Tag Archives: EMage

2nd Place EMage Winner: What’s on the Tip of the Tongue?

Adam Garibay, MD; Kelly Winters, MSN, RN, CPNP, CNS ; Tabitha Cheng, MD,; Supriya Sharma, MD; Manpreet Singh, MD, MBE

Pediatric Emergency Department, Department of Emergency Medicine, Harbor-UCLA Medical Center

Case Presentation: Tongue Depressor

A 5-year-old male presented to the pediatric ED due to a growth on the tip of his tongue.  The patient’s mother was worried as the mass had been increasing in size and was bleeding, causing decreased oral intake. Further history revealed progressive tongue swelling and increasing growth of the mass over a three-month period. Upon further questioning, it was presumed that the mass formed after a traumatic injury where he bit his tongue. Prior to this visit he presented to three other EDs and was unable to receive a referral to Otolaryngology due to insurance issues. read more

3rd Place EMage Winner: Teenager With Swollen Eye

Chloe Knudsen-Robbins
University of Pittsburgh Medical Center

Nelson Bansil
CHOC Children’s

A 13-year-old-female with a past medical history of Crohn’s disease, presented to the Pediatric Emergency Department (PED) with 8 hours of headache, left eye pain and periorbital swelling. She denied trauma or fevers.

Exam demonstrated left periorbital swelling with ecchymosis and tenderness to palpation. Swelling prevented assessment. Intra-ocular pressure (IOP) was unobtainable.

Emergent ophthalmology consult was obtained and a lateral canthotomy with cantholysis was performed in the PED.  CT of the orbits showed left periorbital swelling with diffuse enlargement of the recti muscles.  Diagnosis was determined to be most consistent with orbital compartment syndrome (OCS) secondary to orbital inflammatory pseudotumor (OIP) as a complication of IBD. read more