Chronic cough caused by choledochoduodenal fistula: a case report

Abstract Background Chronic cough is characterized by cough as the only or main symptom, with a duration of more than 8 weeks and no obvious abnormality in chest X-ray examination. Its etiology is complex, including respiratory disease, digestive system disease, circulation system disease, and psychological disease. Although a set of etiological diagnosis procedures for chronic cough have been established, it is still difficult to diagnose chronic cough and there are still some patients with misdiagnosis. Case presentation We present a case of a 54-year-old female patient who had chronic cough for 28 years. Physical examination had no positive signs and she denied any illness causing cough like tuberculosis, rhinitis. Recurrent clinic visits and symptomatic treatment didn’t improve the condition. Finally, gastroscopy identified the possible etiology of choledochoduodenal fistula that was proved by surgery. And after surgery, the patient's cough symptoms were significantly improved. Conclusion We report a rare case of chronic cough caused by choledochoduodenal fistula which demonstrates our as yet inadequate recognition of the etiology and pathogenesis. Written informed consent was obtained from the patient.

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Sudden cardiac death due to angiofibroma: a case report

10.21203/rs.3.rs-295489/v1 ◽

2021 ◽

Author(s):

Duncan Mwangangi Matheka ◽

Edwin Walong ◽

Christine Yuko Jowi

Keyword(s):

Case Report ◽

Cardiac Death ◽

Surgical Intervention ◽

Symptomatic Treatment ◽

Post Mortem ◽

Case Presentation ◽

X Ray ◽

Prevention And Treatment ◽

Pediatric Neoplasms ◽

Chest X Ray

Abstract BackgroundAngiofibromas are benign but locally aggressive vascular tumours that commonly occur in the nasopharynx, neck and face. Angiofibromas located in sites other than head and neck regions are rare. We report a massive interventricular tumour in a 5-month-old who died suddenly.Case presentationWe present a 5-month-old who died suddenly due to a massive rare cardiac tumour. A post mortem carried out diagnosed it as angiofibroma on histopathology. At three months of age, he had a persisting cough for a week, with associated occasional wheezing and dyspnea that stopped after symptomatic treatment. A chest x-ray revealed a mild cardiomegaly. Serial echocardiograms showed a well circumscribed, homogenous, highly vascularized mass filling the left ventricle. Surgical intervention was planned.Conclusions: Cardiac angiofibromas are rare pediatric neoplasms and as seen in this report, invariably fatal. More insights into their pathogenesis, prevention and treatment are required.

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A case of pleuroperitoneal communication in which establishing a laparoscopic pneumoperitoneum was useful for the detection of a fistula

Surgical Case Reports ◽

10.1186/s40792-021-01147-1 ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Takehiko Manabe ◽

Kenji Ono ◽

Soichi Oka ◽

Yuichiro Kawamura ◽

Toshihiro Osaki

Keyword(s):

Thoracic Surgery ◽

Surgical Repair ◽

Abdominal Cavity ◽

Case Presentation ◽

X Ray ◽

Video Assisted Thoracic Surgery ◽

Video Assisted ◽

Pleuroperitoneal Communication ◽

Small Pore ◽

Chest X Ray

Abstract Background Pleuroperitoneal communication (PPC) is rarely observed, accounting for 1.6% of all patients who undergo continuous ambulatory peritoneal dialysis (CAPD). Although there have been several reports concerning the management of this condition, we have encountered several cases in which control failed. We herein report a valuable case of PPC in which laparoscopic pneumoperitoneum with video-assisted thoracic surgery (VATS) was useful for supporting the diagnosis and treatment. Case presentation The patient was a 58-year-old woman with chronic renal failure due to chronic renal inflammation who was referred to a nephrologist in our hospital to undergo an operation for the induction of CAPD. Post-operatively, she had respiratory failure, and chest X-ray and computed tomography (CT) showed right-sided hydrothorax that decreased when the injection of peritoneal dialysate was interrupted. Therefore, PPC was suspected, and she was referred to our department for surgical repair. We planned surgical treatment via video-assisted thoracic surgery. During the surgery, we failed to detect any lesions with thoracoscopy alone; we therefore added a laparoscopic port at her right-sided abdomen near the navel and infused CO2 gas into the abdominal cavity. On thoracoscopy, bubbles were observed emanating from a small pore at the central tendon of the diaphragm, which was considered to be the lesion responsible for the PPC. We closed it by suturing directly. Conclusions VATS with laparoscopic pneumoperitoneum should be considered as an effective method for inspecting tiny pores of the diaphragm, especially when the lesions responsible for PPC are difficult to detect.

