ABSTRACT
Dyspnea and hypoxemia in a patient with cancer may have several causes, including infections, thromboembolism, metastases, and pulmonary injuries by drugs. We report a 47-year-old female with breast cancer and a 70-year-old male with urinary bladder cancer who were admitted for dyspnea, hypoxemia and pulmonary hypertension. Chest X rays and CT scans were normal. The ventilation-perfusion scintigram was highly suspicions of thromboembolism in the female. The male died 16 hours after admission and the post mortem examination revealed the presence of tumor cells in the pulmonary vasculature.
Subject(s)
Aged , Female , Humans , Male , Middle Aged , Adenocarcinoma/complications , Breast Neoplasms/complications , Neoplastic Cells, Circulating , Prostatic Neoplasms/complications , Pulmonary Embolism/etiology , Urinary Bladder Neoplasms/complications , Adenocarcinoma/pathology , Breast Neoplasms/pathology , Carcinoma, Ductal, Breast/complications , Carcinoma, Ductal, Breast/pathology , Fatal Outcome , Neoplastic Cells, Circulating/pathology , Prostatic Neoplasms/pathology , Pulmonary Embolism/pathology , Urinary Bladder Neoplasms/pathologyABSTRACT
Dyspnea and hypoxemia in a patient with cancer may have several causes, including infections, thromboembolism, metastases, and pulmonary injuries by drugs. We report a 47-year-old female with breast cancer and a 70-year-old male with urinary bladder cancer who were admitted for dyspnea, hypoxemia and pulmonary hypertension. Chest X rays and CT scans were normal. The ventilation-perfusion scintigram was highly suspicions of thromboembolism in the female. The male died 16 hours after admission and the post mortem examination revealed the presence of tumor cells in the pulmonary vasculature.
Subject(s)
Adenocarcinoma/complications , Breast Neoplasms/complications , Neoplastic Cells, Circulating , Prostatic Neoplasms/complications , Pulmonary Embolism/etiology , Urinary Bladder Neoplasms/complications , Adenocarcinoma/pathology , Aged , Breast Neoplasms/pathology , Carcinoma, Ductal, Breast/complications , Carcinoma, Ductal, Breast/pathology , Fatal Outcome , Female , Humans , Male , Middle Aged , Neoplastic Cells, Circulating/pathology , Prostatic Neoplasms/pathology , Pulmonary Embolism/pathology , Urinary Bladder Neoplasms/pathologyABSTRACT
La enfermedad de Rendu-Osler-Weber es una enfermedad autosómica dominante que se manifiesta por telangiectasias en piel y mucosas y malformaciones arteriovenosas en diversos órganos. El compromiso neurológico puede ocurrir por la presencia de malformaciones arterio-venosas cerebrales, hemorragia intracraneal, y más habitualmente por accidentes cerebrovasculares isquémicos y abscesos cerebrales secundarios a embolia paradojal, en pacientes con malformaciones arteriovenosas pulmonares. El absceso intramedular es una entidad rara, inusual como complicación de la enfermedad de Rendu-Osler-Weber. Presentamos el caso de una mujer de 56 años de edad, con antecedentes familiares de enfermedad de Rendu-Osler- Weber, que ingresó a Terapia Intensiva con cuadriplejia aguda e hipoxemia, en quien se diagnosticó fístulas arteriovenosas pulmonares y un absceso intramedular cervical.
Rendu-Osler-Weber syndrome is an autosomal dominant disorder characterized by multiple skin and mucosal telangiectasis and multiorgan arteriovenous malformations. Neurological manifestations may occur because of cerebral arteriovenous malformations, intracranial hemorrhage, and most commonly by ischemic stroke and brain abscess secondary to paradoxical embolization in patients with pulmonary arteriovenous malformations. Intramedullary abscess is a rare, unusual condition, in Rendu-Osler-Weber syndrome. We report the case of a 56 years old woman, with a familial history of Rendu-Osler-Weber syndrome, admitted to intensive care with acute quadriplegia and hypoxemia. Our diagnosis was pulmonary arteriovenous malformations and intramedullary abscess.
