scholarly journals Atelectasis: An Uncommon Sign of Achalasia in Childhoo

2021 ◽  
Author(s):  
Aykut Ekşi ◽  
Gökçen Kartal Öztürk ◽  
Gözde Şakul ◽  
Emre Divarcı ◽  
Hüseyin Hüdaver Alper ◽  
...  
Keyword(s):  
Pulmonary Disease ◽  
Standard Test ◽  
Middle Lobe ◽  
Respiratory Problems ◽  
Breath Sounds ◽  
Bird Beak ◽  
Pediatric Pulmonology ◽  
History Of ◽  
The Right

An 11-year-old boy presented to our pediatric pulmonology clinic with a 3-month history of atelectasis evident on his chest radiography. Breath sounds revealed fine crackles in the right lower zone and rhonchi in the upper zones. His initial pulmonary function test was compatible with restrictive pulmonary disease. Chest tomography revealed that the trachea, right intermediate, and middle lobe bronchi were narrowed by megaesophagus. Esophagogram determined dilatation of the esophagus and “bird-beak” sign in the esophagogastric junction but it was not sufficient to diagnose. Esophageal manometry which is the gold standard test for achalasia was performed and type 2 achalasia was diagnosed. His symptoms improved following Heller myotomy conducted together with Dor fundoplication. Although respiratory problems are more common in infants and younger children, atypical respiratory presentations may also occur during adolescence. Achalasia should be one of the rare differential diagnoses of pediatric restrictive pulmonary disease.

scholarly journals Pulmonary Tuberculosis mimicking a right Eventration on Radiography: The falsity of single view radiograph in the diagnosis of a precursor of pulmonary disease: A Case Report

2021 ◽  
Vol 4 (1) ◽  
pp. 33-37
Author(s):  
John Ogunkoya ◽  
Oluwatosin Yetunde Adesuyi
Keyword(s):  
Pulmonary Tuberculosis ◽  
Lower Lobe ◽  
Middle Lobe ◽  
The Body ◽  
Single View ◽  
Lymph Node Enlargement ◽  
History Of ◽  
Chest X Ray ◽  
The Right ◽  
High Index Of Suspicion

Background: The diaphragm is one of the most important muscles of respiration in the body separating the abdomen from the thorax. Abnormalities of the diaphragm could be congenital or acquired, morphological or functional while pulmonary infection e.g. pulmonary tuberculosis, is implicated in its etiology. Case presentation: A 63-year- old man with six weeks history of cough productive of yellowish sputum. Chest X-ray showed a uniform well-circumscribed opacity in the right lower lobe abutting on or in continuum with the right diaphragm consistent with a diaphragmatic hump. Sputum Gene Xpert was positive for Mycobacterium tuberculosis. Chest CT scan revealed bilateral lymph node enlargement with hyperdense lesions in the anterior basal segment of the right lower lobe and medial bronchopulmonary segments of the right middle lobe. He was treated for 6 months with first-line anti-tuberculosis drugs. Discussion: The incidence of the diaphragmatic hump on chest radiograph worldwide and among Nigerians is unknown. The association of diaphragmatic hump with chest infection has been well document. The association of diaphragmatic hump with pulmonary tuberculosis is uncommon. Conclusion: A high index of suspicion is needed to diagnose pulmonary tuberculosis with atypical clinical and radiological presentations. Such prompt diagnosis will aid the treatment of the disease.

Parasagittal meningioma: A not so benign entity

2017 ◽  
Vol 57 (4) ◽  
pp. 175-178 ◽  
Author(s):  
Roger W Byard
Keyword(s):  
Neurofibromatosis Type ◽  
Lethal Effect ◽  
Precentral Gyrus ◽  
Unexpected Death ◽  
Comfort Care ◽  
Posterior Displacement ◽  
History Of ◽  
The Right ◽  
Parasagittal Meningioma

While the majority of intracranial meningiomas have an indolent clinical course, sudden and unexpected death may rarely occur. Two cases are reported to demonstrate rapid clinical deterioration resulting in death in individuals with large, grade I, parasagittal meningiomas. Case 1 was a 46-year-old man with a history of headaches and epilepsy who suddenly collapsed and died. A large right frontal parasagittal meningioma with haemorrhage had compressed the brain and lateral ventricle, causing tonsillar herniation. In case 2, a previously well 83-year-old woman presented with a one-week history of progressive dysphagia and dysphasia. She suffered rapid deterioration and was prescribed comfort care. A right-sided parasagittal meningioma had compressed the right superior and middle frontal gyri with posterior displacement and compression of the right precentral gyrus. If a meningioma is found at autopsy, the possibility of a lethal effect should be considered, and evidence of neurofibromatosis type 2 or other associated heritable conditions checked for.

