scholarly journals Spontaneous pneumomediastinum, pneumothorax and subcutaneous emphysema in COVID-19 patients—a case series

Author(s):  
Akshat Agrawal ◽  
Kamal Kumar Sen ◽  
Gitanjali Satapathy ◽  
Humsheer Singh Sethi ◽  
Ajay Sharawat ◽  
...  

Abstract Background Spontaneous pneumomediastinum, pneumothorax and spontaneous subcutaneous emphysema are rare entities. A rising trend in the setting of COVID-19 even in patients who are not put on invasive ventilation can suggest an alternative aetiology. Case presentation We describe four cases which presented with suspected symptoms of COVID-19 and were diagnosed with pneumomediastinum, pneumothorax, and subcutaneous emphysema which would have been missed if not for computed tomography scan performed at the time of admission. Three of these cases had no prior history of any iatrogenic intervention, and the fourth person developing pneumothorax and subcutaneous emphysema after intubation. Conclusions Pneumomediastinum, pneumothorax and subcutaneous emphysema can be noted as a complication of COVID-19 itself as well as the complication of management of COVID-19.

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Shunichi Murakami ◽  
Shunsuke Tsuruta ◽  
Kazuyoshi Ishida ◽  
Atsuo Yamashita ◽  
Mishiya Matsumoto

Abstract Background Excessive dynamic airway collapse (EDAC) is an uncommon cause of high airway pressure during mechanical ventilation. However, EDAC is not widely recognized by anesthesiologists, and therefore, it is often misdiagnosed as asthma. Case presentation A 70-year-old woman with a history of asthma received anesthesia with sevoflurane for a laparotomic cholecystectomy. Under general anesthesia, she developed wheezing, high inspiratory pressure, and a shark-fin waveform on capnography, which was interpreted as an asthma attack. However, treatment with a bronchodilator was ineffective. Bronchoscopy revealed the collapse of the trachea and main bronchi upon expiration. We reviewed the preoperative computed tomography scan and saw bulging of the posterior membrane into the airway lumen, leading to a diagnosis of EDAC. Conclusions Although both EDAC and bronchospasm present as similar symptoms, the treatments are different. Bronchoscopy proved useful for distinguishing between these two entities. Positive end-expiratory pressure should be applied and bronchodilators avoided in EDAC.


2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Resul Nusretoğlu ◽  
Yunus Dönder

Abstract Background Diaphragmatic hernias may occur as either congenital or acquired. The most important cause of acquired diaphragmatic hernias is trauma, and the trauma can be due to blunt or penetrating injury. Diaphragmatic hernia may rarely be seen after thoracoabdominal trauma. Case presentation A 54-year-old Turkish male patient admitted to the emergency department with abdominal pain and dyspnea ongoing for 2 days. He had general abdominal tenderness in all quadrants. He had a history of a stabbing incident in his left subcostal region 3 months ago without any pathological findings in thoracoabdominal computed tomography scan. New thoracoabdominal computed tomography showed a diaphragmatic hernia and fluid in the hernia sac. Due to respiratory distress and general abdominal tenderness, the decision to perform an emergency laparotomy was made. There was a 6 cm defect in the diaphragm. There were also necrotic fluids and stool in the hernia sac in the thorax colon resection, and an anastomosis was performed. The defect in the diaphragm was sutured. The oral regimen was started, and when it was tolerated, the regimen was gradually increased. The patient was discharged on the postoperative 11th day. Conclusions Acquired diaphragmatic hernia may be asymptomatic or may present with complications leading to sepsis. In this report, acquired diaphragmatic hernia and associated colonic perforation of a patient with a history of stab wounds was presented.


2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Florence Jaguga

Abstract Background Stuttering is a rare side effect of clozapine. It has been shown to occur in the presence of one or more factors such as abnormal electrophysiological findings and seizures, extrapyramidal symptoms, brain pathology, and a family history of stuttering. Few case reports have documented the occurrence of clozapine-induced stuttering in the absence of these risk factors. Case presentation A 29-year-old African male on clozapine for treatment-resistant schizophrenia presented with stuttering at a dosage of 400 mg/day that resolved with dose reduction. Electroencephalogram findings were normal, and there was no clinical evidence of seizures. The patient had no prior history or family history of stuttering, had a normal neurological examination, and showed no signs of extrapyramidal symptoms. Conclusion Clinicians ought to be aware of stuttering as a side effect of clozapine, even in the absence of known risk factors. Further research should investigate the pathophysiology of clozapine-induced stuttering.


2021 ◽  
Vol 30 ◽  
pp. 096368972098545
Author(s):  
Tao Hu ◽  
Xiao Liu ◽  
Qinan Yin ◽  
Xingting Duan ◽  
Li Yan

In this work, we discovered a new phenomenon—asymptomatic COVID-19 infection, or covert case, during the pandemic. All the 3 patients had a history of exposure, with no symptoms, and no abnormalities were found in computed tomography scan or lab tests. Except for case 2, the other patients’ severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) nucleic acid tests were negative. But their anti-SARS-COV-2 nucleocapsid antibody showed a dynamic trend, consistent with the process of virus infection and clearance. A growing number of asymptomatic or covert cases need more attention. Lack of surveillance may lead to another outbreak. We hope to demonstrate our cases to attract the attention of governments or health authorities that covert cases should be the focus as well.


