RESUMEN
OBJECTIVE: Spontaneous mediastinal emphysema is uncommon. Its cause has not been determined precisely, but the entity is usually associated with suddenly raised alveolar pressure. METHODS: Between 1980 and 2001, 114 patients with mediastinal emphysema of various causes were hospitalized in the Wolfson Medical Center. In 22 of these patients (19.3%) the emphysema occurred without an obvious preceding event and was classified as spontaneous. The commonest symptoms and signs were chest pain, dyspnea and subcutaneous emphysema. All patients were kept under observation. Contrast esophagogram was performed in two patients who vomited. Pleural drains were inserted in six patients who had concomitant pneumothorax. RESULTS: All patients recovered and were followed for at least one year. There were no complications and no recurrences. CONCLUSIONS: Spontaneous mediastinal emphysema is usually a benign condition, which can be treated expectantly. The patients should be observed for 24 h. Recurrences are rare.
Asunto(s)
Enfisema Mediastínico/diagnóstico , Adolescente , Adulto , Drenaje , Femenino , Humanos , Masculino , Enfisema Mediastínico/etiología , Enfisema Mediastínico/terapia , Neumotórax/complicaciones , PronósticoRESUMEN
The efficacy of Tc-99m sestamibi scintimammography in the detection of breast carcinoma has been proven in previous studies. In this study we evaluated the influence of active mammary inflammation on Tc-99m sestamibi scintimammography and its ability to detect breast malignancy in the presence of this condition. Twenty-one women with acute nonpuerperal mastitis underwent breast scintimammography using Tc-99m sestamibi. Their mean age was 49.6 years. In 15 women the scan was positive, 2 suffered from inflammatory carcinoma of the breast, and all the other women had acute mastitis. Six patients had a negative scan, and in all of them, acute mastitis was diagnosed. Total accuracy, sensitivity and specificity in the detection of breast mastitis were 62%, 68%, and 88%, respectively. Scintimammography in patients with acute inflammation of the breast is frequently positive in the absence of malignant condition, therefore it should not be used during acute mastitis for the detection of breast cancer.