Assuntos
Dispneia/etiologia , Hérnia Diafragmática/diagnóstico por imagem , Rim/anormalidades , Doenças Torácicas/diagnóstico por imagem , Idoso , Anormalidades Congênitas/diagnóstico por imagem , Dispneia/diagnóstico , Feminino , Seguimentos , Hérnia Diafragmática/etiologia , Humanos , Rim/diagnóstico por imagem , Doenças Torácicas/etiologia , Tomografia Computadorizada por Raios X/métodosRESUMO
ABSTRACT: Slipping rib syndrome is pain created at the lower, anterior border of the rib cage when performing upper-extremity activities, coughing, laughing, or leaning over. Defects in the costal cartilage of ribs 8 to 10 result in increased movement of the ribs, impinging soft tissue and intercostal nerves. Advancements have been made in the diagnosis of slipping rib syndrome by dynamic ultrasound. Ultrasound can identify abnormalities in the rib and cartilage anatomy, as well as soft tissue swelling. Although the mainstays of treatment continue to be reassurance, nonsteroidal anti-inflammatory drugs, physical therapy, intercostal nerve injections, osteopathic manipulative treatment, surgery for refractory pain, and botulinum toxin injections have been attempted, and there may be a role for prolotherapy in treatment. Surgical techniques are being examined secondary to recurrence of pain following resection. The hooking maneuver and surgery remain important for identification and treatment, respectively.
Assuntos
Costelas/diagnóstico por imagem , Costelas/fisiopatologia , Doenças Torácicas/diagnóstico por imagem , Dor no Peito/diagnóstico por imagem , Dor no Peito/etiologia , Dor no Peito/cirurgia , Dor no Peito/terapia , Tratamento Conservador , Humanos , Dor Intratável/diagnóstico por imagem , Dor Intratável/etiologia , Dor Intratável/cirurgia , Dor Intratável/terapia , Recidiva , Síndrome , Doenças Torácicas/etiologia , Doenças Torácicas/terapia , UltrassonografiaRESUMO
BACKGROUND: Thoracic complications from retained abdominal gallstones are quite rare and the incidence rate ranges between 0.08% and 0.3%. Diagnosis and treatment of these complications are challenging due to the uncommon presentations and the debated role of the thoracic approach. This review of all cases reported in literature aims to discuss the best practice of this rare condition. METHODS: A comprehensive literature search was performed for articles from January 1993 to May 2019 using PubMed, MEDLINE, Embase, ScienceDirect. The following mesh-words were used: 'cholelithopthysis', 'thoracic', 'gallstones' 'retained', and 'spilled'. All cases of thoracic complications from retained gallstones after laparoscopic cholecystectomy were extrapolated. RESULTS: Twenty-four patients were included in this study. The most common symptoms were fever, hemoptysis and lithoptysis. Symptoms after laparoscopic cholecystectomy were presented after a mean time of 9.8±14.2 months (range from one week to 60 months). Delayed diagnosis was found in fourteen patients (58.4.%). Only four subjects were treated successfully with antibiotic therapy alone (16.7%), whereas 20 patients needed surgery or interventional radiology (83.3%). Seven patients (29.2%) were successfully managed with an abdominal approach. Three patients were managed using thoracentesis, thoracoscopic-thoracotomic drainage (12.5%). Right lung decortication and pulmonary wedge resections were necessary for ten patients (41.6%). CONCLUSION: Clinicians always must inquire about the previous cholecystectomy for cholelithiasis related diseases in all patients suffering from recurrent right-sided pleural/lung affections, to improve diagnostic delay. The escalated approach must be performed: empirical antimicrobial therapy followed by targeted therapy as soon as microbiological data are available; afterwards, abdominal surgery is effective in approximately 30% of patients while the remaining patients have to be submitted to a thoracic approach.
