Intermittent airway obstruction in a child caused by a cervical lipoblastoma.

Severe intermittent airway obstruction was caused by a lipoblastoma in a 9-month-old boy. The tumor was located in the lower part of the neck and moved into the thoracic inlet causing compression of the trachea when he moved his head forwards. A tumor compressing or obstructing the trachea is infrequently the cause of airway obstruction in infants and children. Nevertheless, overlooking a tumor may have serious consequences when giving anesthesia due to the risk of difficulties with artificial ventilation depending on the localisation of the tumor. Every case of unexplained respiratory failure must be subject to a systematic approach that considers lung disease, bronchoconstriction, large airway obstruction, and external compression of the airway.

Accuracy of the diagnosis of pleural effusion on supine chest X-ray.

Diagnosis of pleural effusion (PE) on supine chest X-ray (SCXR) is considered difficult. This study aimed at evaluating the accuracy of the diagnosis of PE on SCXR and was performed in two phases. At phase 1, a formula for the sonographic estimation of the volume of PE was established by correlating 24 measurements (in 7 patients in whom complete drainage was achieved) with the drained volumes. At phase two, 112 consecutive SCXRs were supplemented by sonography of the chest. The films were evaluated for the presence of PE and for the presence of different radiologic signs of PE. Sonography showed PE in 41 right and 30 left hemithoraces. The overall accuracy of the diagnosis of PE on SCXR was 82 %. Only one of the undiagnosed PEs had a volume of > 300 ml. The most accurate signs were increased density of the hemithorax, blunted costophrenic angle, and loss of the hemidiaphragm silhouette.

Case report: impaired rectal emptying caused by perineal herniation of the rectum: defaecographic demonstration using oblique projections.

Defaecography is usually performed in the lateral projection alone. We present a case of perineal herniation of the rectum, previously unreported, demonstrated by defaecography in oblique projections.