1/110. Central venous catheter-associated thrombosis in severe haemophilia.Significant subclavian vein thromboses associated with indwelling fully implanted (port-a-cath) devices are described in two boys with severe haemophilia A and factor viii inhibitors. Investigations were prompted by prominent chest wall veins in one case, whereas the thrombosis was a chance finding in the other case during investigation of mechanical dislocation of the catheter tubing. Extensive collateral venous circulations were demonstrated by venography in both instances indicating that the thrombus had been present for some time. Possible contributing factors to the thromboses included desensitization therapy (both patients), high-dose FEIBA (in one patient) and use of lower doses of heparin for line flush than that recommended by some authors. Neither patient had a familial or non-familial predisposition to thrombosis.- - - - - - - - - - ranking = 1keywords = chest (Clic here for more details about this article) |
2/110. A complication of pectus excavatum operation: endomyocardial steel strut.An 18-year-old patient who had correction of pectus excavatum deformity in our department 4 years earlier was admitted because of stabbing chest pain. He had not attended to postoperative controls and had not come for extraction of the steel strut, although he had been contacted. He was diagnosed to have a broken steel strut, and the strut was noted to be embedded in the myocardium. This unreported complication of pectus excavatum operation forced us to review sternal support techniques.- - - - - - - - - - ranking = 2.128581059163keywords = chest pain, chest (Clic here for more details about this article) |
3/110. Posterior extradural migration of extruded thoracic and lumbar disc fragments: role of MRI.We report three patients with a sequestrated disc fragment posterior to the thecal sac. The affected disc was lumbar in two cases and thoracic in the third. Disc fragment migration is usually limited to the anterior extra dural space. Migration of a disc fragment behind the dural sac is seldom encountered. MRI appears to be the method of choice to make this diagnosis. The disc fragments gave low signal on T1- and slightly high signal on T2-weighted images and showed rim contrast enhancement. The differential diagnosis includes abscess, metastatic tumour and haematoma.- - - - - - - - - - ranking = 4.8376796904761keywords = behind (Clic here for more details about this article) |
4/110. Delayed pneumothorax and hydrothorax with central venous catheter migration.We report a case of delayed pneumothorax, central venous catheter migration and iatrogenic hydrothorax in a 22-year-old female. The left subclavian central venous catheter initially transfixed the lung apex; pneumothorax occurred 24 h later following initiation of positive pressure ventilation. Lung collapse as a result of the pneumothorax caused catheter migration and hydrothorax. Catheter removal and chest drainage led to an uneventful recovery.- - - - - - - - - - ranking = 1keywords = chest (Clic here for more details about this article) |
5/110. Intrapulmonary artery and intrabronchial migration and extraction of a fragment of J-shaped atrial pacing catheter.A fragment of a fractured Telectronics Atrial Accufix 330-801 lead asymptomatically perforated the adjacent bronchus and was detected on routine chest X-ray. The metallic fragment was located by chest CT scan and bronchial fluoroscopy to lie between the right lobar bronchus and the pulmonary artery, confirming bronchial perforation. The foreign body was removed without complication by direct visualisation with rigid bronchoscopy.- - - - - - - - - - ranking = 2keywords = chest (Clic here for more details about this article) |
6/110. Intrapericardial tumbling bullet.foreign bodies of the pericardium are rare and they are associated most commonly with significant trauma. The diagnosis of a pericardial foreign body can be difficult. One must distinguish between foreign matter in the cardiac chamber or free-floating in the mediastinum. Serial chest x-rays and fluoroscopy were most helpful to us. Neither CT scan nor an echocardiogram were particularly helpful. To prevent pericarditis, either sterile or non-sterile, with potential for other significant complications, removal of a pericardial foreign body is always indicated.- - - - - - - - - - ranking = 1keywords = chest (Clic here for more details about this article) |
7/110. Wandering intraspinal bullet.A case of gun shot injury to the spine, with the bullet entering the thecal sac via the right side of the lower chest and wandering freely in the subarachnoid space, is reported. The patient was neurologically intact initially and developed radicular symptoms with foot drop and urinary retention on the third day after injury. The radiological findings and the problems faced at surgery are discussed, and the relevant literature of this uncommon condition is reviewed.- - - - - - - - - - ranking = 1keywords = chest (Clic here for more details about this article) |
8/110. Potpourri aspiration presenting as tension pneumothorax.Foreign body aspiration in children is a relatively common occurrence, with peanuts, seeds, or other food particles representing the most common items. Because radiological findings such as mediastinal shift, postobstructive emphysema, and pneumonia are notoriously inconsistent, diagnosis hinges on an accurate history, which may be correlated by physical examination and radiography. We present the case of a 2-year-old girl with delayed treatment of a bronchial foreign body who presented with tension pneumothorax before endoscopy. After chest tube removal, her pneumothorax recurred, thereby bringing about the question of bronchial erosion. Furthermore, an uncommonly reported aspirated object, household potpourri, was encountered.- - - - - - - - - - ranking = 1keywords = chest (Clic here for more details about this article) |
9/110. Infusion port dislodgement of bilateral breast tissue expanders after MRI.Tissue expanders are placed routinely for breast reconstruction, and magnetic resonance imaging (MRI) is a common diagnostic procedure. Many studies have reported on the safety of MRI in patients with nonferromagnetic implants; however, many tissue expanders contain ferromagnetic components. The authors present a case of bilateral tissue expander infusion port dislodgment after MRI. A 56-year-old woman underwent bilateral mastectomy and immediate reconstruction with McGhan BIOSPAN tissue expanders. These implants contain integral nonferromagnetic infusion ports, as well as small, powerful Magna-Site magnets. Several weeks postoperatively the patient underwent MRI of her spine, which was ordered by her primary physician for back pain. Subsequently, the infusion ports could not be located with the finder magnet. A chest radiograph was obtained, which demonstrated bilateral dislodgment of the infusion ports. Surgical removal and replacement of the tissue expanders were required. safety considerations of MRI have been discussed extensively in the literature, and data on MRI with various implanted devices have been obtained. The potential risks of performing MRI on patients with metallic implants include conduction of electrical currents, heating of the implant, misinterpretation resulting from artifact, and the possibility of movement or dislodgment of the implant. The small magnet integral to many tissue expanders may be overlooked by patients and physicians during pre-MRI screening. All patients undergoing tissue expansion with implants that contain integral ports should be thoroughly warned about the potential hazards of MRI.- - - - - - - - - - ranking = 1keywords = chest (Clic here for more details about this article) |
10/110. Successful surgical removal of an intrapulmonary aberrant needle under fluoroscopic guidance: report of a case.We describe herein the successful surgical removal of an intrapulmonary aberrant needle. An asymptomatic 47-year-old woman underwent a routine chest X-ray which revealed a needle located in the right S8 area. We first tried to extract the needle; however, fluoroscopic examination confirmed that it had broken into two pieces and therefore, partial resection of the right S8 was performed. To avoid rethoracotomy, the operation was done under fluoroscopic guidance. An intrathoracic aberrant needle should always be removed surgically as soon as possible, even if the patient is asymptomatic, due to the possibility of its migration into the vessels and the development of lung abscess or pyothorax.- - - - - - - - - - ranking = 1keywords = chest (Clic here for more details about this article) |
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