scholarly journals A Case of Unilateral Hyperlucency on Chest X-Ray- A Diagnostic Dilemma

2020 ◽  
Author(s):  
Nafees Ahmad Khan ◽  
Mohammad Arif ◽  
Rakesh Bhargava ◽  
Mohammad Shameem ◽  
Sadaf Sultana
Keyword(s):  
Diaphragmatic Hernia ◽  
Definitive Diagnosis ◽  
Shortness Of Breath ◽  
Fluid Level ◽  
Tube Insertion ◽  
Diagnostic Dilemma ◽  
Left Hemithorax ◽  
X Ray ◽  
Breath Sounds ◽  
Chest X Ray

Unilateral hyperlucency of the lung is not an uncommon finding which arises from a variety of conditions, like technical, congenital and acquired. Here, the author presents a case of diaphragmatic hernia which presented as unilateral hyperlucency on chest radiography. A 45-year-old female, presented with complaint of shortness of breath for 2-3 years, increased since 15 days and pain in abdomen for 2-3 years. She consulted a doctor where a chest X-ray was done and was advised Intercostal tube insertion with the diagnosis of left-sided pneumothorax and was referred to us for further management. Instead of her vitals were stable on examination. On auscultation, breath sounds were of decreased intensity. A chest X-ray was then done which showed unilateral hyperlucency of the left side with the presence of air fluid level. The CECT thorax showed a large diaphragmatic hernia through which the large intestine and stomach were occupying the left hemithorax. Therefore, a thorough evaluation should be done before reaching a definitive diagnosis in such patients.

scholarly journals Case Report: Semilunar Sign of Trans-Mediastinal Herniation of Giant Bullae with Tension Hydropneumothrax

2020 ◽  
Vol 56 (4) ◽  
pp. 320
Author(s):  
Anastasia Tjan ◽  
I Made Dwija Putra Ayusta ◽  
Dewa Gde Mahiswara
Keyword(s):  
Emergency Department ◽  
Case Report ◽  
Severe Disease ◽  
Chest Ct ◽  
Fluid Level ◽  
Tube Insertion ◽  
X Ray ◽  
Giant Bulla ◽  
Chest X Ray ◽  
Giant Bullae

Herniation of bulla across mediastinum is rare, while transmediastinal giant bulla herniation accompanied with hydropneumothorax is even rarer. We report a case of an 18 years old male with dyspnea came to emergency department with trans-mediastinal giant bulla herniation, which appears as semilunar sign on chest x-ray, and right hydropneumothoraks. It appeared that the giant bulla also infected by the presence of air fluid level within. Semilunar sign was seen on the contralateral left mediastinum as the hallmark finding for trans-mediastinal herniation of bulla. Chest CT further confirms the diagnosis. Subsequently chest tube insertion and symptomatic relives were given, however the patient end up dead after 2 days of observation. Heart and lung compression by the lesions were the cause of this patient poor outcome. Bullous lung disease should be evaluated thoroughly and not underestimated since it could cause severe disease progression. 

scholarly journals Semilunar Sign of Trans-Mediastinal Herniation of Giant Bullae with Tension Hydropneumothrax

2021 ◽  
Vol 56 (4) ◽  
pp. 320
Author(s):  
Anastasia Tjan ◽  
I Made Dwija Putra Ayusta ◽  
Dewa Gde Mahiswara
Keyword(s):  
Emergency Department ◽  
Chest Tube ◽  
Severe Disease ◽  
Chest Ct ◽  
Fluid Level ◽  
Tube Insertion ◽  
X Ray ◽  
Giant Bulla ◽  
Chest X Ray ◽  
Giant Bullae

Herniation of bulla across mediastinum is rare, while transmediastinal giant bulla herniation accompanied with hydropneumothorax is even rarer. We report a case of an 18 years old male with dyspnea came to emergency department with trans-mediastinal giant bulla herniation, which appears as semilunar sign on chest x-ray, and righthydropneumothoraks. It appeared that the giant bulla also infected by the presence of air fluid level within. Semilunar sign was seen on the contralateral left mediastinum as the hallmark finding for trans-mediastinal herniation of bulla. Chest CT further confirms the diagnosis. Subsequently chest tube insertion and symptomatic relives were given, however the patient end up dead after 2 days of observation. Heart and lung compression by the lesions were the cause of this patient poor outcome. Bullous lung disease should be evaluated thoroughly and not underestimated since it could cause severe disease progression. 

