RESUMEN
Using two case-histories it is shown that atypical radiological findings caused the delay in diagnosis of pulmonary embolism depsite clinical signs (such as fever and intermittent dyspnoea; cyanosis, haemoptoe and cough reflex were absent). The exact diagnosis was finally established after having excluded all diseases, which were of greater probability on the grounds of the x-ray findings.
Asunto(s)
Embolia Pulmonar/diagnóstico , Adulto , Alopurinol/uso terapéutico , Diagnóstico Diferencial , Glicósidos Digitálicos/uso terapéutico , Femenino , Heparina/uso terapéutico , Humanos , Pulmón/diagnóstico por imagen , Neoplasias Pulmonares/diagnóstico , Masculino , Persona de Mediana Edad , Embolia Pulmonar/diagnóstico por imagen , Embolia Pulmonar/tratamiento farmacológico , Radiografía , Cintigrafía , Espironolactona/uso terapéuticoRESUMEN
A 46-year-old woman with a histologically, immunoserologically and biochemically confirmed chronic destructive non-suppurative cholangitis in the stage of incipient primary biliary cirrhosis developed an erosive, hemorrhagic cholangitis of obscure etiology with massive life-threatening bleeding from the biliary tracts. Hemobilia could be diagnosed endoscopically and confirmed by exploratory laparotomy. Postoperatively the biliary tracts were washed out with Tachostyptan, Ugurol and Trasylol through a T drain. The bleeding stopped within 48 hours and has not recurred since.