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Resumen ANTECEDENTES: El síndrome de Hamman se caracteriza por la coexistencia de aire libre en el mediastino sin una causa identificable; también puede ser secundario a traumatismos, infecciones intratorácicas, procedimientos médicos como la esofagoscopia y broncoscopia. Su incidencia se estima entre 1 en 2000 y 1 en 100,000 embarazos. CASO CLÍNICO: Paciente de 18 años, con 65 kg de peso, 1.56 m de talla e IMC 26.74, correspondiente a sobrepeso, primigesta, sin antecedentes patológicos ni heredofamiliares relevantes, con evolución normal del embarazo. A las 39 semanas acudió a urgencias ginecológicas debido a contractilidad uterina y salida de líquido por la vagina. La finalización del embarazo fue por parto, con recién nacido vivo. En el puerperio mediato (30 horas después del parto) súbitamente tuvo disnea, ortopnea y dolor en la región infraclavicular, sensación de "burbujeo" en la parte anterior del tórax. La radiografía simple de tórax mostró aire libre en el mediastino y enfisema subcutáneo. La TAC de tórax evidenció múltiples burbujas de aire, con extensión del espacio perivertebral de predominio derecho. La conclusión diagnóstica fue: enfisema extenso subcutáneo en los espacios del cuello, con alcance al mediastino anterior, con extenso neumomediastino y cardiomegalia global. CONCLUSIONES: El síndrome de Hamman prevalece en primigestas jóvenes y tiene un curso benigno. El tratamiento debe ser conservador, con oxígeno y analgésicos.
Abstract BACKGROUND: Hamman's syndrome is characterized by the coexistence of free air in the mediastinum without an identifiable cause; it may also be secondary to trauma, intrathoracic infections, medical procedures such as oesophagoscopy and bronchoscopy. Its incidence is estimated to be between 1 in 2000 and 1 in 100,000 pregnancies. CLINICAL CASE: 18-year-old female patient, weight 65 kg, height 1.56 m and BMI 26.74, corresponding to overweight, primigravida, with no relevant pathological or heredofamilial history, with normal evolution of pregnancy. At 39 weeks, she attended the gynaecological emergency department due to uterine contractility and leakage of fluid from the vagina. The pregnancy was terminated by delivery, with a live newborn. In the immediate postpartum period (30 hours after delivery) she suddenly experienced dyspnoea, orthopnoea and pain in the infraclavicular region, with a sensation of "bubbling" in the anterior chest. Plain chest X-ray showed free air in the mediastinum and subcutaneous emphysema. Chest CT showed multiple air bubbles, with extension of the perivertebral space predominantly on the right. The diagnostic conclusion was: extensive subcutaneous emphysema in the neck spaces extending into the anterior mediastinum, with extensive pneumomediastinum and global cardiomegaly. CONCLUSIONS: Hamman syndrome is prevalent in young primigravidae and has a benign course. Treatment should be conservative, with oxygen and analgesics.
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Coronavirus 2019 (COVID-19) is an enveloped ribonucleic acid (RNA) virus that is diversely found in humans and wildlife. A total of six species have been identified to cause disease in humans. The most recent outbreak initially presented as pneumonia of unknown etiology in a cluster of patients in Wuhan, China. The epicenter of infection was linked to seafood and exotic animal wholesale markets in the city. SARS-CoV-2 is highly contagious and is a declared global pandemic. This review will introduce a general overview of virology and describe the clinical features, diagnostic testing, and management of COVID-19 patients. There are multiple drug trials going on with some positive results. However, since no vaccine is available, the best way to combat the virus is by preventive methods. Our review will also provide a means to raise awareness among primary and secondary healthcare providers during the current pandemic.
