scholarly journals Extensive Surgical Emphysema in a Child after Primary Closure of Tracheocutaneous Fistula

2020 ◽  
Vol 2020 ◽  
pp. 1-3
Author(s):  
R. Gurung ◽  
B. M. Shakya ◽  
H. Dutta
Keyword(s):  
Primary Closure ◽  
Signs And Symptoms ◽  
Oxygen Supplementation ◽  
X Ray ◽  
Close Observation ◽  
The Face ◽  
Chest X Ray ◽  
Tracheocutaneous Fistula ◽  
Surgical Emphysema ◽  
Upper Abdomen

A 4-year-old child had closure of tracheocutaneous fistula under general anaesthesia. He developed extensive surgical emphysema over the face, chest, and upper abdomen immediately in the recovery room. We gave him oxygen supplementation, removed surgical stitch, and inserted a 4 mm tracheostomy tube to secure airway. Chest X-ray ruled out pneumothorax or pneumomediastinum. After a week, a tight bandage was applied which approximated the tissue and helped in the closure of stoma; no suture was applied. The patient was discharged home on the fourth postoperative day. The patient needs close observation in the postoperative period with likely complication in mind. Recognizing early signs and symptoms of respiratory distress with quick intervention is lifesaving during the complication of tracheocutaneous fistula surgery. In absence of pneumothorax or pneumomediastinum, extensive surgical emphysema occurring during primary closure of tracheocutaneous fistula can be treated without inserting any drainage tube.

scholarly journals Subcutaneous Emphysema in Pregnancy

2011 ◽  
Vol 51 (183) ◽  
Author(s):  
A Shrestha ◽  
S Acharya
Keyword(s):  
Subcutaneous Emphysema ◽  
Late Pregnancy ◽  
X Ray ◽  
Close Observation ◽  
The Face ◽  
Normal Chest ◽  
Chest X Ray ◽  
Keywords Pregnancy ◽  
Systemic Examination ◽  
The Right

Spontaneous pneumomediastinum and subcutaneous emphysema are rare complications of labor, especially in the late pregnancy period, but they are usually self-limiting. Management includes avoidance of exacerbative factors and close observation with supportive treatment. A 19-year-old primi gravida at 36 weeks pregnancy presented with swelling over the right side of the face, neck and chest. Her general examination was normal. Systemic examination revealed swelling with palpatory crepitation over the right side of chest, neck and face, and other examination findings were normal. Chest X-ray revealed subcutaneous emphysema without pneumothorax. The patient left hospital against medical advice. Keywords: Pregnancy; subcutaneous emphysema; pneumomediastinum.

scholarly journals CLINICAL STUDY OF PAIN IN RIGHT ILIAC FOSSA

2020 ◽  
Vol 4 (8) ◽  
Author(s):  
Saurabh Kothari ◽  
Manjula Kothari ◽  
Shree Mohan Joshi ◽  
Kalp Shandilya
Keyword(s):  
Iliac Fossa ◽  
Signs And Symptoms ◽  
Clinical History ◽  
X Ray ◽  
Pain Abdomen ◽  
Detailed Clinical History ◽  
Right Iliac Fossa Pain ◽  
Chest X Ray ◽  
The Right ◽  
Appendicular Mass

Background: A mass in the right iliac fossa is a common diagnostic problem encountered in clinical practice, requiring skill in diagnosis. Methods: 100 patients with signs and symptoms of right iliac fossa mass admitted in Hospital were identified and were studied by taking detailed clinical history, physical examination and were subjected to various investigations like x ray erect abdomen, chest x-ray, contrast x-ray . Result: In this study of out of 100 cases, 65.00% of cases were related to appendicular pathology either in the form of appendicular mass or appendicular abscess. There were 12.00% cases of ileocaecal tuberculosis. Conclusion: Appendicular lump remains the most common cause for right iliac fossa pain. Ileocaecal tuberculosis is one of the most important differential diagnoses for pain abdomen. Keywords: Appendicular Mass, Ileocaecal Tuberculosis, Carcinoma Caecum, Right Iliac Fossa Mass.

scholarly journals Spontaneous pneumomediastinum and subcutaneous emphysema in a child with unknown aetiology

2019 ◽  
Vol 12 (2) ◽  
pp. e226805
Author(s):  
Anoopkishore Chidambaram ◽  
Sirisha Donekal
Keyword(s):  
Subcutaneous Emphysema ◽  
Rare Entity ◽  
X Ray ◽  
Spontaneous Pneumomediastinum ◽  
Expert Opinions ◽  
Repeat Chest ◽  
Chest X Ray ◽  
Red Flag ◽  
Surgical Emphysema ◽  
Safety Netting

