ABSTRACT
Sepsis-induced cardiomyopathy is a reversible myocardial dysfunction due to sepsis, which may be severe enough to complicate cardiogenic shock, and without effective drug and with high mortality during the acute phase. A case of sepsis-induced cardiomyopathy complicated with cardiogenic shock was treated in the intensive care unit (ICU) of Shunde Hospital Southern Medical University. A 37 years old female patient was admitted because she had suffered repeated fever for 5 days, chest tightness and abdominal pain for 3 days. At the same time, there were severe cardiac depression and abdominal infection, which could be explained by the monismtheory of sepsis cardiomyopathy. The cardiogenic shock patient was not improved after antibiotic therapy and hemodynamic support, extracorporeal membrane oxygenation (ECMO) support was prescribed. The circulation failure was smoothly got through with ECMO and was transfer from ICU to ordinary ward. Computed tomographic angiography (CTA) of abdominal aorta and colonoscopy indicated lesions of small intestine. The diagnosis of infection and bleeding in ileum diverticulum was confirmed during the operation and the lesions was removed. She recovered and was discharged 1 week after operation. Through the case review, we aim to improve the awareness of sepsis-induced cardiomyopathy and the value of ECMO support in cardiogenic shock.
ABSTRACT
Objective To analyze MSCT characteristics of septic pulmonary embolism (SPE) caused by intravenous drug and to improve diagnosis. Methods The MSCT findings of 16 patients of SPE induced by intravenous drug were analyzed retrospectively from March, 2001 to September, 2008. Results Peripheral or sub-pleural zones were commonly affected mainly within upper lung. Patchy, nodular and cavity shadows were detected respectively in 9 (56.25%), 12 (75.00%) and 8 patients (50.00%), while pulmonary cysts in 14 patients (87.50%). Six patients underwent CTPA, and pulmonary arteries filling defect was found in 2 patients. Pleural effusion and pneumothorax were also found in 10 and 3 patients, respectively, whereas miscellaneously shaped lesions were deteced in all 16 patients. Conclusion MSCT is an important method for diagnosing SPE caused by intravenous drug abuse. Pulmonary arteries filling defect is the direct sign and the cysts and nodular shadow with or without cavity in peripheral or sub-pleural pulmonary zones are characteristic findings.
ABSTRACT
Objective To explore the diagnosis value of CT-guide percutaneous biopsy in the pulmonary nodules.Methods A total of 101 cases of the pulmonary nodules with unknown causes who underwent Germany-made auto-spring-gun spiral CT-guide percutaneous pulmonary biopsy were studied.Results The accuracy of centesis was 100%.97 cases were succeeded in getting diagnosis,the diagnosis rate was 96.0%.Among them,there were 61 cases of lung cancer,4 cases of malignant pleural mesothelioma,10 cases of metastatic carcinoma,16 cases of tuberculosis,6 cases of inflammatory pseudotumor.Pneumothorax occurred in 8 cases,hemoptysis occurred in 3 cases.The rate of complication was 10.9%.Conclusion CT-guide percutaneous biopsy to the pulmonary nodules is a safe and effective diagnostic means,which has a high diagnosis raze with few complication.