Assuntos
Colecistectomia Laparoscópica/efeitos adversos , Cálculos Biliares/cirurgia , Complicações Pós-Operatórias/etiologia , Doenças Torácicas/etiologia , Procedimentos Cirúrgicos Torácicos/efeitos adversos , Abdome/cirurgia , Colecistectomia Laparoscópica/métodos , HumanosRESUMO
Extrapleural hematoma (EH) is an uncommon and occasionally life-threatening condition. Huge EH can cause potentially fatal respiratory and circulatory disturbances. The usual causes of EH are chest trauma, iatrogenic injury, and rupture of a thoracic aortic aneurysm. There have been few reports of EH as a complication of pneumonia. Here we describe a case of EH that was not detectable on initial computed tomography (CT) in a patient with pneumonia despite symptoms suggestive of hemorrhage. A 70-year-old man who had been diagnosed with pneumonia the previous day visited our hospital after developing right upper abdominal pain of sudden onset. Initial noncontrast-enhanced computed tomography (CT) showed consolidation of the right lower lobe of the lung but no hematoma. He was discharged from hospital. When the pain recurred the following day, he was transported by ambulance back to our hospital and admitted. Contrast-enhanced CT showed an EH that had not been apparent on the initial CT scan taken 33 h earlier. Coagulation tests were within normal limits. He was treated conservatively and monitored closely. His symptoms improved, and he was discharged 4 days after admission. The EH did not enlarge and had almost disappeared by 56 days after admission. The pathophysiology of the relationship between pneumonia and EH is unclear. This case suggests that EH cannot be ruled out by initial CT findings soon after an episode suggestive of hemorrhage and can occur as a complication of pneumonia. Therefore, patients in whom EH is suspected should be followed up closely.
Assuntos
Hematoma/etiologia , Pneumonia/complicações , Doenças Torácicas/etiologia , Idoso , Hematoma/diagnóstico por imagem , Humanos , Masculino , Doenças Torácicas/diagnóstico por imagem , Tomografia Computadorizada por Raios XRESUMO
Thoracic splenosis is the autotransplantation of splenic tissue in the left thoracic cavity as a result of a splenic injury. This rare pathology is usually asymptomatic and may be discovered on incidental imaging, but the diagnosis often requires invasive procedures such as surgery in order to eliminate a neoplasic origin. We report a rare symptomatic case of a 39-year-old man presenting with chest pain and multiple nodules revealed on a computed tomography scan. The patient underwent a surgical exploration and the pathological studies concluded to a thoracic splenosis. Indeed, the previous medical history of the patient revealed a left thoraco-abdominal traumatism during childhood. The aim of this paper is to emphasize that the diagnosis can now be performed using only imaging techniques such as technetium-99 sulfur colloid or labelled heat-denatured red blood cell scintigraphy to avoid unnecessary invasive procedures including thoracotomy.
Assuntos
Traumatismos Abdominais/complicações , Doenças Assintomáticas , Baço/lesões , Esplenose/diagnóstico , Esplenose/etiologia , Doenças Torácicas/diagnóstico , Doenças Torácicas/etiologia , Traumatismos Torácicos/complicações , Procedimentos Desnecessários , Adulto , Humanos , Masculino , Esplenectomia , Esplenose/patologia , Esplenose/cirurgia , Doenças Torácicas/patologia , Doenças Torácicas/cirurgia , ToracotomiaRESUMO
BACKGROUND: Over the past 100 years, many procedures have been developed for correcting restrictive thoracic deformities which cause thoracic insufficiency syndrome. However, none of them have been assessed by a robust metric incorporating thoracic dynamics. In this paper, we investigate the relationship between radiographic spinal curve and lung volumes derived from thoracic dynamic magnetic resonance imaging (dMRI). Our central hypothesis is that different anteroposterior major spinal curve types induce different restrictions on the left and right lungs and their dynamics. METHODS: Retrospectively, we included 25 consecutive patients with thoracic insufficiency syndrome (14 neuromuscular, 7 congenital, 4 other) who underwent vertical expandable prosthetic titanium rib surgery and received preimplantation and postimplantation thoracic dMRI for clinical care. We measured thoracic and lumbar major curves by the Cobb measurement method from anteroposterior radiographs and classified the curves as per Scoliosis Research Society (SRS)-defined curve types. From 4D dMRI images, we derived static volumes and tidal volumes of left and right lung, along with left and right chest wall and left and right diaphragm tidal volumes (excursions), and analyzed their association with curve type and major curve angles. RESULTS: Thoracic and lumbar major curve angles ranged from 0 to 136 and 0 to 116 degrees, respectively. A dramatic postoperative increase in chest wall and diaphragmatic excursion was seen qualitatively. All components of volume increased postoperatively by up to 533%, with a mean of 70%. As the major curve, main thoracic curve (MTC) was associated with higher tidal volumes (effect size range: 0.7 to 1.0) than thoracolumbar curve (TLC) in preoperative and postoperative situation. Neither MTC nor TLC showed any meaningful correlation between volumes and major curve angles preoperatively or postoperatively. Moderate correlations (0.65) were observed for specific conditions like volumes at end-inspiration or end-expiration. CONCLUSIONS: The relationships between component tidal volumes and the spinal curve type are complex and are beyond intuitive reasoning and guessing. TLC has a much greater influence on restricting chest wall and diaphragm tidal volumes than MTC. Major curve angles are not indicative of passive resting volumes or tidal volumes. LEVEL OF EVIDENCE: Level II-diagnostic.
