RESUMEN
Total eventration of the hemidiaphragm is a rare condition in adults. We report a 75-year-old woman with large eventration of the right diaphragm who required an emergency plication because of acute progressive respiratory distress. The symptom disappeared immediately after operation. Even in asymptomatic elderly patients with eventration, close follow-up is recommended.
Asunto(s)
Eventración Diafragmática/cirugía , Anciano , Eventración Diafragmática/complicaciones , Eventración Diafragmática/diagnóstico por imagen , Disnea/etiología , Urgencias Médicas , Femenino , Estudios de Seguimiento , Humanos , Intubación Intratraqueal , Pleura/cirugía , Atelectasia Pulmonar/terapia , Insuficiencia Respiratoria/etiología , Técnicas de Sutura , Toracotomía , Tomografía Computarizada por Rayos XRESUMEN
This report describes the case of a 48-year-old woman found to have a leiomyoma of the left adrenal gland after presenting with anemia and hypertension. An upper gastrointestinal series revealed a mass in the posterior region of the body that distorted the stomach. A computed tomography (CT) scan showed a well-circumscribed mass with a high-density outline in the left adrenal gland, and magnetic resonance imaging (MRI) revealed a homogeneous mass. Multiple catheter samplings of vena cava blood revealed a slight elevation of epinephrine and norepinephrine in the left adrenal vein and the left renal vein. Thus, asymptomatic pheochromocytoma of the left adrenal gland was highly suspected as a preoperative diagnosis and a left adrenalectomy was performed. However, histologic examination subsequently revealed findings suggestive of leiomyoma of the adrenal gland, which was confirmed by electron microscopy. The patient's postoperative course was uneventful and she has remained free from any further symptoms.
Asunto(s)
Neoplasias de las Glándulas Suprarrenales , Leiomioma , Neoplasias de las Glándulas Suprarrenales/diagnóstico , Neoplasias de las Glándulas Suprarrenales/patología , Neoplasias de las Glándulas Suprarrenales/cirugía , Diagnóstico Diferencial , Femenino , Humanos , Leiomioma/diagnóstico , Leiomioma/patología , Leiomioma/cirugía , Persona de Mediana Edad , FeocromocitomaRESUMEN
A case of empyema necessitatis presenting a mass in the retroperitoneal space is reported. Computer tomography preoperatively revealed the transdiaphragmatic abscess with calcified capsule. The operation was performed by means of resection of the abscess together with overlying ribs. Dead space after resection of the lesion was filled up with intercostal muscles. Empyema necessitatis is rare after introduction of antituberculous drugs. However, recognition of this disease is necessary for an appropriate surgical management. Total resection of the abscess followed by filling of the dead space with the intercostal muscles should be considered as a useful alternative method.