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Przewlekły kaszel jako główna manifestacja chłoniaka Hodgkina – opis przypadku

Nowa Pediatria ◽

10.25121/np.2019.23.3.107 ◽

2019 ◽

Vol 23 (3) ◽

Author(s):

Katarzyna Wójcicka ◽

Andrzej Pogorzelski

Keyword(s):

Chronic Cough ◽

Correct Diagnosis ◽

Diagnostic Methods ◽

Radiographic Examination ◽

Older Children ◽

X Ray ◽

Volume Curve ◽

Flow Volume Curve ◽

Mediastinal Widening ◽

Chest X Ray

A cough lasting longer than 4-8 weeks, defined as chronic cough, always requires thorough diagnostic evaluation. In addition to detailed history-taking and physical examination, simple and available diagnostic methods, such as chest x-ray and spirometry, should be performed. They may be helpful tool to establish the underlying cause of cough. Many younger children may have difficulties in performing the forced expiratory maneuvers and fulfilling repeatability criteria for spirometry. The disturbances resulting from insufficient cooperation should be considered in interpratation of the obtained results. The shape of the flow-volume curve, which suggests upper or central airways obstruction, can not be ignored and always requires further investigation for diagnosis of respiratory pathology. The chest x-ray is the most frequently performed radiographic examination in children. Accurate interpretation is essential in reaching a correct diagnosis. Mediastinal widening on the chest x-ray in children can occur due to a large variety of causes. The normal thymus can take on a variety of sizes and shapes and still be considered normal in the first few years of life. In older children mediastinal widening should be differentiated from mediastinal masses. Lymph node enlargement represents a frequent cause, usually as a result of infection or malignancy. The article reports a case of a 12-year-old boy with chronic cough, mediastinal widening on the chest X-ray and abnormal spirometry results, who was finally diagnosed with stage III Hodgkin’s lymphoma.

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Hoarseness of Voice as a Rare Presentation of Tuberculosis: A Case Report Study

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2019.817 ◽

2019 ◽

Vol 7 (19) ◽

pp. 3262-3264

Author(s):

Taher Felemban ◽

Abdullah Ashi ◽

Abdullah Sindi ◽

Mohannad Rajab ◽

Zuhair Al Jehani

Keyword(s):

Laryngeal Carcinoma ◽

Incidental Finding ◽

Chain Reaction ◽

Rare Presentation ◽

Case Presentation ◽

X Ray ◽

History Of ◽

Chest X Ray ◽

Polymerase Chain ◽

Laryngeal Tuberculosis

BACKGROUND: Having hoarseness of voice as the first clinical manifestation of tuberculosis is rare. This atypical presentation causes some confusion since other more common conditions, such as laryngeal carcinoma, present similarly and might require more invasive tests to confirm the diagnosis. CASE PRESENTATION: A 38-year-old male presented to the otorhinolaryngology clinic with a four-month history of change in voice. Laryngoscopy demonstrated a right glottic mass, raising suspicion of laryngeal cancer. The computed tomography showed a mass and incidental finding of opacities in lung apices. Chest x-ray demonstrated findings suggestive of tuberculosis. Polymerase chain reaction and culture of sputum samples confirmed the diagnosis and the patient was started on anti-tuberculosis treatment. CONCLUSION: Despite accounting for only 1% of pulmonary tuberculosis cases and having a similar presentation to laryngeal carcinoma, we recommend considering laryngeal tuberculosis when evaluating hoarseness of voice in endemic areas.

