RESUMO
BACKGROUND: The blunt laryngotracheal trauma is a potentially life-threatening infrequent cause of injury that can present with subtle symptoms which often lead to delay in diagnosis if not suspected. CASE PRESENTATION: The authors report a case of a 16-year-old adolescent admitted to the emergency room after a bicycle accident with isolated blunt cervical trauma subsequent to headphones use. The patient presented with odynophagia, hemoptysis, edema, tenderness, linear ecchymosis in the anterior cervical area and no signs of respiratory distress. Cervical computed tomography scan revealed an aligned left side thyroid cartilage fracture. The patient progressed with a complete clinical recovery and at 3 month-follow-up reported no symptoms. CONCLUSIONS: Laryngeal fracture is a rare entity in patients with blunt cervical trauma. A high level of suspicion along with a systematic approach is essential for rapid recognition and early treatment, regardless of the severity of the presenting symptoms, in order to preserve airway and voice functions and improve outcomes.
RESUMO
Ureteroceles are cystic dilations of the intravesical submucosal ureter. Most cases are associated with complete ureteral and renal duplication, and association with ureterohydronephrosis is frequent. The authors describe the 4 cases of fetal ureterocele diagnosed from March 2008 to March 2012. Mean gestational age at diagnosis was 23 weeks (16-34 weeks). One of 4 cases progressed to severe hydronephrosis with megacystis and was referred to a Fetal Medicine Center for fetoscopy and laser ureterocelotomy. The remaining 3 cases did not need fetal therapy. Mean gestational age at delivery was 37 weeks. One case abandoned follow-up; 2 children were submitted to cystoscopic ureterocele incision and the child submitted to fetal therapy needed heminephrectomy due to recurrent urinary tract infections. In those 3 cases renal function was preserved. When a fetal ureterocele is diagnosed, close sonographic surveillance should be offered to monitor the possible urinary tract obstruction and assess the need for prenatal intervention. Fetal diagnosis is important to program the timing of delivery and postnatal care.
