A 65-year-old female patient was brought to our emergency department (ED) with alleged history of road traffic collision (RTC). The patient had respiratory distress on arrival and hence she was immediately intubated a...A 65-year-old female patient was brought to our emergency department (ED) with alleged history of road traffic collision (RTC). The patient had respiratory distress on arrival and hence she was immediately intubated and ventilated. Blood pressure and peripheral pulses were not measurable;however the central pulses were present. Aggressive fluid resuscitation was started. Primary assessment revealed distended neck veins, bony crepitus over right chest. Bedside plain chest radiograph and focused assessment with sonograph in trauma (FAST) were done which did not establish an immediate diagnosis. Computed tomography (CT) of the thorax revealed a tension pneumopericardium and moderate right hemopneumothorax, with multiple ribs fracture. An intercostal drainage tube (ICD) was inserted on right chest. The patient suffered a cardiac arrest and resuscitation measures were unsuccessful. The diagnostic pitfalls, the CT findings, possible clues to the diagnosis and the discussion of this rare case are presented in this case report.展开更多
Pneumomediastinum is sometimes observed in adult patients but its occurrence in pediatric patients (especially infants) is very rare. We here report a 14-month-old male infant who had subcutaneous emphysema, pneumomed...Pneumomediastinum is sometimes observed in adult patients but its occurrence in pediatric patients (especially infants) is very rare. We here report a 14-month-old male infant who had subcutaneous emphysema, pneumomediastinum, and importantly, pneumopericardium. He had no particular past <span>histories. He abruptly had cough, fever, and eruption on the abdomen.</span> Computed tomography and echocardiography revealed pneumomediastinum and <span>pneumopericardium. Antibiotics, rest, and supportive therapy ameliorated</span> the condition. We must be aware that pneumomediastinum, and importantly pneumopericardium, can be present in a pediatric patient with subcutaneous emphysema.</span></span><span><span><span style="font-family:""> </span></span></span><span><span><span style="font-family:"">The infant</span></span></span><span><span><span style="font-family:"">’</span></span></span><span><span><span style="font-family:"">s symptoms disappeared under strict monitoring of respiratory status, nasal oxygen therapy and antibiotic therapy</span></span></span><span><span><span style="font-family:"">.展开更多
Rationale:Gastropericardial fistula is a rare condition in which the patient presented with chest pain,dyspnea,tachycardia,pneumo/hydropericardium,or pericarditis.Alcohol intake or previous history of gastroesophageal...Rationale:Gastropericardial fistula is a rare condition in which the patient presented with chest pain,dyspnea,tachycardia,pneumo/hydropericardium,or pericarditis.Alcohol intake or previous history of gastroesophageal surgery made the patient susceptible to fistula formation.Patient concerns:An 80-year-old male complained of sudden onset of dyspnea and respiratory distress.Nausea,hematemesis,and constipation were noted on clinical examination.Diagnosis:Herniation of the gastric fundus and massive pneumopericardium due to formation of fistula in the lesser curvature.Interventions:Urgent surgery was performed.Outcomes:The patient was discharged without any complication.Lessons:Although the lethal form of this condition is rare,gastroepicardial fistula should be included in the differential diagnosis workup of cases with stomach cardia and fundus ulceration.展开更多
Afistula between pericardium and its adjacent structures is an extremely rare and usually fatal complication with the esophagus and stomach most frequently involved.In this report, we present the rare case of a patien...Afistula between pericardium and its adjacent structures is an extremely rare and usually fatal complication with the esophagus and stomach most frequently involved.In this report, we present the rare case of a patient who developed a jejunopericardial fistula after surgery for gastric cancer and intraperitoneal chemotherapy with placement of Port-A-Cath 14 years ago.展开更多
文摘A 65-year-old female patient was brought to our emergency department (ED) with alleged history of road traffic collision (RTC). The patient had respiratory distress on arrival and hence she was immediately intubated and ventilated. Blood pressure and peripheral pulses were not measurable;however the central pulses were present. Aggressive fluid resuscitation was started. Primary assessment revealed distended neck veins, bony crepitus over right chest. Bedside plain chest radiograph and focused assessment with sonograph in trauma (FAST) were done which did not establish an immediate diagnosis. Computed tomography (CT) of the thorax revealed a tension pneumopericardium and moderate right hemopneumothorax, with multiple ribs fracture. An intercostal drainage tube (ICD) was inserted on right chest. The patient suffered a cardiac arrest and resuscitation measures were unsuccessful. The diagnostic pitfalls, the CT findings, possible clues to the diagnosis and the discussion of this rare case are presented in this case report.
文摘Pneumomediastinum is sometimes observed in adult patients but its occurrence in pediatric patients (especially infants) is very rare. We here report a 14-month-old male infant who had subcutaneous emphysema, pneumomediastinum, and importantly, pneumopericardium. He had no particular past <span>histories. He abruptly had cough, fever, and eruption on the abdomen.</span> Computed tomography and echocardiography revealed pneumomediastinum and <span>pneumopericardium. Antibiotics, rest, and supportive therapy ameliorated</span> the condition. We must be aware that pneumomediastinum, and importantly pneumopericardium, can be present in a pediatric patient with subcutaneous emphysema.</span></span><span><span><span style="font-family:""> </span></span></span><span><span><span style="font-family:"">The infant</span></span></span><span><span><span style="font-family:"">’</span></span></span><span><span><span style="font-family:"">s symptoms disappeared under strict monitoring of respiratory status, nasal oxygen therapy and antibiotic therapy</span></span></span><span><span><span style="font-family:"">.
文摘Rationale:Gastropericardial fistula is a rare condition in which the patient presented with chest pain,dyspnea,tachycardia,pneumo/hydropericardium,or pericarditis.Alcohol intake or previous history of gastroesophageal surgery made the patient susceptible to fistula formation.Patient concerns:An 80-year-old male complained of sudden onset of dyspnea and respiratory distress.Nausea,hematemesis,and constipation were noted on clinical examination.Diagnosis:Herniation of the gastric fundus and massive pneumopericardium due to formation of fistula in the lesser curvature.Interventions:Urgent surgery was performed.Outcomes:The patient was discharged without any complication.Lessons:Although the lethal form of this condition is rare,gastroepicardial fistula should be included in the differential diagnosis workup of cases with stomach cardia and fundus ulceration.
文摘患儿女性,27 min,因“呼吸困难20 min”由本院产房转入。患儿系第1胎第1产,经阴道分娩出生,出生胎龄37周+2,出生体重2900 g,羊水量少、色清,胎盘正常,脐带绕颈1周。生后1、5 min Apgar评分均为10分。患儿生后7 min出现呻吟伴皮肤青紫,产科医师予常压吸氧后急请新生儿科会诊。8 min时患儿呼吸困难加重,查体见反应差、肤色苍白、自主呼吸浅弱,心率120次/min,经皮氧饱和度89%,立即予复苏囊正压通气。10 min Apgar评分5分(呼吸、肌张力、反应各减1分,肤色减2分),继续正压通气。新生儿科医师到场,见患儿自主呼吸略好转(经皮血氧饱和度恢复正常),但反应仍差,遂将其紧急转入新生儿重症监护病房。患儿母亲29岁,A型Rh阳性血,孕晚期反复羊水过少,否认妊娠期高血压及糖尿病史。
文摘Afistula between pericardium and its adjacent structures is an extremely rare and usually fatal complication with the esophagus and stomach most frequently involved.In this report, we present the rare case of a patient who developed a jejunopericardial fistula after surgery for gastric cancer and intraperitoneal chemotherapy with placement of Port-A-Cath 14 years ago.
