Ectopic pregnancy is a pregnancy that occurs outside the uterus, most commonly in the fallopian tube. It is usually suspected if a pregnant woman experiences any of these symptoms during the first trimester: vaginal bleeding, lower abdominal pain, and amenorrhea. An elevated BhCG level above the discriminatory zone (2000 mIU/ml) with an empty uterus on a transvaginal ultrasound is essential for confirming ectopic pregnancy diagnosis. Such pregnancy can be managed medically with methotrexate or surgically via laparoscopy or laparotomy depending on the hemodynamic stability of the patient and the size of the ectopic mass. In this case study, we report on a 38-year-old woman, G3P2+0 who presented to King Abdulaziz University Hospital’s emergency department with a history of amenorrhea for three months. She was unsure of her last menstrual period and her main complaint was generalized abdominal pain. Upon examination, she was clinically unstable and her abdomen was tender on palpation and diffusely distended. Her BhCG level measured 113000 IU/ml and a bedside pelvic ultrasound showed an empty uterine cavity, as well as a live 13 weeks fetus (measured by CRL). The fetus was seen floating in the abdominal cavity and surrounded by a moderate amount of free fluid, suggestive of ruptured tubal ectopic pregnancy. The patient’s final diagnosis was live ruptured 13 weeks tubal ectopic pregnancy which was managed successfully through an emergency laparotomy with a salpingectomy.

Cecal volvulus is a very rare cause of large bowel obstruction (LBO) that develops when a part of the bowel twists around the mesentery. Cases of acute abdomen, regardless of age, race, and ethnicity, should be examined to exclude volvulus from differential diagnoses. Surgery is the only confirmatory method to diagnose and treat this life-threatening condition. Here, we report a case of a 35-year-old female patient who presented with abdominal pain, distension, constipation, and vomiting. Abdominal computed tomography (CT) aided in accurately diagnosing the cecal volvulus, and the patient immediately underwent an exploratory laparotomy.

Background: Cardiac arrest is a problem that has gotten surprisingly little attention in the ER. ER Patients are more likely (29%) than patients in the intensive care unit (25%) or on telemetry (25%), to encounter an initial ventricular fibrillation rhythm or pulseless ventricular tachycardia. Our research aims to identify the prognostic factors for cardiac arrest in the ER at KSMC. Method: From January 2022 to Jun 2022, a retrospective study was done in the tertiary care hospital KSMC in Riyadh, Saudi Arabia. The ministry of health introduced and oversees the hospital records system, which was used to collect data, in 2015. All persons over the age of 18 who experienced an in-hospital resuscitation attempt after cardiac arrest were eligible to take part in the study. Results: We included 98 people who received resuscitation techniques after suffering ER cardiac arrest. Patients who had ER cardiac arrest had an average age of 69.5 + 23.4 years. Overall, 60.2% of the patients were men. The two most common concurrent comorbidities were hypertension (43.8%) and coronary artery disorders (41.8%). The average time spent performing CPR was 22 minutes (IQR 11-49 minutes). When the factors influencing the success of resuscitation were determined using multiple regression analysis, resuscitation lasting fewer than 30 minutes was the most component that could predict the restoration of spontaneous circulation. Conclusion:Our study concluded that ER cardiac arrest more common in male gender. About one third of patients affected with ER cardiac arrest discharged home well.

No abstract