ABSTRACT
This case report describes an 82-year-old female patient with myasthenia gravis (MG) who presented with worsening dysphagia. The patient was found to have cricopharyngeal sphincter and esophageal achalasia, and a percutaneous endoscopic gastrostomy (PEG) tube was placed due to severe pharyngeal dysphagia and cricopharyngeal dysfunction. The patient had class IVb myasthenia gravis and was treated with intravenous immunoglobulin (IVIG), prednisone, and pyridostigmine. The report discusses the link between myasthenia gravis and dysphagia, which is seen in 20% of patients. The report also explores the relationship between myasthenia gravis and achalasia, which is a rare disorder characterized by the failure of relaxation of the sphincter muscles. While myasthenia gravis leads to muscle weakness and should not cause achalasia, there have been a few case reports describing a link between the two disorders. Cricopharyngeal dysfunction, which is a common disorder causing dysphagia in the elderly, was also noted in the patient. The report highlights that cricopharyngeal dysfunction may be primary or secondary, with the latter often being associated with inflammatory myopathies such as polymyositis or mixed connective tissue disorders. The patient did not have a workup for other autoimmune diseases that could have been the cause of achalasia.
ABSTRACT
We herein present two cases of spontaneous pneumothorax. The first one is occurring in an elderly female who has an extensive history of smoking and an underlying chronic obstructive lung disease, whereas the second case represents a congenital bleb in a male patient who has no other underlying pulmonary disorder. Both cases presented to our facility with a spontaneous pneumothorax following pulmonary bleb rupture. Both patients underwent thoracoscopic surgery with subsequent partial pleurectomy and pleurodesis.
ABSTRACT
Small cell lung cancer (SCLC) is one of many types rapidly growing malignant diseases, such as Burkitt's lymphoma and testicular germ cell cancers. At present, there is no reliable way to screen for SCLC, and imaging modalities tend to be delayed in detecting this type of cancer. The clinical presentation of acutely and rapidly growing SCLC can mimic those of pulmonary inflammatory or infectious disorders, and in some instances, this delays appropriate management and negatively affects patient outcome.
ABSTRACT
BACKGROUND: Because of the aging of the American population, osteoporotic vertebral fractures are becoming a common problem in the elderly. Minimally invasive percutaneous vertebral augmentation techniques have gained a great deal of importance in relieving the pain associated with these fractures, and are becoming the standard of care. METHODS: These procedures involve the injection of polymethylmethacrylate (PMMA) into the vertebral body. However, these techniques have their complications, and among these, pulmonary embolism is one of the most feared. It is attributable to the passage of cement into the pulmonary vasculature. After encountering a case of PMMA embolism in our practice, we decided to highlight this topic and discuss the incidence, clinical presentation, diagnosis, and treatment of cement pulmonary embolisms.
