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Query: UMLS:C0476273 (respiratory distress)
 19,632 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Surgical exclusion of the thoracic esophagus can result in the accumulation of secretions and dilatation of the esophageal remnant, a clinical picture known as esophageal mucocele. Although it is usually asymptomatic, if it increases in size it can produce a variety of compressive symptoms such as coughing, chest pain and respiratory distress. We present two cases of symptomatic mucocele after esophageal exclusion treated successfully with surgical resection. We believe that surgical resection should be considered for symptomatic patients, and that esophageal bypass surgery should be used with caution and indicated mostly in patients with a limited life span or with contraindications for esophagectomy.
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PMID:Symptomatic mucocele after esophageal exclusion. 1850 34

We report a case of multisystem organ failure after large volume subcutaneous injection of castor oil for cosmetic enhancement. An unlicensed practitioner injected 500 mL of castor oil bilaterally to the hips and buttocks of a 28-year-old male to female transsexual. Immediate local pain and erythema were followed by abdominal and chest pain, emesis, headache, hematuria, jaundice, and tinnitus. She presented to an emergency department 12 hours postinjection. Persistently hemolyzed blood samples complicated preliminary laboratory analysis. She rapidly deteriorated despite treatment and developed fever, tachycardia, hemolysis, thrombocytopenia, hepatitis, respiratory distress, and anuric renal failure. An infectious diseases evaluation was negative. After intensive supportive care, including mechanical ventilation and hemodialysis, she was discharged 11 days later, requiring dialysis for an additional 1.5 months. Castor oil absorption was inferred from recovery of the Ricinus communis biomarker, ricinine, in the patient's urine (41 ng/mL). Clinicians should anticipate multiple complications after unapproved methods of cosmetic enhancement.
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PMID:Multisystem organ failure after large volume injection of castor oil. 1913 11

A male, 62-year-old patient presented with chest pain with no apparent cause. Imaging studies revealed solution of continuity of the bone tissue at the level of the sternum, which led to paradoxical respiration. Open reduction and fixation with an LCP plate and screws were performed to address the problem. An important part of the patient's history was lumbar pain treated conservatively with analgesics and muscle relaxants. The pain did not subside and X-rays were done with findings of osteolysis in several parts of the body. The patient had chest pain and respiratory distress and was referred for management. Sternum fractures occur occasionally and are due to high-energy trauma or sports accidents. Treatment is conservative in most cases or may consist of a wire cerclage. Treatment was aimed at fixing the sternum to improve ventilatory mechanics so that the patient could continue with background therapy for multiple myeloma. At 18 weeks the patient is doing fine, X-rays show grade IV healing, and he will go on to the second stage of radiotherapy.
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PMID:[Spontaneous sternum fracture in a pathologic area. Case report and literature review]. 2037 63

A 30-year-old female was admitted to our hospital for chest pain and dyspnea We diagnosed lung abscess of the left lung. On day 2, the patient required mechanical ventilation for pneumopyothorax due to ruptured lung abscess with acute respiratory distress syndrome. We managed this patient antibiotics, sivelestat sodium hydrate and steroid pulse therapy. Curettage and decortication for empyema cavity and closure of bronchopleural fistula was done under video-assisted thoracic surgery with minithoracotomy on day 17. Postoperative course was uneventful.
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PMID:[Pyothorax due to ruptured lung abscess successfully treaed by video-assisted thoracic surgery; report of a case]. 2071 68

Neck injuries resulting from motor vehicle collisions (MVC), often referred to as whiplash trauma and injury, often demonstrate little or no evidence of significant tissue damage. In rare instances, however, serious injury to the anterior neck organ injuries can result from such trauma. The present study describes esophageal injury associated with rear-impact collisions, based on a unique case report, review of the scientific literature and a query in the National Automotive Sampling System (NASS) database of the US National Highway Traffic Safety Administration. The Medline search and present case study totaled five cases of rear-impact collision-related serious esophageal injury (laceration or rupture). In the four published cases all patients survived, whereas in the presented case study, the patient died due to mediastinitis and sepsis. The NASS query revealed an additional three cases out of a total of 55,926 investigated crashes. All three cases were associated with fatalities. Although no anatomical or bioengineering studies have presented data on the behavior of the esophagus during rear-impact whiplash loading, sudden tensile and/or compressive forces is the likely explanation of injury, often in combination with a local fracture of a vertebral body. In these 8 cases significant esophageal injury carried a substantial (50%) risk of mortality. Clinicians should be aware of the potential for significant complications in the whiplash trauma-exposed patient who complains of chest pain, mid-thoracic pain, discomfort in the neck and throat, respiratory distress, or hoarseness. For those forensic specialists involved in whiplash cases these study results highlight the need to consider esophageal injuries as a rare but potential consequence of whiplash trauma.
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PMID:Esophageal injury in fatal rear-impact collisions. 2093 95

