This postmortem scan is from a 66-year-old woman with chronic constipation. Her colon contained 16.8 pounds (7.6 kg) of stool. The massive fecal burden caused extreme enlargement of the colon, pushing the diaphragm upward and severely limiting the lungs’ ability to expand. The result was fatal respiratory compromise.
This incredible (and painful-looking) footage captures a severe, involuntary contraction of the gastrocnemius (calf) muscle, commonly referred to as a Charley Horse.
You can clearly see the muscle fibers undulating and tightly knotting up under the skin as the spasm peaks.
What is happening here?
A muscle cramp is a sudden, involuntary, and painful contraction of one or more muscles. At the physiological level, it is caused by the hyper-excitability of the motor neurons that innervate the muscle. Instead of a controlled signal, the nerves fire rapid, repetitive action potentials, keeping the muscle locked in a state of tetanic contraction.
Common Triggers:
Dehydration & Electrolyte Imbalance: A depletion of essential minerals like magnesium, potassium, calcium, or sodium can disrupt the normal nerve transmission and muscle contraction cycle.
Muscle Fatigue: Overuse or keeping the leg in an awkward, restricted position for too long (such as sitting in a cramped car seat, as seen here).
Poor Circulation or Temperature Changes: Sudden exposure to cold air (like an AC vent blowing directly on the leg) or restricted blood flow can sometimes initiate the spasm.
How to stop it in the moment:
The natural instinct is to panic or curl the toes downward, which actually shortens the calf muscle and worsens the cramp. The best immediate treatment is passive stretching:
Dorsiflexion: Pull the foot and toes upward toward the shin to manually force the gastrocnemius muscle to lengthen.
Massage & Warmth: Gently massaging the knotted muscle or applying heat can help restore normal blood flow and promote relaxation.
Cases like this are more common in the emergency department than many people realize. Unfortunately, patients often delay seeking medical care because of embarrassment. However, waiting can lead to serious, life-threatening complications such as bowel obstruction, tears in the rectum or colon, severe infection, hemorrhage, or peritonitis from a perforation.
In the emergency department, advanced imaging like this sagittal CT scan is crucial. It helps the clinical team determine the object’s exact size, shape, and location, while checking for any signs of internal injury or free air before deciding on the safest method of removal (ranging from transanal manual extraction under sedation to an emergency laparotomy).
Any EMS, ED, or surgical staff here? Have you ever encountered a case with an object this large during a shift? How did your team manage to safely extract it?
A large blood clot that was removed from the arteries of the lungs. Most clots like this begin as a deep vein thrombosis (DVT) in the legs or pelvis. If part of the clot breaks loose, it can travel through the bloodstream to the lungs, where it blocks blood flow. Without rapid treatment, this can quickly become life-threatening
This case highlights the devastating effects of septic microvascular injury — leading to irreversible ischemia, tissue necrosis, and ultimately multiple distal fingertip amputations.
The surgeon carefully debrides the nonviable distal phalanges and soft tissue to preserve as much healthy function and tissue as possible.
Cases like this are a reminder of how severe sepsis can rapidly progress beyond infection alone, causing profound vascular compromise and permanent functional damage despite aggressive ICU management.
As she finished tending to the flower beds and reached to hang up her gardening fork, the tool slipped from her grasp and fell directly into her hand, resulting in a dramatic impalement injury.
The gardening fork penetrated deep through the soft tissues of the hand, creating a transfixion wound with potential injury to tendons, nerves, blood vessels, and even bone. Despite the alarming appearance, the most important step was leaving the object in place until surgical evaluation could be performed, as removal outside a controlled setting can worsen bleeding and tissue damage.
After transport to the hospital, imaging was obtained to assess the path of the tines and identify any associated fractures or structural injuries. The patient underwent operative exploration, careful removal of the foreign body, extensive irrigation and debridement, and assessment of critical hand structures. Given the contamination associated with gardening tools and soil exposure, tetanus prophylaxis and antibiotic therapy were also essential to reduce the risk of infection.