RESUMO
A young female patient was referred by her general practitioner to the ear, nose and throat outpatient clinic with a 5-year history of progressive hoarseness and loss of voice. A chest radiograph was reported as showing marked dilatation of the left pulmonary artery without any other features to suggest underlying pulmonary arterial hypertension. A provisional diagnosis of left recurrent laryngeal nerve palsy secondary to its compression between the left pulmonary artery and the undersurface of the aortic arch-Ortner's or cardiovocal syndrome-was suggested and confirmed on further investigation including CT, microlaryngoscopy and echocardiography.
Assuntos
Aneurisma , Artéria Pulmonar , Paralisia das Pregas Vocais , Feminino , Humanos , Aneurisma/diagnóstico , Aneurisma/etiologia , Dilatação Patológica , Ecocardiografia , Doenças das Valvas Cardíacas/complicações , Doenças das Valvas Cardíacas/diagnóstico , Rouquidão/diagnóstico , Rouquidão/etiologia , Artéria Pulmonar/diagnóstico por imagem , Artéria Pulmonar/patologia , Valva Pulmonar/diagnóstico por imagem , Síndrome , Tomografia Computadorizada por Raios X , Paralisia das Pregas Vocais/diagnóstico , Paralisia das Pregas Vocais/etiologiaRESUMO
The case of a female patient in her 50s presenting as a surgical emergency with abdominal pain and a positive Obraztsova's sign. Seven days prior to the presentation, a lumbar puncture (LP) had been performed to investigate severe headaches and exclude a subarachnoid haemorrhage. The patient was subsequently found to have an acute lumbar arterial bleed causing haemodynamic instability and a psoas haematoma. An emergency lumbar artery embolisation procedure was performed by the interventional radiology department in order to stabilise the bleed. The patient made a full recovery prior to discharge.
