Also known as: Torn major vein in liver area with blood collection
16-year-old bull rider trampled by a 1,000-pound bull, resulting in a tear of the inferior vena cava behind the liver with a large contained hematoma that ruptures during surgery, requiring emergency sternotomy and cardiac massage to control life-threatening bleeding.
Also known as: Spinal fractures
Multiple unstable burst fractures from T10 through L3, particularly an unstable L3 fracture requiring immediate spinal fusion surgery to prevent permanent paralysis. The surgery is complicated by the IVC tear.
Also known as: Liver injury
Liver crush injury from bull trampling that contributed to the retrohepatic hematoma and IVC tear, requiring surgical management during the emergency procedure.
Also known as: Perforated intestine
Patient with severe abdominal pain who visited multiple ERs seeking pain medication. Eventually diagnosed with intestinal perforation caused by an impacted toothpick in the distal ileum that was missed on multiple CT scans. The diagnosis was made by reviewing scans sequentially to detect the pattern of intermittent cecal wall thickening and fat stranding.
Also known as: Lung infection
60-year-old widow working at a bookstore without health insurance who presents with cough, wheezing, and suspected pneumonia. She initially refuses chest X-ray and treatment due to inability to pay, but is eventually convinced to accept care with payment plan after being educated about risks of untreated pneumonia.