scholarly journals A dangerous pleural effusion

2010 ◽  
Vol 92 (5) ◽  
pp. e53-e54 ◽  
Author(s):  
Somprakas Basu ◽  
Shilpi Bhadani ◽  
Vijay K Shukla
Keyword(s):  
Rare Complication ◽  
Sudden Onset ◽  
Biliary Surgery ◽  
Biliary Leak ◽  
X Ray ◽  
Delay In Diagnosis ◽  
Aged Woman ◽  
Middle Aged Woman ◽  
Life Threatening ◽  
Chest X Ray

Bilothorax is a rare complication of biliary peritonitis and, if not treated promptly, can be life-threatening. We report a case of a middle-aged woman who had undergone a bilio-enteric bypass and subsequently a biliary leak developed, which finally led to intra-abdominal biliary collection and spontaneous bilothorax. The clinical course was rapid and mimicked venous thromboembolism, myocardial infarction and pulmonary oedema, which led to a delay in diagnosis and management and finally death. We high-light the fact that bilothorax, although a rare complication of biliary surgery, should always be considered as a probable cause of massive effusion and sudden-onset respiratory and cardiovascular collapse in the postoperative period. A chest X-ray and a diagnostic pleural tap can confirm the diagnosis. Once detected, an aggressive management should be instituted to prevent organ failure and death.

scholarly journals Pneumothorax in the cases of silicosis in southern part of Rajasthan

2017 ◽  
Vol 4 (6) ◽  
pp. 1547 ◽  
Author(s):  
Rishi K. Sharma ◽  
Atul Luhadia ◽  
Shanti K. Luhadia ◽  
Yash Mathur ◽  
Harshil Pandya ◽  
...  
Keyword(s):  
Spontaneous Pneumothorax ◽  
Rare Event ◽  
Silica Particles ◽  
Sudden Onset ◽  
Bilateral Pneumothorax ◽  
X Ray ◽  
Occupational Lung Disease ◽  
Secondary Spontaneous Pneumothorax ◽  
Life Threatening ◽  
Chest X Ray

Background: Silicosis is an occupational lung disease caused by inhalation of dust containing crystalline silica particles of size 0.5-5 microns in diameter. It commonly occurs in workers involved in quarrying, mining, sandblasting, tunneling, foundry work and ceramics. Pneumothorax is one of the complications of silicosis. The occurrence of pneumothorax in a patient with silicosis is a rare event, but it may be fatal. The incidence of secondary spontaneous pneumothorax (SSP) in silicosis as such is not known. This study aims to report the cases of secondary spontaneous pneumothorax in patients of silicosis in Southern part of Rajasthan.Methods: 50 patients of silicosis established by historical, clinical evaluation and radiological evidence with increased dyspnoea were included in the study. In all patients Chest X ray was done immediately.Results: Among 50 patients of silicosis with increased dyspnoea, Chest X ray showed pneumothorax in 20 patients of which 4 had bilateral pneumothorax, 7 had right pneumothorax and 9 had left pneumothorax. The mean duration of exposure to silica particles was 10 years (5 to 15 years). All the patients had various degrees of dyspnoea and chest pain. Tube thoracostomy was performed in 15 patients while 5 patients were managed conservatively with oxygen and bronchodilators.Conclusions: Our study showed an increased incidence of secondary pneumothorax in silicosis patients. The occurrence of pneumothorax, though rare in silicosis is a potentially life-threatening complication and may cause serious morbidity and mortality. The patients of silicosis who develop sudden onset of dyspnoea should be promptly investigated for this complication.

scholarly journals THE PITFALL OF RELYING ON A SPHYGMOMANOMETER DURING A HYPERTENSIVE CRISIS

2019 ◽  
Vol 12 (1) ◽  
pp. 9
Author(s):  
Toh Leong Tan ◽  
Chuan Hun Ding
Keyword(s):  
Target Organ Damage ◽  
Hypertensive Crisis ◽  
Organ Damage ◽  
Aged Woman ◽  
Middle Aged Woman ◽  
Life Threatening ◽  
History Of ◽  
Chest X Ray ◽  
Hypertensive Crises ◽  
The Right