Assuntos
Imageamento por Ressonância Magnética/métodos , Implantação de Prótese , Insuficiência Respiratória , Costelas/cirurgia , Escoliose , Doenças Torácicas , Adolescente , Criança , Feminino , Humanos , Masculino , Equipamentos Ortopédicos , Implantação de Prótese/efeitos adversos , Implantação de Prótese/instrumentação , Implantação de Prótese/métodos , Insuficiência Respiratória/diagnóstico , Insuficiência Respiratória/etiologia , Insuficiência Respiratória/fisiopatologia , Insuficiência Respiratória/prevenção & controle , Estudos Retrospectivos , Escoliose/complicações , Escoliose/diagnóstico , Escoliose/fisiopatologia , Escoliose/cirurgia , Doenças Torácicas/diagnóstico , Doenças Torácicas/etiologia , Doenças Torácicas/fisiopatologia , Doenças Torácicas/cirurgia , Parede Torácica/diagnóstico por imagem , Parede Torácica/patologia , Resultado do TratamentoRESUMO
BACKGROUND: Injury to vital structures posterior to the sternum is a complication associated with redo sternotomy in congenital cardiac surgery. The goal of our study was a novel evaluation of real-time cine cardiovascular magnetic resonance (CMR) to predict the presence of significant retrosternal adhesions of cardiac and vascular structures prior to redo sternotomy in patients with congenital heart disease. METHODS: Twenty-three patients who had prior congenital heart surgery via median sternotomy had comprehensive CMR studies prior to redo sternotomy. The real time cine (RTC) sequence that was used is an ungated balanced steady-state free precession (bSSFP) sequence using SENSitivity Encoding for acceleration with real-time reconstruction. Spontaneously breathing patients were instructed to take deep breaths during the acquisition whilst increased tidal volumes were delivered to mechanically ventilated patients. All patients underwent redo cardiac surgery subsequently and the presence and severity of retrosternal adhesions were noted at the time of the redo sternotomies. RESULTS: Median age at the time of CMR and operation were 5.5 years (range, 0.2-18.4y) and 6.1 years (range, 0.3-18.8y) respectively. There were 15 males and 8 females in the study group. Preoperative retrosternal adhesions were identified on RTC in 13 patients and confirmed in 11 (85%) at the time of surgery. In only 2 patients, no adhesions were identified on CMR but were found to have significant retrosternal adhesions at surgery; false positive rate 15% (CI 0.4-29.6%), false negative rate 20% (CI 3.7-36.4%). The total classification error of the real time cine sequence was 17% (CI 1.7-32.4%) with an overall accuracy of 83% (CI 67.7-98.4%). Standard breath-hold cine images correlated poorly with surgical findings and did not increase the diagnostic yield. CONCLUSIONS: RTC imaging can predict the presence of significant retrosternal adhesions and thus help in risk assessment prior to redo sternotomy. These findings complement the surgical planning and potentially reduce surgical complications .