Acute Mitral Regurgitation: an important cause of respiratory distress

2016 ◽  
Vol 15 (1) ◽  
pp. 30-32
Author(s):  
Legate Philip ◽  
◽  
Neil Andrews ◽  
Keyword(s):  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Respiratory Distress ◽  
Severe Mitral Regurgitation ◽  
Shortness Of Breath ◽  
Valve Repair ◽  
X Ray ◽  
Clinical Presentations ◽  
Acute Mitral Regurgitation ◽  
Chest X Ray

Acute mitral regurgitation (acute MR) is a rare cause of acute respiratory distress, which can present diagnostic challenges. We present the case of a 57 year old man who developed acute shortness of breath subsequently associated with fever, raised white cells and elevated CRP. Chest x-ray revealed unilateral shadowing and he was treated for pneumonia, despite the finding of severe mitral regurgitation on echo. Failure to respond to antibiotic treatment following 3 weeks on ITU led to the consideration of acute MR as the cause of his symptoms and he responded well to diuretics. He subsequently underwent mitral valve repair. The causes and clinical presentations of this condition are discussed.

Anterior diaphragmatic hernias in children: long-term surgical outcomes

2021 ◽  
Vol 16 (3) ◽  
pp. 7-15
Author(s):  
D.A. Morozov ◽  
◽  
D.V. Khaspekov ◽  
E.A. Okulov ◽  
V.G. Masevkin ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Diaphragmatic Hernia ◽  
Complex Analysis ◽  
Long Term Results ◽  
Long Term Outcomes ◽  
X Ray ◽  
Hernial Sac ◽  
Chest X Ray ◽  
Diaphragmatic Hernias

Anterior diaphragmatic hernia (ADH) is a rare congenital pathology that occurs in children with a frequency of 1:4800 (1–6% of all congenital diaphragmatic hernias). There are many controversial aspects in the surgical treatment of patients with ADH: the choice of surgical approach, the method of diaphragmatic repair and the feasibility of excision of the hernial sac. Objective. To conduct a comparative analysis of the surgical treatment of patients with ADH in different clinics, assessing longterm outcomes. Patients and methods. The medical records of 7 children with ADH who underwent surgical repair in different clinics (in time period from 2009 to 2019) were retrospecively reviewed. Evaluating the long-term results of ADH repair was made by telephone and online surveys of the parents of patients and by outpatient examination of children (chest x-ray in two projections). Results. In a ten-year period, 7 patients (4 boys and 3 girls) were operated on with a diagnosis of “anterior diaphragmatic hernia” at the age of 3 months to 12 years. In most children, a hernia was discovered accidentally by chest x-ray. Laparoscopic correction was performed in 5 (71%) cases, thoracoscopic correction – in 2 cases (29%). The main difference in surgical tactics in ADH patients was the manipulation with the hernial sac – the hernial sac was excised in 4 (57%) patients, but it was left in three cases (43%). The defect closure was performed by “full-thickness” separated sutures that fix the diaphragm to the anterior abdominal wall during laparoscopy (5) and to the chest tissue during thoracoscopy (2); in some cases, additional fixation to the rib (4) was performed. Sutures were tied extracorporeally and buried in the subcutaneous layer in 6 (86%) patients. Average follow-up was 7 years. While evaluating long-term outcomes no ADH recurrence were found. Conclusions. There are still many controversial aspects in the surgical treatment of ADH patients. In our opinion, multicenter studies with complex analysis of long-term results are required to standardize the surgical treatment of such patients. Key words: anterior diaphragmatic hernia, Larrey hernia, long-term outcomes, Morgani hernia

DOZ047.79: Bronchoscopic treatment of plastic bronchitis in children

2019 ◽  
Vol 32 (Supplement_1) ◽  
Author(s):  
M Y Erdas ◽  
N Valiyev ◽  
K K Cerit ◽  
Y Gokdemir ◽  
G Kiyan
Keyword(s):  
Respiratory Distress ◽  
Rare Condition ◽  
Airway Disease ◽  
Underlying Disease ◽  
Bronchial Tree ◽  
X Rays ◽  
Plastic Bronchitis ◽  
Left Hemithorax ◽  
X Ray ◽  
Chest X Ray

Abstract Purpose Plastic bronchitis or cast bronchitis is a rare condition characterized by the formation of large gelatinous or rigid airway casts. Classification of plastic bronchitis is done by disease association and cast histology. This rare condition can cause airway obstruction and there is no standardized treatment. Here are presented two cases with plastic bronchitis treated by bronchoscopic removal of casts in our clinic. Patients Case 1: A 9-year-old boy presented with wheezing, cough, and respiratory distress. He expectorated the cast spontaneously and the cast was misdiagnosed as germinative membrane of a hydatid cyst at the previous center. Total collapse of the left hemithorax was seen on chest X-ray. Any underlying disease was not detected. The plastic-like solid structure was detected and easily extracted from the bronchial tree. Pathology results of the casts were eosinophilic mucoid casts. The patient experienced three bronchoscopic removals and had no recurrence thereafter for two years. Case 2: A 7-year-old girl presented with persistent cough and respiratory distress. The patient was referred to our center with the diagnosis of foreign body aspiration. Total collapse of the right middle and lower segment and partial collapse of the upper segment were seen on chest X-ray. Previously, she was diagnosed with reactive airway disease. The plastic-like semisolid structure was detected during bronchoscopy its extraction from the bronchial tree was not easy but was possible. Pathology results were eosinophilic mucoid and fibrinotic casts. This patient still needs bronchoscopy for cast removal after 12 bronchoscopic removals but her symptoms and bronchoscopy findings have regressed with time. Conclusion Bronchoscopic extraction of casts provides fast improvement of patients’ symptoms and postoperative chest X-rays, but recurrence of cast formation is common. Nevertheless, it is the mostly chosen therapy in the literature. Further researches in this area are required.