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Resumen Los tumores cardíacos primarios son poco frecuentes y a menudo asintomáticos. Tienen una incidencia que varía de 0,0017% a 0,28%. El diagnóstico diferencial de masas cardíacas incluye vegetaciones, trombos y tumores. Puede involucrar el endocardio, miocardio o epicardio. La afectación secundaria del corazón por tumores extracardíacos es rara. Los tumores benignos constituyen el 80% de las neoplasias cardíacas primarias y los mixomas son el tipo predominante. El tumor cardíaco maligno más frecuente es el angiosarcoma, y se caracteriza por crecimiento rápido, invasión local y metástasis a distancia. Se presenta el caso de paciente adulta joven con síntomas cardiovasculares inespecíficos asociados a pérdida de peso, cuyo diagnóstico ecocardiográfico e histopatológico es compatible con mixoma cardíaco.
Abstract Primary cardiac tumours are rare and are often asymptomatic, with an incidence that varies from 0.0017% to 0.28%. The differential diagnosis of cardiac masses includes, growth, clots, and tumours. It can involve the endocardium, myocardium or epicardium. The secondary involvement of the heart due to extra-cardiac tumours is rare. Benign tumours make up 80% of the primary cardiac neoplasms, and myxomas are the most predominant type. The most common malignant cardiac tumour is the angiosarcoma, and is characterised by rapid growth, local invasion, and distant metastases. A case is presented of a young adult patient, with non-specific cardiovascular symptoms together with a loss of weight. Her echocardiographic and histopathology diagnosis was compatible with a cardiac myxoma.
Subject(s)
Humans , Female , Adult , Dyspnea , Heart Neoplasms , Neoplasms , Weight Loss , Diagnosis, Differential , MyxomaABSTRACT
Background: Epidemiology and clinical course of dilated cardiomyopathy (DCM) in children and infants are not well established. Thus, this study aims to investigate the clinical course and prognosis of DCM in childrenMethods: This was a single-center, prospective, observational study conducted at a tertiary-care center in India between February 2011 and September 2012. A total of 31 patients admitted to the paediatric department diagnosed with DCM were included in the study. Patients were divided into three groups based on the age at the time of diagnosis: 0-3 years, >3-12 years and >12-16 years. Among the study population, 28 patients were followed up for a mean period of 1.44 years and three patients were lost to follow-up.Results: Of the 31 patients, 11 patients were male with a mean age of 8.9±6 years and 20 patients were female with a mean age of 8.3±6 years. All patients were presented with same characteristics of New York heart association (NYHA) class III-IV dyspnoea and fatigue. Among 28 patients who were followed-up for a mean period of 1.44 years, 20(71.4%) patients died and eight patients were on follow up. Of the eight patients, five patients were with NYHA class III symptoms and three patients were with NYHA class I-II symptoms.Conclusions: Dilated cardiomyopathy in children is a very serious disease with a grave prognosis. Patients with NYHA III-IV symptoms have a very high mortality rate and potential use of other therapies remains to be fully evaluated in paediatric population.
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Resumen Se expone el caso de una paciente femenina de 39 años, con antecedente de disnea progresiva y eventos recurrentes de palpitaciones, en quien durante examen físico se observó ingurgitación yugular, ascitis de gran importancia y tercer ruido cardíaco compatible con "golpe pericárdico". Las pruebas de laboratorio mostraron niveles aumentados de péptido cerebral natriurético y titulación positiva de anticuerpos para el factor antinuclear. La radiografía de tórax mostró imagen radiopaca alrededor de la silueta cardiaca en patrón de "cáscara de huevo". La reconstrucción tomográfica evidenció calcificación pericárdica circunferencial difusa, incluida la pared miocárdica del ventrículo izquierdo y el músculo anteromedial papilar de la válvula mitral.
Abstract It is presented the case of a 39 year-old female patient with a history of progressive dyspnoea and recurrent palpitation events. On physical examination jugular ingurgitation was observed, as well as a highly significant ascites, and heart sounds compatible with "pericardial knock". The laboratory test results reported increased levels of brain natriuretic peptide and a positive antibody titre for antinuclear factor. The chest X-ray showed a radio-opaque image around the cardiac outline in an "egg shell pattern". The computed tomography reconstruction showed evidence of a diffuse calcification of the pericardial circumference, including the myocardial wall of the left ventricle and the antero-medial papillary muscle of the mitral valve.
