Cases reported "Mediastinal Diseases"

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1/8. Reversed portal vein pulsatility on Doppler ultrasound secondary to an iatrogenic mediastinal haematoma.

    The Doppler ultrasound pattern of reversed pulsatile flow (RPF) of the portal vein (PV) is strongly associated with high atrial pressure. Tricuspid regurgitation is considered to be the main cause of RPF in patients with chronic heart disease, but the precise pathomechanism of this PV flow pattern has not yet been resolved. We describe for the first time a RPF of the PV in a young patient with a mediastinal haematoma after inadvertent puncture of the subclavian artery. In this patient, transcutaneous echocardiography demonstrated normal valves without any tricuspid regurgitation as well as normal diameters of the cardiac cavities. The RPF of the PV in this patient resolved spontaneously within 7 days. An increased hepatic outflow resistance with transmission of hepatic artery pulsations across arterioportal communications seems the most likely pathomechanism to explain our finding.
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2/8. Peritoneal-mediastinal leakage complication of peritoneal dialysis.

    The authors report a case of mediastinal fluid collection resulting from peritoneal-mediastinal communication after continuous ambulatory peritoneal dialysis (CAPD). To the best of the authors' knowledge, this is the first reported case in the medical literature. A dry cough developed in the patient who had been receiving CAPD for 4 years. A mediastinal mass owing to peritoneal leakage of dialysate to the mediastinum was confirmed by a computed tomography scan taken 4 hours after the intraperitoneal infusion of contrast-mixed dialysate. The leakage persisted for 12 weeks after the discontinuation of CAPD fluid instillation.
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3/8. Cavitation of a mediastinal mass following chemotherapy for histiocytosis-X: CT demonstration.

    A recurrent mediastinal mass, believed to be thymus, in an infant with classic idiopathic histiocytosis-X underwent massive cavitation following chemotherapy. Both the mass and cavitation resolved. The exact nature of development of air inside the mass is not known but communication with the airways or airspaces of the lungs is suspected.
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4/8. pancreatic pseudocyst of the mediastinum. Evaluation by CT.

    This paper describes a case of pancreatic pseudocyst involving the mediastinum. diagnosis was made by CT, which demonstrated the cystic nature of the lesion and its communication with an intra abdominal pseudocyst.
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5/8. Bilateral hydrothorax and hydromediastinum after a subclavian line insertion.

    A 28-year-old male patient developed bilateral hydrothorax due to extravasation of fluid into the mediastinum from a subclavian line. The injection of radio-opaque dye through the central venous cannula confirmed spillage into the mediastinum. There was no direct communication between the central venous cannula and the pleural cavities. The hydrothorax appeared to develop as a result of a shift of fluid from the mediastinum into the pleural cavities due to pressure differences in the two compartments. Bilateral chest tubes were inserted, the subclavian cannula was removed and the patient made a good recovery.
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6/8. Tuberculous oesophagopulmonary communication: effectiveness of antituberculous chemotherapy. A case report and review of literature.

    A patient with tuberculous oesophagopulmonary communication diagnosed by oesophagography and confirmed by endoscopy was successfully treated by medical means: a tuberculous aetiology was suggested by the detection of tubercle bacilli in the gastric washings and on culture. On reviewing the medical literature, successful results were reported in 3 adults and 2 children.
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7/8. Traumatic subarachnoid-mediastinal fistula mimicking a ruptured aorta.

    A 35-year-old man, injured in an automobile accident was found to have a subarachnoid-mediastinal fistula that mimicked a ruptured aorta. Of 16 reported cases of traumatic subarachnoid-mediastinal fistula, this is only the third in which the fistulous communication was with the extrapleural space only. The possibility of subarachnoid-mediastinal fistula, although rare, should be entertained in injuries to the thoracocervical spine when neurologic symptoms are present.
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8/8. Bare area abscess: imaging findings and potential communication with the mediastinum.

    The bare area of the liver is not usually visualized by standard cross-sectional imaging techniques except in patients with ascites or subphrenic collections where this area is spared of fluid. We present a case of an abscess in the bare area of the liver with imaging findings and demonstration of a communication with the mediastinum, not previously described.
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