scholarly journals Nuclear Imaging to Detect Diaphragmatic Perforation as a Rare Complication of Microwave Ablation

2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
Stephanie Cull ◽  
Gebran Khneizer ◽  
Abhishek Krishna ◽  
Razi Muzaffar ◽  
Sameer Gadani ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Microwave Ablation ◽  
Rare Complication ◽  
Rapid Development ◽  
Nuclear Imaging ◽  
Positive Pressure ◽  
Hepatic Hydrothorax ◽  
Pleuroperitoneal Communication ◽  
Life Threatening ◽  
The Right

Acquired diaphragmatic perforation leading to massive hepatic hydrothorax and respiratory failure is a rare complication of microwave ablation (MWA) of hepatocellular carcinoma (HCC). Imaging modalities to detect pleuroperitoneal communication remain poorly described. We report a nuclear imaging technique used to efficiently diagnose and locate diaphragmatic defects. A 57-year-old male with cirrhosis and HCC presented with respiratory distress after undergoing MWA of a HCC lesion. He was admitted to the intensive care unit for noninvasive positive pressure ventilator support. Chest radiography revealed a new large right pleural effusion. Large-volume thoracentesis was consistent with hepatic hydrothorax. The fluid reaccumulated within 24 hours; therefore an acquired diaphragmatic perforation induced by the ablation procedure was suspected. To investigate,  99mTechnetium-labeled albumin was injected into the peritoneal cavity. The tracer accumulated in the right hemi thorax almost immediately. The patient then underwent transjugular intrahepatic portosystemic shunting in efforts to relieve portal hypertension and decrease ascites volume. Unfortunately, the patient deteriorated and expired after few days. Although diaphragmatic defects develop in cirrhotic patients, such small fenestrations do not normally lead to rapid development of life-threatening pleural effusion. MWA procedures can cause large diaphragmatic defects. Immediate detection of this complication is essential for initiating early intervention.

scholarly journals A hematologic condition expressed as a lung disease

F1000Research ◽  
2012 ◽  
Vol 1 ◽  
pp. 28 ◽  
Author(s):  
Mónica Egozcue-Dionisi ◽  
José Nieves-Nieves ◽  
Ricardo Fernández-Gonzalez ◽  
Rosángela Fernández-Medero ◽  
Raúl Reyes-Sosa ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Pleural Effusion ◽  
Plasma Cells ◽  
Rare Complication ◽  
Disease Stage ◽  
Fluid Analysis ◽  
Progressive Dyspnea ◽  
Breath Sounds ◽  
The Right ◽  
Pleural Involvement

Pleural involvement secondary to Multiple Myeloma is considered a very rare complication. According to the literature only 1% of these patients develop a myelomatous pleural effusion. We present a case of a 39 year old man with multiple myeloma diagnosed six years prior to our evaluation, which developed progressive dyspnea, dry cough and right pleuritic chest pain two weeks prior to admission. On physical examination the patient had decreased breath sounds over the right posterior hemithorax accompanied by dullness to percussion. The chest radiogram was consistent with a right sided pleural effusion. Pleural fluid analysis revealed the presence of abundant abnormal plasma cells. The patient died four weeks after hospitalization. The presence of myelomatous pleural effusion is considered to be a poor prognostic finding, no matter at what disease stage it develops. So far no definite treatment has been shown to improve survival.

scholarly journals Giant Intrahepatic Subcapsular Haematoma: A Rare Complication following Laparoscopic Cholecystectomy—A Case Report and Literature Review

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Eltaib Saad ◽  
Lauren O’Connell ◽  
Anne M. Browne ◽  
W. Khan ◽  
R. Waldron ◽  
...  
Keyword(s):  
Rare Complication ◽  
Rare Event ◽  
Decisive Role ◽  
Postoperative Monitoring ◽  
Refractory Hypotension ◽  
Life Threatening ◽  
The Right ◽  
Tomography Scan

