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Cirugia Y Cirujanos 2021Spontaneous lesions can affect only a part of the esophageal wall (Mallory-Weiss syndrome) or constitute a full-thickness rupture of the organ, leading to Boerhaave... (Review)
Review
Spontaneous lesions can affect only a part of the esophageal wall (Mallory-Weiss syndrome) or constitute a full-thickness rupture of the organ, leading to Boerhaave syndrome. Most commonly affecting males between 50 and 70 years of age, Clinically, the Mackler triad is vomiting, severe chest pain, and subcutaneous cervical emphysema. The delay in diagnosis explains the high mortality rate of this pathology up to 40-60% in those treated at 48 hours. The prognosis improves if treatment is established within the first 24 hours.
Topics: Aged; Chest Pain; Esophageal Perforation; Humans; Male; Mallory-Weiss Syndrome; Mediastinal Diseases; Rupture, Spontaneous
PubMed: 34932533
DOI: 10.24875/CIRU.21000010 -
Computerised tomography scan in multi-drug-resistant versus extensively drug-resistant tuberculosis.Polish Journal of Radiology 2020Multi-drug-resistant tuberculosis (MDR-TB) is simultaneously resistant to isoniazid and rifampin. Of course, this germ may also be resistant to other anti-tuberculosis...
PURPOSE
Multi-drug-resistant tuberculosis (MDR-TB) is simultaneously resistant to isoniazid and rifampin. Of course, this germ may also be resistant to other anti-tuberculosis drugs. Patients with extensively drug-resistant tuberculosis (XDR-TB) are also resistant to all types of fluoroquinolone and at least one of the three injectable medications: amikacin, clarithromycin, or kanamycin, in addition to isoniazid and rifampin. Therefore, the main objective of the current study was to evaluate and compare the computed tomography (CT) scan findings of MDR-TB and XDR-TB patients.
MATERIAL AND METHODS
In this comparative descriptive cross-sectional study 45 consecutive TB patients who referred to Masih Daneshvari Hospital, Tehran, Iran from 2013 to 2019 were enrolled. TB was diagnosed based on sputum smear and sensitive molecular and microbial tests. Patients were divided into two groups (MDR-TB and XDR-TB) based on two types of drug resistance. CT scan findings were compared for cavitary, parenchymal, and non-parenchymal disorders. The early diagnostic values of these factors were also calculated.
RESULTS
Findings related to cavitary lesions including the pattern, number, size of the largest cavity, maximum thickness of the cavity, lung involvement, number of lobes involved, and the air-fluid levels in the two patient groups were similar ( > 0.05). Parenchymal findings of the lung also included fewer and more nodules of 10 mm in the MDR-TB and XDR-TB groups, respectively. Tree-in-bud, ground-glass-opacity, bronchiectasis, cicatricial emphysema, and lobar atelectasis were similar in the two patient groups ( > 0.05). Findings outside the parenchymal lung, including mediastinal lymphadenopathy and pericardial effusion, showed no statistically significant difference between the MDR-TB and XDR-TB groups ( > 0.05). Parenchymal calcification was more common in the XDR group than in the MDR group (64.7% and 28.6%, respectively) with a significant difference ( = 0.01).
CONCLUSIONS
CT scan findings in patients with XDR-TB are similar to those of patients with MDR-TB for cavitary, parenchymal, and non-parenchymal lung characteristics. However, patients with XDR-TB tend to have more parenchymal calcification and left-sided plural effusion. CT characteristics overlap between XDR-TB and those with MDR-TB. It can be concluded that CT scan features are not sensitive to the diagnosis.
PubMed: 32180853
DOI: 10.5114/pjr.2020.93123 -
European Review For Medical and... Nov 2022The effect of pulmonary complications of COVID-19, such as pneumothorax, pneumomediastinum, and subcutaneous emphysema, is still unclear. This study aimed at...
OBJECTIVE
The effect of pulmonary complications of COVID-19, such as pneumothorax, pneumomediastinum, and subcutaneous emphysema, is still unclear. This study aimed at investigating the relationship between COVID-19 and spontaneous pneumothorax.
PATIENTS AND METHODS
This study was conducted as a single-center retrospective study. Groups were assigned as study and control groups. The study group (n=120) included patients who were followed up in ICU and developed pneumothorax during their follow-up. The control group (n=120) included patients who did not develop a pneumothorax in ICU and who had been randomly selected using hospital records. Demographic findings, laboratory parameters, radiological findings, clinical management, patients' follow-up patterns, and survival status of the patients were recorded.
RESULTS
There was a significant relationship between gender, outcome, last hospitalization, general condition, first follow-up, intubation, uptake tomography, uptake rate, CO-RADS, and involvement variables between groups (p<0.05). In the survival analysis performed in the control and study groups, a significant difference was obtained between the averages of the two groups (LogRank=3.944, p<0.05). Intubation and mortality rates of the patients who developed pneumothorax during the patient follow-ups were significantly higher than the control group.
