1/5. Postpneumonectomy syndrome after left pneumonectomy.Postpneumonectomy syndrome, a late complication of pneumonectomy, is secondary to shift of the mediastinum and remaining lung toward the pneumonectomy side, leading to tracheobronchial compression between the vertebral body and the aorta or pulmonary artery. Obstructive airway symptoms are usually due to tracheobronchial tree compression, however, secondary airway malacia may develop. We report herein a case of postpneumonectomy syndrome with secondary bronchomalacia after left pneumonectomy in a patient with normal mediastinal vascular anatomy.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
2/5. Partial hammock valve: surgical repair in adulthood.We describe a forme frustree of hammock valve involving only the posterior mitral leaflet. Three adult patients were referred to surgery with the diagnosis of severe mitral regurgitation due to fibrosis of the posterior mitral leaflet. The final diagnosis was done intraoperatively. In all of them the posterior leaflet was attached to some accessory papillary muscles arranged en palisade, with three to four fused muscle heads producing restrictive leaflet motion in systole. Repair consisted in division of the papillary muscles, patch augmentation, and ring annuloplasty. This previously unreported lesion is congenital but manifests itself in adulthood.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
3/5. Imaging of pediatric mediastinal histoplasmosis.histoplasmosis can present a diagnostic dilemma if unusually large masses of lymph nodes, invasive mediastinal fibrosis, or pericarditis result from the infection. These rare, late sequelae are often first suspected from findings on chest radiographs obtained for unrelated reasons. Organisms are not always evident at histologic analysis at this stage. Mediastinal granulomas consist of lobulated masses of enlarged lymph nodes with central caseation, a peripheral thin capsule, and, occasionally, calcification. The mass does not invade or compromise adjacent anatomic structures. Mediastinal fibrosis invades and can seriously compromise the function of the tracheobronchial tree, superior vena cava, pulmonary arteries and veins, and esophagus; its symptoms mimic those of many other disorders. pericarditis is commonly accompanied by pericardial effusion, pneumonia, and adenopathy. Although the radiologic findings of these conditions are nonspecific, they can be used with the clinical findings to suggest a diagnosis. Complications of histoplasmosis should be included in the differential diagnosis for patients residing in areas endemic to histoplasma capsulatum.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
4/5. Idiopathic fibrosing pancreatitis: a cause of obstructive jaundice in childhood.Idiopathic fibrosing pancreatitis is a chronic process of unknown etiology characterized by extensive infiltration of the pancreatic parenchyma by fibrous tissue. This disease process is uncommon in the pediatric patient and is consequently rarely considered in the differential diagnosis of abdominal pain and jaundice in the child. The sonographic demonstration of a dilated biliary tree and common bile duct compressed by an enlarged pancreas may be the first suggestion of this entity. Two patients with idiopathic fibrosing pancreatitis and obstructive jaundice are reported with a review of the clinical, radiographic, and pathologic findings.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
5/5. Obstructive jaundice due to retroperitoneal fibrosis involving the head of the pancreas.A 51-year-old man with no history of liver disease had acute severe jaundice, with a serum level of total bilirubin of 27.4 mg/dl and an alkaline phosphatase level of 731 IU/L due to distal common bile duct compression from peripancreatic head fibrosis associated with retroperitoneal fibrous. Other obstructive phenomena in this patient included bilateral hydronephrosis from ureteral fibrosis encasement and testicular swelling from fibrous encasement of vessels draining the scrotum. autopsy demonstrated massive retroperitoneal fibrosis, with angulation and compression of the distal common bile duct by fibrosis covering the head of the pancreas. The intrahepatic biliary tree was dilated because of the distal choledochal obstruction, but the proximal common bile duct was not dilated due to mural fibrosis.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |