Paget Schroetter Syndrome and Chylothorax After Rhinoplasty.

ABSTRACT: Paget-Schroetter syndrome is a rare clinical condition characterized by subclavian vein thrombosis following repetitive upper extremity effort. In this case, we presented a 35-year-old female patient who underwent septorhinoplasty in our clinic. A swelling of the left part of the neck extending to the clavicle was detected 4 hours after the operation. Computed tomography of the thorax revealed a pleural effusion at the base of the left lung and a computed tomography angiogram demonstrated a recanalized left subclavian vein thrombosis. History of the patient clarified that she had moved to another house and had lifted heavy furnitures 4 days before the surgery. The patient was diagnosed with Paget Schroetter syndrome followed by chylothorax. Paget-Schroetter syndrome followed by chylothorax could be presented after a surgical intervention of the head and neck. Early diagnosis is essential to reduce the risk of ongoing morbidity and mortality.

[Esophageal foreign bodies in children and adults: 20 years experience]. / Çocuklarda ve eriskinlerde özofagus yabanci cisimleri: 20 yillik deneyim.

BACKGROUND: Esophageal foreign object ingestion is frequently seen in all ages. Failure to treat can cause serious complications such as esophageal perforation. The aims of this study were to characterize the clinical features related to foreign objects in the esophagus and to analyze the results of commonly used methods for their removal. METHODS: We analyzed 20 years of records from Siyami Ersek Hospital, Istanbul and identified 512 cases of foreign objects enlodged in the esophagus. RESULTS: In pediatric patients, the majority were aged between 2-5 years (34.4%), while in adult patients, the majority were above 55 years (38.7%). Coins were the most common foreign object detected in children (68.8%), whereas meat impaction was most common in adults (87.4%). The most common location of the foreign object was the cervical esophagus in children (78.2%), and the thoracic esophagus in adults (66.4%). In 30.8% of adults, there was esophageal or systemic disease. Objects were removed with a Magill clamp in 48.3% of children. Rigid endoscopy was the main treatment in adult patients. Perforation due to endoscopy developed in three patients. Surgical repair was performed on these patients but all died due to mediastinitis. CONCLUSION: Underlying esophageal or systemic diseases may predispose adults to foreign object ingestion in the esophagus. Improved endoscopic experience and clinical management of thoracic surgeons led to reduced morbidity and mortality in recent years.

Surgical properties and survival of a pericardial window via left minithoracotomy for benign and malignant pericardial tamponade in cancer patients.

BACKGROUND: Surgical drainage is a rapid and effective treatment for pericardial tamponade in cancer patients. We aimed to investigate the effectiveness of pericardial window formation via mini-thoracotomy for treating pericardial tamponade in cancer patients, and to evaluate clinical factors affecting long-term survival. METHODS: Records of 53 cancer patients with pericardial tamponade treated by pericardial window formation between 2002 and 2008 were examined. Five patients were excluded due to insufficient data. Kaplan-Meier and Cox regression analysis were used for analysis. RESULTS: Forty-eight patients (64.7% male), with a mean age of 55.20 ± 12.97 years were included. Patients were followed up until the last control visit or death. There was no surgery-related mortality and the 30-day mortality rate was 8.33%; all died during postoperative hospitalization. Morbidity rate was 18.75%. Symptomatic recurrence rate was 2.08%. Cancer type and nature of the pericardial effusion were the major factors determining long-term survival (P <0.001 and P <0.004, respectively).Overall median survival was 10.41 ± 1.79 months. One- and 2-year survival rates were 45 ± 7% and 18 ± 5%, respectively. CONCLUSION: Pericardial window creation via minithoracotomy was proven to be a safe and effective approach in surgical treatment of pericardial tamponade in cancer patients. Cancer type and nature of pericardial effusion were the main factors affecting long-term survival.

Spermatic cord metastasis as an initial manifestation of non-small cell carcinoma of the lung.

Lung cancer is among the most common cancers which continue to be a major cause of death in the world and many present with distant metastasis in advanced stages precluding curative treatment. Herein, we report a 62-year-old male patient admitted to our hospital with complaint of a painful mass in his left inguinal region. Surprisingly, a chest radiograph revealed a mass in his left lung with ipsilateral pleural effusion. Thorough radiological and pathologic examinations he was confirmed to have a non-small cell lung cancer with only spermatic cord metastasis and unfortunately the patient died two weeks after admission.

Primary cardiac hydatid disease: cross-sectional imaging features.

BACKGROUND: Although hydatid disease is common, individual series are usually not large as far as primary cardiac hydatid disease is concerned. We believe this study is the largest series of primary cardiac hydatid disease for which cross-sectional imaging is available. Methods. We reviewed the radiologic and medical records of 9 pathologically proven cases of primary cardiac hydatid disease. Echocardiography, computed tomography (CT), and magnetic resonance imaging (MRI) were used. In 5 patients, all three modalities were used, and in 4 only CT was available. RESULTS: Three types of cardiac involvement (pericardial, left ventricular, and right atrial wall) were detected. The cysts showed daughter cyst formation, detached parasitic membrane, rupture, segmental calcification, and end-stage calcification. CONCLUSION: Echocardiography is useful in detecting the cystic nature. Computed tomography best shows the wall calcification. Magnetic resonance imaging depicts the exact anatomic location and nature of the internal and external structures and is the modality of posttreatment follow-up.