Contraste radiológico oral en la cavidad pleural / Oral radiological contrast in the pleural cavity

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When you hear hoofbeats, think of horses but do not forget the zebras.

We report a case of a 68-year-old man who was admitted to the department of cardiology with increasing abdominal and chest pain during the day. The prehospital ECG showed clear ST segment elevation in inferior leads. The patient was routed directly to the catheterisation laboratory with acute myocardial infarction as a tentative diagnosis. The coronary angiography showed an occluded right coronary artery that was reopened with a plain old balloon angioplasty procedure. After the procedure, the patient was expected to feel better, but the abdominal pain worsened. The following bedside ultrasound examination was quite surprising.

Occurrence of a simultaneous bilateral spontaneous pneumothorax due to a pleuro-pleural communication.

Herein we present a case of a simultaneous bilateral spontaneous pneumothorax caused by a pleuro-pleural communication. A 70-year-old man with a history of esophagectomy presented with dyspnea. A chest roentgenogram revealed a bilateral pneumothorax and bilateral chest drainage procedures were performed. A left bullectomy was also performed 3 days later due to persistent air leakage on the left side. During surgery, a small fistula was detected in the anterior mediastinal pleura and was found to be in communication with the bilateral pleural spaces.

[Unique monoblock lung right-left, unique pleural cavity]. / Plamân monobloc dreapta-stânga. Cavitate pleurala unica. Plamîn hipoplazic stâng. Caz clinic.

A 34-year-old female with WPW syndrome has been under surgical treatment in our clinic with left basal chronic pleural empyema. During the surgical intervention multiple anatomical anomalies were detected, like unique pleural cavity, monoblock lung left-right, hypoplasic left lung, no scissures on the left side, no left pulmonary arteria with an aberrant arteria for the left lung derived from the right pulmonary arteria, the same for the bronchis. The pleural-pulmonary shelling proceeded without incidents and it has been finalized with the drainage of the whole pleural cavity.

Surgical management of an incidentally diagnosed true pleuroperitoneal hernia in a cat.

Diaphragmatic defects in cats are common and most frequently occur as a result of trauma. Congenital diaphragmatic defects include peritoneopericardial hernias, hiatal hernias and, infrequently, true diaphragmatic, or pleuroperitoneal, hernias. Only three reports of feline pleuroperitoneal hernias could be found in the veterinary literature. All of these cats presented for evaluation of respiratory distress and two were managed successfully with surgery. This report describes the incidental diagnosis and successfully surgical treatment of a pleuroperitoneal hernia in a cat. It highlights the fact that pleuroperitoneal hernias may not always be symptomatic and that they may not be as rare as previously considered.

The persisting pneumatoenteric recess and the infracardiac bursa: possible role in the pathogenesis of right hydrothorax complicating peritoneal dialysis.

Hydrothorax, an uncommon complication of peritoneal dialysis (PD), results from the migration of dialysis fluid under pressure from the peritoneal cavity into the pleural space. The exact site of the transdiaphragmatic fluid leak remains obscure, but the right-sided predominance of the hydrothorax points to the presence of abnormalities in the right hemidiaphragm. Such abnormalities have occasionally been described. In a recent case of acute massive right hydrothorax at the start of PD, the autopsy revealed extensive changes of amyloidosis that were comparable in both hemidiaphragms, prompting us to revisit the accepted explanation for right hydrothorax. We propose that an embryonic remnant--namely, the persisting pneumatoenteric recess and the infracardiac bursa--provides a passage connecting the peritoneal cavity to the right pleural space. The potential presence of this mechanism is consistent with the recognized clinical features of right hydrothorax complicating PD. This proposed route for dialysis fluid to form a right hydrothorax during PD can be investigated by currently available high-definition imaging techniques. This novel mechanism may also be involved in the pathogenesis of right hydrothorax observed in other medical conditions with tense ascites (liver cirrhosis, Meigs syndrome).