RESUMEN
BACKGROUND/PURPOSE: Pectus carinatum (PC) traditionally has been managed with surgical reconstruction. Compressive orthosis also has resulted in subjective improvement in this defect. The goal of the authors was to develop an alternative brace and an objective radiographic marker to monitor the effects of chest wall compression on sternal protrusion. METHODS: Baseline chest computed tomography (CT) scans were obtained for 5 teenage boys with chondrogladiolar type of PC. The angle at the point of greatest sternal rotation was measured as the baseline deformity. Compressive orthosis was initiated using a custom-fitted brace. Follow-up chest CT scans were obtained to document change in sternal rotation. RESULTS: One patient was lost to follow-up after 6 months with subjective improvement. Another opted for surgical correction after 3 months, having shown a 16% decrease in sternal rotation preoperatively. Two patients showed subjective improvement corroborated by 33% and 44% decreases in sternal rotation. The fifth patient, who discontinued bracing after 1 month, showed a 25% increase 6 months later. CONCLUSIONS: Preliminary results indicate a potential role for compressive orthosis in the management of pectus carinatum. The objective radiographic marker described may be used to monitor the effects of growth or treatment with compressive orthosis.
Asunto(s)
Enfermedades del Desarrollo Óseo/terapia , Tirantes , Esternón/anomalías , Adolescente , Enfermedades del Desarrollo Óseo/diagnóstico por imagen , Estudios de Seguimiento , Humanos , Masculino , Esternón/diagnóstico por imagen , Factores de Tiempo , Tomografía Computarizada por Rayos XRESUMEN
During a 5-year period from 1983 to 1987, a total of 226 thoracotomies were performed at David Grant USAF Medical Center. Within this group, 62 patients (27%) had resection of a solitary pulmonary nodule. Fifty percent of the resected nodules were subsequently proven malignant, with 27 of 62 (43%) having a primary lung carcinoma. From 1958 to 1963, the Veterans Administration Armed Forces Cooperative Study evaluated a total of 1,134 patients with asymptomatic solitary pulmonary nodules. The data generated from that report has become the standard within the literature. We compared our recent 5-year experience to that data. The primary difference found in our series was an increase in solitary pulmonary nodules in our female population.
Asunto(s)
Carcinoma/cirugía , Neoplasias Pulmonares/cirugía , Personal Militar , Nódulo Pulmonar Solitario/cirugía , Adulto , Anciano , Carcinoma/diagnóstico , Femenino , Humanos , Neoplasias Pulmonares/diagnóstico , Masculino , Registros Médicos , Persona de Mediana Edad , Estudios Retrospectivos , Nódulo Pulmonar Solitario/diagnóstico , ToracotomíaRESUMEN
In a patient with Swyer-James syndrome, the dynamic, ultrafast HRCT (DUHRCT) findings show multifocal bilateral air-trapping that was not seen on chest radiography or conventional CT scan. This technique accentuates the air trapping associated with post-infectious obliterative bronchiolitis, which is underappreciated by plain chest radiography and conventional CT.
Asunto(s)
Enfermedades Pulmonares/diagnóstico por imagen , Pulmón/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Niño , Volumen Espiratorio Forzado , Humanos , Enfermedades Pulmonares/fisiopatología , Masculino , Síndrome , Tomografía Computarizada por Rayos X/métodos , Capacidad VitalRESUMEN
The authors present a case of a Meckel's diverticulum identified during a routine prenatal ultrasound examination as a complex mass, superior and posterior to the urinary bladder, that prompted meticulous postnatal evaluation. A 4.0-cm Meckel's diverticulum containing heterotopic gastric mucosa was excised before complications could arise. Meckel's diverticulum should be included in the differential of a complex intraabdominal mass of the fetus/neonate.