Cases reported "Cough"

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1/5. Late presentation of Bochdalek hernia: clinical and radiological aspects.

    Three infants with late presentation of Bochdalek hernia are presented. The presenting symptoms were cough, intermittent vomiting, dyspnea, and cyanosis. Initial diagnoses of isolated paravertebral mass and foreign material aspiration were made in two infants, based on plain chest x-ray findings and history of the patients. Further radiological investigations, such as contrast upper gastrointestinal series or enema, computerized tomography, and magnetic resonance imaging of the chest, suggested the diagnosis of Bochdalek hernia. The hernia was found on the left side in two patients and on the right side in one. At operation, the stomach, small intestine, and spleen were found as herniated organs in one patient, ascending colon in one, and all of the small intestine together with ascending colon in the other. A congenital diaphragmatic defect should be suspected in every child presenting with unusual respiratory or gastrointestinal symptoms and with abnormal chest x-ray findings. The radiological findings vary greatly from one case to another, and even in the same case at different times because of differences in herniated organs and intermittent spontaneous reduction. The possibility of congenital diaphragmatic hernia should be kept in mind to avoid a wrong diagnosis, undue delay in diagnosis, and inappropriate treatment.
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2/5. An unusual anterior mediastinal mass in a child with B-thalassemia major.

    This case report describes the delayed appearance of Morgagni's hernia in a 5 year old child with B-thalassemia major to present as an anterior mediastinal mass. The progressive enlargement of the liver resulted in herniation of the left lobe of the liver through the already congenitally present Morgagni's hernia leading to its enlargement. The report also emphasizes the fact that a previously normal chest x-ray should not preclude the diagnosis of Morgagni's hernia. Morgagni's hernia should also be included in the differential diagnosis of anterior mediastinal masses in children.
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3/5. Acute respiratory distress due to fibrosarcoma of the carina in a child.

    We report a 12-year-old boy with primary bronchopulmonary fibrosarcoma (PBPF). He was misdiagnosed a having asthma until he presented with acute respiratory distress syndrome. Chest x-ray showed atelectasis of the right lung. bronchoscopy performed to rule out foreign body inhalation revealed a friable mass obstructing the right main bronchus. Successful treatment was achieved with surgical resection of the lesion followed by radiotherapy and chemotherapy.
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4/5. Tracheopathia osteochondroplastica.

    The case of a male, 61 years of age, presenting with occasional hemoptysis and shortness of breath (duration of 1 year) is reported. Congestive heart failure was presumed and supported by chest x-ray and echocardiography. The patient improved with diuretic and angiotensin converting enzyme (ACE) inhibitor therapy, but continued to experience cough and occasional hemoptysis. bronchoscopy revealed numerous firm nodular projections within the trachea with distribution along the cartilaginous rings. Tracheopathia osteochondroplastica (TPO) was diagnosed. TPO is an uncommon, benign, but slowly progressive disease of unknown etiology. It is characterized by endoluminal projection of cartilaginous and bony nodules arising in the submucosa of the trachea. Involvement may extend to lobar or segmental bronchi. TPO should be considered in cases where cough, dyspnea, persistent pulmonary infection, hoarseness, or recurrent hemoptysis remain after appropriate treatment of other presumptive underlying causes.
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5/5. Pericardial cyst: an incidental finding.

    Pericardial cysts are rare mediastinal cysts occurring with an incidence of 1 in 100, 000. Characteristically, they occur along the right border of the heart. Their size varies from 1.0 cm to 15 cm, and they are often asymptomatic. patients with symptoms usually have atypical chest pain. In the case reported here, a 37-year-old man complained of nonproductive cough. Chest x-ray film revealed a pericardial cyst that appeared as a large echolucent unilocular mass along the left border of the heart. diagnosis was confirmed with the use of both computed tomography and transthoracic echocardiography.
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