Subject(s)
Female , Humans , Middle Aged , Abscess/complications , Arteriovenous Fistula/diagnosis , Spinal Diseases/complications , Telangiectasia, Hereditary Hemorrhagic/complications , Abscess/diagnosis , Arteriovenous Fistula/surgery , Fatal Outcome , Magnetic Resonance Spectroscopy , Pulmonary Artery/abnormalities , Pulmonary Veins/abnormalities , Tomography, X-Ray ComputedABSTRACT
Rendu-Osler-Weber syndrome is an autosomal dominant disorder characterized by multiple skin and mucosal telangiectasis and multiorgan arteriovenous malformations. Neurological manifestations may occur because of cerebral arteriovenous malformations, intracranial hemorrhage, and most commonly by ischemic stroke and brain abscess secondary to paradoxical embolization in patients with pulmonary arteriovenous malformations. Intramedullary abscess is a rare, unusual condition, in Rendu-Osler-Weber syndrome. We report the case of a 56 years old woman, with a familial history of Rendu-Osler-Weber syndrome, admitted to intensive care with acute quadriplegia and hypoxemia. Our diagnosis was pulmonary arteriovenous malformations and intramedullary abscess.
Subject(s)
Abscess/complications , Arteriovenous Fistula/diagnosis , Spinal Diseases/complications , Telangiectasia, Hereditary Hemorrhagic/complications , Abscess/diagnosis , Arteriovenous Fistula/surgery , Fatal Outcome , Female , Humans , Magnetic Resonance Spectroscopy , Middle Aged , Pulmonary Artery/abnormalities , Pulmonary Veins/abnormalities , Tomography, X-Ray ComputedABSTRACT
Impending paradoxical embolism. An intracardiac thrombus traversing a patent foramen ovale is a very infrequent but potentially catastrophic complication of the thromboembolic disease. It is named "impending paradoxical embolism". We report the case of a 71-year-old Caucasian male warded in ten days after a prostatectomy because of bilateral pulmonary embolism. Diagnosis was confirmed by HCT scan and the patient received anticoagulation with heparin. A transesophageal ecocardiogram disclosed a thrombus traversing foramen ovale into the left atrium. Surgical embolectomy was performed, but the patient died shortly after surgery.
Subject(s)
Embolism, Paradoxical/diagnostic imaging , Heart Septal Defects, Atrial/diagnostic imaging , Pulmonary Embolism/diagnostic imaging , Aged , Echocardiography, Doppler , Echocardiography, Transesophageal , Embolectomy , Embolism, Paradoxical/etiology , Embolism, Paradoxical/surgery , Fatal Outcome , Heart Septal Defects, Atrial/complications , Humans , Male , Pulmonary Embolism/complicationsABSTRACT
La presencia de un trombo venoso atrapado en un defecto interauricular e insinuándose en las cavidades izquierdas configura una forma extremadamente inusual de enfermedad tromboembólica denominada embolia paradojal inminente. Presentamos el caso de un varón de 71 años, sometido 10 días antes a adenomectomía prostática, que consultó por disnea y mareos. Se le diagnosticó tromboembolismo pulmonar bilateral por tomografía axial computada helicoidal. Se lo anticoaguló con heparina sódica y se le realizó un ecocardiograma transesofágico que mostró un trombo que atravesaba el foramen oval y se alojaba en la aurícula izquierda. No presentaba signos clínicos de embolización sistémica. Se realizó la embolectomía quirúrgica y cierre del defecto auricular. El paciente falleció
An intracardiac thrombus traversing a patent foramen ovale is a very infrequent but potentially catastrophic complication of the thromboembolic disease. It is named "impending paradoxical embolism". We report the case of a 71 year old Caucasian male warded in ten days after a prostatectomy because of bilateral pulmonary embolism. Diagnosis was confirmed by HCT scan and the patient received anticoagulation with heparin. A transesophageal ecocardiogram disclosed a thrombus traversing foramen ovale into the left atrium. Surgical embolectomy was performed, but the patient died shortly after surgery
Subject(s)
Humans , Male , Aged , Embolism, Paradoxical , Heart Septal Defects, Atrial , Pulmonary Embolism , Echocardiography, Doppler , Echocardiography, Transesophageal , Embolectomy , Embolism, Paradoxical/etiology , Embolism, Paradoxical/surgery , Fatal Outcome , Heart Septal Defects, Atrial/complications , Pulmonary Embolism/complicationsABSTRACT
