scholarly journals Craniocerebral gunshot injury bullet migration to the cardiac right ventricle

2021 ◽  
Vol 12 ◽  
pp. 491
Author(s):  
Taylor Duda ◽  
Euan Zhang ◽  
Kesava Reddy
Keyword(s):  
Rare Complication ◽  
Clinical Status ◽  
Paradoxical Embolism ◽  
High Rate ◽  
X Ray ◽  
Cardiac Ventricle ◽  
Slow Velocity ◽  
Close Range ◽  
Chest X Ray ◽  
The Right

Background: Missile embolism is the process of slow velocity projectiles penetrating into vascular spaces followed by arterial, venous, or paradoxical embolism of the fragments. This is a rare complication in craniocerebral gunshot injuries (CGI), with only five other cases previously published demonstrating pulmonary or arterial emboli from these injuries. There is a high rate of mortality from these injuries. Case Description: A patient presented with a CGI from an occipital trajectory, causing penetrating fragments into the venous sinus system. The weapon was a Glock Model 17M 9 mm with a hollow-point bullet, fired close range. Initial chest X-ray demonstrated only atelectasis. After stabilization, 18 min from the initial chest X-ray, subsequent computed tomography (CT) imaging demonstrated extensive intracranial injuries and fragmentation of the bullet with the expected devastating intracranial injuries. Unexpectedly, chest CT revealed metallic fragments in the right cardiac ventricle which was redemonstrated on follow-up chest X-ray. Unfortunately, his extensive intracranial injuries and poor clinical status were nonsurvivable, and thus the family elected to discontinue supportive measures. Conclusion: This case demonstrates radiographic imaging of a metallic intravascular fragment from CGI through presumed transvenous mechanisms. The imaging provides a consistent timeline demonstrating migration can occur in the acute phase. This study additionally supports the presumed mechanism for pulmonary of migration through the right heart. Fragment embolization should be considered in cases of acute deterioration in this patient population.

scholarly journals Misplacement of Tracheostomy Tube in the Right Main Bronchus: a Rare Complication

2020 ◽  
Vol 2020 ◽  
pp. 1-3
Author(s):  
Armin Amirian ◽  
Reza Shahriarirad ◽  
Bizhan Ziaian ◽  
Parviz Mardani ◽  
Amirhossein Erfani
Keyword(s):  
Squamous Cell Carcinoma ◽  
Tracheostomy Tube ◽  
Pressure Effect ◽  
Main Bronchus ◽  
Rare Complication ◽  
Fiberoptic Bronchoscopy ◽  
X Ray ◽  
Metastatic Squamous Cell Carcinoma ◽  
Chest X Ray ◽  
The Right

A 38-year-old woman known case of metastatic squamous cell carcinoma of the cervical esophagus due to increasing dyspnea and stridor attributed to the pressure effect of the primary mass was scheduled for tracheostomy, which ended up in the right main bronchus. This rare complication occurred using a tracheostomy tube number 7.5 via a vertical tracheotomy over 4th and 5th tracheal rings. The misplacement was confirmed by chest X-ray and fiberoptic bronchoscopy, and the tracheostomy tube was successfully repositioned in a nonoperative approach.

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 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 CLINICAL STUDY OF PAIN IN RIGHT ILIAC FOSSA

2020 ◽  
Vol 4 (8) ◽  
Author(s):  
Saurabh Kothari ◽  
Manjula Kothari ◽  
Shree Mohan Joshi ◽  
Kalp Shandilya
Keyword(s):  
Iliac Fossa ◽  
Signs And Symptoms ◽  
Clinical History ◽  
X Ray ◽  
Pain Abdomen ◽  
Detailed Clinical History ◽  
Right Iliac Fossa Pain ◽  
Chest X Ray ◽  
The Right ◽  
Appendicular Mass

Background: A mass in the right iliac fossa is a common diagnostic problem encountered in clinical practice, requiring skill in diagnosis. Methods: 100 patients with signs and symptoms of right iliac fossa mass admitted in Hospital were identified and were studied by taking detailed clinical history, physical examination and were subjected to various investigations like x ray erect abdomen, chest x-ray, contrast x-ray . Result: In this study of out of 100 cases, 65.00% of cases were related to appendicular pathology either in the form of appendicular mass or appendicular abscess. There were 12.00% cases of ileocaecal tuberculosis. Conclusion: Appendicular lump remains the most common cause for right iliac fossa pain. Ileocaecal tuberculosis is one of the most important differential diagnoses for pain abdomen. Keywords: Appendicular Mass, Ileocaecal Tuberculosis, Carcinoma Caecum, Right Iliac Fossa Mass.

