Catamenial pneumothorax with partial liver herniation due to diaphragmatic laceration: a case report and literature review

Abstract Background Catamenial pneumothorax is generally uncommon, with an incidence of less than 3–6% in women with spontaneous pneumothorax. As few cases of catamenial pneumothorax with diaphragmatic defect and liver herniation have been reported, this case report may be useful for understanding the cause and treatment. This case highlights the importance of the approach for liver hernia in patients with catamenial pneumothorax and endometriosis. Case presentation We report a case of catamenial pneumothorax in a 43-year-old woman with diaphragmatic partial liver hernia who was treated with thoracoscopic surgery. She was diagnosed with a right pneumothorax at menstruation onset. Chest computed tomography showed a nodule protruding above the right diaphragm. We performed thoracoscopic surgery to treat the persistent air leak and biopsied the nodule on the right diaphragm. There were blueberry spots on the diaphragm; the nodule was found to be the herniated liver. The diaphragmatic defect was sutured. Histological examination of the tissue near the partial prolapsed liver revealed endometrial tissue. Conclusions It is speculated that ectopic endometrial tissue in the diaphragm will periodically necrose to become a diaphragmatic tear, which is a pathway for air to enter the thoracic cavity and eventually a herniated liver. Thoracoscopic surgery should be considered in patients with catamenial pneumothorax when a diaphragmatic lesion is suspected.

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Large Spontaneous Right Catamenial Pneumothorax with Diaphragmatic Defect and Liver Herniation

Case Reports in Pulmonology ◽

10.1155/2019/8436450 ◽

2019 ◽

Vol 2019 ◽

pp. 1-4

Author(s):

Venkata Kishore Mukku ◽

Emily Cassidy ◽

Catalina Negulescu ◽

Tonya Jagneaux ◽

John Godke

Keyword(s):

Chest Tube ◽

Spontaneous Pneumothorax ◽

Thoracoscopic Surgery ◽

Diaphragmatic Defect ◽

Air Leak ◽

Thoracic Imaging ◽

Catamenial Pneumothorax ◽

Child Bearing ◽

Liver Herniation ◽

The Right

Catamenial pneumothorax is a spontaneous pneumothorax that occurs predominantly women of child bearing age. We describe a case of a 40-year-old nulliparous woman with medical history significant for endometriosis who presented with severe chest tightness of one-day duration. Chest radiography (CXR) showed a large right spontaneous pneumothorax, what was thought to be a 5.6 cm pleural mass at the right lung base. Following pneumothorax diagnosis, the patient underwent emergent right thoracostomy with pigtail catheter placement. A repeat CXR revealed marked re-expansion of the lung but persistence of a right pleural mass. Follow up computed tomography scan of the chest showed a 33 mm diaphragmatic defect with 5.8 x 4.6 x 3.9 cm area of herniated liver corresponding to the presumed pleural mass. Following complete thoracic imaging, patient underwent video-assisted thoracoscopic surgery, mechanical pleurodesis, and open repair of the right diaphragmatic defect. Intraoperatively, an endometrial implant was noted on the chest wall. On postoperative day three, she began her menstrual cycle and was evaluated by gynecologist who recommended hormonal therapy to reduce risk of recurrent pneumothorax. Due to a persistent air leak, the chest tube was transitioned to a Heimlich valve to facilitate home discharge. The patient was discharged on postoperative day eight, seen as outpatient with resolution of air leak and removal of chest tube.

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A case of Bochdalek hernia with anomalous hepatic lobe heterotopia-case report

Egyptian Pediatric Association Gazette ◽

10.1186/s43054-021-00075-x ◽

2021 ◽

Vol 69 (1) ◽

Author(s):

Wajiha Khan ◽

Adnan Safi ◽

Asrar Ahmad ◽

Mehwish Mooghal

Keyword(s):

Case Report ◽

Common Type ◽

Diaphragmatic Defect ◽

Bochdalek Hernia ◽

Good Recovery ◽

Liver Lobe ◽

Case Presentation ◽

Hepatic Lobe ◽

The Right ◽

Ladd’S Procedure

Abstract Background Bochdalek hernia is the most common type of congenital diaphragmatic hernia (CDH) resulting from postero-lateral diaphragmatic defect. Hepatic heterotopia is very rarely associated with CDH, and hepatic herniation favors the worst prognosis. Case presentation We present a case of a neonate diagnosed with right Bochdalek hernia (BH) with anomalous hepatic lobe heterotopia. Intra operatively, mal-rotated loops were also found to be herniating in the right hemithorax. The mal-rotated loops were reduced back into abdomen after performing Ladd’s procedure and diaphragmatic defect was repaired over the anomalous liver lobe. Baby was discharged on 7th postoperative day and follow-ups showed good recovery. Conclusion This case report discusses the presentation, classification, and significance of this association. Our case report is noteworthy as Bochdalek hernia is very rarely associated with anomalous hepatic lobe.