Hypertensive crises can be life-threatening if undiagnosed due to the risk of acute target organ damage. This is a case of a middle-aged woman with poorly controlled hypertension who presented with a 3-day history of dyspnea, orthopnea, and cough productive of frothy sputum. Repeated attempts to measure her blood pressure (BP) using both a mercury and an electronic sphygmomanometer were unsuccessful. However, when an arterial catheterization of the right radial artery was performed, her mean BP was 358/151 mm Hg. A chest X-ray revealed cardiomegaly with plethoric lung fields. Following a diagnosis of hypertensive emergency with acute pulmonary edema, a glyceryl trinitrate infusion at a dose of 20 mg/min was commenced and titrated in an escalating manner. She was also given a single dose of intravenous frusemide 40 mg. Her BP was successfully reduced by 25% within 3 h of presentation.

Benzocaine-related methaemoglobinemia after transoesophageal echocardiography: a rare, life-threatening complication

2021 ◽  
Vol 14 (4) ◽  
pp. e241887
Author(s):  
John Wagner ◽  
Nicole Cornet ◽  
Alan Goldberg
Keyword(s):  
Transoesophageal Echocardiography ◽  
Supplemental Oxygen ◽  
Sudden Onset ◽  
Arterial Blood Gas ◽  
X Ray ◽  
Arterial Blood ◽  
Life Threatening ◽  
Chest X Ray ◽  
Life Threatening Complication ◽  
Methaemoglobin Level

Methaemoglobinemia is an uncommon but potentially life-threatening complication of topical benzocaine use that requires prompt identification in patients who undergo transoesophageal echocardiography (TEE). In this case, a 21-year-old patient who had sustained a stroke with residual right-sided weakness a few days prior to presentation underwent TEE to evaluate for intracardiac shunt. She required intubation as part of her poststroke care with some instrumentation to the posterior oropharynx. Shortly after TEE, the patient experienced sudden onset respiratory distress and hypoxia that did not improve with supplemental oxygen. Chest X-ray did not reveal any acute cardiopulmonary process. Arterial blood gas co-oximetry panel with methaemoglobin level confirmed the diagnosis of methaemoglobinemia. The patient promptly received methylene blue, recovered quickly and did not have any additional episodes of hypoxia.

Pneumopericardium and pleural effusion: a rare complication of paediatric pericardiocentesis

2020 ◽  
Vol 13 (11) ◽  
pp. e236308
Author(s):  
Andreia Palma ◽  
Claudio Henriques ◽  
Patrícia Vaz Silva ◽  
António Pires
Keyword(s):  
Pleural Effusion ◽  
Rare Complication ◽  
Drainage System ◽  
Diagnostic Methods ◽  
X Ray ◽  
Rare Association ◽  
Life Threatening ◽  
Chest X Ray ◽  
Tension Pneumopericardium ◽  
Life Threatening Event

Pneumopericardium is a rare complication of pericardiocentesis (PC), occurring as a result of either a direct pleuropericardial communication or a leaky drainage system. Pneumopericardium is often self-limiting; however, physicians should be aware of this complication as it may progress to tension pneumopericardium, which requires immediate recognition and management. PC has been associated with pneumothorax, pneumomediastinum or subcutaneous emphysema, but the association with pleural effusion has been less reported. The authors present the case of a 14-year-old healthy boy who developed post-PC pneumopericardium and pleural effusion, a rare association reported in the literature. The diagnosis of this potential life-threatening event was made using readily available complementary diagnostic methods, such as transthoracic echocardiography and chest X-ray.

scholarly journals ‘Transvenous’ pleurocentesis

2019 ◽  
Vol 27 (5) ◽  
pp. 313-315
Author(s):  
Kelvin Shenq Woei Siew ◽  
Huynh Quoc Hieu ◽  
Alexander Loch
Keyword(s):  
Central Venous Catheter ◽  
Fluid Resuscitation ◽  
Venous Catheter ◽  
Central Venous Catheter Insertion ◽  
Central Venous ◽  
X Ray ◽  
Aged Woman ◽  
Appropriate Treatment ◽  
Middle Aged Woman ◽  
Chest X Ray