Subject(s)
Humans , Female , Adult , Pericarditis, Constrictive , Ascites , Dyspnea , Papillary Muscles , Radiography , Tomography , Heart Ventricles , Mitral ValveABSTRACT
Background: Many of the ILDs are difficult to differentiate on clinical examination and history as they have similar clinical features. Symptom complex is not beyond that of respiratory symptoms. The objective was to study the clinical picture and spirometry pattern of the patients having interstitial lung disease.Methods: Hospital based cross sectional study was carried out among 73 cases of ILDs. Data related to history, clinical examination was recorded. Six minute walk test and spirometry was carried out. The data was analysed using proportions.Results: Incidence of Idiopathic pulmonary fibrosis (IPF) increased with age. Exertional dyspnea (100%) and cough (95.9%) were the commonest presenting symptoms amongst ILD patients. End inspiratory fine crackles (95.1%) and clubbing (67.1%) are the predominant clinical signs. Mean BMI of various ILDs patients were 24.86±8.2 Kg/m² in NSIP followed by 22.9±4.6 in sarcoidosis 21.9±6.4 and 20.8±3.94 in IPF and in Cryptogenic Organizing Pneumonias 19.34±1.8 Kg/M². Serum ACE level was raised in 69.2% patients of sarcoidosis. 81 % of patients could successfully perform 6 Minute Walk Test. Among those who could perform, average desaturation was 8.11% in sarcoidosis, 7.52% in IPF, 6.0% In Hypersensitivity Pneumonitis, 5.75% in NSIP and 4.75% in CTD associated ILDs patients. Raised C Reactive Protein label was consistent (45.2%) in ILDs, maximum in HP (63%) and 2 out of 3 patients with COP and 3 out of 5 patients of CTD associated ILDs. 17.8% cases had positive serum ANA, maximum in IPF.Conclusions: Idiopathic pulmonary fibrosis (IPF) was the commonest Interstitial Lung disease present in 39.7% of 73 cases followed by sarcoidosis in 17.9%, cases.
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Background: Allocation of the limited resources to the needed patients and decision making regarding timely interventions demand development of a reliable, cost effective, simple assessment tool. Several studies propose body-mass index, airflow obstruction, dyspnea, and exercise (BODE) index for this purpose in patients with Chronic obstructive pulmonary disease (COPD). The objective of this study was to assess the utility of BODE index to predict the severity of exacerbations and systemic involvement in COPD.Methods: A Present hospital based cross sectional study was carried out among 100 COPD patients. BODE index was used to assess the patients and its association was studied with various variables. The data was analyzed using one-way analysis of variance (ANOVA) test.Results: As the body index class of severity increases, the number of hospitalizations required in the past also increases and this association is statistically significant. As the severity of the disease increased as indicated by the class the mean number of exacerbations in the past increased and this association was found out to be statistically significant. As the severity of the disease increased as indicated by the class level, the mean number of days of hospitalization increased. But this increase was of small difference and hence on one-way ANOVA test was not found out to be statistically significant. As the pack years increases, the BODE index increases significantly (p value <0.001). As the severity of the disease increased, the mean body mass index decreased. Haemoglobin level was found to decrease with increase in BODE index class of severity. This association was statistically significant.Conclusions: The BODE index has been found to be a very good tool to assess the prognosis of COPD as well as severity of acute exacerbations.