Persistent Interstitial Pulmonary Emphysema-like Cyst Associated with Metastatic Synovial Sarcoma

2000 ◽  
Vol 3 (4) ◽  
pp. 391-393 ◽  
Author(s):  
Marta C. Cohen ◽  
Ricardo Drut
Keyword(s):  
Respiratory Distress ◽  
Pulmonary Disease ◽  
Synovial Sarcoma ◽  
Pulmonary Emphysema ◽  
Assisted Ventilation ◽  
Preterm Neonates ◽  
Inner Surface ◽  
Cystic Changes ◽  
History Of ◽  
The Right

Interstitial pulmonary emphysema is characterized by the presence of gas dissecting the interstitial tissues of the lung. Clinically, it may be acute or persistent, and the latter can be further categorized as localized or diffuse. Usually, it appears in preterm neonates with a history of assisted ventilation or respiratory distress. Although far from frequent, the localized variety of persistent interstitial pulmonary emphysema (PIPE) can develop spontaneously in full-term babies or infants without any obvious underlying pulmonary disease. Histologically, PIPE is characterized by the presence of uni- and multinucleated histiocytes lining the inner surface of the cysts. In this report, we describe a 15-year-old male with synovial sarcoma (SS) of the right ankle diagnosed 4 years previously who developed pulmonary metastasis, one of which presented cystic changes with features of PIPE.

scholarly journals Clinical Utility of Bronchoalveolar Lavage Pepsin in Diagnosis of Gastroesophageal Reflux among Wheezy Infants

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Ahmed Fathi Abdallah ◽  
Tarek El-Desoky ◽  
Khalid Fathi ◽  
Wagdy Fawzi Elkashef ◽  
Ahmed Zaki
Keyword(s):  
Gastroesophageal Reflux ◽  
Bronchoalveolar Lavage ◽  
Ph Monitoring ◽  
Standard Test ◽  
Respiratory Problems ◽  
Healthy Infants ◽  
Healthy Control ◽  
History Of ◽  
Antireflux Therapy ◽  
Gerd Symptoms

Background. There is no gold standard test for diagnosis of gastroesophageal reflux disease (GERD) associated infantile wheezing.Objectives. To evaluate the value of bronchoalveolar lavage (BAL) pepsin assay in diagnosis of GERD in wheezy infants.Methods. Fifty-two wheezy infants were evaluated for GERD using esophageal combined impedance-pH (MII-pH) monitoring, esophagogastroduodenoscopy with esophageal biopsies, and BAL pepsin. Tracheobronchial aspirates from 10 healthy infants planned for surgery without history of respiratory problems were examined for pepsin.Results. Wheezy infants with silent reflux and wheezy infants with typical GERD symptoms but normal MII-pH had significantly higher BAL pepsin compared to healthy control (45.3 ± 8.6 and 42.8 ± 8 versus 29 ± 2.6,P<0.0001andP=0.011, resp.). BAL pepsin had sensitivity (61.7%, 72 %, and 70%) and specificity (55.5%, 52.9%, and 53%) to diagnose GERD associated infantile wheeze compared to abnormal MII-pH, reflux esophagitis, and lipid laden macrophage index, respectively.Conclusion. A stepwise approach for assessment of GERD in wheezy infants is advised. In those with silent reflux, a trial of antireflux therapy is warranted with no need for further pepsin assay. But when combined MII-pH is negative despite the presence of typical GERD symptoms, pepsin assay will be needed to rule out GERD related aspiration.

scholarly journals Lifelong Idiopathic Unilateral Diaphragmatic Paralysis With Recurrent Pneumonia: A Case Report