scholarly journals Subcutaneous Emphysema in Pregnancy

2011 ◽  
Vol 51 (183) ◽  
Author(s):  
A Shrestha ◽  
S Acharya
Keyword(s):  
Subcutaneous Emphysema ◽  
Late Pregnancy ◽  
X Ray ◽  
Close Observation ◽  
The Face ◽  
Normal Chest ◽  
Chest X Ray ◽  
Keywords Pregnancy ◽  
Systemic Examination ◽  
The Right

Spontaneous pneumomediastinum and subcutaneous emphysema are rare complications of labor, especially in the late pregnancy period, but they are usually self-limiting. Management includes avoidance of exacerbative factors and close observation with supportive treatment. A 19-year-old primi gravida at 36 weeks pregnancy presented with swelling over the right side of the face, neck and chest. Her general examination was normal. Systemic examination revealed swelling with palpatory crepitation over the right side of chest, neck and face, and other examination findings were normal. Chest X-ray revealed subcutaneous emphysema without pneumothorax. The patient left hospital against medical advice. Keywords: Pregnancy; subcutaneous emphysema; pneumomediastinum.

scholarly journals Radiographic aspects of acute community-acquired bacterial pneumonia and pulmonary tuberculosis in children

2021 ◽  
Author(s):  
Rivo Lova Herilanto Rakotomalala ◽  
Harimino Mireille Rakotondravelo ◽  
Andrianina Harivelo Ranivoson ◽  
Annick Lalaina Robinson
Keyword(s):  
Community Acquired Pneumonia ◽  
University Hospital ◽  
Radiographic Images ◽  
X Ray ◽  
Male Predominance ◽  
Mother And Child ◽  
Chest X Ray ◽  
The Right ◽  
The University ◽  
Tuberculosis In Children

Background: The etiological diagnosis of pneumonia is often difficult because of the impossibility of microbiological confirmation most of the time. Therefore, chest X-ray is still essential for a positive diagnosis and etiological orientation. The main objective of our study was to describe the radiographic aspects of acute community-acquired pneumonia and tubercular pneumonia in children.Methods: This was a descriptive retrospective study conducted at the university hospital mother and child of Tsaralalana from January 1st to July 31st, 2017.Results: Sixty-nine cases of pneumonia were included, including 13 cases of TB pneumonia and 46 cases of acute community-acquired pneumonia. The average age was 36.68 months with a male predominance. Clinically, respiratory functional signs predominated in both cases. Alteration in general condition was mainly observed in tubercular pneumonia (26.08%). Alveolar syndromes were present in 43.47% of TB pneumonias and 36.94% of acute community-acquired pneumonia. With regard to the radiographic images, alveolar involvement was common to both types of pneumonia; the nodular image was present in 8.69% of the tubercular pneumonias and 2.17% of the acute community-acquired pneumonia; the cavity image was present only in the tubercular pneumonia (p=0.04); the right-sided location predominated in both cases.Conclusions: X-ray images were common to both TB pneumonia and acute community-acquired pneumonia; some images were specific to TB pneumonia. However, the etiologic orientation of pneumonia is based on a combination of epidemiologic, clinical, and radiographic evidence.

Complete heart block as a herald sign for cardiac lymphoma

2021 ◽  
Vol 14 (1) ◽  
pp. e239356
Author(s):  
Holly P Morgan ◽  
Muram El-Nayir ◽  
Christopher Jenkins ◽  
Philip G Campbell
Keyword(s):  
Ejection Fraction ◽  
Heart Block ◽  
Complete Heart Block ◽  
B Cell Lymphoma ◽  
Left Ventricular ◽  
Chop Chemotherapy ◽  
Severe Left Ventricular Dysfunction ◽  
X Ray ◽  
Chest X Ray ◽  
The Right

A previously well 48-year-old man presented with presyncope and was found to be in complete heart block. Blood tests, echocardiography and coronary angiography were reported as normal, and a dual chamber permanent pacemaker was inserted. Six months later he re-presented with breathlessness. His chest X-ray showed cardiomegaly and echocardiography revealed a 4.4 cm pericardial effusion. A CT thorax revealed a mass originating from the intra-atrial septum, extending into the right atrium and ventricle. There were multiple pulmonary lesions suspected to be metastases. Histology demonstrated high-grade B-cell lymphoma. He was treated with eight cycles of R-CHOP chemotherapy and showed good radiological and clinical improvement. Post-treatment echocardiography found severe left ventricular dysfunction with an ejection fraction of <20%. Heart failure medical therapy was optimised and the pacemaker was upgraded to a resynchronisation device. A repeat scan 6 months post device upgrade showed an improvement in ejection fraction to 45%–50%.