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Studies regarding clinical profile of Acute Exacerbation of Chronic Obstructive Pulmonary Disease (AECOPD) is extremely rare from the north-eastern part of India. This necessitates the present study. Aim: The present study aimed to describe the clinical profile of Acute Exacerbation of COPD (AECOPD) patients admitted in the Department of Respiratory Medicine, JNIMS, Imphal. Methods: The hospital records of all Acute Exacerbations of COPD patients admitted during the period Sept 2015 to Aug 2016 in the IPD of the Department of Respiratory Medicine, JNIMS were recorded retrospectively and analyzed by using descriptive statistics. Results: A total of 100 patients were admitted during the study period of one year. The mean age (SD) of the patients was found to be 71.3 (10.567) years. Female patients outnumbered male patients (M:F=1:1.08). The last quarter of the year (Sept-Dec) showed the least number of patients admitted while remaining months of the year had variable but relatively higher number of patients admitted with a peak in August. Dyspnoea was the commonest symptom which was found in almost all the patients (99%). Co-amoxiclav, Cephalosporin, Macrolide and Fluoroquinolone were the antibiotics most frequently used. In addition to the antibiotics mentioned above, steroids were needed and administered in 74 cases (74%). Methylprednisolone and Hydrocortisone were the main steroidal preparations used. Ventilation support was needed by two (2%) patients. And altogether three patients died during the study period (3%). The period of stay in IPD by all the patients ranged from 2-35 days with a mean (SD) of 8.51 (6.268) days. Conclusion: COPD exacerbation was seen in ageing population of both sexes. Dyspnoea was commonest symptom and mean hospital stay was 8.51 days. Antibiotics and steroid commonly prescribed were Coamoxiclav and methylprednisolone respectively. 3% of study population expired.
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Background: This study is done to study the clinical profile of community acquired pneumonia in patients admitted in medical wards at MNR Hospital, Sangareddy and to find out the associated risk factors of community acquired pneumonia.Methods: 75 Patients admitted in the department of medicine of MNR Medical college and Hospital, Sangareddy with clinical manifestations of Community acquired pneumonia from august 2012 to January 2015 (Two years and 6 months) were taken into the study. All adult patients of both genders aged above 14 yrs, who presented with acute onset of fever associated with chills and rigors, having cough with expectoration and/ or chest pain and breathlessness were included in the study. All the patients were subjected for detailed clinical examination to make a provisional diagnosis of community acquired pneumonia (CAP). Patients with hospital acquired pneumonia, aspiration pneumonia and PCP pneumonia in patients with HIV were excluded.Results: Among 75 cases studied, the mean patient age was 52.1 years with Male: Female patient ratio 3.17:1. The associated diseases in this study are COPD (30.67%) and DM (12.0%).The most common presenting symptoms were fever (100%), cough (100%), and expectoration (100%); other symptoms included chest pain (60%), dyspnoea (61.33%). The respiratory signs included bronchial breath sounds, increased VF and VR, and presence of whispering pectorolique in all subjects. Conclusions: Identification and determining the clinical patterns of community acquired pneumonia helps in adoption of regionally optimized diagnostic approach.
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@#A case study of a 76-year-old man with end-stage chronic obstructive pulmonary disease (COPD) with refractory breathlessness and the challenges in managing the dyspnoea he had been experiencing are described. A multi-modal approach is the mainstay of management, encompassing pharmacological agents, home oxygen therapy, and non-pharmacological approaches, namely, breathing techniques and smoking cessation. As this patient was at an advanced stage of disease, integration of palliative care with disease care was needed. Administering oxygen therapy for a patient who is still smoking and has household members who are current smokers need firm adherence to rules. The AIC HOME Programme is also briefly described.