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Embolization of the false lumen using IMPEDE-FX embolization plugs as part of treatment of an infrarenal post-dissection aneurysm: a case report

CVIR Endovascular ◽

10.1186/s42155-020-00183-6 ◽

2020 ◽

Vol 3 (1) ◽

Author(s):

Anne-Jet S. Jansen ◽

Paul M. van Schaik ◽

Jasper M. Martens ◽

Michel M. P. J. Reijnen

Keyword(s):

Case Report ◽

Mesenteric Artery ◽

Inferior Mesenteric Artery ◽

False Lumen ◽

True Lumen ◽

Case Presentation ◽

Type A Dissection ◽

Prospective Trials ◽

The Right ◽

Embolization Procedure

Abstract Background This case report demonstrates the value of IMPEDE-FX plugs in an embolization procedure of a false lumen of an infrarenal post-dissection aneurysm. Case presentation A 69-year-old patient was treated with mitral valve replacement, complicated by a Stanford type-A dissection. After 9 years he presented with an enlarging infrarenal post-dissection aneurysm. The false lumen was embolized using multiple IMPEDE-FX plugs as part of the treatment in addition to embolization of the inferior mesenteric artery and overstenting of the re-entry in the right iliac artery. At 15 months the CTA showed a fully thrombosed false lumen and remodeling of the true lumen. Conclusions The false lumen of an infrarenal post-dissection aneurysm can successfully be embolized using IMPEDE-FX embolization plugs as part of the treatment strategy. Prospective trials on patients with non-thrombosed false lumina are indicated.

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Catamenial pneumothorax with bubbling up on the diaphragmatic defects: a case report

BMC Women s Health ◽

10.1186/s12905-021-01318-0 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Bo Dong ◽

Chun-Li Wu ◽

Yin-liang Sheng ◽

Bin Wu ◽

Guan-Chao Ye ◽

...

Keyword(s):

Thoracoscopic Surgery ◽

Lung Lesion ◽

Parietal Pleura ◽

Catamenial Pneumothorax ◽

Endometrial Cells ◽

Retrograde Menstruation ◽

History Of ◽

The Right ◽

Thoracic Endometriosis

Abstract Background Catamenial pneumothorax is characterized by spontaneous recurring pneumothorax during menstruation, which is a common clinical manifestation of thoracic endometriosis syndrome. There are still controversies about its pathogenesis. Case presentation A 43-year-old woman with a history of endometriosis came to our hospital due to recurring pneumothorax during menstruation. Uniportal Video-assisted Thoracoscopic Surgery (VATS) exploration was performed on the eve of menstruating. We thoroughly explored the diaphragm, visceral and parietal pleura: The lung surface was scattered with yellowish-brown implants; no bullae were found; multiple diaphragmatic defects were found on the dome. And surprisingly, we caught a fascinating phenomenon: Bubbles were slipping into pleural cavity through diaphragmatic defects. We excised the diaphragmatic lesions and wedge resected the right upper lung lesion; cleared the deposits and flushed the thoracic cavity with pure iodophor. Diaphragmatic lesions confirmed the presence of endometriosis, and interestingly enough, microscopically, endometrial cells were shedding with impending menses. After a series of intraoperative operations and postoperative endocrine therapy, the disease did not recur after a period of follow-up. Conclusion We have witnessed the typical signs of catamenial pneumothorax at the accurate timing: Not only observed the process of gas migration macroscopically, but also obtained pathological evidence of diaphragmatic periodic perforation microscopically, which is especially precious and confirms the existing theory that retrograde menstruation leads to diaphragmatic endometriosis, and the diaphragmatic fenestration is obtained due to the periodic activities of ectopic endometrium.

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Patient re-presents to the clinic with reactive arthritis in the right hip after covid-19 infection: A case report

10.21203/rs.3.rs-230354/v1 ◽

2021 ◽

Author(s):

Kamyar Shokraee ◽

Soroush Moradi ◽

Tahereh Eftekhari ◽

Rasoul Shajari ◽

Maryam Masoumi

Keyword(s):