CONCLUSIONS
We found that patients diagnosed with COVID-19 who developed pneumothorax during intensive care follow-up had a higher hospital stay and intubation rate. The pneumothorax rate was also higher in follow-up methods such as noninvasive/HFO providing PEEP to the patients. The data in our study may help reducing mortality by shedding light on the early prevention and recognition of pneumothorax in critically ill patients diagnosed with COVID-19.
Topics: Humans; Pneumothorax; Retrospective Studies; COVID-19; Mediastinal Emphysema; Length of Stay
PubMed: 36394764
DOI: 10.26355/eurrev_202211_30168 -
Ugeskrift For Laeger Oct 2021This is a case report of a 35-year-old women who had spontaneous pneumomediastinum (SPM) during the second stage of labour. Although this condition during labor is very...
This is a case report of a 35-year-old women who had spontaneous pneumomediastinum (SPM) during the second stage of labour. Although this condition during labor is very rare, it is described in the literature as Hamman's syndrome. The symptoms are dyspnoea, chest pain and subcutaneous emphysema which leads to much more severe differential diagnoses that should be eliminated quickly. There has not yet been found any dispositions to the condition. Duration of the second stage of labour is a theoretic factor of relevance, which naturally puts nulliparas at a higher risk.
Topics: Adult; Chest Pain; Dyspnea; Female; Humans; Labor, Obstetric; Mediastinal Emphysema; Pregnancy; Subcutaneous Emphysema
PubMed: 34704924
DOI: No ID Found -
Internal Medicine (Tokyo, Japan) Jul 2020
PubMed: 32321894
DOI: 10.2169/internalmedicine.4460-20 -
JAAPA : Official Journal of the... Nov 2021Since its discovery, COVID-19 has infected nearly 112 million people and caused about 2.5 millions deaths worldwide. Our understanding of the clinical presentation and...
Since its discovery, COVID-19 has infected nearly 112 million people and caused about 2.5 millions deaths worldwide. Our understanding of the clinical presentation and complications of COVID-19 is still evolving. Bilateral pulmonary ground-glass opacities on imaging have become characteristic in the diagnosis of COVID-19, but pneumomediastinum has now also been reported in some patients with COVID-19. Reports on the overall prognosis for these patients are conflicting and little information exists regarding long-term complications. This article describes the clinical course of a patient who did not need mechanical ventilation but developed spontaneous pneumomediastinum.
Topics: COVID-19; Humans; Mediastinal Emphysema; Prognosis; Respiration, Artificial; SARS-CoV-2
PubMed: 34593717
DOI: 10.1097/01.JAA.0000794992.99292.48 -
Chirurgia (Bucharest, Romania : 1990) Jun 2022Abstract COVID-19 (Coronavirus-19 disease), a new clinical entity caused by SARS-COV-2 infection, could explain the physiopathology of cervicothoracic air collections... (Review)
Review
Abstract COVID-19 (Coronavirus-19 disease), a new clinical entity caused by SARS-COV-2 infection, could explain the physiopathology of cervicothoracic air collections (pneumothorax, pneumomediastinum, and subcutaneous emphysema). We conducted an 8-months retrospective analysis of a single-center SARS-CoV-2 cases associating pneumothorax, pneumomediastinum, and subcutaneous emphysema, either alone or combined. All non-intubated patients with the complications cited above had a favorable outcome after pleural drainage, percutaneous drainage, and/or conservative treatment, while the intubated patients, with multiple comorbidities, have had an unfavorable outcome, regardless the chosen treatment. Pleural drainage was used for pneumothorax cases; pneumomediastinum with subcutaneous emphysema required insertion of subcutaneous needles or angio-catheters with manual decompressive massage. Conservative methods of treatment were used for patients with pneumomediastinum and medium or severe respiratory disfunction. Etiopathogenic classification of pneumothorax should include SARS-CoV-2 infection as a possible cause of secondary spontaneous pneumothorax due to COVID-19 pneumonia. Survival rate after the occurrence of these complications was small (18,75%), 4 of the patients were cured, 2 had a favorable outcome and 26 have died. Pleural drainage which is mandatory to do for patients with pneumothorax complication in COVID -19 pneumonia, doesn't change the prognosis for those with severe affecting lungs, because the prolonged ventilation and the other comorbidities have led to death in most of these cases.
Topics: COVID-19; Humans; Mediastinal Emphysema; Pneumothorax; Retrospective Studies; SARS-CoV-2; Subcutaneous Emphysema; Treatment Outcome
PubMed: 36049090
DOI: 10.21614/chirurgia.2719 -
Veterinary Journal (London, England :... Jun 2024Pneumomediastinum denotes the presence of gas within the mediastinum and generally occurs by leakage of air from an aerated viscus that traverses or abuts the...