Chest pain remains a common complaint among children seeking care in the United States. Asthma and lower respiratory tract infections such as pneumonia can be significant causes of chest pain. Children with chest pain caused by either of these pulmonary etiologies generally present with associated respiratory symptoms, including cough, wheezing, tachypnea, respiratory distress, and/or fever. Although analgesic medications can improve chest pain associated with pulmonary pathologies, the mainstay of therapy is to treat the underlying etiology; this includes bronchodilator and/or steroid medications in children with asthma and appropriate antibacterial administration in children with suspicions of bacterial pneumonia. The chest pain generally resolves along with the resolution of other respiratory symptoms.
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PMID:Asthma and pneumonia. 2111 Nov 21

An 8-year-old child presented with severe chest pain and respiratory distress after he accidentally bit an automobile tyre tube which burst into his mouth. The chest radiograph revealed left-sided pneumothorax. Both esophagogram and computed tomogram (CT) scan revealed a perforation of the distal third of esophagus with extravasation of contrast on left side. The patient was treated conservatively with gastrostomy feeds and antibiotics for 5 weeks with a good response.
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PMID:Esophageal perforation following bite of inner tube of automobile tyre: An unusual cause of barotrauma. 2118 May 5

Chest pain is a worrisome symptom that often causes parents to bring their child to emergency department(ED) for evaluation. In the majority of cases, the etiology of the chest pain is benign, but in one-fourth of the cases symptoms are distressing enough to cause children to miss school. The clinician's primary goal in ED evaluation of chest pain is to identify serious causes and rule out organic pathology. The diagnostic evaluation includes a thorough history and physical examination. Younger children are more likely to have a cardiorespiratory source for their chest pain, whereas an adolescent is more likely to have a psychogenic cause. Children having an organic cause of chest pain are more likely to have acute pain, sleep disturbance due to pain and associated fever or abnormal examination findings, whereas those with non-organic chest pain are more likely to have pain for a longer duration. Chest radiograph is required in some, especially in patients with history of trauma . In children, myocardial ischemia is rare, thus routine ECG is not required on every patient. However, both pericarditis and myocarditis can present with chest pain and fever. Musculoskeletal chest pain, such as caused by costochondritis and trauma, is generally reproducible on palpation and is exaggerated by physical activity or breathing. Pneumonia with or without pleural effusion, usually presents with fever and tachypnea; chest pain may be presenting symptom sometimes. In asthmatic children bronchospasm and persistent coughing can lead to excess use of chest wall muscles and chest pain. Patients' who report acute pain and subsequent respiratory distress should raise suspicion of a spontaneous pneumothorax or pneumomediastinum. ED management includes analgesics, specific treatment directed at underlying etiology and appropriate referral.
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PMID:Acute chest pain. 2154 47

This article emphasizes on the laboratory investigations that may play a significant role in the prompt management of the patient. Hence, other conditions where laboratory investigations will not play a major role are not included in this article. An attempt has been made to highlight certain issues wherein we can prevent inadvertent ordering of tests to minimize the burden on the overworked emergency laboratory, without compromising patient care. The conditions that will be dealt here include: acute chest pain, acute abdominal pain, road traffic injuries, acute respiratory distress, high grade fever, vomiting, loss of consciousness, poisoning and laboratory accidents, and lastly occupational exposure to potential biological hazards.
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PMID:Laboratory approach to the management of clinical emergencies: a diagnostic series. 2193 47

Diaphragmatic injuries are quite uncommon and often result from either blunt or penetrating trauma. Diaphragmatic ruptures are usually associated with abdominal trauma; however, it can occur in isolation. Acute traumatic rupture of the diaphragm may go unnoticed and there is often a delay between the injury and the diagnosis. Patients present with non-specific symptoms and may complain of chest pain, abdominal pain, dyspnoea, tachypnoea and cough, heartburn and symptoms of gastro-oesophageal reflux. Respiratory distress and faeco-pneumothorax have been reported. We present an interesting case of traumatic diaphragmatic hernia presenting 5 years after a road traffic accident as acute abdomen and massive haematemesis due to strangulated gangrenous gastric hernia.
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PMID:Massive haematemesis due to strangulated gangrenous gastric herniation as the delayed presentation of post-traumatic diaphragmatic rupture. 2277 92


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