2020 ◽  
Vol 10 (1) ◽  
pp. 26743
Author(s):  
Khosrow Agin ◽  
Akram Sabkara ◽  
Farzaneh Sadat Mirsafai Rizi ‎ ◽  
Bita Dadpour ◽  
Maryam Vahabzadeh ◽  
...  
Keyword(s):  
Primary Diagnosis ◽  
Diaphragmatic Paralysis ◽  
Recurrent Pneumonia ◽  
Emergency Center ◽  
Diabetes Mellitus Type Ii ◽  
X Ray ◽  
Breath Sounds ◽  
History Of ◽  
Chest X Ray ◽  
The Right

A 50-year-old woman was admitted to the emergency center with dyspnea, cough, and fever symptoms. She had a medical history of diabetes mellitus type II, rheumatoid arthritis, as well as several admission records due to aspiration pneumonia. The primary diagnosis was diabetic ketoacidosis and pneumonia. Normal breath sounds were reduced on the lower posterior right side of the thorax. A standard chest x-ray and lung Computed Tomography (CT) scan revealed collapse consolidation in the Right Lower Lobes (RLL) and Right Middle Lobes (RML). We here presented a case of unilateral diaphragmatic paralysis with a history of recurrent pneumonia.

scholarly journals Cryptococcal empyema treated with tube thoracostomy and intrapleural fibrinolysis

2020 ◽  
Vol 90 (4) ◽  
Author(s):  
Akshay Kohli ◽  
Ashutosh Sachdeva ◽  
Edward M. Pickering
Keyword(s):  
Underlying Disease ◽  
Tube Thoracostomy ◽  
Pleuritic Chest Pain ◽  
First Case ◽  
Breath Sounds ◽  
Severe Underlying Disease ◽  
History Of ◽  
Dornase Alpha ◽  
The Right ◽  
Repeat Imaging

A 55-year old woman with a history of relapsed T-cell ALL presented with right pleuritic chest pain and decreased breath sounds over the right hemithorax. Imaging of the chest showed loculated effusions. Tube thoracostomy was performed with intrapleural application of alteplase and dornase alpha over a 3-day period. Repeat imaging demonstrated a marked decrease in the volume of the effusion. In most prior published cases of pleural cryptococcosis, surgical drainage was required in addition to prolonged antifungal agents. More than 50% of patients with cryptococcal infection have severe underlying disease or immunodeficiency state making them high risk for surgery. This is the first case to our knowledge of cryptococcal empyema successfully treated with tube thoracostomy and intrapleural fibrinolysis.

Spontaneous Closure of a Macular Hole in Macular Telangiectasia Type 2

2020 ◽  
pp. 247412642095890
Author(s):  
Varun Chandra ◽  
Rohan Merani ◽  
Alex P. Hunyor ◽  
Mark Gillies
Keyword(s):  
Macular Hole ◽  
Internal Limiting Membrane ◽  
Spontaneous Closure ◽  
Full Thickness ◽  
External Limiting Membrane ◽  
Macular Telangiectasia ◽  
History Of ◽  
Macular Telangiectasia Type 2 ◽  
The Right

Purpose: Spontaneous closure of a macular hole in macular telangiectasia type 2 (MacTel) with vision improvement is described. Methods: A case report is presented. Results: A 71-year-old man presented with a 1-week history of distorted vision in his left eye. Left visual acuity (LVA) was 20/80. Optical coherence tomography showed an almost full-thickness left macular hole with an intact internal limiting membrane drape. Small inner retinal cavitations were present at the right macula; multimodal imaging confirmed MacTel. Managed conservatively, at 5 months the patient’s LVA had improved to 20/60, the defect was no longer full thickness, and the external limiting membrane had reconstituted. At the right macula, the inner cavitations grew and outer cavitations developed, but the external limiting membrane remained intact. At 32 months, right VA was 20/20 and LVA was 20/40. Conclusions: This case of MacTel with spontaneous closure of a macular hole was associated with an overlying internal limiting membrane drape.

scholarly journals Left cranial lung torsion in a Bernese Mountain dog: a case report

2011 ◽  
Vol 56 (No. 8) ◽  
pp. 416-422 ◽  
Author(s):  
R. Tamburro ◽  
M. Pietra ◽  
G. Militerno ◽  
A. Diana ◽  
A. Spadari ◽  
...  
Keyword(s):  
Clinical Course ◽  
Small Animal ◽  
Middle Lobe ◽  
Pleural Space ◽  
Complete Occlusion ◽  
Lung Lobe ◽  
History Of ◽  
Lung Torsion ◽  
The Right

