RESUMO
Although rare in the general population, pulmonary fungal infections usually occur in immunocompromised patients. The mainstay of pulmonary fungal infection treatment is prolonged intravenous antifungal therapy. However, surgical management may be required in cases of complex disease, resistance to medical therapy or percutaneous procedures, or associated complications such as fungal empyema and massive hemoptysis. In this series, we present three patients with complicated thoracic fungal infections who underwent individualized surgical management over a 3-month period in 2022 at our institution. Complicated pulmonary fungal infections require surgical intervention to ensure complete resolution. The choice of operation is dependent on several factors, and surgeons operating on these patients must be privy to the various surgical modalities that may be required to successfully treat these patients.
RESUMO
Posterior rectus sheath hernias are rare hernias that can be difficult to diagnose due to unreliable physical exam characteristics and subtle radiological findings. We present an interesting case of an elderly female found to have a posterior rectus sheath hernia during a diagnostic laparoscopy for chronic abdominal pain. CT evaluation revealed possible appendicitis and laxity of the abdominal wall of the right lower quadrant. Intraoperatively, a 4 cm hernia defect in the right lateral abdominal wall was appreciated. Appendectomy and herniorrhaphy with mesh repair were performed. Postoperative review of CT imaging and intraoperative photographs determined that this hernia defect is a posterior rectus sheath hernia likely caused by trocar placement from previous laparoscopic surgery. This report contributes to the limited body of the literature for this rare type of hernia. Posterior rectus sheath hernias should be considered in differential diagnoses for patients presenting with chronic abdominal pain without clear etiology.