ABSTRACT
A 42 years old patient who underwent laparoscopic appendectomy developed negative pressure pulmonary oedema (NPPO) with an atypical presentation. Point of care ultrasound (POCUS) played a decisive role in the diagnostic approach. POCUS, as a goal-orientated tool, can provide key elements for a prompt diagnosis of respiratory and airway complications in the surgical patient. The identification of a B-line pattern, as an imagiological surrogate of alveolar oedema, with a specific distribution and the exclusion of other differential diagnosis using POCUS allowed for an early NPPO diagnosis. NPPO is a rare, potentially life threatening complication whose early diagnosis and direct treatment may lead to better outcomes. Our case emphasizes the diagnostic role of ultrasound in the operating theatre in the identification of life threatening airway and pulmonary complications, such as NPPO.
ABSTRACT
O carcinoma hepatocelular (CHC) é o tumor maligno primário do fígado mais frequente, apresentando na maioria das vezes em doentes cirróticos. O espectro de apresentação é muito variado e as manifestações clínicas dependem da fase evolutiva da doença. A progressão local e sistémica do carcinoma hepatocelular é frequente e as metástases ósseas não são incomuns. Apesar de as metástases ósseas serem uma forma de apresentação rara de carcinoma hepatocelular, por vezes estas precedem as manifestações hepáticas pelo que o carcinoma hepatocelular deve ser incluído no diagnóstico diferencial de lesões ósseas osteolíticas. Os autores apresentam um caso clínico e uma breve revisão teórica, pela sua raridade e importância clínica, sublinhando a importância do diagnóstico diferencial de carcinoma hepatocelular um doente previamente assintomático, sem doença hepática conhecida anteriormente, com um fractura patológica...
Hepatocellular carcinoma (HCC) is the most frequent primary malignancy of the liver, presenting most often in cirrhotic patients. The spectrum of presentation is very varied and clinical manifestations depend on the phase of the disease. The local and systemic progression of hepatocellular carcinoma is frequent and bone metastases are not uncommon. Although bone metastases are a rare form of presentation of hepatocellular carcinoma, sometimes they precede hepatic manifestations and that's way hepatocellular carcinoma should be included in the differential diagnosis of osteolytic bone lesions. The authors present a case report and a brief literature review, due to its rarity and clinical importance, stressing the importance of the differential diagnosis of hepatocellular carcinoma in a previously healthy patient without previously known liver disease, with a pathological fracture...