La presencia de un trombo venoso atrapado en un defecto interauricular e insinuándose en las cavidades izquierdas configura una forma extremadamente inusual de enfermedad tromboembólica denominada embolia paradojal inminente. Presentamos el caso de un varón de 71 años, sometido 10 días antes a adenomectomía prostática, que consultó por disnea y mareos. Se le diagnosticó tromboembolismo pulmonar bilateral por tomografía axial computada helicoidal. Se lo anticoaguló con heparina sódica y se le realizó un ecocardiograma transesofágico que mostró un trombo que atravesaba el foramen oval y se alojaba en la aurícula izquierda. No presentaba signos clínicos de embolización sistémica. Se realizó la embolectomía quirúrgica y cierre del defecto auricular. El paciente falleció (AU)
An intracardiac thrombus traversing a patent foramen ovale is a very infrequent but potentially catastrophic complication of the thromboembolic disease. It is named "impending paradoxical embolism". We report the case of a 71 year old Caucasian male warded in ten days after a prostatectomy because of bilateral pulmonary embolism. Diagnosis was confirmed by HCT scan and the patient received anticoagulation with heparin. A transesophageal ecocardiogram disclosed a thrombus traversing foramen ovale into the left atrium. Surgical embolectomy was performed, but the patient died shortly after surgery (AU)
Subject(s)
Humans , Male , Aged , Embolism, Paradoxical/diagnostic imaging , Pulmonary Embolism/diagnostic imaging , Heart Septal Defects, Atrial/diagnostic imaging , Embolism, Paradoxical/etiology , Embolism, Paradoxical/surgery , Pulmonary Embolism/complications , Heart Septal Defects, Atrial/complications , Echocardiography, Transesophageal , Echocardiography, Doppler , Embolectomy , Fatal OutcomeABSTRACT
La presencia de un trombo venoso atrapado en un defecto interauricular e insinuándose en las cavidades izquierdas configura una forma extremadamente inusual de enfermedad tromboembólica denominada embolia paradojal inminente. Presentamos el caso de un varón de 71 años, sometido 10 días antes a adenomectomía prostática, que consultó por disnea y mareos. Se le diagnosticó tromboembolismo pulmonar bilateral por tomografía axial computada helicoidal. Se lo anticoaguló con heparina sódica y se le realizó un ecocardiograma transesofágico que mostró un trombo que atravesaba el foramen oval y se alojaba en la aurícula izquierda. No presentaba signos clínicos de embolización sistémica. Se realizó la embolectomía quirúrgica y cierre del defecto auricular. El paciente falleció (AU)
An intracardiac thrombus traversing a patent foramen ovale is a very infrequent but potentially catastrophic complication of the thromboembolic disease. It is named "impending paradoxical embolism". We report the case of a 71 year old Caucasian male warded in ten days after a prostatectomy because of bilateral pulmonary embolism. Diagnosis was confirmed by HCT scan and the patient received anticoagulation with heparin. A transesophageal ecocardiogram disclosed a thrombus traversing foramen ovale into the left atrium. Surgical embolectomy was performed, but the patient died shortly after surgery (AU)
Subject(s)
Humans , Male , Aged , Embolism, Paradoxical/diagnostic imaging , Pulmonary Embolism/diagnostic imaging , Heart Septal Defects, Atrial/diagnostic imaging , Embolism, Paradoxical/etiology , Embolism, Paradoxical/surgery , Pulmonary Embolism/complications , Heart Septal Defects, Atrial/complications , Echocardiography, Transesophageal , Echocardiography, Doppler , Embolectomy , Fatal OutcomeABSTRACT
This is a report of a 61 year old man who was admitted at the Intensive Care Unit because of massive hemoptysis and respiratory failure. Four years before he had had an aortic dissection type A, and at that time an aortic valve, ascending aorta and aortic arch replacement, had been carried out. A thorax CT scan showed an aneurysm of the ascending aorta. A bronchoscopy was normal. In the angiography, a collateral of the left mammary artery was identified as the cause of bleeding and was subsequently embolized. After the procedure, the patient had a new episode of massive hemoptysis, and surgery was recommended. During surgery, the diagnosis of aortobronchial fistula was confirmed but the patient died during the intervention.
