Usefulness of the suspended microbubble sign in differentiating empyemic and nonempyemic hydropneumothorax. (1/16)
OBJECTIVE: The suspended microbubble sign is defined as the image seen on ultrasonography consisting of a pleural effusion strewn with numerous hyperechoic pinpoints and more or less linear shadows that move synchronously with respiration. In this study, we intended to evaluate the clinical usefulness of the suspended microbubble sign in differentiating empyemic and nonempyemic hydropneumothorax. METHODS: This series consisted of 8 patients with empyemic hydropneumothorax and 23 patients with nonempyemic hydropneumothorax. The finding of the presence of the suspended microbubble signs on ultrasonography was recorded. To further elucidate the generation of the suspended microbubble sign, the interaction between air and pleural fluid of different types was investigated in vitro. RESULTS: The suspended microbubble sign was shown on ultrasonography in all 8 patients with empyemic hydropneumothorax but was absent in the 23 patients with nonempyemic hydropneumothorax. These findings were supported by the observation that the pus seemed to mix with and trap the air more easily than did the nonpurulent pleural fluid, as shown in vitro. In this selected population, the sensitivity and specificity of the suspended microbubble sign in aiding a diagnosis of empyemic hydropneumothorax were both 100%. CONCLUSION: The suspended microbubble sign shown on ultrasonography might be of considerable value in differentiating empyemic and nonempyemic hydropneumothorax. (+info)A case of Lemierre's syndrome presenting with multiple pulmonary abscesses associated with a tension hydropneumothorax resulting in a mediastinal shift. (2/16)
INTRODUCTION: We report a case of Lemierre's syndrome. CLINICAL PICTURE: A previously healthy 36-year-old woman presented with a 2- to 3-month history of fever, cough, dyspnoea and sore throat, which had worsened in the week prior to presentation. Computed tomography of the thorax showed multiple bilateral cavitating lesions and a right-sided hydropneumothorax with mediastinal shift. Blood cultures grew Fusobacterium and Bacteroides species. TREATMENT: Broad-spectrum antibiotics were commenced, a chest drain was inserted, and the patient was transferred to the intensive care unit due to worsening respiratory failure. OUTCOME: Despite intensive supportive care with broad-spectrum antibiotics, aggressive fluid resuscitation and high-dose inotropic support, the patient developed acute renal failure, disseminated intravascular coagulation and intractable shock, and succumbed 8 days later. CONCLUSIONS: Although this condition is uncommon, it should be considered in the differential diagnosis of patients with pulmonary cavitating lesions, especially in the context of fever and rigors preceded by a sore throat. (+info)Fecopneumothorax and colopleural fistula - uncommon complications of Crohn's disease. (3/16)
BACKGROUND: Colopleural fistula and fecopneumothorax are very rare complications of Crohn's disease. Fistula formation is frequent in Crohn's disease and occurs in approximately 33% of patients. On the other hand, fistulous communication between the pleural cavity and adjacent organs below the diaphragm is extremely rare. CASE PRESENTATION: We describe the case of 27 year-old female with colopleural fistula as a complication of Crohn's disease. The diagnosis was established with clinical exam, barium enema, chest X-ray, abdominal and chest CT exam. The treatment was surgical. CONCLUSION: Colopleural fistula and fecopneumothorax are rare but life treating complications of Crohn's disease. Surgical treatment is mandatory as soon as the diagnosis is established. (+info)'Nutrothorax' due to misplacement of a nasogastric feeding tube. (4/16)
we report a serious complication of blind nasogastric feeding tube insertion in a 65-year-old female patient, which was overlooked and caused severe respiratory failure. (+info)Serial CT findings of Paragonimus infested dogs and the Micro-CT findings of the worm cysts. (5/16)
