RESUMO
Disorders of the oesophagus present a diagnostic and therapeutic challenge. The presenting symptoms of dysphagia, reflux, pain and vomiting are almost universal, irrespective of the underlying pathology. A combination of endoscopy, barium studies, pH studies and manometry are often required to determine the exact diagnosis and to plan the most effective treatment. Paraoesophageal hiatal hernia is an uncommon condition, present in 14% of all hiatal hernias, which requires urgent correction to prevent life-threatening complications. It is unusual for other oesophageal disorders to coexist. We present a case where achalasia and a paraoesophageal hiatal hernia probably coexisted.
Assuntos
Acalasia Esofágica/complicações , Hérnia Hiatal/complicações , Idoso , Transtornos de Deglutição/etiologia , Acalasia Esofágica/cirurgia , Feminino , Fundoplicatura , Hérnia Hiatal/diagnóstico por imagem , Hérnia Hiatal/cirurgia , Humanos , Jejunostomia , Manometria , Radiografia , Reoperação , Vômito/etiologiaAssuntos
Doença das Coronárias/etiologia , Vasos Coronários/lesões , Implante de Prótese de Valva Cardíaca/efeitos adversos , Complicações Intraoperatórias , Valva Mitral/cirurgia , Idoso , Angiografia Coronária , Doença das Coronárias/diagnóstico por imagem , Feminino , Doenças das Valvas Cardíacas/cirurgia , Humanos , Técnicas de Sutura/efeitos adversosRESUMO
We present a case of prosthetic valve endocarditis and paravalvular abscess caused by the canine bacteria Capnocytophaga canimorsus in a 63-year-old man, who made a habit of snogging his pet dog. Capnocytophaga canimorsus can cause culture-negative endocarditis, therefore a high level of clinical awareness and the appropriate isolation techniques are important for making the diagnosis. Antibiotic therapy and properly timed excision of the infected focus are recommended.