October 2016

First place

Dr. Mark Hug

Prize: $15 Starbucks gift certificate

JCB: "Dr. Hug was taking care of an ill elderly man overnight, the patient was dehydrated, pale, ill appearing with vague complaints. He was found initially on labs to have AKI and hyperkalemia. Near the time to admit the pt, he started to complain of severe abdominal pain and was not able to void. Dr. Hug intended on checking the kidneys for hydronephrosis but instead found massively dilated bowel loops and was very concerned, he got me and we together found textbook evidence of small bowel obstruction on US (see images from google below, and lets all blame Dr. Avi for not saving them correctly so we are unable to see the actual images). Immediately NG tube was place based off of this US and 1.5L of feculent material came out, on close exam he had a small incarcerated L inguinal hernia found when trying to decompress the bladder (the likely culprit, however the patient did not complain of pain at that site)." 

Pic 1

Pic 2

Pic 3

Slide 1

 

runner-up

Dr. Ken Inamasu

Prize: Fame and Glory

Small Bowel Obstruction