Assuntos
Cardiopatias Congênitas/cirurgia , Imagem Cinética por Ressonância Magnética , Esternotomia/efeitos adversos , Doenças Torácicas/diagnóstico por imagem , Adolescente , Criança , Pré-Escolar , Estudos de Viabilidade , Feminino , Humanos , Lactente , Masculino , Valor Preditivo dos Testes , Reoperação , Reprodutibilidade dos Testes , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Doenças Torácicas/etiologia , Aderências TeciduaisRESUMO
OBJECTIVE: To evaluate multidetector computed tomography (MDCT) findings in patients with achalasia, to assess its role in differentiating subtypes in detecting lung involvement and extra-esophageal thoracic complications. SUBJECTS AND METHODS: This clinical retrospective study included 51 patients with manometrically confirmed achalasia who underwent chest X-ray and MDCT in diagnostic work-up. Esophageal wall thickness and morphology, luminal dilatation, lung changes, and extra-esophageal manifestations were analyzed on MDCT by 2 readers. Wilcoxon, Kruskal-Wallis and Mann-Whitney test were used for assessing the differences among the achalasia subtypes, and intra-class correlation coefficients (ICC) assessing the inter-observer agreement between the measurements of 2 readers. RESULTS: Fourteen (27.5%) patients had achalasia subtype I, 21 (60.8%) had subtype II while 6 (11.8%) had subtype III. Esophageal wall thickness of the esophageal body (EB) and distal esophageal segment (DES) as well as nodular/lobulated appearance of DES were found significantly more often in subtype III (p = 0.024, p < 0.001, p = 0.009, respectively). Esophageal dilatation gradually decreased from subtype I to III (p = 0.006). Chest X-ray revealed lung changes in 9 (17%) and MDCT in 21 (41%) patients (p = 0.001), most frequently in subtype I, with predominance of ground-glass opacities. Tracheal/carinal compression was detected in 27 (52.9%) and left atrial compression in 17 (33.3%) patients. Excellent inter-observer agreement was observed in measuring the EB and DES wall thickness, and diameter of EB (ICC 0.829, 0.901, and 0.922). CONCLUSION: MDCT is a useful tool for detecting lung and extra-esophageal thoracic complications in patients with achalasia, and could be a valuable additional imaging modality in the differentiation of achalasia subtypes.
Assuntos
Acalasia Esofágica/complicações , Acalasia Esofágica/diagnóstico por imagem , Pneumopatias/diagnóstico por imagem , Pneumopatias/etiologia , Tomografia Computadorizada Multidetectores/métodos , Doenças Torácicas/diagnóstico por imagem , Doenças Torácicas/etiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Manometria , Pessoa de Meia-Idade , Radiografia Torácica , Estudos RetrospectivosRESUMO
INTRODUCTION: Bariatric surgeries are increasingly performed to treat obesity worldwide. The currently available literature on these surgeries mainly focuses on their abdominal complications, giving less attention to their thoracic ones. Hence, the present work aimed to highlight the thoracic complications associated with bariatric surgeries. METHODS: A retrospective descriptive study was performed and involved the review of the medical charts of 390 patients who underwent different bariatric surgeries between January 2014 and January 2017 in our hospital or who were referred to us from other centers after their specific operations. The data of patients who developed thoracic complications and who required further intervention were identified and categorized by the modality of diagnosis, outcome, duration of hospital and ICU stays, and management. Patients with a history of a preexisting pulmonary disease were excluded. RESULTS: Twenty-six patients were observed to have thoracic complications secondary to their bariatric surgeries. Twenty-two patients (84.6%) received post-laparoscopic sleeve gastrectomy (LASG). Nine patients (34.6%) required ICU stays. Twenty patients (76.9) had incidences of pleural effusion in the postoperative period. The mean duration of hospital and ICU stays were 4.4 ± 11.67 days and 15 ± 19.36 days, respectively. Other reported thoracic complications included esophageal perforations, thoracic empyema, septic pericardial effusion, and pancreaticopleural fistula. CONCLUSION: Bariatric surgeries are safe procedures in selected patients. There is a significant amount of literature describing abdominal, nutritional, neurological, and even ophthalmic complications after bariatric surgeries. Being that they are relatively rare, thoracic complications are underreported in the literature. The management of thoracic complications after bariatric surgery requires awareness and a high index of suspicion to prevent further morbidities and mortalities.