Pericardial masses and congenital abnormalities

ESC CardioMed ◽  
2018 ◽  
pp. 1582-1584
Author(s):  
Angelos G. Rigopoulos ◽  
Hubert Seggewiss
Keyword(s):  
Computed Tomography ◽  
Surgical Management ◽  
Congenital Abnormalities ◽  
Benign Lesions ◽  
Chest Computed Tomography ◽  
X Ray ◽  
Wall Calcification ◽  
Chest X Ray ◽  
Pericardial Cysts ◽  
The Right

Pericardial masses include cysts, pericardial tumours, and pericardial haematomas. Pericardial cysts are benign lesions commonly located in the right cardiophrenic angle that remain typically asymptomatic and are incidentally found in chest X-ray or chest computed tomography but might cause pressure symptoms or become infected, thus requiring surgical management. Hydatid cysts due to echinococcosis are the most common acquired pericardial cysts, characterized by wall calcification, and indicate surgery.

scholarly journals Recurrent Empyema Thoracic Secondary to Pulmonary Nocardiosis in Immunocompetent Patients

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Samshol Sukahri ◽  
Lily Diana Zainudin ◽  
Mohd Firdaus Hadi ◽  
Mohd Al-Baqlish Mohd Firdaus ◽  
Muhammad Imran Abdul Hafidz
Keyword(s):  
Vital Signs ◽  
C Reactive Protein ◽  
Nocardia Species ◽  
X Ray ◽  
Reactive Protein ◽  
Pulmonary Nocardiosis ◽  
Erythrocyte Sedimentation ◽  
Chest X Ray ◽  
The Right ◽  
Tomography Scan

Pulmonary nocardiosis is a rare disorder that mainly affects immune-compromised patients. We report a 37-year-old male who presented with persistent fever associated with productive cough. During this course of therapy, he had recurrent admissions for empyema thoracic. Clinically, his vital signs were normal. Blood investigations show leukocytosis with a significantly raised erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). Sputum acid-fast bacilli (AFB) was scanty 1+ and sputum mycobacterium culture was negative. Chest X-ray (CXR) showed consolidative changes with mild to moderate pleural effusion on the right side. Skin biopsy was taken and showed Paecilomyces species. A computed tomography scan (CT thorax) was performed and revealed a multiloculated collection within the right hemithorax with a split pleura sign. Decortications were performed and tissue culture and sensitivity (C+S) growth of Nocardia species. And it is sensitive to sulfamethoxazole-trimethoprim and completed treatment for 4 months. This case highlights that pulmonary nocardiosis should be kept in mind in also immune-competent patients, especially in suspected cases of tuberculosis not responding to antitubercular therapy.

scholarly journals Hydropneumothorax Revealing a Pneumoblastoma in Children

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Karima El Fakiri ◽  
Ghizlane Draiss ◽  
Noureddine Rada ◽  
Mohammed Bouskraoui ◽  
Abderrachid Hamdaoui ◽  
...  
Keyword(s):  
Outer Segment ◽  
Middle Lobe ◽  
High Grade ◽  
Cystic Lesions ◽  
Type Ii ◽  
Pathological Study ◽  
X Ray ◽  
Thoracic Drainage ◽  
Chest X Ray ◽  
The Right

Pneumoblastoma is a rare primary childhood tumor. We report the observation of an infant aged 2 years and 8 months who presented with dry cough and dyspnea. The physical examination found mixed pleural effusion syndrome on the right. The chest X-ray revealed a right pneumothorax. Biology has shown leukocytosis at 16,000/mm3. The CT scan revealed parenchymal air cystic lesions affecting the outer segment of the middle lobe mimicking a pulmonary malformation. Thoracic drainage brought back 100 ml of the fluid. Two months later, when a pyopneumothorax appeared, a medium lobectomy was performed. Pathological study specimen showed a high-grade type II pneumoblastoma The extension assessment identified a secondary hepatic location. Chemotherapy has been indicated. This observation illustrates the diagnosis challenge of pneumoblastoma in children.

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