ABSTRACT
SUMMARY: A 38-year female with no prior medical or surgical history presented with pleuritic pain and respiratory distress. Imaging revealed a right diaphragmatic hernia with colonic content. At right anterolateral thoracotomy, a diaphragmatic hernia containing a perforated right hemi-colon was found. The colon was resected in the chest and continuity restored via a laparotomy. This case illustrates the risk of obstruction, ischaemia and perforation and highlights the importance of early identification and prompt surgical management to reduce morbidity and mortality.
Subject(s)
Hernia, Diaphragmatic , Female , HumansABSTRACT
CASE REPORT: We report a patient with multiple cholesterol retinal embolism in both eyes following coronary angiography. She also had associated renal, skin and cardiac manifestations of the Cholesterol Embolization Syndrome (CES) and died 10 weeks later. Autopsy revealed cholesterol crystal emboli in several organs. DISCUSSION: Atheromatous plaques can be ruptured and displaced during a diagnostic catheterisation, and thus can be a potential source of these massive emboli. Retinal cholesterol crystals help to establish the diagnosis of the syndrome, particularly when other systemic manifestations exist. When this complication occurs, the prognosis can be devastating because of associated multiorgan failure.
Subject(s)
Coronary Angiography/adverse effects , Embolism, Cholesterol/etiology , Aged , Coronary Artery Disease/complications , Coronary Artery Disease/diagnostic imaging , Fatal Outcome , Female , Humans , MaleABSTRACT
Caso clínico: Se presenta un paciente con múltiplesembolismos retinianos por colesterol en ambosojos, tras una coronariografía. Asociaba además,manifestaciones renales, cutáneas y cardíacas delSíndrome de Embolismo por Colesterol (CES),falleciendo a las 10 semanas. La autopsia confirmóla presencia de cristales de colesterol en múltiplesórganos.Discusión: Las placas ateromatosas, durante unprocedimiento invasivo arterial, pueden ser origende embolizaciones masivas por colesterol. La presenciade émbolos retinianos ayuda al diagnósticodel síndrome, sobre todo cuando se acompaña desintomatología sistémica. El pronóstico vital esmalo por la insuficiencia multiorgánica
Case report:We report a patient with multiple cholesterol ;;retinal embolism in both eyes following ;;coronary angiography. She also had associated ;;renal, skin and cardiac manifestations of the Cholesterol ;;Embolization Syndrome (CES) and died 10 ;;weeks later. Autopsy revealed cholesterol crystal ;;emboli in several organs. ;;Discussion: Atheromatous plaques can be ruptured ;;and displaced during a diagnostic catheterisation, ;;and thus can be a potential source of these massive ;;emboli. Retinal cholesterol crystals help to establish ;;the diagnosis of the syndrome, particularly ;;when other systemic manifestations exist. When ;;this complication occurs, the prognosis can be ;;devastating because of associated multiorgan failure
Subject(s)
Male , Aged , Humans , Coronary Angiography/adverse effects , Coronary Artery Disease/complications , Coronary Artery Disease , Fatal OutcomeABSTRACT
Retinal embolism is a highly infrequent complication of cardiac catheterization of thrombotic, lipidic, and calcific etiology. We provide the first reported clinical case of retinal embolism caused by cholesterol crystal without systemic adverse effects as a severe complication of diagnostic cardiac catheterization. Cathet. Cardiovasc. Intervent. 51:323-325, 2000.