Spontaneous pulmonary interstitial emphysema, pneumomediastinum and cervical subcutaneous emphysema secondary to the Macklin effect in dogs with no clinical signs: 12 cases.
Pneumomediastinum denotes the presence of gas within the mediastinum and generally occurs by leakage of air from an aerated viscus that traverses or abuts the mediastinal plane. The Macklin effect has been described in several veterinary studies and describes gas tracking along the perivascular interstitium following alveolar rupture causing interstitial emphysema, pneumomediastinum and subsequently cervical subcutaneous emphysema. This retrospective case series describes incidental spontaneous pulmonary interstitial emphysema, pneumomediastinum and cervical subcutaneous emphysema secondary to the Macklin effect in dogs with no related clinical signs. Twelve dogs were identified from the author's institution, of which 75 % were Sighthounds (Greyhounds, Whippets or Lurchers). Pulmonary interstitial emphysema had a predominantly paravascular distribution, although in some cases a parabronchial distribution was also identified. We conclude that incidental pulmonary interstitial emphysema, pneumomediastinum and secondary cervical subcutaneous emphysema can be incidental, presumed secondary to the Macklin effect and that Sighthound breeds may be overrepresented.
PubMed: 38849024
DOI: 10.1016/j.tvjl.2024.106158 -
Monaldi Archives For Chest Disease =... Sep 2020Spontaneous pneumomediastinum is a benign entity but can worsen the underlying condition with which it is associated. We evaluated the incidence and the clinical...
Spontaneous pneumomediastinum is a benign entity but can worsen the underlying condition with which it is associated. We evaluated the incidence and the clinical relevance of spontaneous pneumomediastinum in a consecutive series of 102 patients with COVID-19 pneumonia. Six cases of pneumomediastinum were identified by high-resolution chest CT-scan. Three patients required early intubation, and one of them died, while in in the remaining subjects the clinical course was benign. The presence of pneumomediastinum required some changes in the management of mechanical ventilation. In conclusion, spontaneous pneumomediastinum is a possible complication of severe COVID-19 pneumonia that can affect patient management and clinical outcomes.
Topics: Aged; Aged, 80 and over; Betacoronavirus; COVID-19; Coronavirus Infections; Female; Humans; Incidence; Italy; Male; Mediastinal Emphysema; Middle Aged; Pandemics; Pneumonia, Viral; Retrospective Studies; SARS-CoV-2; Tomography, X-Ray Computed
PubMed: 32990690
DOI: 10.4081/monaldi.2020.1399 -
Journal of Cardiothoracic Surgery Mar 2022Traumatic asphyxia (TA) is a rarely reported disease characterized as thoraco-cervico-facial petechiae, facial edema and cyanosis, subconjunctival hemorrhage and...
BACKGROUND
Traumatic asphyxia (TA) is a rarely reported disease characterized as thoraco-cervico-facial petechiae, facial edema and cyanosis, subconjunctival hemorrhage and neurological symptoms. This study aimed to report 51 children of TA at the pediatric medical center of west China.
METHODS
Scanned medical reports were reviewed and specific variables as age, sex, cause of injury, clinical manifestations and associated injuries were analyzed using SPSS 25.0.
RESULTS
The average age of patients was 5.3 ± 2.9 (1.3-13.2) year-old. Thirty (58.8%) were boys and 21 (41.2%) were girls. Most TAs occurred during vehicle accident, object compression and stampede. All patients showed facial petechiae (100.0%, CI 93.0-100.0%), 25 (49.0%, CI 34.8-63.2%) out of 51 presented with facial edema, 29 (56.9%, CI 42.8-70.9%) presented with subconjunctival hemorrhage, including bilateral 27 and unilateral 2. Six patients had facial cyanosis (11.8%, CI 2.6-20.9%). Other symptoms were also presented as epileptic seizure, vomiting, incontinence, paraplegia, etc. The most frequent companion injury was pulmonary contusion (76.5%, CI 64.4-88.5%). Other companion injuries included mediastinal emphysema, fracture, cerebral contusion and hemorrhage, hypoxic-ischemic brain injury, abdominal organ contusion, mastoid hemorrhage, hematocele of paranasal sinuses, spinal cord injury, hepatic insufficiency, myocardial injury and retinal hemorrhage and edema. Treatment was mainly supportive. No death occurred in our study. The prognosis is rather good if without damage of central nervous system.
CONCLUSION
TA could bring out multiple symptoms, among which retinal hemorrhage and edema, spinal cord injury and viscera impairment have been less observed. Comprehensive physical and auxiliary examination should be performed considering TA. Its prognosis is rather good with focus on life-threatening complications.
Topics: Adolescent; Asphyxia; Child; Child, Preschool; Female; Hemorrhage; Humans; Infant; Male; Prognosis; Retrospective Studies; Spinal Cord Injuries
PubMed: 35282839
DOI: 10.1186/s13019-022-01773-2