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Introduction: Heart failure is the end stage of all diseases of the heart and is a major cause of morbidity and mortality. Since 1970s the treatment of CHF has been transformed, resulting in major benefit to patients. This advance has been the consequence of better understanding of the pathophysiology, investigations, the introduction of newer drugs and cardiac transplantation. Aim of the study: To find out the prevalence of congestive heart failure among the patients admitted in the hospital and to analyse their presenting features and precipitating factors. Materials and methods: A total of 196 cases that satisfied the inclusion and exclusion criteria stated above were taken up for subsequent study. Results: During the study period, 6072 patients were admitted in the medical wards. Out of them 196 satisfied the inclusion criteria. So the prevalence was 3.2 % (196/6072). Among the 196, 7 were expired, thus case fatality rate was 3.5% (7/196). Conclusion: The prevalence of congestive heart failure among hospitalized was 3.2 %Congestive heart failure was common among the age group of 45 – 65 years. Drug intake mainly Non-steroidal anti-inflammatory drugs, anaemia and infections were the most common precipitating factors
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La neumoconiosis es caracterizada por el depósito nodular difuso de polvo en los pulmones como resultado de la exposición prolongada a polvo bituminoso o de antracita en los trabajadores de las minas de carbón. La neumoconiosis de los mineros del carbón también se denomina enfermedad del pulmón negro o antracosis. Un minero del carbón que padece o desarrolla una Antracosis puede presentar numerosos nódulos redondeados pulmonares en poco tiempo. Dichos nódulos aparecen en ocasiones en ausencia de una antracosis simple. A nivel histológico pueden parecerse a los nódulos reumatoides, pero tienen una zona periférica de inflamación aguda. Estos nódulos representan la respuesta inmunológica a la diátesis reumatoide asociada. En Colombia la minería es un factor estratégico a nivel económico para su desarrollo. Sin embargo, existen factores negativos derivados de ésta que giran en una carrera sin control ni reglas claras; esta actividad hace trámite en el territorio, arrastrando una estela de problemas sobre la sociedad, el ambiente, el bienestar y la salud de las personas.
Pneumoconiosis is characterized by diffuse nodular dust in the lungs as a result of prolonged exposure of workers in coal mines to bituminous dust or anthracite. Pneumoconiosis presented in coal miners is also called black lung disease lung. A coal miner who develops Anthracosis can present numerous pulmonary rounded nodules in a short time. These nodules appear sometimes in the absence of a simple anthracosis. Histologically they may look like resemble rheumatoid nodules, with the difference; they have a peripheral area of acute inflammation. These nodes represent the immune response associated to rheumatoid diathesis. In Colombia, mining is a strategy for economical development. However, there are negative factors arising rotating it in a race without control or clear rules; This activity is pending in the territory, dragging a trail of problems on society, the environment, welfare and People's health
A pneumoconiose é caracterizada por poeira nodular difusa nos pulmões como resultado da exposição prolongada a poeiras betuminosas ou antracite nas minas de carvão. Pneumoconiose de mineiros de carvão também chamado preto ou preto doença pulmonar pulmão. Um mineiro de carvão que sofre ou desenvolve uma antracose pode apresentar numerosos nódulos pulmonares arredondados em um curto espaço de tempo. Estes nódulos aparecem às vezes na ausência de uma antracose simples. Histologicamente podem assemelhar-se a nódulos reumatóides, mas têm uma área periférica de inflamação aguda. Esses nódulos representam a resposta imune associada à diátese reumatóide. A mineração na Colômbia é um fator estratégico economicamente para o desenvolvimento. No entanto, existem fatores negativos decorrent surgindo girando-o em uma corrida sem controle ou regras claras. Esta atividade está pendente no território, arrastando um rastro de problemas na sociedade, o meio ambiente, bem-estar e da saúde das pessoas.
Subject(s)
Humans , Male , Adult , Pneumoconiosis , Macrophages, Alveolar , Colombia , Dyspnea , AnthracosisABSTRACT
Dyspnoea is the subjective experience of breathing discomfort, made up of distinct sensations varying in intensity. It is caused by multiple factors in palliative patients, such as infections, anaemia or anxiety. Tools like the Visual Analogue Scale (VAS), Numerical Rating Scale (NRS) and the Modified Borg scale, together with Functional Assessment Scales like the Medical Research Council Dyspnoea Scale and Baseline Dyspnoea Index (BDI) are used to measure the severity of Dyspnoea. Oxygen therapy can provide comfort for patients and can increase survival in selected COPD patients. An N=1 trial of supplemental oxygen is encouraged for patients with dyspnoea.Other non-pharmacological interventions such as breathing training and walking aids have been proven to be effective in managing dyspnoea. Studieshave shown that oral or parenteral opioids are useful for relieving dyspnoea. They are safe to use in titrated doses. However, morphine should be used cautiously in patients with impaired renal and liver functions. Benzodiazepines are not recommended for first-line treatment, and should be administered after consult with a palliative physician. Effort should always be made to correct reversible causes.Family education is important to alleviate the stress of caring for patients with dyspnoea.
