RESUMO
Fistulous communications between the abdomen and pleural space are rare. The Authors report a case of hydropneumothorax following transdiaphragmatic perforation of an anterior wall gastric ulcer.
Assuntos
Fístula Gástrica/complicações , Hidrotórax/etiologia , Úlcera Péptica Perfurada/complicações , Doenças Pleurais/complicações , Pneumotórax/etiologia , Fístula do Sistema Respiratório/complicações , Úlcera Gástrica/complicações , Doença Aguda , Idoso , Biópsia , Tubos Torácicos , Diagnóstico Diferencial , Drenagem , Dispneia/etiologia , Evolução Fatal , Feminino , Fístula Gástrica/diagnóstico , Fístula Gástrica/cirurgia , Humanos , Hidrotórax/diagnóstico , Hidrotórax/cirurgia , Úlcera Péptica Perfurada/diagnóstico , Úlcera Péptica Perfurada/cirurgia , Doenças Pleurais/diagnóstico , Doenças Pleurais/cirurgia , Pneumotórax/diagnóstico , Pneumotórax/cirurgia , Fístula do Sistema Respiratório/diagnóstico , Fístula do Sistema Respiratório/cirurgia , Sepse/etiologia , Úlcera Gástrica/diagnóstico , Úlcera Gástrica/cirurgia , Toracostomia , Toracotomia , Tomografia Computadorizada por Raios XRESUMO
OBJECTIVE: Describe a rare localization of spontaneous cerebrospinal fistula. CASE REPORT: A 75-year-old women was admitted for bacterial meningitis arising from a sinus infection. She had not experienced facial or head trauma. The CT-scan revealed pneumocephaly and a defect in the posterior part of the sphenoid sinus. DISCUSSION: Spontaneous cerebrospinal fistula is uncommon. The exact etiology remains unknown.
Assuntos
Fístula/diagnóstico por imagem , Doenças dos Seios Paranasais/diagnóstico por imagem , Seio Esfenoidal/diagnóstico por imagem , Idoso , Feminino , Fístula/cirurgia , Humanos , Doenças dos Seios Paranasais/cirurgia , Seio Esfenoidal/cirurgia , Tomografia Computadorizada por Raios XRESUMO
Manubrio-sternal joint involvement in arthritis is described and may be evidenced by erosion, reactive sclerosis and ankylosis. Some reports of such involvement appear in the radiological literature in association with psoriatic arthritis and spondylarthropathy. Involvement of the manubrio-sternal joint in Behçet's disease is very uncommon. To our knowledge, only one case has been described. We report a case of manubrio-sternal arthritis in a women with Behçet's disease. Two others cases with suspicion of Behçet's disease are described.
Assuntos
Artrite/etiologia , Síndrome de Behçet/complicações , Esterno , Adulto , Feminino , Humanos , MasculinoRESUMO
BACKGROUND: Extramedullary haematopoiesis is a physiological response to chronic anemia, observed frequently during homozygous thalassemia. It is usually asymptomatic but can be manifested by compression of adjacent organs, particularly the spinal cord. CASE REPORT: A 44-year-old woman diagnosed with thalassaemia intermedia, was admitted for difficulties to walk and sphincter disturbances. Neurologic examination suggested spinal cord compression, which is confirmed by dorso-lumbar resonance magnetic imaging. The histology obtained by laminectomy led to the diagnosis of extramedullary hematopoiesis related to thalassemia. A radiotherapy enabled with good outcome. DISCUSSION: Spinal cord compressions by extramedullary hematopoiesis during thalassemia are uncommon (75 cases in the literature) but can induce severe sequelae if the diagnostic is not rapidly obtained. Magnetic resonance imaging is the gold standard allowing precise diagnosis and spreading of extramedullary hematopoiesis. Radiotherapy and more recently hydroxyurea are the first line treatment. CONCLUSION: This observation recalls that extramedullary hematopoiesis is a differential diagnostic of spinal cord compression in patients with thalassemia. A screening of paravertebral localization of extramedullary hematopoiesis should be performed in high risk thalassemic patients.