Case Report ◽

Reactive Arthritis ◽

Respiratory Symptoms ◽

Gastrointestinal Infection ◽

Case Presentation ◽

Sexually Transmitted ◽

Methyl Prednisolone ◽

First Case ◽

The Right

Abstract Background: SARS-COV-2, first reported in December 2019, usually presents with respiratory symptoms but can have various other manifestations and sequelae. One of the rare complications of COVID-19 infection is Reactive Arthritis. This complication is more likely to occur following sexually transmitted or gastrointestinal infection.Case presentation: Herein, we report a 58 years old woman hospitalized following COVID-19 infection and was discharged after a week. She consequently presented to the clinic ten days after her discharge, complaining of walking difficulties and radiating pain in her right hip. After ultrasound and MRI, she was diagnosed with reactive arthritis inflammation in the hip’s neck. Other known microorganisms responsible for reactive arthritis were ruled out before attributing it to the earlier COVID-19 infection. She reached remission after being treated using a combination of indomethacin and depot methyl-prednisolone for 14 days. Conclusion: To our knowledge, this is the first case of reactive arthritis caused by SARS-COV-2 in the hip. Further attention should be paid to symptoms occurring after an episode of infection with COVID-19 in order to expand our understanding of the disease and the symptoms with which it can manifest.

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Spontaneous orbital subcutaneous emphysema mimicking lacrimal duct obstruction after sneezing: A case report

Hong Kong Journal of Emergency Medicine ◽

10.1177/1024907918797530 ◽

2018 ◽

Vol 27 (3) ◽

pp. 176-179

Author(s):

Hung-Yen Chan ◽

Chon-Fu Lio ◽

Chang-Ching Yu ◽

Nan-Jing Peng ◽

Hung-Pin Chan

Keyword(s):

Case Report ◽

Subcutaneous Emphysema ◽

Relevant Information ◽

Lacrimal Duct ◽

Case Presentation ◽

Duct Occlusion ◽

Painful Sensation ◽

Eyelid Swelling ◽

Visual Problems ◽

The Right

Introduction: Orbital subcutaneous emphysema after trauma has been carefully reported, but its development in the absence of trauma is rare. Case presentation: We report on a 70-year-old patient who developed unilateral orbital subcutaneous emphysema, mimicking lacrimal duct occlusion, after this man sneezed, and presented with right crepitant eyelid swelling and progressive ptosis. Orbital subcutaneous emphysema develops when air can get into the periorbital soft tissue, which presents as a result of facial bone trauma, iatrogenic procedures, and gas-forming infectious microorganisms, as seen in many published articles. It is very uncommon to see this kind of case report after sneezing; however, in our case, spontaneous orbital subcutaneous emphysema occurred after sneezing that resolved slowly after a few weeks without surgical intervention. Our patient denied any painful sensation over the right orbital area, including no visual problems with the right eye but right eyeball limited movements. It can be stressful to patients due to its symptoms but is not a true emergency. Conclusion: In this article, we should bring awareness to physicians of the possibility of a spontaneously orbital subcutaneous emphysema with complications after sneezing, yielding relevant information for patients to be informed about avoid excessive nose blowing or occluding the nose, creating controlled symptoms.

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Internal hernia beneath superior vesical artery after pelvic lymphadenectomy for cervical cancer: a case report and literature review

BMC Surgery ◽

10.1186/s12893-020-00985-4 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Wen Ai ◽

Zhihua Liang ◽

Feng Li ◽

Haihua Yu

Keyword(s):

Cervical Cancer ◽

Case Report ◽

Literature Review ◽

Internal Hernia ◽

Radical Hysterectomy ◽

Pelvic Lymphadenectomy ◽

Case Presentation ◽

The Common ◽

Laparoscopic Pelvic Lymphadenectomy ◽

The Right

Abstract Background The common complications of radical hysterectomy and pelvic lymphadenectomy usually include wound infection, hemorrhage or hematomas, lymphocele, uretheral injury, ileus and incisional hernias. However, internal hernia secondary to the orifice associated with the uncovered vessels after pelvic lymphadenectomy is very rare. Case presentation We report a case of internal hernia with intestinal perforation beneath the superior vesical artery that occurred one month after laparoscopic pelvic lymphadenectomy for cervical cancer. A partial ileum resection was performed and the right superior vesical artery was transected to prevent recurrence of the internal hernia. Conclusions Retroperitonealization after the pelvic lymphadenectomy should be considered in patients with tortuous, elongated arteries which could be causal lesions of an internal hernia.

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Disseminated Nocardia infection with a lesion occupying the intracranial space complicated with coma: a case report

BMC Infectious Diseases ◽

10.1186/s12879-020-05569-4 ◽

2020 ◽

Vol 20 (1) ◽

Cited By ~ 1

Author(s):

Mei-Hong Yu ◽

Xiao-Xin Wu ◽

Chun-Lei Chen ◽

Song-Jia Tang ◽

Jian-Di Jin ◽

...

