RESUMEN
Swallowed foreign bodies encounter a major problem especially in children, but fortunately they mostly do not cause any related complication and are easily passed with the stool. In this paper, an interesting journey of a needle is presented. A 20-year old female admitted to our emergency service after she had swallowed a sewing machine needle, which is initially observed in the stomach in the plain abdominal radiography. During the follow-up period, the needle traveled through bowels, and surprisingly was observed in the left lung on 10th day of the follow-up. It was removed with a thoracotomy and pneumotomy under the fluoroscopic guidance. The postoperative period was uneventful and the patient was discharged from the hospital on the day 5. We also review the literature on interesting extra-abdominal migrations of swallowing foreign bodies.
Asunto(s)
Ingestión de Alimentos , Migración de Cuerpo Extraño/complicaciones , Lesión Pulmonar/etiología , Pulmón , Agujas , Estómago , Toracotomía/métodos , Diagnóstico Diferencial , Femenino , Estudios de Seguimiento , Migración de Cuerpo Extraño/diagnóstico por imagen , Migración de Cuerpo Extraño/cirugía , Humanos , Lesión Pulmonar/diagnóstico por imagen , Lesión Pulmonar/cirugía , Radiografía Abdominal , Radiografía Torácica , Tomografía Computarizada por Rayos X , Adulto JovenRESUMEN
Sarcoidosis is a systemic disease characterized by noncaseating granulomas. Thyroid involvement is rare in sarcoidosis. In this paper, two sarcoidosis patients who demonstrated cold thyroid nodules are presented. A 42-year-old woman presented with multinodular goiter and was diagnosed as having sarcoidosis when noncaseating granulomas were observed during the pathological examination of the thyroidectomy specimen. Enlarged mediastinal lymph nodes were observed in the routine preoperative chest X-ray in another 53-year-old woman, while she was being prepared to undergo a thyroidectomy. The pathological examination of the thyroid specimens showed noncaseating granulomas in both patients, and the diagnosis was confirmed by either hepatic biopsy or chest X-ray findings. In conclusion, thyroid involvement should be suspected in sarcoidosis patients who present with cold nodules in the thyroid. Furthermore, if noncaseating granulomas are observed in thyroid specimens after a thyroidectomy in an otherwise healthy person, the patient should be evaluated further for sarcoidosis.
Asunto(s)
Sarcoidosis/cirugía , Enfermedades de la Tiroides/cirugía , Nódulo Tiroideo/cirugía , Diagnóstico Diferencial , Femenino , Humanos , Persona de Mediana Edad , Sarcoidosis/diagnóstico , Enfermedades de la Tiroides/diagnóstico , Nódulo Tiroideo/diagnóstico , TiroidectomíaRESUMEN
BACKGROUND: Traumatic diaphragma rupturesare difficult to diagnose and generally with associated organe injuries. The aim ofthe study is to evaluate the factors effect on mortality. METHODS: Twenty-three patients with traumatic diaphragma injuries, admitted to our hospital were retrospectively evaluated for demographics, diagnosis, otherorgan injuries, treatment, mortalityand morbidity. RESULTS: All patients were male and the mean age was 24.7 10.0. The diaphragma injuries were observed during laparatomy in 19 patients (%82.6), during laparatomy and thoracotomy in 2 (%8.7). The injuries were diagnosed with fluid drainage from thorax tube during peritoneal lavage in 2 patients (%8. 7). All patients, but one, had other organ injuries (%95.7), most commonly in stomach, spleen and liver. Seven patients died during peroperative or postoperative peiod (%30.4). When these seven patients were compared to survived patients, it was observed that age and trauma score were statistically related to mortality rate (p<0.05), but the lenght ofthe diaphragmatic injury was not related to mortality rate (p > 0.05). CONCLUSION: Traumatic diaphragma injuries are generally diagnosed during laparatomy and associated with other organ injuries. The high mortality rate in patients with traumatic diaphragma injuries, is not related to the characteristics ofthe diaphragma injury, but it is closely related to concomitant problems such as patient is age and trauma score.