VizD Vol 1.3

Case 1.3

Name that Bodily Fluid

1. A 23-year-old man after performing 30 minutes straight of leg-squats

2. A 66-year-old woman with abdominal distension

3. A 42-year-old man with epigastric pain that radiates to his back

Questions for each image above:

1. What is the fluid?  What condition is it associated with?

2. What is the fluid?  What condition is it associated with?

3. What is the substance?  What condition is it associated with?

Please post your answer in the “reply box” or click on the “comments” link You will not see your answer post until next week when all of the submitted answers will be posted. Good luck!

VizD is a weekly contest of an interesting or pathognomonic image from emergency medicine. Its goal is to integrate learning into a fun and relaxed environment. All images are original and are posted with the consent of the patient.

9 Responses

  1. 1. Urine with myoglobinuria – Rhabdomyolysis
    2. Gastric Fluid with Bile – Bowel Obstruction
    3. Melena – Upper GI Bleed

  2. 1) Urine containing myoglobin (myoglobinuria) secondary to rhabomyolysis caused from excessive muscle use.

    2) Gastric juice likely pulled from an NG Tube that had accumulated from a small bowel obstruction.

    3) A very thickened biliary sludge bordering on gallstone that is causing gallstone (sludge) pancreatitis.

  3. 1. Myoglobinuria–associated with muscle breakdown or rhabdomyolysis.
    2. Bilious emesis—associated with bowel obstruction, such as volvulus.
    3. Black pigment gallstones–can lead to pancreatitis

  4. 1. Urine (bloody) associated with rhabdomyolysis, secondary int his case to strenuous excercise and possible steroid use?

    2. Bilious gastric contents. Associated with bowel obstruction.

    3. Melanotic stool. Associated with upper GI bleed, in this case due to pancreatitis vs peptic ulcer.

  5. 1.) This is urine. Associated with myoglobinuria due to the red color.
    2.) This is bile fluid probably due to a bowel obstruction, or even drainage from biliary disease.
    3.) This is melena probably from a GI bleed due more commonly to an ulcer.

  6. 1) urine, rhabdo
    2) bilious emesis, SBO
    3) melena, GIB

  7. 1. Red fluid is red urine. But it isnt hematuria. The discoloration is secondary to rhabdomyolysis and the red isnt blood, its myoglobin.

    2. Green fluid from NG is from bile and that plus distention indicates a possible bowel obstruction.

    3. Epigastric pain radiating to back and a pile of rocks on a surgical towel = gallstones and referred pain from cholelithiasis.

  8. 1. Serosanguinous fluid, Synovitis
    2.Bile, Biliary leak…did patient have surgery recently??
    3. Gallstones, Gallstone pancreatitis

  9. 1. Hematuria. Associated with rhabdomyolysis.
    2. Bilious gastric fluid. Associated with small bowel obstruction/ileus.
    3. Gallstone. Assocated with gallstone pancreatitis or cholecystitis but in his case it sounds more like gallstone pancreatitis.

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