Assuntos
Cirurgia Bariátrica/efeitos adversos , Obesidade Mórbida/cirurgia , Complicações Pós-Operatórias/etiologia , Doenças Torácicas/etiologia , Adulto , Cirurgia Bariátrica/métodos , Perfuração Esofágica/diagnóstico por imagem , Perfuração Esofágica/epidemiologia , Perfuração Esofágica/etiologia , Feminino , Gastrectomia/efeitos adversos , Gastrectomia/métodos , Humanos , Incidência , Unidades de Terapia Intensiva/estatística & dados numéricos , Tempo de Internação/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Obesidade Mórbida/epidemiologia , Derrame Pleural/diagnóstico por imagem , Derrame Pleural/epidemiologia , Derrame Pleural/etiologia , Complicações Pós-Operatórias/diagnóstico por imagem , Complicações Pós-Operatórias/epidemiologia , Radiografia Torácica , Estudos Retrospectivos , Arábia Saudita/epidemiologia , Doenças Torácicas/diagnóstico por imagem , Doenças Torácicas/epidemiologia , Tomografia Computadorizada por Raios XRESUMO
Intrathoracic splenosis is a rare diagnosis that is usually made after an invasive procedure. Most cases report concomitant rupture of the spleen and left hemidiaphragm with autotransplantation of splenic tissue into the left hemithorax. We report a case of intrathoracic splenosis with no evidence of diaphragmatic rupture. The mechanism may be explained by hematogenous spread. The patient underwent video-assisted thoracoscopic surgery for diagnosis, which could have been avoided if splenosis was suspected.
Assuntos
Esplenose/diagnóstico , Esplenose/cirurgia , Doenças Torácicas/diagnóstico , Doenças Torácicas/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Esplenose/etiologia , Doenças Torácicas/etiologia , Cirurgia Torácica Vídeoassistida , Tomografia Computadorizada por Raios XAssuntos
Abscesso/etiologia , Aspiração por Agulha Fina Guiada por Ultrassom Endoscópico/efeitos adversos , Esofagoscopia/efeitos adversos , Pescoço/diagnóstico por imagem , Infecções Estreptocócicas/etiologia , Streptococcus anginosus/isolamento & purificação , Síndrome da Veia Cava Superior/etiologia , Doenças Torácicas/etiologia , Abscesso/microbiologia , Abscesso/terapia , Adenocarcinoma/diagnóstico , Adenocarcinoma/patologia , Adenocarcinoma/terapia , Antibacterianos/uso terapêutico , Quimiorradioterapia , Terapia Combinada , Drenagem , Esofagoscopia/métodos , Humanos , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares/terapia , Masculino , Meropeném/uso terapêutico , Pessoa de Meia-Idade , Fumar/efeitos adversos , Infecções Estreptocócicas/microbiologia , Infecções Estreptocócicas/terapia , Tela Subcutânea , Síndrome da Veia Cava Superior/terapia , Doenças Torácicas/microbiologia , Doenças Torácicas/terapia , Tomografia Computadorizada por Raios XRESUMO
BACKGROUND: Dysphagia affects one in twenty-five adults yearly in the United States. OBJECTIVE: While dysphagia may be common, the prevalence of dysphagia may be underestimated primarily due to under-reporting. Dysphagia may be caused by intraluminal, intrinsic, extrinsic, or motility disorders. METHOD/RESULTS: We present a case of dysphagia caused by extra-thoracic extrinsic compression due to bra use. CONCLUSION: Despite many published reports on dysphagia caused by other diagnoses, we occasionally overlook extrinsic abdominal compression as the cause for dysphagia.