We report on a 59-year-old female with symptomatic cholelithiasis on a background of morbid obesity who underwent an elective LC with an uncomplicated intraoperative course; however, she experienced a refractory hypotension within one hour postoperatively with an acute haemoglobin drop requiring fluid resuscitation and blood transfusion. A triphasic computed tomography scan revealed a large intrahepatic subcapsular haematoma (ISH) measuring 21   cm × 3.1   cm × 17   cm surrounding the lateral surface of the right hepatic lobe without active bleeding. She was managed conservatively with serial monitoring of haemoglobin and haematoma size. A follow-up ultrasound scan after eight weeks confirmed complete resolution of the haematoma. Giant ISH is a fairly rare, but life-threatening complication following LC which merits special attention. This case demonstrates the necessity of close postoperative monitoring of patients undergoing LC and considering the possibility of ISH, although being rare event, in those who experience a refractory postoperative hypotension. It also highlights the decisive role of diagnostic imaging in securing a timely and accurate diagnosis of post LC-ISH.

scholarly journals Diaphragmatic hernia: a rare complication of hepatic ablation

2020 ◽  
Vol 65 (3) ◽  
pp. 103-106
Author(s):  
Mark T Macmillan ◽  
Shueh Hao Lim ◽  
Hamish M Ireland
Keyword(s):  
Microwave Ablation ◽  
Rare Complication ◽  
Diaphragmatic Injury ◽  
Diaphragmatic Defect ◽  
Emergency Laparotomy ◽  
Effective Technique ◽  
Case Presentation ◽  
Hepatocellular Carcinomas ◽  
Hepatic Ablation ◽  
Life Threatening

Introduction Ablation has become an effective treatment for small hepatocellular carcinomas (HCC). Whilst ablation is a safe and effective technique, diaphragmatic injury is a rarely associated but significant complication. Case presentation: We present a case of a 67 year old patient who developed a diaphragmatic defect following microwave ablation (MWA) for HCC. The diaphragmatic defect progressed to herniation which was complicated by perforation of intrahernial large bowel. The patient was treated by emergency laparotomy and an extended right hemi-colectomy was performed. Conclusion Our report adds to the current available knowledge on diaphragmatic injury following hepatic ablation and demonstrates the potential for life threatening consequences associated with this complication.

scholarly journals Non-Cardiogenic Pulmonary Oedema Following the Use of Gadolinium-Based Contrast Medium: A Case Report

2020 ◽  
Vol 6 (3) ◽  
pp. 181-185
Author(s):  
Chilan Nguyen ◽  
Tho Pham
Keyword(s):  
Pulmonary Oedema ◽  
Positive Pressure Ventilation ◽  
Rare Complication ◽  
Positive Pressure ◽  
Cardiogenic Pulmonary Oedema ◽  
Contrast Administration ◽  
Prompt Treatment ◽  
Appropriate Treatment ◽  
Life Threatening ◽  
Life Threatening Complication

AbstractNon-cardiogenic pulmonary oedema can be life threatening and requires prompt treatment. While gadolinium-based contrast is generally considered safe with a low risk of severe side effects, non-cardiogenic pulmonary oedema has become increasingly recognised as a rare, but possibly life-threatening complication. We present a case of a usually well, young 23-year-old female who developed non-cardiogenic pulmonary oedema with a moderate oxygenation impairment and no mucosal or cutaneous features of anaphylaxis following the administration of gadolinium-based contrast. She did not respond to treatment of anaphylaxis but made a rapid recovery following the commencement of positive pressure ventilation. Our case highlights the importance of recognising the rare complication of non-cardiogenic pulmonary oedema following gadolinium-based contrast administration in order to promptly implement the appropriate treatment.

scholarly journals Chemical pleurodesis for hepatic hydrothorax

2001 ◽  
Vol 38 (2) ◽  
pp. 125-128 ◽  
Author(s):  
Ilka de Fatima Santana Ferreira BOIN ◽  
Aurea Maria Oliveira SILVA ◽  
Luiz Sergio LEONARDI
Keyword(s):  
Liver Transplantation ◽  
Case Report ◽  
Pleural Effusion ◽  
Hepatic Cirrhosis ◽  
Chronic Alcoholism ◽  
Hepatic Hydrothorax ◽  
Chemical Pleurodesis ◽  
Hepatic Diseases ◽  
Massive Pleural Effusion ◽  
Pleuroperitoneal Communication

