RESUMEN
We describe a case of an eupnoeic patient complaining of a foreign body sensation in his mouth and throat, with sudden drooling and supine gagging. This condition was caused by an isolated uvular angioedema (Quincke's oedema). As this uvular hydrops did not decrease with initial standard therapy for angioedema, epinephrin was applied directly on the swollen uvula, causing it to shrink very rapidly. Isolated uvular oedema is a potentially life-threatening condition with risk of sudden upper airway obstruction, and should therefore be recognized and treated as soon as possible. As described in this case, its initial presentation can consist of gagging and drooling without dyspnoea, thus causing a real challenge for triage and diagnosis.
Asunto(s)
Angioedema/diagnóstico , Atragantamiento , Sialorrea , Adulto , Angioedema/tratamiento farmacológico , Angioedema/fisiopatología , Servicio de Urgencia en Hospital , Epinefrina/uso terapéutico , Humanos , Masculino , Posición Supina , Factores de Tiempo , ÚvulaRESUMEN
The early diagnosis of hollow viscous injury after blunt abdominal trauma remains a challenge for physicians in the Emergency Department, although the early diagnosis of hollow viscous injury decreases morbidity and mortality. After a description of two cases of hollow viscous injury after blunt abdominal trauma, a literature review is performed concerning the indications and limitations of diagnostic imaging modalities. Focused abdominal sonography for trauma, computed tomography scan and diagnostic peritoneal lavage are described. On the basis of the review a proposal for maximal diagnostic accuracy is made.