Lung lobe torsion (LLT) is an uncommon pathology in small animal practice. In large breed dogs LLT effects are localized mainly to the middle lobe of the right lung. This report describes a case of left cranial lung torsion in a Bernese Mountain dog: the patient was referred with a two-day history of asthenia, anorexia, dyspnea and haemoptysis. No trauma was reported. Physical examination showed the presence of bilateral pleural effusion confirmed by radiography and ultrasonography. Broncoscopy revealed that the left cranial lobe appeared to be compressed laterally with complete occlusion of the lumen. Thoracoscopy was performed to exclude other pathologies of the pleural space. The pathological lobe was removed. Histological examination revealed aspects consistent with lung lobe torsion. Clinical follow up carried out after three months showed a normal clinical course.

scholarly journals Perplexing case of lung mass perfectly mimicking a malignancy

2019 ◽  
Vol 12 (7) ◽  
pp. e229273
Author(s):  
Eid Humaid Alqurashi ◽  
Ahmed Sayeed ◽  
Hasheema Hasheem Alsulami ◽  
Hadeel Mashhour Al-Qurashi
Keyword(s):  
Connective Tissue ◽  
Connective Tissue Disease ◽  
Wedge Resection ◽  
Biopsy Result ◽  
X Ray ◽  
Breath Sounds ◽  
History Of ◽  
Chest X Ray ◽  
The Right ◽  
Histopathology Examination

A 35-year-old man, a known asthmatic and with a history of smoking presented with a history of recurrent episodes of mild haemoptysis. On examination, there was decreased intensity of breath sounds on the right infraclavicular area. The chest X-ray and CT chest showed a mass in right upper lobe with nodules in the other lobe. The VAT showed large heavily vascularised mass with surface laden with multiple nodules. The wedge resection of the mass was taken and sent for histopathology examination. The biopsy result showed picture suggestive of connective tissue disease associated follicular bronchiolitis. The patient did not have any signs or symptoms of connective tissue disease. However he was positive for Rheumatoid factor, ANA, anti-RO, anti-CCP antibodies. He was started on steroids and azathioprine. After 6 months of treatment, the size of the mass and nodules reduced by 50% and ESR was reduced to 5 from 75.

WED 142 ‘anti-hu syndrome’ – a case of paraneoplastic sensory neuropathy with encephalitis

2018 ◽  
Vol 89 (10) ◽  
pp. A16.3-A16
Author(s):  
Gupta Srishti ◽  
Jaiswal Amit ◽  
Knopp Michael
Keyword(s):  
Sensory Neuropathy ◽  
Middle Lobe ◽  
Past Medical History ◽  
Small Cell Lung ◽  
Mri Brain ◽  
Brain Scan ◽  
History Of ◽  
Right Middle Lobe ◽  
T2 Hyperintensity ◽  
The Right

A 75-year-old female was referred to the neurology outpatients department with a 6 month history of progressive amnesia and cognitive decline as well as symptoms/signs suggestive of a sensory neuropathy. Past medical history included TIA, cervical spondylosis and recent investigation for hyponatraemia which had been attributed to SIADH. She had been a smoker with a 50+pack year history and consumed minimal alcohol. An MRI brain scan demonstrated bilateral hippocampal T2 hyperintensity. A lumbar puncture demonstrated normal CSF constituents and negative viral PCRs. Full autoimmune and paraneoplastic screening was undertaken which was all normal except for a positive anti-Hu antibody. A CT-TAP highlighted a mass lesion in the right middle lobe of the lung and biopsy confirmed small cell lung cancer (T1aN2M0). A diagnosis of anti-Hu antibody related paraneoplastic syndrome was made and an initial treatment course of IV Methylprednisolone was administered. The patient’s cancer was treated with chemotherapy and adjuvant radiotherapy. Despite a good response with regard to her tumour and hyponatraemia, the patient did not improve significantly cognitively. This case highlights the need for awareness of the combination of symptoms/signs of the described ‘anti-Hu syndrome’ with paraneoplastic sensory neuropathy and/or encephalomyelitis.

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