Background - Ascites can occur after hepatic diseases causing dyspnea, coughing and pain. When associated with pleural effusion it can also increase respiratory distress. In a bibliographic survey hydrothorax has been observed in up to 20% of the patients and the kind of treatment is still being discussed. Objective — This case report shows the occurrence of a large volume of ascites and pleural effusion in a cirrhotic patient and his treatment. Methods — Report the case of a patient with hepatic cirrhosis due to chronic alcoholism and massive pleural effusion and ascites. He was submitted to several pleural paracenteses without success. Scintigraphy showed the presence of ascites and confirmed a possible pleuroperitoneal communication. The thoracic surgery group was called and after evaluation it was decided to submit the patient to a pulmonary decortication and chemical pleurodesis. Results — These procedures were carried out with success. The pleural effusion was solved and the treatment of ascites was decided upon because the patient did not accept any surgical procedure. Conclusion - This treatment could be applied to patients with hydrothorax who could not be submitted to a liver transplantation.

scholarly journals Systemic Air Embolism Associated with Pleural Pigtail Chest Tube Insertion

2016 ◽  
Vol 2016 ◽  
pp. 1-3
Author(s):  
Emad Alkhankan ◽  
Ahmad Nusair ◽  
Rida Mazagri ◽  
Mohammed Al-Ourani
Keyword(s):  
Airway Pressure ◽  
Positive Pressure Ventilation ◽  
Positive Airway Pressure ◽  
Rare Complication ◽  
Air Embolism ◽  
Positive Pressure ◽  
Pigtail Catheter ◽  
Tube Insertion ◽  
Systemic Air Embolism ◽  
The Right

Pleural pigtail catheter placement is associated with many complications including pneumothorax, hemorrhage, and chest pain. Air embolism is a known but rare complication of pleural pigtail catheter insertion and has a high risk of occurrence with positive pressure ventilation. In this case report, we present a 50-year-old male with bilateral pneumonia who developed a pneumothorax while on mechanical ventilation with continuous positive airway pressure mode. During the placement of the pleural pigtail catheter to correct the pneumothorax, the patient developed a sudden left sided body weakness and became unresponsive. An air embolism was identified in the right main cerebral artery, which was fatal.

scholarly journals Case report: Recovery after large intramyocardial dissecting haematoma of the ventricular septum—a rare complication of myocardial infarction

2021 ◽  
Vol 5 (2) ◽  
Author(s):  
David Lovasz ◽  
Daniele Camboni ◽  
Judith Zeller ◽  
Christof Schmid
Keyword(s):  
Myocardial Infarction ◽  
Plaque Rupture ◽  
Rare Complication ◽  
Coronary Intervention ◽  
Ventricular Septum ◽  
Feasible Option ◽  
Life Threatening ◽  
Magnetic Resonance Imaging Mri ◽  
The Right

Abstract Background Intramyocardial dissecting haematoma is a rare and potentially life-threatening complication of myocardial infarction (MI). Only a few isolated cases have been reported so far. Case summary We report the case of a patient with a large, obstructing intramyocardial haematoma of the ventricular septum following MI due to plaque rupture of the right coronary artery (RCA) and following successful coronary intervention. The clinically inapparent haematoma was discovered during routine echocardiography and confirmed by both computed tomography (CT) and magnetic resonance imaging (MRI). With non-surgical treatment, the patient remained clinically stable. Repeated echocardiography showed gradual regression of the haematoma. Follow-up echocardiography 3 months after the initial diagnosis demonstrated no evidence of septal haematoma. Discussion This report suggests that even large intramyocardial haematoma may recede without operative intervention. Echocardiography, CT, and MRI are all helpful in quantifying the size of the haematoma. The appropriate management should be patient-oriented, depending on clinical stability and progression of the haematoma. Conservative treatment in clinically stable patients suffering from septal haematoma following MI and coronary intervention can be a feasible option.

scholarly journals A rare complication of ventriculoperitoneal shunt: Pleural effusion without intrathoracic ventriculoperitoneal shunt catheter

