RESUMO
The authors report 5 cases that presented to the emergency department of the Athens Naval and Veterans Hospital (Athens, Greece) with spontaneous pneumomediastinum. The clinical picture was not diagnostic in most of the cases, with symptoms of acute retrosternal pain and severe dyspnea in just one case. Diagnostic work disclosed the presence of mediastinal air, and after the exclusion of other diagnoses, spontaneous pneumomediastinum was treated conservatively in all cases. In this case series the authors discuss the main aspects of treatment of these patients, the value of antibiotics during the recovery period and the air distribution in the thoracic tissues.
Assuntos
Enfisema Mediastínico/terapia , Adulto , Analgésicos/uso terapêutico , Broncoscopia , Seguimentos , Hospitalização , Humanos , Masculino , Enfisema Mediastínico/complicações , Enfisema Mediastínico/diagnóstico , Enfisema Mediastínico/diagnóstico por imagem , Dor/tratamento farmacológico , Dor/etiologia , Radiografia Torácica , Enfisema Subcutâneo/diagnóstico , Fatores de Tempo , Tomografia Computadorizada por Raios XRESUMO
We report on a 70-year-old male who was admitted to hospital due to progressive onset of dyspnea and fever. Diagnostic work-up revealed a high diaphragmatic position, compression of the right heart and supraventricular tachycardia. A simultaneous incidental finding was hepatodiaphragmatic colonic interposition (Chilaiditi's syndrome). Diaphragmatic plication through a right thoracotomy with bowel reduction was effective to treat the patient.This is the second reported case in the literature of a simultaneous occurrence of diaphragmatic eventration and Chilaiditi's syndrome.
Assuntos
Anormalidades Múltiplas , Colo/anormalidades , Eventração Diafragmática/complicações , Fígado/anormalidades , Taquicardia Supraventricular/etiologia , Anormalidades Múltiplas/patologia , Anormalidades Múltiplas/cirurgia , Idoso , Colo/patologia , Colo/cirurgia , Eventração Diafragmática/patologia , Eventração Diafragmática/cirurgia , Ecocardiografia , Átrios do Coração/patologia , Humanos , Fígado/patologia , Fígado/cirurgia , Masculino , Síndrome , Taquicardia Supraventricular/patologia , Taquicardia Supraventricular/cirurgia , Toracotomia , Tomografia Computadorizada por Raios X , Resultado do TratamentoRESUMO
A case of leiomyoma of the thoracic trachea is described in a 35-year-old man. The tumour was excised by sleeve resection and end-to-end anastomosis of the trachea was performed. Leiomyoma is a very rare benign tumour of the trachea. Only 15 cases have been reported in the English literature. Our case was not only confirmed by electron microscopy, but is the first reported case in the respiratory tract to be confirmed by positive immunostaining for desmin.
