RESUMEN
Ventricular septal perforation(VSP) after blunt chest trauma is rare. As the clinical symptoms and timing of presentation are varied, appropriate diagnosis can be difficult or delayed. An 86-year-old man presented with a traumatic VSP following a forestry injury. He showed a normal cardiac structure at the time of injury, but echocardiography after 9 days revealed VSP. He was treated successfully with surgical closure of the VSP.
Asunto(s)
Traumatismos Torácicos/cirugía , Rotura Septal Ventricular/cirugía , Anciano de 80 o más Años , Ecocardiografía , Humanos , Masculino , Imagen Multimodal , Traumatismos Torácicos/complicaciones , Traumatismos Torácicos/diagnóstico por imagen , Procedimientos Quirúrgicos Torácicos , Tomografía Computarizada por Rayos X , Rotura Septal Ventricular/diagnóstico por imagen , Rotura Septal Ventricular/etiologíaRESUMEN
A 94-year-old woman was admitted to our hospital with sudden onset of chest pain without any episode of trauma. Computed tomography(CT) revealed left massive pleural effusion and extravasation of contrast medium from the side chest wall to the back. Neither aortic aneurysm nor dissection was evident. During the investigation, the patient went into hypovolemic shock. Hemothorax due to bleeding from an intercostal artery was diagnosed, and emergency surgery was performed. A 1-mm hole was detected in the descending aorta, and closed by a single suture. The final diagnosis was spontaneous rupture of the thoracic aorta. Three-dimensional CT (3D-CT), reconstructed postoperatively, revealed extravasation of the contrast medium from the descending aorta. The postoperative course was satisfactory, and the patient was discharged on the 20th postoperative day. 3D-CT may be useful for identifying the source of bleeding in such cases.
RESUMEN
Lactobacillus (LB) is a gram-positive rod-shaped bacterium that inhabits the oral cavity, gastrointestinal tract, vagina and nasal cavity. Although LB plays a role in the prevention of infections caused by pathogenic bacteria, it causes some critical infectious diseases such as infective endocarditis (IE). IE due to LB is rare; however, early diagnosis and early treatment are important because of its high mortality rate. We report the onset of IE after otologic treatment in a heavy drinker of alcohol, the second case of IE due to LB in Japan.
Asunto(s)
Endocarditis Bacteriana/microbiología , Infecciones por Bacterias Grampositivas/microbiología , Huésped Inmunocomprometido , Lactobacillus , Insuficiencia de la Válvula Mitral/microbiología , Adulto , Alcoholismo/inmunología , Endocarditis Bacteriana/inmunología , Endocarditis Bacteriana/cirugía , Infecciones por Bacterias Grampositivas/inmunología , Implantación de Prótesis de Válvulas Cardíacas , Humanos , Masculino , Insuficiencia de la Válvula Mitral/inmunología , Insuficiencia de la Válvula Mitral/cirugíaRESUMEN
Imaging findings of 26 cases of leflunomide (Arava)-related acute lung injury were analyzed. Thirteen cases had pre-existing interstitial pulmonary disease on chest X-ray or computed tomography. The main features of clinically determined leflunomide-induced acute lung injury were similar to those caused by other drugs: diffuse or widespread patchy ground-glass opacities and/or consolidation, frequently accompanied by septal thickening and intralobular reticular opacities. We categorized these findings into four patterns: diffuse alveolar damage (DAD), acute eosinophilic pneumonia, hyperreaction, and cryptogenic organizing pneumonia. The DAD group had a higher mortality rate, but statistically not a significant one. It is impossible to exclude infectious disease such as pneumocystis carinii pneumonia based on imaging findings, and detailed correlation of imaging findings with clinical and laboratory findings is essential in order to make a correct diagnosis.