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Background: Pleural effusions commonly occur in patients with advanced cancer and tuberculosis. Pleural aspiration by the conventional tube thoracostomy using large bore chest tube-intercostal drain (ICD) - can often cause discomfort to patients. The aim of this study is to compare the efficacy of drainage of pleural effusions using flexible small bore Pleural Catheter (PC) and ICD. Methods: In this prospective study, 101 patients (age 16-65 years) with pleural effusions were divided into PC (n=60) and ICD (n=41) groups. Responses were evaluated and analyzed statistically. Results: The PC group was equally efficacious as ICD with regard to complete re-expansion of lung. The most common complication in the PC group was block (9/60 i.e. 15%). Difference in the mean number of days on drain in the PC (4.9 days) and ICD group (5.8 days) as well as the mean number of times analgesics administered in the PC (2.85 days) and the ICD group (7.53 days) were statistically significant (p <0.05). Similarly, the complications such as surgical emphysema, haemorrhage, desaturation and hypotension were high in the conventional group when compared to that of PC group (p <0.05). Conclusions: Flexible small bore intercostal catheter is a valid and safe option for drainage of pleural effusion when compared to the conventional tube thoracostomy.
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Breathlessness, also known as dyspnoea, is a common presenting complaint in the outpatient family physician clinic. It is most commonly caused by respiratory and cardiac disorders, but there are lots of other important aetiologies that need to be considered. The initial goal of assessment is to determine the severity of the dyspnoea, considering the need for oxygen therapy and intubation. Unstable patients usually present with abnormal vital signs, hypoxia, diaphoresis, and/or altered mental states, and require urgent management. Ongoing care depends on the differential diagnosis established by an adequate history and physical examination, and investigations, if available, can aid definitive diagnosis. The family physicians must be equipped to initiate appropriate therapy, conduct continuous monitoring and stabilise an acutely dyspnoeic patient before determining the final disposition of the patient.
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Background: We aimed to determine the mortality two months after exacerbation of chronic obstructive pulmonary disease (eCOPD) and to identify factors associated with mortality, comparing patients admitted to wards and those discharged to home from the emergency department. Methods: This prospective multicentre study included all consecutive patients presenting with eCOPD at emergency departments in 16 public hospitals in Spain. Clinical variables were recorded from a standardized questionnaire. Independent predictors of mortality were modelled by logistic regression analysis. The calibration and discriminative power of the models for the two groups (discharged and admitted) were estimated by the Hosmer-Lemeshow test and the area under the curve (AUC), respectively. Bootstrap methods were applied for internal validation. Results: 2487 patients were included; 1537 (62%) of these were admitted to wards. A total of 155 (6.2%; 95% CI: 5.2% - 7.1%) patients had died at 2 months: mortality was four times higher in patients admitted than in patients discharged. Age ≥ 80 years, Charlson score >2, and pronounced dyspnoea were independent factors for mortality in both groups; in admitted patients, Glasgow scale, baseline treatments for COPD, previous heart disease, complications during hospitalization, and corticoids at discharge were also independent factors. Conclusions: In eCOPD, age, comorbidities, and dyspnoea are important for short-term prognosis in both patients admitted to wards and those discharged to home. In patients admitted to wards, the severity of baseline disease and eCOPD and corticoid treatment affect the short-term prognosis.