OBJECTIVE: To investigate the serial CT findings of Paragonimus westermani infected dogs and the microscopic structures of the worm cysts using Micro-CT. MATERIALS AND METHODS: This study was approved by the committee on animal research at our institution. Fifteen dogs infected with P. westermani underwent serial contrast-enhanced CT scans at pre-infection, after 10 days of infection, and monthly thereafter until six months for determining the radiologic-pathologic correlation. Three dogs (one dog each time) were sacrificed at 1, 3 and 6 months, respectively. After fixation of the lungs, both multi-detector CT and Micro-CT were performed for examining the worm cysts. RESULTS: The initial findings were pleural effusion and/or subpleural ground-glass opacities or linear opacities at day 10. At day 30, subpleural and peribronchial nodules appeared with hydropneumothorax and abdominal or chest wall air bubbles. Cavitary change and bronchial dilatation began to be seen on CT scan at day 30 and this was mostly seen together with mediastinal lymphadenopathy at day 60. Thereafter, subpleural ground-glass opacities and nodules with or without cavitary changes were persistently observed until day 180. After cavitary change of the nodules, the migratory features of the subpleural or peribronchial nodules were seen on all the serial CT scans. Micro-CT showed that the cyst wall contained dilated interconnected tubular structures, which had communications with the cavity and the adjacent distal bronchus. CONCLUSION: The CT findings of paragonimiasis depend on the migratory stage of the worms. The worm cyst can have numerous interconnected tubular channels within its own wall and these channels have connections with the cavity and the adjacent distal bronchus. (+info)Isolated thoracic duct injury in penetrating neck trauma: a case report. (6/16)
A 39-year-old man was admitted with a stab wound to left lower neck. Chest X-ray revealed a left hydropneumothorax. Thoracentesis was performed and analysis of the fluid revealed chyle. Patient was treated conservatively by closed chest drainage and total parenteral nutrition. On the basis of this clinical report and review of the literature, it is concluded that thoracic duct injury should be kept in mind in penetrating neck trauma and conservative treatment should be the first line therapy. (+info)Negative pressure dressing for radiation-associated wound dehiscence after posterolateral thoracotomy. (7/16)
(+info)Oesophageal perforation complicating intraoperative transoesophageal echocardiography: suspicion can save lives. (8/16)
(+info)'Hydropneumothorax' is a condition characterized by the presence of both air (pneumothorax) and fluid (hydropthorax) in the pleural space, which can result from various causes such as trauma, lung disease or medical procedures.
Hydropneumothorax is a medical condition that involves the presence of both air (pneumothorax) and fluid (hydrothorax) in the pleural space, which is the area between the lungs and the chest wall. This condition can result from various causes such as trauma, lung disease, or certain medical procedures. It can cause symptoms like chest pain, shortness of breath, and coughing, and it may require prompt medical attention to prevent complications.
Suppuration is the process of forming and discharging pus, typically characterized by the accumulation of white blood cells, dead tissue, and bacteria in an infected wound or cavity.
Suppuration is the process of forming or discharging pus. It is a condition that results from infection, tissue death (necrosis), or injury, where white blood cells (leukocytes) accumulate to combat the infection and subsequently die, forming pus. The pus consists of dead leukocytes, dead tissue, debris, and microbes (bacteria, fungi, or protozoa). Suppuration can occur in various body parts such as the lungs (empyema), brain (abscess), or skin (carbuncle, furuncle). Treatment typically involves draining the pus and administering appropriate antibiotics to eliminate the infection.
Empyema, Pleural is defined as the accumulation of pus within the pleural space, often resulting from a complication of pneumonia or chest trauma, and characterized by symptoms such as cough, chest pain, fever, and difficulty breathing.
Empyema is a collection of pus in a body cavity. Pleural empyema refers to the presence of pus in the pleural space, which is the thin fluid-filled space that surrounds the lungs. This condition usually develops as a complication of pneumonia or lung infection, and it can cause symptoms such as chest pain, cough, fever, and difficulty breathing. Treatment typically involves antibiotics to treat the underlying infection, as well as drainage of the pus from the pleural space through procedures such as thoracentesis or chest tube placement. In severe cases, surgery may be necessary to remove the infected pleura and prevent recurrence.