Langstonsims1367

Acute foreign body aspiration can cause severe damage to the respiratory system, leading to laceration and even death due to asphyxia. However, a foreign body that has been aspirated could go unnoticed acutely and lead to persistent shortness of breath symptoms. Most of the patients will be able to recall the acute aspiration event, but others do not. On the latter, a more meticulous approach will lead to the diagnosis and subsequent effective management. We hereby present the case of a 52-year-old male with history of partly controlled severe asthma and chronic persistent cough with bloody sputum. Upon evaluation, he was found with a right-sided pneumonia and pertinent history remarkable for several episodes of bronchitis in the past 3 years. There circumstances and subsequent images led to the successful finding and removal of a chronic foreign body aspirated 3 years prior to evaluation. A procedure led to almost complete resolution of symptoms of cough and asthma.In rare instances, endometrial glandular tissue can implant in the thorax of women suffering from endometriosis. The presentation is variable depending on site of implant and can be a rare cause of hemothorax in women. A 28-year-old woman presented with shortness of breath and was found to have a significant right sided hemothorax. The hemothorax was drained but subsequently recurred, with shortness of breath increasing around the time of her menses. Considerable workup was performed and ultimately surgery was required to diagnose her with thoracic endometriosis. This case describes how thoracic endometriosis is a challenging diagnosis and may be under reported in the literature. However, there are key elements of the disease that can prevent delay in diagnosis to reduce pain and suffering.Hepatic portal venous gas (HPVG) is a rare imaging finding in infants and usually indicative of a severe disease process such as necrotizing enterocolitis, bowel ischemia, or bowel wall rupture / infarction. The diagnosis of HPVG may have serious implications such as parenteral nutrition, antibiotics and even surgery. In this case, we present an 8-week-old male with a history of prematurity presenting with HPVG, later concluded to be caused by milk protein allergy. Milk protein allergy is a rare cause of HPVG, but it should be recognized due to its benignity and potential prevention of unnecessary testing and interventions.Uterine arteriovenous malformation (AVM) is a rare condition that may lead to a life-threatening state. The urgency of diagnosis and treatment for uterine AVM should be emphasized. This case report describes a 42-year-old woman with a vaginal hemorrhage. In the previous month, the patient also had a hemorrhage after induced abortion that required a bilateral artery suture hemostasis of the uterus. On ultrasound, there was a lesion suspected by acquired AVM. Magnetic Resonance Angiography and Digital Subtraction Angiography was indicated to confirm the diagnosis. The patient was successfully treated by uterine artery embolization. After 6 months, the re-examined result showed no lesion of AVM.Gout is a common cause of inflammatory arthritis, typically affecting the joints of the appendicular skeleton. In this report, we present the relatively less common scenario of chronic tophaceous gout affecting the lumbar spine and pelvis, complicated by compressive neuropathy, and notable for its advanced initial presentation in a young patient. We review the pathophysiology underlying gout and discuss its clinical and laboratory presentation. We also use our case as an example to present the radiographic, CT, and MR imaging features of gout affecting the lumbar spine, which can often present a diagnostic dilemma. Finally, we discuss therapeutic options for gout resulting in spinal canal compromise, which include interventions not commonly performed for gout elsewhere in the body.Fibrous dysplasia is a benign, congenital skeletal disorder which leads to the formation of fibro-osseous intramedullary bone lesions. Clival fibrous dysplasia is a rare variant which commonly presents asymptomatically with no findings on examination and is often picked up incidentally on radiological investigation. A 39-year-old female presented with a sudden onset headache of 3 days' duration alongside diplopia and right lower limb weakness upon examination. Computerized tomography head scan revealed an expansile clivus with a ground-glass appearance, magnetic resonance imaging brain scan revealed a predominantly hypointense signal on T1- and T2-weighted images and subsequent whole-body bone imaging confirmed the diagnosis of monostotic clival fibrous dysplasia. This case highlights the importance of considering monostotic clival fibrous dysplasia as a differential diagnosis in patients presenting with sudden onset symptoms of headache alongside cranial and peripheral nerve involvement, when other more sinister causes have been excluded.Orthotopic liver transplantation can be a surgically complex undertaking, with hepatic venous outflow obstruction occurring at a rate of 1%-6% due to inferior vena cava (IVC) torsion, compression, or anastomotic stenosis. In this report, we present 2 cases of immediate postoperative hepatic venous outflow obstruction in the setting of Budd-Chiari syndrome successfully treated with immediate IVC stenting. read more Although IVC stenting has been reported for management of long-term IVC anastomotic stenosis after orthotopic liver transplantation, use of stenting to address immediate postoperative caval outflow obstruction is less commonly described. We describe the potential utility of immediate stenting to improve outflow from the transplanted liver and highlight the value of this approach in addressing early postsurgical IVC pathology.[This corrects the article DOI 10.1016/j.jccase.2020.06.003.].We report the case of a 31-year-old man with Uhl's anomaly. Echocardiography revealed severely enlarged nonfunctioning right ventricle and unusual findings of the premature opening of the pulmonary valve along with substantial forward flow during late-diastole, indicating that pulmonary circulation was largely dependent on compensatory right atrial contraction. Moreover, right-to-left shunt through the patent foramen ovale (PFO) achieved systemic circulation at the expense of severe hypoxia. During accelerated idioventricular rhythm (AIVR) accompanied by ventriculo-atrial (VA) conduction, hypoxemia deteriorated further because of an increased right-to-left shunt through the PFO. We report the case of an adult with Uhl's anomaly whose hemodynamics was largely dependent on the ventricularized right atrium and PFO. Although the unique hemodynamics contributed to his survival into adulthood, detrimental aspects manifested themselves during AIVR with VA conduction like a "double-edged sword." .