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Background: The measurement of ECO may represent a new method for the non-invasive monitoring of airway inflammation and oxidant stress in Chronic Obstructive Pulmonary Disease, asthma, bronchiectasis, cystic fibrosis patients. Quantification of lung oxidative stress in stable COPD patients by measuring ECO levels may also contribute to the understanding of the pathophysiology of COPD. Aims & Objective: To study the utility of measuring Exhaled Carbon Monoxide (ECO) level in addition to Pulmonary Function Test (Spirometry) in the monitoring of Chronic Obstructive Pulmonary Disease (COPD). Materials and Methods: COPD patients who were smokers and with a history of exposure to wood smoke (n =60) and healthy non-smokers as control (n =40) were selected as subjects by fulfilling the exclusion criteria as per the GOLD guidelines. Clinical examinations and spirometry including reversibility test were made following the standard protocol/procedure. ECO was measured using a MICRO III Smokerlyser. Results: The difference in level of ECO between COPD cases and healthy non-smokers was highly significant (F = 23.897; df = 98; p < 0.0001). The difference in the level of ECO among different groups (mild, moderate, severe and very severe) was highly significant (F=15.995; df =2; p<0.0001). ECO level in female COPD cases who were exposed to wood smoke was elevated (4.11 ± 1.323) when compared to healthy female non-smokers (1.50 ± 0.519) and the difference was highly significant. (F =1.593; df = 30; p < 0.0001). Conclusion: ECO levels in COPD cases vary with different grades of air way obstruction. We concluded that measuring the level of ECO in COPD cases along with spirometry forms a new approach for better understanding of pathophysiology of COPD cases, with indirect assessment of airway inflammation, oxidative stress and severity of airway obstruction.
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We present a case of 50 year old male patient with coexistence of Pneumothorax and Chilaiditi sign. Chilaiditi sign is an incidental radiographic finding of a usually asymptomatic condition in which a part of intestine is located between the liver and diaphragm; however, the term "Chilaiditi syndrome" is used for symptomatic hepatodiaphragmatic interposition. The patient had no symptoms of abdominal pain, constipation, diarrhea, or emesis. Incidentally, Chilaiditi sign was diagnosed on chest radiography. Pneumothorax is defined as air in the pleural space. Pneumothoraces are classified as spontaneous or traumatic. Spontaneous pneumothorax is labelled as primary when no underlying lung disease is present, or secondary, when it is associated with pre-existing lung disease. Our case is the rare in the literature indicating the coexistence of Chilaiditi sign and pneumothorax.
Subject(s)
Humans , Male , Middle Aged , Chest Pain , Chilaiditi Syndrome , Diagnosis , Dyspnea , Pneumothorax , DiagnosisABSTRACT
We present a case of 50 year old male patient with coexistence of Pneumothorax and Chilaiditi sign. Chilaiditi sign is an incidental radiographic finding of a usually asymptomatic condition in which a part of intestine is located between the liver and diaphragm; however, the term“Chilaiditi syndrome”is used for symptomatic hepatodiaphragmatic interposition. The patient had no symptoms of abdominal pain, constipation, diarrhea, or emesis. Incidentally, Chilaiditi sign was diagnosed on chest radiography. Pneumothorax is defined as air in the pleural space. Pneumothoraces are classified as spontaneous or traumatic. Spontaneous pneumothorax is labelled as primary when no underlying lung disease is present, or secondary, when it is associated with pre-existing lung disease. Our case is the rare in the literature indicating the coexistence of Chilaiditi sign and pneumothorax.
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Oesophageal Carcinoma presenting as symptoms of acute respiratory distress is extremely rare. Hence diagnosis may be difficult as all the initial investigations are focused towards finding a respiratory cause. In this paper the authors report a 62 year old Caucasian male who presented with acute dyspnoea with no respiratory history but was subsequently discovered to have an oesophageal carcinoma as the likely underlying cause. Subsequent investigations revealed it to be a stage IB squamous cell midoesophageal carcinoma that was treated by radiotherapy. It is important when evaluating a patient with acute respiratory symptoms but no previous respiratory history to consider alternative pathologies related to surrounding anatomical structures also.