Assuntos
Vestuário/efeitos adversos , Transtornos de Deglutição/etiologia , Doenças Torácicas/etiologia , Dor Abdominal/diagnóstico , Dor Abdominal/etiologia , Transtornos de Deglutição/diagnóstico , Feminino , Humanos , Pessoa de Meia-Idade , Doenças Torácicas/diagnósticoRESUMO
BACKGROUND Radial artery access during coronary angiography has gained popularity as there are fewer associated complications when compared with femoral artery access. However sporadic complications can occur following radial artery catheterization. A rare case of axillary, chest wall and abdominal hematoma is presented following radial artery catheterization. CASE REPORT A 58-year-old man with hypertension, type 2 diabetes, with a history of smoking, underwent elective coronary artery angiography via the right radial artery route. He was discharged from care without event, before returning 24 hours later with a large hematoma of the right axilla, extending to the anterior chest wall and abdomen. One year previously, he underwent coronary artery angiography with catheterization of the femoral artery, which was without complications. On this occasion, after resolution of the hematoma, he underwent coronary artery bypass graft (CABG) surgery. CONCLUSIONS This case has reported a rare complication of radial artery catheterization that involved extensive hematoma involving the chest, abdominal wall, and axilla. Although such complications may be rare, a high level of vigilance should be maintained for rare complications in patients undergoing radial artery catheterization.
Assuntos
Abdome , Cateterismo Cardíaco/efeitos adversos , Angiografia Coronária , Hematoma/etiologia , Artéria Radial , Doenças Torácicas/etiologia , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
Chest wall inflammatory and lymphangitic breast cancer represents a clinical spectrum and a model disease. Inflammation and the immune response have a role in the natural history of this special clinical presentation. Preclinical models and biomarker studies suggest that inflammatory breast cancer comprises a more important role for the tumour microenvironment, including immune cell infiltration and vasculogenesis, especially lympho-angiogenesis. Across this clinical continuum of the chest wall disease there is an important role of the inflammation cascade. The activation of mature dendritic cells (DCs) through toll like receptors (TLRs) or by inflammatory cytokines converts immature DCs into mature DCs that present specific antigen to T cells, thereby activating them. Maturation of DCs is accompanied by co-stimulatory molecules and secretion of inflammatory cytokines polarizing lymphocytic, macrophages and fibroblast infiltration. It is unknown whether immune cells associated to the IBC microenvironment play a role in this scenario to transiently promote epithelial to mesenchymal transition (EMT) in these cells. Immune and microenvirnment factors can induce phenotypic, morphological, and functional changes in breast cancer cells. We can hypothesize that similar inflammatory conditions in vivo may support both the rapid metastasis and tight tumor emboli that are characteristic of chest wall disease and that targeted anti-inflammatory therapy may play a role in this patient population. The current review will review biological and clinical data of this special condition.
Assuntos
Competência Clínica , Neoplasias Inflamatórias Mamárias/complicações , Oncologistas/normas , Doenças Torácicas/etiologia , Diferenciação Celular , Feminino , Humanos , Neoplasias Inflamatórias Mamárias/diagnóstico , Doenças Torácicas/diagnóstico , Parede Torácica , Microambiente TumoralRESUMO
INTRODUCTION: Type 1 neurofibromatosis, also called "Recklinghausen's disease" is among the most frequent autosomal dominant genetic disorders, with an incidence of 1:3500 births. It mainly affects the skin and peripheral nervous system. However, in its less frequent manifestations, are tumors such as meningocele and skeletal dysplasias leading to severe clinical presentation. CASE REPORT: We report the case of a 55-year-old patient with type 1 neurofibromatosis and dyspnea due to a large left thoracic meningocele combined with a significant kyphoscoliosis, causing a severe restrictive ventilatory defect, complicated by chronic respiratory failure and pulmonary hypertension. Symptomatic treatment with non-invasive ventilation permitted an improvement of the clinical situation. CONCLUSIONS: Our observation shows the complexity of the therapeutic support of the neurofibromatosis of type 1. The contribution of non-invasive ventilation was illustrated by the arterial blood gas and clinical improvements as well as improved quality of life, with an acceptable level of inconvenience to the patient.
