ABSTRACT
Pneumothorax is an extremely common entity that is typically readily diagnosed and treated. Standard treatment for a small pneumothorax in an otherwise healthy patient is oxygen and observation. For many cases of pneumothorax (those that are larger, more symptomatic, occur in patients with underlying lung disease, or occur in patients who live far from an emergency facility), treatment includes needle aspiration or chest tube placement. We report the clinical presentation and imaging appearance of a 47-year-old female who had a trocar traverse the heart during pleural chest tube placement. Based on this case, policies in the emergency department were reviewed and quality measures were improved.
ABSTRACT
OBJECTIVE: This is a case report of an adult male with complex type IV intraosseous DAVF causing severe venous hypertension and bony destruction, presenting with severe hemotympanum, and a novel way of staged arterial and venous embolizations to treat the emergent symptoms. METHODS: First and second stages were direct selective arterial embolizations using Onyx liquid agent. Goal was to reduce flow into the fistula by embolizing the feeder branch and distal penetration of the nidus with Onyx. The third stage was performed through the venous route: the transverse sinus and the sigmoid sinus were embolized using Penumbra Ruby coils and Onyx, two microcatheters were used and two large coils were placed simultaneously to form a stable coil mass, and the entire sinus was embolized using Coils and Onyx. RESULTS: Patient's venous hypertension and degree of hydrocephalus had significantly decreased after the procedure. He was able to return to work, but was instructed to avoid heavy lifting and placing anything in and around his right ear. CONCLUSIONS: Multiple step arterial and venous embolization procedures were successful in decreasing the frequency of hemotympanum, degree of hydrocephalus, and improving quality of life of this patient.
ABSTRACT
We report a case of alveolar soft-part sarcoma involving the posterior paraspinal musculature of the neck. This rare tumor of uncertain histogenesis typically occurs in the lower extremities in young adults and in the tongue or orbit in infants.
