Okayama University Medical SchoolActa Medica Okayama0386-300X7742023An Unusual Presentation of Chest Pain and Laryngeal Discomfort in a Pregnant Woman: A Case Report and Literature Review429431ENMisaSasanamiDepartment of Emergency, Critical Care and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesAtsuyoshiIidaDepartment of Emergency, Critical Care and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMasayaIwamuroDepartment of Gastroenterology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesRyousukeHiraiDepartment of Gastroenterology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakashiObaraDepartment of Emergency, Critical Care and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKoheiTsukaharaDepartment of Emergency, Critical Care and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTetsuyaYumotoDepartment of Emergency, Critical Care and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHiromichiNaitoDepartment of Emergency, Critical Care and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesAtsunoriNakaoDepartment of Emergency, Critical Care and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesCase Report10.18926/AMO/65755Intramural esophageal dissection (IED), characterized by bleeding into the submucosal space, leads to mucosal separation and dissection. The most prevalent symptoms are sudden chest or retrosternal pain, hematemesis, and dysphagia. Therefore, acute coronary syndrome and aortic dissection are among its most notable differential diagnoses. A 31-year-old pregnant woman presented with acute chest pain, laryngeal discomfort, and hematemesis. Emergency esophagogastroscopy revealed longitudinal mucosal dissection (upper esophagus to esophagogastric junction). The patient was successfully treated by avoiding the ingestion of solid foods. Clinicians should consider a diagnosis of IED for pregnant patients with acute chest pain, especially if hematemesis is present.No potential conflict of interest relevant to this article was reported. ElsevierActa Medica Okayama22102612702020Three-year-old traumatic liver injury patient treated successfully using transcatheter arterial embolization205208ENAtsuyoshiIidaCritical Care Medical Center, Okayama Red Cross HospitalTsuyoshiRyukoDepartment of Surgery, Okayama Red Cross HospitalMasaichiKemmotsuDepartment of Surgery, Okayama Red Cross HospitalHiroakiIshiiDepartment of Radiology, Okayama Red Cross HospitalHiromichiNaitouDepartment of Emergency, Critical Care, and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesAtsunoriNakaoDepartment of Emergency, Critical Care, and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesIntroduction</br>
Liver injury is the most vulnerable to blunt abdominal trauma. Diagnostic evaluation and treatment of blunt liver trauma in children have changed essentially over the last decades.</br>
Presentation of case</br>
A 3-year-old girl, weighing 10 kg was run over by a car and admitted to our hospital. Due to the liver injury and increased intra-abdominal hemorrhage confirmed by computed tomography, emergent transcatheter arterial embolization (TAE) was performed. Hemostasis was successfully obtained without complications. The patient had a good postoperative course and was discharged on the 9th day after admission.</br>
Discussion</br>
To the best of our knowledge, this case is the youngest and lowest weight emergency TAE success cases of childhood liver injury. TAE is an alternative to laparotomy and a useful procedure to accomplish nonsurgical management in adult who are hemodynamically stable and have no other associated injury requiring laparotomy. On the other hand, TAE is considered to have some complications in child cases because of the small diameter of the artery and the tendency to spasm. Our case showed that TAE can be a safe option for emergency hemostasis in pediatric trauma cases weighing 10 kg.</br>
Conclusion</br>
Emergency physicians must be aware that radiological intervention is an important adjunct to management of childhood liver injury.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7152017Occult Sources of Bleeding in Blunt Trauma : A Narrative Review363368ENTetsuyaYumotoAdvanced Emergency and Critical Care Medical Center, Okayama University HospitalYoshinoriKosakiAdvanced Emergency and Critical Care Medical Center, Okayama University HospitalYasuakiYamakawaAdvanced Emergency and Critical Care Medical Center, Okayama University HospitalAtsuyoshiIidaAdvanced Emergency and Critical Care Medical Center, Okayama University HospitalHirotsuguYamamotoAdvanced Emergency and Critical Care Medical Center, Okayama University HospitalTaiheiYamadaAdvanced Emergency and Critical Care Medical Center, Okayama University HospitalKoheiTsukaharaAdvanced Emergency and Critical Care Medical Center, Okayama University HospitalHiromichiNaitoAdvanced Emergency and Critical Care Medical Center, Okayama University HospitalTakaakiOsakoAdvanced Emergency and Critical Care Medical Center, Okayama University HospitalAtsunoriNakaoAdvanced Emergency and Critical Care Medical Center, Okayama University HospitalReview10.18926/AMO/55433Worldwide, hemorrhagic shock in major trauma remains a major potentially preventable cause of death. Controlling bleeding and subsequent coagulopathy is a big challenge. Immediate assessment of unidentified bleeding sources is essential in blunt trauma patients with hemorrhagic shock. Chest/pelvic X-ray in conjunction with ultrasonography have been established classically as initial diagnostic imaging modalities to identify the major sources of internal bleeding including intra-thoracic, intra-abdominal, or retroperitoneal hemorrhage related to pelvic fracture. Massive soft tissue injury, regardless of whether isolated or associated with multiple injuries, occasionally causes extensive hemorrhage and acute traumatic coagulopathy. Specific types of injuries, including soft tissue injury or retroperitoneal hemorrhage unrelated to pelvic fracture, can potentially be overlooked or be considered “occult” causes of bleeding because classical diagnostic imaging often cannot exclude such injuries. The purpose of this narrative review article is to describe “occult” or unusual sources of bleeding associated with blunt trauma.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7052016The Clinical Application of Hydrogen as a Medical Treatment331337ENAtsuyoshiIidaDepartment of Emergency and Critical Care Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNobuyukiNosakaDepartment of Emergency and Critical Care Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTetsuyaYumotoDepartment of Emergency and Critical Care Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesEmilyKnaupDepartment of Emergency and Critical Care Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHiromichiNaitoDepartment of Emergency and Critical Care Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesChihiroNishiyamaDepartment of Emergency and Critical Care Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYasuakiYamakawaDepartment of Emergency and Critical Care Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKoheiTsukaharaDepartment of Emergency and Critical Care Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMichihisaTeradoDepartment of Emergency and Critical Care Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKeijiSatoDepartment of Emergency and Critical Care Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesToyomuUgawaDepartment of Emergency and Critical Care Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesAtsunoriNakaoDepartment of Emergency and Critical Care Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesReview10.18926/AMO/54590In recent years, it has become evident that molecular hydrogen is a particularyl effective treatment for various disease models such as ischemia-reperfusion injury; as a result, research on hydrogen has progressed rapidly. Hydrogen has been shown to be effective not only through intake as a gas, but also as a liquid medication taken orally, intravenously, or locally. Hydrogenʼs effectiveness is thus multifaceted. Herein we review the recent research on hydrogen-rich water, and we examine the possibilities for its clinical application. Now that hydrogen is in the limelight as a gaseous signaling molecule due to its potential ability to inhibit oxidative stress signaling, new research developments are highly anticipated.No potential conflict of interest relevant to this article was reported.