Image 2 repeat 3 hrs later, Image 3 lab summary. What is your analysis and thoughts on treatment?

A 52-year-old man presented with a 20-minute history of chest pain radiating to the left shoulder and neck, associated with dyspnea and diaphoresis. He had a history of hypertension, long-term smoking, and a sedentary lifestyle. On physical examination, bibasilar crackles were noted on lung auscultation. An electrocardiogram (ECG) was performed in the primary care setting, and the patient was promptly referred to the emergency department.

A 28-year-old woman presented with a 3-day history of intense pruritus over the lower back. She reported no recent travel or exposure to new environments. She cares for a small kennel with approximately eight dogs rescued from the streets. Physical examination revealed multiple small vesicles, some clustered and others scattered, predominantly involving the lumbar region and the left gluteal area.

A 4-month-old male infant presented with skin lesions localized to the chin for the past 3 days. Physical examination revealed multiple small pustules with surrounding inflammatory signs on the chin, along with a few scattered papules on the chest.

patient in late teens presenting after a collapse, no chest pain, no previous cardiac history, no history of sudden death in family, are there any features in this ekg that would warrant further work-up or is this just a pediatric ekg?