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GAMBARAN FOTO TORAKS PADA PENDERITA BATUK KRONIK DI BAGIAN/SMF RADIOLOGI FK UNSRAT/RSUP PROF. DR. R.D. KANDOU MANADO PERIODE JULI – SEPTEMBER 2015

e-CliniC ◽

10.35790/ecl.4.1.2016.10955 ◽

2016 ◽

Vol 4 (1) ◽

Author(s):

Divertt Tamaweol ◽

Ramli H. Ali ◽

Martin L. Simanjuntak

Keyword(s):

Chronic Cough ◽

Medical Records ◽

Smoking Habit ◽

Radiological Diagnosis ◽

Radiology Department ◽

Common Symptom ◽

Inclusion Criteria ◽

X Ray ◽

X Ray Imaging ◽

Chest X Ray

Abstract: Chronic cough is defined as cough that lasts 8 weeks or more. Chronic cough itself is not a disease, but a symptom of other diseases. Chronic cough is the most common symptom that occurs among outpatients and is the main cause of morbidity which was reported by 3-40% population. Chronic cough can be caused by some diseases such as pneumonia, tuberculosis, asthma, chronic bronchitis, emphysema, and lung fibrosis. Chronic cough is closely associated with smoking habit which is one of the predisposing factors. Chest x-ray is one of the seed examination for chronic cough because it is very helpful in diagnosing diseases especially pulmonary diseases and others that may cause chronic cough. Objective: To identify the chest x-ray imaging in chronic cough patients. Methods: This study using retrospective description data in November 2015. Sample is obtained from all the medical records of patients with radiological diagnosis chronic cough who undertook a chest x-ray examination in the Radiology Department of the Medical Faculty of Sam Ratulangi University / Prof. Dr. R. D. Kandou Central General Hospital Manado during July – September 2015. Data was collected from chest x-ray request form and the results show 178 cases of chronic cough that fit the inclusion criteria. The results showed that there was 178 cases of chronic cough based on the radiological diagnosis. The most frequent cases were chronic cough caused by pulmonary tuberculosis (97 patients; 54.49%). Most patients were male (107 patients; 60.11%), and the most frequent age group was 20-49 years (60 patients; 33.71%). Keywords: chronic cough, chest x-ray Abstrak: Batuk kronik adalah batuk yang berlangsung selama 8 minggu atau lebih. Batuk kronik sendiri bukanlah penyakit, tetapi merupakan suatu gejala dari penyakit-penyakit lain. Batuk kronik merupakan gejala yang paling umum terdapat pada orang dewasa yang melakukan pengobatan rawat jalan dan penyebab utama morbiditas yang dilaporkan oleh 3-40% populasi. Batuk kronik dapat disebabkan oleh beberapa penyakit seperti pneumonia, tuberculosis, asma, bronchitis kronik, emfisema, dan fibrosis paru. Batuk kronik erat hubungannya dengan kebiasaan merokok dimana merokok merupakan salah satu faktor predisposisi. Foto toraks adalah salah satu pemeriksaan pilihan untuk batuk kronik karena sangat bermanfaat dalam mendiagnosis penyakit terutama penyakit paru dan gangguan lain yang dapat menyebabkan batuk kronik. Penelitian ini bertujuan untuk mengetahui gambaran foto toraks pada penderita batuk kronik. Penelitian ini menggunakan metode deskriptif retropektif yang dilakukan pada bulan November 2015. Sampel diambil dari semua data catatan medik pasien dengan diagnosis radiologis batuk kronik yang melakukan foto toraks di Bagian/SMF Radiologi FK Unsrat/RSUP Prof. Dr. R. D. Kandou Manado periode Juli – September 2015. Data diperoleh melalui lembaran permintaan pemeriksaan foto toraks dan didapatkan sebanyak 178 kasus batuk kronik yang masuk dalam kriteria inklusi. Hasil penelitian memperlihatkan 178 kasus batuk kronik berdasarkan diagnosis radiologis. Kasus terbanyak ialah batuk kronik akibat tuberkulosis paru sebanyak 97 orang (54,49%), penderita terbanyak ialah laki-laki yaitu 107 orang (60,11%), dan golongan umur terbanyak ialah 20-49 tahun yaitu 60 penderita (33,71%). Kata kunci: batuk kronik, foto toraks

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Unilateral Right Exophthalmia Revealing Systemic Sarcoidosis: A Case Report and a Review of the Literature