A middle-aged woman had a central venous catheter insertion for fluid resuscitation presented with tachypnea and oxygen desaturation 6 h later. Diagnosis was made based on the chest X-ray performed 6 h after the catheter placement. Thereafter, the patient received appropriate treatment.

scholarly journals THE PITFALL OF RELYING ON A SPHYGMOMANOMETER DURING A HYPERTENSIVE CRISIS

2019 ◽  
Vol 12 (1) ◽  
pp. 9
Author(s):  
Toh Leong Tan ◽  
Chuan Hun Ding
Keyword(s):  
Target Organ Damage ◽  
Hypertensive Crisis ◽  
Organ Damage ◽  
Aged Woman ◽  
Middle Aged Woman ◽  
Life Threatening ◽  
History Of ◽  
Chest X Ray ◽  
Hypertensive Crises ◽  
The Right

Hypertensive crises can be life-threatening if undiagnosed due to the risk of acute target organ damage. This is a case of a middle-aged woman with poorly controlled hypertension who presented with a 3-day history of dyspnea, orthopnea, and cough productive of frothy sputum. Repeated attempts to measure her blood pressure (BP) using both a mercury and an electronic sphygmomanometer were unsuccessful. However, when an arterial catheterization of the right radial artery was performed, her mean BP was 358/151 mm Hg. A chest X-ray revealed cardiomegaly with plethoric lung fields. Following a diagnosis of hypertensive emergency with acute pulmonary edema, a glyceryl trinitrate infusion at a dose of 20 mg/min was commenced and titrated in an escalating manner. She was also given a single dose of intravenous frusemide 40 mg. Her BP was successfully reduced by 25% within 3 h of presentation.

scholarly journals Diagnosing gastric volvulus in chest X-ray: report of three cases

2020 ◽  
Vol 2020 (7) ◽  
Author(s):  
Narendra Pandit ◽  
Abhijeet Kumar ◽  
Tek Narayan Yadav ◽  
Qamar Alam Irfan ◽  
Sujan Gautam ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Acute Abdomen ◽  
Gastric Volvulus ◽  
X Ray ◽  
Pain Abdomen ◽  
Life Threatening ◽  
Chest X Ray ◽  
High Index Of Suspicion ◽  
Specific Symptoms ◽  
Prompt Diagnosis

Abstract Gastric volvulus is a rare abnormal rotation of the stomach along its axis. It is a surgical emergency, hence requires prompt diagnosis and treatment to prevent life-threatening gangrenous changes. Hence, a high index of suspicion is required in any patients presenting with an acute abdomen in emergency. The entity can present acutely with pain abdomen and vomiting, or as chronic with non-specific symptoms. Chest X-ray findings to diagnose it may be overlooked in patients with acute abdomen. Here, we report three patients with gastric volvulus, where the diagnosis was based on the chest X-ray findings, confirmed with computed tomography, and managed successfully with surgery.

Life-threatening presentation of a parahiatal hernia after esophagectomy: a case report and review of the literature

2021 ◽  
Vol 14 (6) ◽  
pp. e242158
Author(s):  
Camille Plourde ◽  
Émilie Comeau
Keyword(s):  
Small Bowel ◽  
Transverse Colon ◽  
Acute Abdominal Pain ◽  
Haemodynamic Instability ◽  
Acute Setting ◽  
X Ray ◽  
Left Diaphragm ◽  
Life Threatening ◽  
Chest X Ray ◽  
Obstructive Shock

A woman presented to our hospital with acute abdominal pain 7 months following an oesophagectomy. A chest X-ray revealed a new elevation of the left diaphragm. CT demonstrated a large left diaphragmatic hernia incarcerated with non-enhancing transverse colon and loops of small bowel. She deteriorated rapidly into obstructive shock and was urgently brought to the operating room for a laparotomy. The diaphragmatic orifice was identified in a left parahiatal position, consistent with a parahiatal hernia. Incarcerated necrotic transverse colon and ischaemic loops of small bowel were resected, and the diaphragmatic defect was closed primarily. Because of haemodynamic instability, the abdomen was temporarily closed, and a second look was performed 24 hours later, allowing anastomosis and definitive closure. Parahiatal hernias are rare complications following surgical procedures and can lead to devastating life-threatening complications, such as an obstructive shock. Expeditious diagnosis and management are required in the acute setting.

