Bindu Vanapalli Samuel Lee Richard Gordon
David Mishkin Marjan Siadat Chris Guyer
Julie Nguyen Allison Loynd Maria Pak
Answer Case 2.1
A 23-year-old man presents to your ED after being in a bar fight. The patient states he received multiple punches to his head and face. You note the following finding on exam.
1. What is the diagnosis?
Pinna hematoma – characterized by swelling, discoloration, ecchymosis, and flocculence.
2. What is the treatment in the ED?
This should undergo incision and drainage or large needle aspiration followed by the application of a pressure dressing to prevent reaccumulation of the hematoma.The patient should receive antistaphylococcal antibiotics and referred to an ENT surgeon.
3. What is a complication of this condition?
Failure to adequately drain a pinna hematoma results in reaccumulation of blood and increases the chances for perichondritis and ear disfigurement (cauliflower ear)
Thank you to everyone who submitted their answer. Stay tuned for next week’s VizD
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.