EMJ Respiratory ◽

10.33590/emjresp/19-00088 ◽

2019 ◽

Author(s):

Sophia Bania

Keyword(s):

Ct Scan ◽

Exceptional Case ◽

Mediastinal Lymphadenopathy ◽

Case Presentation ◽

X Ray ◽

Caseous Necrosis ◽

History Of ◽

Chest X Ray ◽

Systemic Sarcoidosis

Background: Sarcoidosis is only revealed in 3% of the cases among Caucasians by ophthalmic damage and, when it does, it presupposes that the visceral impairment has remained silent so far. In this article, the exceptional case of a patient with systemic sarcoidosis revealed by unilateral exophthalmia is reported. Case presentation: The patient is a female with no history of substantial pathology. She had a unilateral right exophthalmia and ptosis evolving over 3 years. A dyspnea and dry cough were also reported with a duration of 1 year. The chest X-ray and CT scan revealed bilateral hilar opacities and mediastinal lymphadenopathy that lead to the suspicion of sarcoidosis. The cerebro-orbital CT scan led to the classification of the patient’s exophthalmia as Grade I and eliminated the possibility of other aetiologies. The mediastinoscopy indicated a granulomatous adenitis with no caseous necrosis, which allowed the diagnosis of a mediastinopulmonary sarcoidosis. Discussion and conclusion: The diagnostic approach to exophthalmia should involve a systematic search for sarcoidosis, although this aetiology remains exceptional.

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PECTUS EXCAVATUM: A CASE REPORT OF AN EARLY REPAIR

10.36106/ijsr/3721898 ◽

2021 ◽

pp. 51-52

Author(s):

Priyadarshan Konar ◽

Subhendu Mahapatra ◽

Jayita Chakrabarti ◽

Gautam Sengupta

Keyword(s):

Case Report ◽

Chest Wall ◽

Pectus Excavatum ◽

Anterior Chest Wall ◽

Chest Wall Deformity ◽

Case Presentation ◽

X Ray ◽

Abnormal Chest ◽

Great Vessels ◽

Chest X Ray

Introduction: Pectus Excavatum usually recognized during infancy and become worse with growing ages. Case presentation: We presented a 6 months old male child to our departmental OPD with complaints of indrawing of anterior chest wall. On physical examination revealed a signicant Pectus Excavatum deformity. There was no other abnormality except the chest wall deformity. An abnormal chest X-ray and CT scan demonstrated leftward displacement of heart and great vessels. Conclusion: Surgery for Pectus Excavatum is specialized and can be done in early childhood with better outcome.

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Recurrent spontaneous pneumothoraces and vaping in an 18-year-old man: a case report and review of the literature

Journal of Medical Case Reports ◽

10.1186/s13256-019-2215-4 ◽

2019 ◽

Vol 13 (1) ◽

Cited By ~ 14

Author(s):

Alex Bonilla ◽

Alexander J. Blair ◽

Suliman M. Alamro ◽

Rebecca A. Ward ◽

Michael B. Feldman ◽

...

Keyword(s):

Spontaneous Pneumothorax ◽

Electronic Cigarettes ◽

Diagnostic Testing ◽

Cigarette Use ◽

Case Presentation ◽

X Ray ◽

History Of ◽

Chest X Ray ◽

Tomography Scan

Abstract Background Primary spontaneous pneumothorax is a common disorder occurring in young adults without underlying lung disease. Although tobacco smoking is a well-documented risk factor for spontaneous pneumothorax, an association between electronic cigarette use (that is, vaping) and spontaneous pneumothorax has not been noted. We report a case of spontaneous pneumothoraces correlated with vaping. Case presentation An 18-year-old Caucasian man presented twice with recurrent right-sided spontaneous pneumothoraces within 2 weeks. He reported a history of vaping just prior to both episodes. Diagnostic testing was notable for a right-sided spontaneous pneumothorax on chest X-ray and computed tomography scan. His symptoms improved following insertion of a chest tube and drainage of air on each occasion. In the 2-week follow-up visit for the recurrent episode, he was asymptomatic and reported that he was no longer using electronic cigarettes. Conclusions Providers and patients should be aware of the potential risk of spontaneous pneumothorax associated with electronic cigarettes.