AN ABDOMINAL INFECTION SIMULATING MALIGNANCY : A CASE REPORT

2021 ◽  
pp. 29-30
Author(s):  
Varsha Konyala ◽  
Poornima M
Keyword(s):  
Histopathological Examination ◽  
The Road ◽  
Aged Woman ◽  
Loss Of Weight ◽  
Middle Aged Woman ◽  
Chest X Ray ◽  
Extra Pulmonary ◽  
On The Road ◽  
Anti Tubercular Therapy ◽  
Spread Of Infection

Tuberculosis is notorious for its afiction to the lungs.However, one mustn't forget the case burden that extra pulmonary TB imposes.Here we present a case of a middle aged woman who came with non specic complaints per abdomen.Her abdominal pain, discomfort, loss of weight and appetite along with clinical examination and investigations pointed towards malignancy. On surgical exploration and histopathological examination, the case was conrmed as that of abdominal TB.Tuberculosis of the abdomen is one of the extra pulmonary sites where tubercular bacilli can reside. In such cases, apart from treating tuberculosis medically with anti tubercular therapy, one must also order a chest X-ray to identify any pulmonary foci of tuberculosis. This is to curb any potential spread of infection. Further, one must look acutely at cases with non specic ndings and consider TB in the differential diagnosis, particularly if the patient hails from a TB endemic region.With a keen eye for tuberculosis along with corroborative and relevant investigations, one can diagnose this chronic illness and put patients well on the road to recovery.

scholarly journals Automated segmentation and diagnosis of pneumothorax on chest X-rays with fully convolutional multi-scale ScSE-DenseNet: a retrospective study

2020 ◽  
Vol 20 (S14) ◽  
Author(s):  
Qingfeng Wang ◽  
Qiyu Liu ◽  
Guoting Luo ◽  
Zhiqin Liu ◽  
Jun Huang ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Automatic Segmentation ◽  
Medical Emergency ◽  
Dice Similarity Coefficient ◽  
X Rays ◽  
X Ray ◽  
Learning Framework ◽  
Multi Scale ◽  
Life Threatening ◽  
Chest X Ray

Abstract Background Pneumothorax (PTX) may cause a life-threatening medical emergency with cardio-respiratory collapse that requires immediate intervention and rapid treatment. The screening and diagnosis of pneumothorax usually rely on chest radiographs. However, the pneumothoraces in chest X-rays may be very subtle with highly variable in shape and overlapped with the ribs or clavicles, which are often difficult to identify. Our objective was to create a large chest X-ray dataset for pneumothorax with pixel-level annotation and to train an automatic segmentation and diagnosis framework to assist radiologists to identify pneumothorax accurately and timely. Methods In this study, an end-to-end deep learning framework is proposed for the segmentation and diagnosis of pneumothorax on chest X-rays, which incorporates a fully convolutional DenseNet (FC-DenseNet) with multi-scale module and spatial and channel squeezes and excitation (scSE) modules. To further improve the precision of boundary segmentation, we propose a spatial weighted cross-entropy loss function to penalize the target, background and contour pixels with different weights. Results This retrospective study are conducted on a total of eligible 11,051 front-view chest X-ray images (5566 cases of PTX and 5485 cases of Non-PTX). The experimental results show that the proposed algorithm outperforms the five state-of-the-art segmentation algorithms in terms of mean pixel-wise accuracy (MPA) with $$0.93\pm 0.13$$ 0.93 ± 0.13 and dice similarity coefficient (DSC) with $$0.92\pm 0.14$$ 0.92 ± 0.14 , and achieves competitive performance on diagnostic accuracy with 93.45% and $$F_1$$ F 1 -score with 92.97%. Conclusion This framework provides substantial improvements for the automatic segmentation and diagnosis of pneumothorax and is expected to become a clinical application tool to help radiologists to identify pneumothorax on chest X-rays.

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