2018 ◽  
Vol 30 (4) ◽  
pp. 646-650 ◽  
Author(s):  
Ryan Schafbuch ◽  
Stacy Tinkler ◽  
Chee Kin Lim ◽  
Rebecca Wolking ◽  
José Ramos-Vara

A 1.5-y-old spayed female Juliana pot-bellied pig was presented to the Purdue University Veterinary Teaching Hospital with a history of wasting and anorexia. Enlarged and partially mineralized lymph nodes were identified on radiographs and computed tomography scan. Generalized lymphadenomegaly and disseminated nodules in the lungs, liver, spleen, and kidneys were identified on postmortem examination. Histologic examination revealed caseonecrotic granulomas with numerous intracellular, acid-fast bacilli. Mycobacterium kansasii type II was identified as the etiologic agent by PCR amplification using universal Mycobacterium primers, direct sequencing of the PCR amplicon, and comparison to sequences in GenBank. We describe a case in a pot-bellied pig of mycobacteriosis caused by an atypical mycobacterial species and highlight the important role of laboratory testing in suspected cases of tuberculosis.


2018 ◽  
Vol 22 (1) ◽  
Author(s):  
Suman Mewa Kinoo ◽  
Vikesh V. Ramkelawon ◽  
Jaynund Maharajh ◽  
Bugwan Singh

Amoebic colitis, caused by ingestion of water or food contaminated with the protozoan Entamoeba histolytica, can progress to a fulminant colitis. Computed tomography (CT) findings reported in the literature on this type of colitis are sparse. We present a 59-year-old male patient with a one-week history of progressive abdominal pain, abdominal distension and associated watery and bloody diarrhoea. A CT scan revealed deep ulcerations with submucosal and intramural tracking of contrast. Colonoscopy and biopsy confirmed a diagnosis of Amoebic colitis. The patient required a laparotomy and demised. Deep ulcerations with submucosal and intramural tracking of contrast on CT are diagnostic of fulminant amoebic colitis. Although not demonstrated at CT in this case, discontinuous bowel necrosis, omental wrapping (seen at laparotomy in our case) and neovascularisation of the bowel wall may be other features to look out for.


2020 ◽  
pp. 201010582094853
Author(s):  
Mohamed Faisal Abdul Hamid ◽  
Sopian Wahab ◽  
Nik Nuratiqah Nik Abeed ◽  
Ng Boon Hau ◽  
Andrea Ban Yu-Lin

Primary tracheal synovial sarcoma is a rare malignancy and is usually found incidentally. Tumours can present with cough, dyspnoea, stridor and intermittent haemoptysis. The diagnosis is challenging because it is rare, and the symptoms may mimic other diseases of airway obstruction. A previously well 53-year-old man presented with an eight-month history of cough. He had a history of minimal haemoptysis a few months prior to presentation. Spirometry showed an obstructive pattern, and a computed tomography scan of the thorax revealed an intraluminal tracheal mass. This case highlights that a thorough initial evaluation, including spirometry, leads to an earlier diagnosis and successful treatment of this rare sarcoma.


2020 ◽  
Vol 4 (2) ◽  
pp. 232-233
Author(s):  
Drew Long ◽  
Brit Long

Case Presentation: A 55 year-old female presented to the emergency department with left sided abdominal pain and hematuria. Computed tomography scan of her abdomen and pelvis demonstrated a large left renal mass with extension into the left ureter, left renal vein, and inferior vena cava. She was admitted and treated for presumed renal cell carcinoma (RCC). Discussion: RCC may present with abdominal or flank pain and hematuria, but more commonly presents with vague symptoms. RCC should be suspected in a patient presenting with hematuria and abdominal or flank pain, especially if vague symptoms such as fatigue or anorexia are also present.


2015 ◽  
Vol 62 (4) ◽  
pp. 893-899 ◽  
Author(s):  
Kedar S. Lavingia ◽  
Sebastion Larion ◽  
Sadaf S. Ahanchi ◽  
Chad P. Ammar ◽  
Mohit Bhasin ◽  
...  

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Shireen Samargandy ◽  
Hani Marzouki ◽  
Talal Al-Khatib ◽  
Mazin Merdad

Background. Dentures are a common cause of inadvertent foreign body ingestion particularly in the elderly. Due to their radiolucent nature, they often present a diagnostic challenge to care providing physicians. Case Presentation. A 66-year-old female presented to our otolaryngology clinic with a 2-year history of dysphagia. Her physical examination was unremarkable. Computed tomography scan of the neck and barium swallow suggested Zenker diverticulum. She was planned for endoscopic diverticulotomy; however, during surgery, a foreign body was incidentally found and retrieved, which was a partial lower denture. The diverticulum resolved thereafter, and the patient's symptoms abated. Conclusion. The authors recommend evaluating the esophagus endoscopically first in cases of upper esophageal diverticular formation, even when planning an open repair approach, to rule out any concealed foreign bodies.


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