IMAGES IN EMERGENCY MEDICINE Edward P. Manning, MS; Larissa K. Laskowski, DO; Lewis S. Nelson, MD; Michael Touger, MD 0196-0644/$-see front matter Copyright © 2014 by the American College of Emergency Physicians. http://dx.doi.org/10.1016/j.annemergmed.2013.12.022
Figure 2. Upper endoscopy images, revealing erythema and superficial erosion to the lower esophagus (left panel) and the body of the stomach (right panel).
Figure 1. CT of the abdomen and pelvis, revealing gas in the stomach and hepatic portal veins.
[Ann Emerg Med. 2014;64:330.] A 23-year-old woman presented to the emergency department with epigastric pain and vomiting after unintentionally ingesting a cleaning agent stored in her refrigerator. On physical examination, the patient was tachycardic, at 100 beats/min, but was otherwise well appearing with a soft, nontender abdomen. Initial blood testing result was unremarkable. Computed tomography (CT) of the abdomen and pelvis (Figure 1) and upper endoscopy were performed (Figure 2).
For the diagnosis and teaching points, see page 333 To view the entire collection of Images in Emergency Medicine, visit www.annemergmed.com 330 Annals of Emergency Medicine
Volume 64, no. 3 : September 2014
Correspondence would not reduce the patients’ cancer risk, whereas such efforts may reduce image quality, resulting in less accurate diagnoses, and may also cause delays in the diagnosis and care of emergency patients, potentially placing their health at risk. In conclusion, radiation dose justification and optimization should not be applied to medical imaging in emergency medicine. Mohan Doss, PhD Diagnostic Imaging Fox Chase Cancer Center Philadelphia, PA http://dx.doi.org/10.1016/j.annemergmed.2014.03.032
Funding and support: By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article as per ICMJE
Volume 64, no. 3 : September 2014
conflict of interest guidelines (see www.icmje.org). The author has stated that no such relationships exist.
1. Sierzenski PR, Linton OW, Amis ES Jr, et al. Applications of justification and optimization in medical imaging: examples of clinical guidance for computed tomography use in emergency medicine. Ann Emerg Med. 2014;63:25-32. 2. Doss M. Radiation doses from radiological imaging do not increase the risk of cancer. Letter to the editor regarding the article by Brenner: what we know and what we don’t know about cancer risks associated with radiation doses from radiological imaging. Br J Radiol. 2014;87: 20130629. 3. Doss M. Linear no-threshold model vs. radiation hormesis. Dose Response. 2013;11:480-497. 4. Doss M. Low dose radiation adaptive protection to control neurodegenerative diseases. Dose Response. 2014;12:277-287. 5. Doss M. Shifting the paradigm in radiation safety. Dose Response. 2012;10:562-583.
Annals of Emergency Medicine 333
Figure 2. Upper endoscopy images, revealing erythema and superficial erosion to the lower esophagus (left panel) and the body of the stomach (right panel).
Figure 1. CT of the abdomen and pelvis, revealing gas in the stomach and hepatic portal veins.
[Ann Emerg Med. 2014;64:330.] A 23-year-old woman presented to the emergency department with epigastric pain and vomiting after unintentionally ingesting a cleaning agent stored in her refrigerator. On physical examination, the patient was tachycardic, at 100 beats/min, but was otherwise well appearing with a soft, nontender abdomen. Initial blood testing result was unremarkable. Computed tomography (CT) of the abdomen and pelvis (Figure 1) and upper endoscopy were performed (Figure 2).
For the diagnosis and teaching points, see page 333 To view the entire collection of Images in Emergency Medicine, visit www.annemergmed.com 330 Annals of Emergency Medicine
Volume 64, no. 3 : September 2014
Correspondence would not reduce the patients’ cancer risk, whereas such efforts may reduce image quality, resulting in less accurate diagnoses, and may also cause delays in the diagnosis and care of emergency patients, potentially placing their health at risk. In conclusion, radiation dose justification and optimization should not be applied to medical imaging in emergency medicine. Mohan Doss, PhD Diagnostic Imaging Fox Chase Cancer Center Philadelphia, PA http://dx.doi.org/10.1016/j.annemergmed.2014.03.032
Funding and support: By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article as per ICMJE
Volume 64, no. 3 : September 2014
conflict of interest guidelines (see www.icmje.org). The author has stated that no such relationships exist.
1. Sierzenski PR, Linton OW, Amis ES Jr, et al. Applications of justification and optimization in medical imaging: examples of clinical guidance for computed tomography use in emergency medicine. Ann Emerg Med. 2014;63:25-32. 2. Doss M. Radiation doses from radiological imaging do not increase the risk of cancer. Letter to the editor regarding the article by Brenner: what we know and what we don’t know about cancer risks associated with radiation doses from radiological imaging. Br J Radiol. 2014;87: 20130629. 3. Doss M. Linear no-threshold model vs. radiation hormesis. Dose Response. 2013;11:480-497. 4. Doss M. Low dose radiation adaptive protection to control neurodegenerative diseases. Dose Response. 2014;12:277-287. 5. Doss M. Shifting the paradigm in radiation safety. Dose Response. 2012;10:562-583.
Annals of Emergency Medicine 333