2020 ◽  
Vol 11 ◽  
pp. 291
Author(s):  
Said Hilmani ◽  
Tarek Mesbahi ◽  
Abderrahman Bouaggad ◽  
Abdelhakim Lakhdar
Keyword(s):  
Pleural Effusion ◽  
Ventriculoperitoneal Shunt ◽  
Rare Complication ◽  
Peritoneal Catheter ◽  
X Ray ◽  
Thoracic Drainage ◽  
Repeat Chest ◽  
Chest X Ray ◽  
The Right ◽  
Catheter Replacement

Background: Symptomatic pleural effusion following ventriculoperitoneal shunt (VPS) insertion is very rare and poorly understood in the literature in contrary to other mechanical complications. Case Description: We report a case of 15 month-year-old girl who had VP shunt for congenital hydrocephalus. Twelve months after surgery, she was diagnosed with massive hydrothorax. Chest X-ray and thoracoabdominal CT scan confirmed the right pleurisy and showed the tip of the peritoneal catheter in the general peritoneal cavity. We made thoracic drainage of the transudative pleural effusion. When we released the chest tube, 24 h after, the girl showed a respiratory distress again and the effusion resumed at the X-ray control. Her symptoms abated after the realization of a ventriculoatrial shunt “VAS.” Repeat chest X-ray confirmed the resolution of the hydrothorax. Conclusion: Despite the not yet well-understood mechanism of this rare and important VPS complication, management is simple based on X-ray confirmation, thoracentesis with biological analysis, and catheter replacement, especially in atrium “VAS.”

scholarly journals A case of successful surgical treatment of a patient with a cement embolism of the right heart chambers after vertebroplasty

2021 ◽  
Vol 23 (1) ◽  
pp. 119-123
Author(s):  
R. M. Muratov ◽  
A. G. Khramchenkov ◽  
A. S. Sachkov ◽  
S. I. Babenko ◽  
B. V. Meshchanov
Keyword(s):  
Heart Surgery ◽  
Rare Complication ◽  
Open Heart Surgery ◽  
Thoracic Vertebrae ◽  
Successful Operation ◽  
Right Heart ◽  
Open Operation ◽  
Cement Embolism ◽  
Life Threatening ◽  
The Right

Cement embolism of the right chambers of the heart after vertebral surgery is an extremely rare complication and occurs in 4 % of cases. The strategies for choosing the treatment of this complication are open-heart surgery under conditions of cardiopulmonary bypass, conservative treatment, or endovascular support. In the case of a fatal complication of embolism, such as perforation of the heart with the development of tamponade or life-threatening arrhythmias, the patient is shown an open operation with infrared. According to the literature, only 14 such operations are described, performed to save the patient’s life. We performed a successful operation of embolectomy from the right heart chambers in a 69‑year-old patient who had previously undergone vertebroplasty of the thoracic vertebrae.

A ruptured ovarian cystadenofibroma presenting with life-threatening sepsis and an incidental synchronous endometrial stromal sarcoma

2021 ◽  
Vol 14 (11) ◽  
pp. e245473
Author(s):  
Alistair Boyd ◽  
Hemant Sheth ◽  
Faris Kubba ◽  
Mohammad Aziz
Keyword(s):  
Rare Complication ◽  
Iliac Fossa ◽  
Endometrial Stromal Sarcoma ◽  
Uterine Sarcoma ◽  
Stromal Sarcoma ◽  
Gene Testing ◽  
Uterine Neoplasm ◽  
Life Threatening ◽  
History Of ◽  
The Right

A woman in her 60s presented with a rare complication of an ovarian cyst which many clinicians may not consider at first presentation. She was admitted with life-threatening staphylococcus aureus sepsis. She presented shocked with a collapse following a 2-day history of diarrhoea, vomiting and pain in the right iliac fossa. She was taken to theatre where a ruptured, widely infarcted left ovarian serous cystadenofibroma was discovered with over 2 litres of purulent fluid exuding from the cyst into the abdomen. She had a left cyst removal, hysterectomy and bilateral salpingo-oophorectomy performed. Histological analysis and molecular gene testing of an incidentally discovered uterine neoplasm revealed an undifferentiated uterine sarcoma. She successfully recovered as an inpatient and was discharged under the care of an oncology team for ongoing management.

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