Subject(s)
Humans , Male , Middle Aged , Aortic Diseases , Bronchial Fistula , Hemoptysis , Vascular Fistula , Aorta, Thoracic , Aortic Diseases , Bronchial Fistula , Fatal Outcome , Hemoptysis , Vascular FistulaABSTRACT
This is a report of a 61 year old man who was admitted at the Intensive Care Unit because of massive hemoptysis and respiratory failure. Four years before he had had an aortic dissection type A, and at that time an aortic valve, ascending aorta and aortic arch replacement, had been carried out. A thorax CT scan showed an aneurysm of the ascending aorta. A bronchoscopy was normal. In the angiography, a collateral of the left mammary artery was identified as the cause of bleeding and was subsequently embolized. After the procedure, the patient had a new episode of massive hemoptysis, and surgery was recommended. During surgery, the diagnosis of aortobronchial fistula was confirmed but the patient died during the intervention. (Au)
Subject(s)
Humans , Male , Middle Aged , Hemoptysis/etiology , Bronchial Fistula/complications , Vascular Fistula/complications , Aortic Diseases/complications , Hemoptysis/diagnosis , Hemoptysis/surgery , Bronchial Fistula/diagnosis , Bronchial Fistula/surgery , Vascular Fistula/diagnosis , Vascular Fistula/surgery , Aortic Diseases/diagnosis , Aortic Diseases/surgery , Aorta, Thoracic , Fatal OutcomeABSTRACT
Bajo el título de infecciones severas de las partes blandas, se estudia, en conjunto, una serie de 70 casos, cada uno de los cuales, según la bibliografía existente sobre el tema, hubiera merecido una denominación distinta: celulitis, fascitis, miositis, generalmente con el agregado de algún detalle semiológico o bacteriológico. Los autores sostienen que las infecciones severas de las partes blandas constituyen un verdadero síndrome. Se analizan enfermedades asociadas, factores desencadentes, clínica, sistemática de diagnóstico, tratamiento y pronóstico. Resultó difícil establecer una relación entre el agente causal por un lado, y la semiología local, tejidos afectados y evolución, por el otro
Subject(s)
Middle Aged , Humans , Male , Female , Cellulitis/therapy , Fasciitis/therapy , Bacterial Infections/etiology , Clostridium Infections/microbiology , Myositis/therapy , Arterial Occlusive Diseases/complications , Diabetes Mellitus/complications , Gangrene/therapy , Hyperbaric Oxygenation , Surgical Wound Infection/microbiology , Necrosis , Neoplasms/complications , Prognosis , Sepsis/etiologyABSTRACT
Bajo el título de infecciones severas de las partes blandas, se estudia, en conjunto, una serie de 70 casos, cada uno de los cuales, según la bibliografía existente sobre el tema, hubiera merecido una denominación distinta: celulitis, fascitis, miositis, generalmente con el agregado de algún detalle semiológico o bacteriológico. Los autores sostienen que las infecciones severas de las partes blandas constituyen un verdadero síndrome. Se analizan enfermedades asociadas, factores desencadentes, clínica, sistemática de diagnóstico, tratamiento y pronóstico. Resultó difícil establecer una relación entre el agente causal por un lado, y la semiología local, tejidos afectados y evolución, por el otro (AU)