Assuntos
Dispneia/diagnóstico , Dispneia/etiologia , Neurofibromatose 1/complicações , Neurofibromatose 1/diagnóstico , Insuficiência Respiratória/diagnóstico , Feminino , Humanos , Hipertensão Pulmonar/diagnóstico , Hipertensão Pulmonar/etiologia , Meningocele/diagnóstico , Meningocele/etiologia , Pessoa de Meia-Idade , Radiografia Torácica , Insuficiência Respiratória/etiologia , Doenças Torácicas/diagnóstico , Doenças Torácicas/etiologiaRESUMO
According to some studies, extragenital endometriosis represents 5% of the localisations. Its prevalence seems to be underestimated. The extra pelvic localisation can make the diagnosis more difficult. Nevertheless, the recurrent and catamenial symptomatology can evoke this pathology. Surgery seems to be the unique efficient treatment for parietal lesions. Pain linked to nervous lesions (peripheric and sacral roots) seems to be underestimated and difficult to diagnose because of various localisations. Neurolysis seems to have encouraging results. Diaphragmatic lesions are often discovered either incidentally during laparoscopy, or by pulmonary symptomatology as recurrent catamenial pneumothorax or cyclic thoracic pain. Surgical treatment seems as well to be efficient.
Assuntos
Abdome/cirurgia , Diafragma/cirurgia , Endometriose/terapia , Doenças do Sistema Nervoso Periférico/terapia , Doenças Torácicas/cirurgia , Endometriose/complicações , Endometriose/diagnóstico , Feminino , Humanos , Laparoscopia , Doenças do Sistema Nervoso Periférico/etiologia , Doenças Torácicas/etiologiaRESUMO
Sickle cell disease is an inherited hemolytic disease with systemic complications. These complications significantly impact the patients' quality of life. There are characteristic radiological findings that can aid in the diagnosis and management of common sequelae of sickle cell disease. In this review, we will discuss the thoracic imaging findings of common complications of sickle cell disease in an organ-based approach and provide imaging examples of them.
Assuntos
Anemia Falciforme/complicações , Doenças Torácicas/etiologia , Tórax/patologia , Progressão da Doença , Humanos , Qualidade de Vida , Radiografia Torácica , Doenças Torácicas/diagnóstico por imagem , Tórax/diagnóstico por imagemAssuntos
Eventração Diafragmática/diagnóstico , Síndrome de Heterotaxia/diagnóstico , Pulmão/patologia , Doenças Torácicas/diagnóstico , Baço Flutuante/diagnóstico , Idoso , Eventração Diafragmática/complicações , Síndrome de Heterotaxia/complicações , Humanos , Pulmão/diagnóstico por imagem , Masculino , Radiografia Torácica , Doenças Torácicas/etiologia , Baço Flutuante/complicaçõesAssuntos
Ligadura/efeitos adversos , Imagem Cinética por Ressonância Magnética/métodos , Doenças Torácicas/etiologia , Varizes/diagnóstico por imagem , Veia Cava Inferior/cirurgia , Idoso , Dispneia/diagnóstico , Dispneia/etiologia , Humanos , Ligadura/métodos , Masculino , Monitorização Fisiológica/métodos , Prognóstico , Medição de Risco , Índice de Gravidade de Doença , Doenças Torácicas/diagnóstico por imagem , Varizes/etiologia , Veia Cava Inferior/lesõesRESUMO
Thoracoliths are rare benign intrapleural loose bodies, often containing calcification, that are mobile in the pleural cavity. The presence of these intrapleural nodules is referred to as thoracolithiasis. The exact etiology of thoracoliths is unknown, but they presumably result from a prior episode of mediastinal (epipericardial) fat necrosis. Thoracoliths are usually asymptomatic and incidentally encountered on computed tomography. However, they sometimes pose diagnostic challenges, as a thoracolith may be located within a pleural fissure, and is then indistinguishable from a pulmonary nodule. In addition, migration and rotation of thoracoliths within the pleural space observed on serial computed tomography studies has been reported to raise concern that these might be neoplastic lesions, leading to their surgical removal. Awareness of this benign condition is important in order to avoid unnecessary invasive procedures.