Conservatively managed saddle pulmonary embolism

Saddle pulmonary embolism visualized by transthoracic echocardiography.

Asymptomatic giant appendicolith managed conservatively

A 67-year-old lady was found to have a giant appendicolith during a colorectal cancer screening colonoscopy, following a positive faecal occult blood test. Computed tomography confirmed the presence of a calcified giant appendicolith within the base of the appendix, which otherwise appeared normal. Appendicoliths are widely believed to be a major cause of acute appendicitis via obstruction of t...

Thrombolysis for saddle pulmonary embolism and 3-chamber thrombus.

Currently, the only widely accepted indication for thrombolysis in cases of pulmonary embolism is hemodynamic instability. However, the presence of a right-heart thrombus along with pulmonary embolism is a poor prognostic indicator, and the use of thrombolytic agents should also be considered in this circumstance. Furthermore, despite a risk of distal embolization, thrombolytic therapy may be i...

Large Substernal Thyroid Goiter Associated with Saddle Pulmonary Embolism

A 75-year-old woman with a longstanding history of a substernal thyroid goiter presented with acute shortness of breath, and she was intubated due to respiratory distress. Computed tomography (CT) scan revealed a compressive substernal goiter with associated vascular compression, axillosubclavian thrombosis, and saddle pulmonary embolism. Weight-based heparin was immediately administered, and t...

Emphysematous Gastritis: An Ominous Diagnosis Managed Conservatively

A 54-year-old female with HIV, diabetes, and chronic obstructive pulmonary disease (COPD) presented with altered mental status, diabetic ketoacidosis, nonspecific gastrointestinal symptoms, and a buttock abscess. Initial abdominal and pelvic computed tomography (CT) without contrast demonstrated a small pericardial effusion, air in the gastric wall, and perianal abscess. Amid worsening leukocyt...