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Lund–Mackay Computed Tomography Score Is Associated With Obstructive Pulmonary Function Changes in Chronic Cough Patients

American Journal of Rhinology and Allergy ◽

10.1177/1945892418825094 ◽

2019 ◽

Vol 33 (3) ◽

pp. 294-301 ◽

Cited By ~ 2

Author(s):

Shin Kariya ◽

Mitsuhiro Okano ◽

Takaya Higaki ◽

Tomoyasu Tachibana ◽

Toru Rikimaru ◽

...

Keyword(s):

Computed Tomography ◽

Lung Function ◽

Pulmonary Function ◽

Paranasal Sinus ◽

Chronic Cough ◽

Eosinophil Count ◽

Upper Airway ◽

Peripheral Blood Eosinophil ◽

X Ray ◽

Chest X Ray

Background A remarkable relationship between upper airway conditions and lung diseases has been reported. At the same time, sinonasal findings in chronic cough patients have not been fully examined. Objective The purpose of this study is to show paranasal sinus findings and lung function in chronic cough patients without asthma and chest X-ray abnormalities. Methods A total of 1412 patients with persistent cough were enrolled in this study. Of these patients, 376 patients were evaluated for further examination, as the patients with asthma and/or chest X-ray abnormality were excluded from the study. Normal control subjects without any chronic respiratory symptoms were also recruited. Pulmonary function was examined by spirometry. A bronchial obstruction reversibility test was applied. The Lund–Mackay computed tomography (CT) score, peripheral blood eosinophil count, and immunoglobulin E concentration in serum samples were examined. The Sino-Nasal Outcome Test was used to determine the severity of clinical symptoms. Results The patients with an abnormal soft tissue shadow in the paranasal sinus had significant obstructive lung function. The percent predicted forced expiratory volume in 1 second (FEV1.0) and the FEV1.0/forced vital capacity ratio negatively correlated with Lund–Mackay CT scores both before and after bronchodilator inhalation. There was a statistically significant correlation between pulmonary function and eosinophil count. Conclusion The patients with chronic cough frequently had paranasal sinus abnormalities. The Lund–Mackay CT score may be useful for assessing the condition of the lower airway in chronic cough patients. Upper airway examinations should play a part in the management of chronic cough.

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Pediatric liver transplantation and COVID-19: a case report

BMC Surgery ◽

10.1186/s12893-020-00878-6 ◽

2020 ◽

Vol 20 (1) ◽

Cited By ~ 1

Author(s):

Hamed Nikoupour ◽

Kourosh Kazemi ◽

Peyman Arasteh ◽

Saba Ghazimoghadam ◽

Hesameddin Eghlimi ◽

...

Keyword(s):

Liver Transplantation ◽

Pediatric Patients ◽

Distress Syndrome ◽

Clinical Course ◽

Antibiotic Regimen ◽

Case Presentation ◽

Extreme Caution ◽

X Ray ◽

Immunosuppressed Patients ◽

Chest X Ray

Abstract Background Immunosuppressed patients, including individuals with organ transplantation, have been among susceptible groups with regard to COVID-19, on the other hand pediatric patients more commonly undergo a mild clinical course after acquiring COVID-19. To the best of the authors knowledge, to this date very little data exists on COVID-19 in a pediatric patient with liver transplantation. Case presentation We report a three year-old boy who had liver transplantation at 18 months old. He was admitted due to dyspnea with impression of acute respiratory distress syndrome and was then transferred to the intensive care unit. Chest X-ray at admission showed bilateral infiltration. Vancomycin, meropenem, azithromycin, voriconazole and co-trimoxazole were started from the first day of admission. On day 4 of admission, with suspicion of COVID-19, hydroxychloroquine, lopinavir/ritonavir and oseltamivir were added to the antibiotic regimen. PCR was positive for COVID-19. The patient developed multi-organ failure and died on day 6 of admission. Conclusions For pediatric patients with organ transplantations, extreme caution should be taken, to limit and prevent their contact with COVID-19 during the outbreak, as these patients are highly susceptible to severe forms of the disease.

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