Keyword(s):

Case Report ◽

Immunosuppressive Treatment ◽

Lung Infection ◽

C Reactive Protein ◽

Altered Consciousness ◽

Blood Cell Count ◽

Case Presentation ◽

Reactive Protein ◽

Nocardia Cyriacigeorgica ◽

The Right

Abstract Background Disseminated Nocardia infection is a disease that is easily overlooked in patients with lesions occupying the intracranial space complicated with coma. Early diagnosis and treatment are crucial. Case presentation A 65-year-old man was admitted to the First Affiliated Hospital of Zhejiang University in October 2018 with weakness in the right limbs for 3 days and altered consciousness for 1 day. Five months earlier, he had been diagnosed with membranous kidney disease and had received cyclophosphamide and prednisone. At admission, the white blood cell count was 1.37 × 1010/L (with 86.4% neutrophils), and C-reactive protein was 115.60 mg/L. Imaging examinations revealed a lesion occupying the intracranial space, lung infection, and multiple abscesses in the rhomboid muscle. The abscesses were drained. Pus culture confirmed Nocardia cyriacigeorgica infection. With antibiotics and vacuum-sealed drainage of the back wound, the patient improved and was discharged from the hospital. Conclusions This case report shows that infection should be considered during the differential diagnosis of lesions in the intracranial space, especially in patients receiving immunosuppressive treatment. In patients with disseminated N. cyriacigeorgica infection, combination antibiotic therapy and surgical drainage of localised abscesses can be effective.

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Malignant Gastrointestinal Neuroectodermal Tumor in the Right Atrium: The First Case Report Presenting with an Extra-Gastrointestinal Mass

10.21203/rs.3.rs-620292/v1 ◽

2021 ◽

Author(s):

Zhiwen Li ◽

Xiaohong Pu ◽

Yao Fu ◽

Lin Li ◽

Yuemei Xu ◽

...

Keyword(s):

Case Report ◽

Right Atrium ◽

Tumor Location ◽

Neuroectodermal Tumor ◽

Case Presentation ◽

First Case ◽

Mitotic Figures ◽

The Right ◽

Whole Transcriptome

Abstract Background: Malignant gastrointestinal neuroectodermal tumor is an extremely rare soft tissue sarcoma which was firstly described in 2003 but until recently it had been designated as a definite new entity. According to the previous literatures, Malignant gastrointestinal neuroectodermal tumor was almost exclusively occurred in gastrointestinal tract.Case presentation: A 62-year-old male showed a mass in right atrium and the occupying mass was founded on the right ventricular diaphragm and involved the right atrium along the coronary sinus during the operation. Microscopically, the tumor characterized by the solid sheet and pseudopapillary focally architectures, and was composed of small to medium cells with round or oval nuclei, variable amount of eosinophilic or clear, and frequent mitotic figures. Immunohistochemically, the neoplastic cells were positive for S100 and SOX-10 but negative for HMB-45, A103 and CD99. EWSR1-AFTF1 rearrangement was detected by fluorescence in situ hybridization and further confirmed involving fusion of EWSR1 exon 8 with ATF1 exon 4 by whole transcriptome sequence analysis.Conclusions: This is the first case report of extra-gastrointestinal Malignant gastrointestinal neuroectodermal tumor that occurring in the right atrium，which remind of the new prospect of the tumor location.

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Solitary Fibrofolliculoma of the Upper Eyelid in a 68-year Old Female: A Case Report

10.21203/rs.2.435/v4 ◽

2020 ◽

Author(s):

Wenqiu Wang ◽

Jinwei Cheng

Keyword(s):

Case Report ◽

Connective Tissue ◽

Benign Tumor ◽

Upper Eyelid ◽

Solitary Lesion ◽

Case Presentation ◽

Multiple Lesions ◽

Tissue Tumor ◽

Upper Lid ◽

The Right

Abstract Background : Fibrofolliculoma is a benign, perifollicular, connective tissue tumor, and it usually arises in the form of multiple lesions, but rarely as a solitary lesion. We report a case of solitary fibrofolliculoma on the eyelid. Case presentation: A 68-year-old female presented with an asymptomatic mass on the right upper eyelid. The lesion appeared as a flesh-colored, dome-shaped, smooth nodule being the size of 5×5×4 mm, with eyelashes protruding from the surface, and located on the upper lid margin. Shave excision was performed, and the diagnosis of fibrofolliculoma was confirmed finally through histological exam. Conclusions: Solitary fibrofolliculomas rarely arises on the eyelid. However, it should be suspected when a flesh-colored and doom-shaped lesion of the eyelid is encountered. The benign tumor on the lid margin can be removed by shave biopsy.

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