RESUMO
INTRODUCTION: Misdiagnosed and complicated diaphragmatic hernia can lead to diagnostical and therapeutical difficulties. CASE REPORT: A strangulated post-traumatic diaphragmatic hernia in a 53 years old woman was at the origin of whole hemithoracic hydroaeric opacity. The hernia diagnosis based on digestive opacification and thoraco-phreno-abdominal ultrasonography. Emergent intervention is critical and allowed aetiologic and lesional assessment. CONCLUSIONS: After thoracic traumatism, it's necessary to carry on observation and realize, in front of any suspicion, radiological investigations especially modern imaging.
Assuntos
Hérnia Diafragmática/diagnóstico , Traumatismos Torácicos/complicações , Tórax/patologia , Diagnóstico Diferencial , Hérnia Diafragmática/diagnóstico por imagem , Hérnia Diafragmática/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , UltrassonografiaRESUMO
BACKGROUND: Because of the immunity depression, patients with chronic renal failure undergoing haemodialysis are at increased risk for developing infections, Mycobacterium tuberculosis (MTb) in particular. OBJECTIVE: To evaluate, in a prospective longitudinal study over 36 months period, the frequency of Tb among these patients and underline the diagnostic difficulties. PATIENTS AND METHODS: Sixty dialysis patients were interested. The Tb assessment comprised: a questionnaire, a meticulous clinical examination, a chest X-ray, a tuberculin skin testing, as well as MT bacilli screening in biological fluids. RESULTS: Tb was seen in six among dialysis patients(10%), this rate represents 15 times the general population tuberculosis incidence in our country (23/100,000). Tb has occurred early compared to the beginning of the haemodialysis. The Tb localizations were: 4 cases of extra-pulmonary tuberculosis (3 peritoneal and one ganglionic) and only 2 cases of pleuro-pulmonary localization. The positive diagnosis represents a real problem: no bacteriological confirmation in all patients and only in one, the histological diagnosis was obtained. CONCLUSION: There was a high rate of tuberculosis in our study. The prognosis appears to be closely related to therapeutic precocity, thus specific chemotherapy started sometimes without diagnostic confirmation.
Assuntos
Diálise Renal/efeitos adversos , Tuberculose/epidemiologia , Humanos , Incidência , Prognóstico , Diálise Renal/estatística & dados numéricos , Tuberculose/etiologia , Tunísia/epidemiologiaAssuntos
Rinite Alérgica Perene , Rinite Alérgica Sazonal , Diagnóstico Diferencial , Humanos , Rinite Alérgica Perene/diagnóstico , Rinite Alérgica Perene/imunologia , Rinite Alérgica Perene/terapia , Rinite Alérgica Sazonal/diagnóstico , Rinite Alérgica Sazonal/imunologia , Rinite Alérgica Sazonal/terapiaRESUMO
The authors report, in a retrospective study 11 cases of thoracic extra-pulmonary hydatic cyst observed during 4 years of pneumopathology practice. They stress the rarity of this localization and the variability of the clinical data. Chest X-Ray was found no specific whereas, computed tomography led often to the right diagnosis and helped in some cases a puncture of the hydatic cyst.