Woman in her 50s with shortness of breath on exertion

Heart ◽  
2018 ◽  
Vol 105 (2) ◽  
pp. 110-110
Author(s):  
Takao Konishi ◽  
Hironori Murakami ◽  
Shinya Tanaka
Keyword(s):  
Tricuspid Regurgitation ◽  
Vena Cava ◽  
List Type ◽  
Shortness Of Breath ◽  
Supplementary Data ◽  
X Ray ◽  
Doppler Image ◽  
Chest X Ray ◽  
Supplementary Material ◽  
Axis View

Clinical introductionA 59-year-old woman visited an outpatient cardiology clinic due to shortness of breath on exertion. Physical examination showed no significant abnormality of vital signs. A III/VI systolic murmur was heard on the fourth intercostal space at the right sternal border. The majority of laboratory tests were normal. Chest X-ray showed a curved vessel shadow (figure 1A). Initial transthoracic echocardiography showed abnormal blood flow into the inferior vena cava (IVC) in the subxiphoid long axis view (figure 1B) and mild right heart dilatation (online supplementary figure 1). Transoesophageal echocardiography showed severe tricuspid regurgitation (online supplementary figure 2).Figure 1(A) Chest X-ray. (B) Colour Doppler image in the subxiphoid long axis view.Supplementary dataSupplementary dataQuestionWhat is the most likely underlying disease for the patient’s shortness of breath on exertion?Pulmonary arteriovenous fistula.Pulmonary arterial hypertension.Lung cancer.Partial anomalous pulmonary venous connection.Isolated tricuspid regurgitation.

scholarly journals Recurrent spontaneous pneumothorax in pregnancy-a case report

2021 ◽  
Vol 8 (11) ◽  
pp. 3449
Author(s):  
Muhammad S. Shafique ◽  
Fatima Rauf ◽  
Hamza W. Bhatti ◽  
Noman A. Chaudhary ◽  
Muhammad Hanif
Keyword(s):  
Case Report ◽  
Spontaneous Pneumothorax ◽  
Respiratory Illness ◽  
Tube Thoracostomy ◽  
Shortness Of Breath ◽  
Past Medical History ◽  
Pleuritic Chest Pain ◽  
X Ray ◽  
Chest X Ray ◽  
In Pregnancy

Spontaneous pneumothorax during pregnancy is a rare but a serious condition. The typical symptoms of spontaneous pneumothorax include pleuritic chest pain and shortness of breath. Diagnosis is usually made on chest X-ray with abdominal shielding. Management differs according to severity and no specific guidelines are described for management of spontaneous pneumothorax in pregnancy. We report a case of a 27-year-old multigravida, with insignificant past medical history for any respiratory illness, presenting with recurrent, left sided spontaneous pneumothorax during a single pregnancy. It was managed by chest tube thoracostomy each time and patient was discharged with tube till the delivery of the fetus.

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.

Case of e-cigarette or vaping product use-associated lung injury (EVALI) in London, UK

2021 ◽  
Vol 14 (4) ◽  
pp. e240700
Author(s):  
Ruth Elizabeth Evans ◽  
Sophie Herbert ◽  
William Owen ◽  
Deepak Rao
Keyword(s):  
Vitamin E ◽  
Lung Injury ◽  
Synergistic Effect ◽  
Respiratory Disease ◽  
Corticosteroid Treatment ◽  
Shortness Of Breath ◽  
X Ray ◽  
Product Use ◽  
Vitamin E Acetate ◽  
Chest X Ray

We present a case of a 38-year-old man with no medical comorbidities who presented to the hospital with haemoptysis and shortness of breath on a background of vaping home-manufactured cannabis oil. He developed e-cigarette or vaping product use-associated lung injury (EVALI) visible on chest X-ray requiring oxygen, and corticosteroid treatment before making a recovery. Research reports that the contents vitamin E acetate and tetrahydrocannabinol are frequently found in substances acquired from informal sources which increase the likelihood of EVALI developing. Further research into their synergistic effect is ongoing. Although safer than smoking, vaping is not risk free and EVALI should be considered in patients presenting with respiratory disease.

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