1/7. Severe exertional dyspnea in a patient with localized emphysema.The case of a middle-aged, male smoker who presented with progressive severe dyspnea is described. The cause of the progressive severe dyspnea remained unexplained after a comprehensive history, physical examination, chest radiograph, electrocardiogram and spirometry. Subsequent investigations resulted in a diagnosis of localized pulmonary emphysema. Detailed exercise testing helped uncover the physiological basis of the patient's extreme dyspnea.- - - - - - - - - - ranking = 1keywords = physical examination, physical (Clic here for more details about this article) |
2/7. 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 = physical examination, physical (Clic here for more details about this article) |
3/7. Surgical emphysema over the pelvis: an unusual physical sign found on primary survey.Open fractures of the pelvis are associated with high energy trauma and present a challenge to successful management and sometimes, early and correct diagnosis. These patients require more aggressive blood resuscitation particularly in the first 24 hours, repeated wound care operations, and often require a diverting colostomy. Usually these pelvic fractures can be distinguished from closed pelvic fractures by an open wound or lacerations of the vagina and rectum. Occasionally, however, the wounds associated with these fractures may remain undetected and the severity of the injury underestimated until complications develop. The authors believe this to be the first report of subcutaneous surgical emphysema associated with an open pelvic fracture.- - - - - - - - - - ranking = 0.36025272831706keywords = physical (Clic here for more details about this article) |
4/7. Pneumomediastinum and subcutaneous emphysema as the manifestation of emphysematous pyelonephritis.Pneumomediastinum, a collection of mediastinal air, often results from the rupture of intrathoracic structures. A 41-year-old diabetic woman initially presented with signs of pneumomediastinum and nuchal subcutaneous emphysema, but was finally diagnosed with unilateral emphysematous pyelonephritis. Pneumomediastinum as a presentation in retroperitoneal infection has not been reported previously, which prompts us to discuss its etiology and emphasize the importance of physical examination.- - - - - - - - - - ranking = 1keywords = physical examination, physical (Clic here for more details about this article) |
5/7. Emphysematous septic arthritis due to klebsiella pneumoniae.A 60-year-old woman with rheumatoid arthritis developed acute emphysematous septic arthritis of the knee due to klebsiella pneumoniae. She was brought to the hospital in septic shock with disseminated intravascular coagulation and had striking physical signs and roentgenograms showing distention of the knee with gas. She also had an infection of the hand with subcutaneous gas. After surgical drainage and institution of antibiotic therapy, she remained critically ill for several days but gradually improved. Two months later, she was ambulating independently. Emphysematous septic arthritis is rare. Four cases have previously been reported, but none were caused by Klebsiella.- - - - - - - - - - ranking = 0.090063182079265keywords = physical (Clic here for more details about this article) |
6/7. Computed tomography of vaginitis emphysematosa.vaginitis emphysematosa is characterized by multiple gas-filled spaces in the vagina and exocervix. Although the diagnosis can be made on physical examination and on plain radiography, it is important to recognize its appearance on CT since it may constitute a serendipitous finding that should be differentiated from more serious diseases that have a similar appearance.- - - - - - - - - - ranking = 1keywords = physical examination, physical (Clic here for more details about this article) |
7/7. Asymptomatic rectal perforation with retroperitoneal emphysema.A 57-year-old man administered an enema to himself, preparatory to intravenous pyelography. He left after the films were taken and could not be reached when retroperitoneal emphysema was detected, He was located 12 days later and found in good health. Abdominal x-ray films and rectosigmoidoscopy were normal. The patient refused further investigations. It is assumed that a small perforation occurred at the rectosigmoid junction during the self-administration of the enema. This assumption is borne out by the pattern of air distribution. The total absence of complaints and physical signs is unusual, although not unique; similar cases have been reported previously. The cause of such injury is mechanical, since the high pressures necessary to rupture the rectum are not usually attained in ordinary enemas. Caution is called for in intrarectal instrumentation, especially in older patients.- - - - - - - - - - ranking = 0.090063182079265keywords = physical (Clic here for more details about this article) |