Spontaneous subcutaneous emphysema and pneumomediastinum in children without any predisposing factors is a rare entity. We present a case of an adolescent boy with spontaneous pneumomediastinum. He is a 14-year-old boy brought to the hospital with an odd feeling in the neck and chest. Initial chest X-ray revealed subcutaneous emphysema and pneumomediastinum. He was further evaluated with CT thorax and abdomen with contrast which revealed extensive pneumomediastinum with associated surgical emphysema in the chest wall and neck. Expert opinions from the cardiothoracic and respiratory teams were obtained. The child was discharged with safety netting and description of red flag signs. Repeat chest X-ray in 2 weeks showed complete resolution of the pneumomediastinum and subcutaneous emphysema. We will briefly discuss about the diagnosis and treatment of spontaneous pneumomediastinum and subcutaneous emphysema.

scholarly journals The Pattern of Presentation and Prevalence of Tuberculosis in HIV-Seropositive Patients Seen at Benin City, Nigeria

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Christopher C. Affusim ◽  
Emeka Kesieme ◽  
Vivien O. Abah
Keyword(s):  
Clinical Presentation ◽  
Signs And Symptoms ◽  
Hiv Positive ◽  
X Ray ◽  
Benin City ◽  
Immunodeficiency Virus ◽  
High Incidence ◽  
Chest X Ray ◽  
Negative Sputum ◽  
Hiv Seropositive

Background. The emergence of Human immunodeficiency virus (HIV), led to the rise in the incidence and prevalence of tuberculosis (TB) worldwide. However, the trend is being reversed recently due to the widespread use of effective Anti-Retrovirals. Immunosuppression induced by HIV infection modified the clinical presentation of TB, resulting in atypical signs and symptoms, and a more frequent extrapulmonary presentation. This study was undertaken to determine the pattern of presentation and prevalence of TB in HIV seropositive patients seen in Benin City, Nigeria, from January to April, 2007. Method. The study was done using 330 HIV positive patients (123 males and 207 females). A designed questionnaire was used as a diagnostic instrument. Results. The prevalence of TB HIV was found to be 33.9%. It was found to be commoner in females, commonest in the age group 30–39 years. Pulmonary TB was the commonest type of TB found (78.6%). This was followed by TB adenitis (12.5%). The incidence of extrapulmonary TB was 21.4%. There was a high incidence of atypical chest X-ray features and high frequency of negative sputum smears. Conclusions. The overall prevalence rate of TB in HIV (33.9%), and the extrapulmonary presentation of TB are high. Some investigation results were found to be atypical in those with both infections. Physicians should be aware of this pattern of presentation and the atypical findings on investigation for early diagnosis and treatment.

scholarly journals Pulmonary paracoccidoidomycosis: radiology and clinical-epidemiological evaluation

2010 ◽  
Vol 43 (6) ◽  
pp. 651-656 ◽  
Author(s):  
Ricardo Miguel Costa de Freitas ◽  
Renata Prado ◽  
Fábio Luis Silva do Prado ◽  
Ivie Braga de Paula ◽  
Marco Túlio Alves Figueiredo ◽  
...  
Keyword(s):  
Statistical Difference ◽  
Radiological Finding ◽  
General Rule ◽  
Signs And Symptoms ◽  
Adult Males ◽  
Radiographic Findings ◽  
X Ray ◽  
Rural Workers ◽  
Chest X Ray ◽  
Group 1

INTRODUCTION: The purpose of this study was to compare respiratory signs and symptoms between patients with and without chest X-ray abnormalities in order to establish the meaning of radiographic findings in pulmonary PCM diagnosis. METHODS: The epidemiological, clinical and radiological lung findings of 44 patients with paracoccidiodomycosis (PCM) were evaluated. Patients were divided into two groups of 23 and 21 individuals according to the presence (group 1) or absence (group 2) of chest X-ray abnormalities, respectively, and their clinical data was analyzed with the aid of statistical tools. RESULTS: As a general rule, patients were rural workers, young adult males and smokers - group 1 and 2, respectively: males (91.3% and 66.7%); mean age (44.4 and 27.9 year-old); smoking (34.7% and 71.4 %); acute/subacute presentation (38.1% and 21.7%); chronic presentation (61.9% and 78.3%). The most frequent respiratory manifestations were - group 1 and 2, respectively: cough (25% and 11.4%) and dyspnea (22.7% and 6.8%). No statistical difference was observed in pulmonary signs and symptoms between patients with or without radiographic abnormalities. The most frequent radiological finding was nodular (23.8%) or nodular-fibrous (19%), bilateral (90.5%) and diffuse infiltrates (85.7%). CONCLUSIONS: Absence of statistical difference in pulmonary signs and symptoms between these two groups of patients with PCM indicates clinical-radiological dissociation. A simplified classification of radiological lung PCM findings is suggested, based on correlation of these data and current literature review.

scholarly journals Detection of pneumonia among children under six years by clinical evaluation

2004 ◽  
Vol 10 (4-5) ◽  
pp. 482-487
Author(s):  
H. Shamo'on ◽  
A. Hawamdah ◽  
R. Haddadin ◽  
S. Jmeian
Keyword(s):  
Clinical Study ◽  
Chest Wall ◽  
Clinical Symptoms ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Prospective Clinical Study ◽  
X Rays ◽  
X Ray ◽  
Chest X Ray ◽  
Symptoms And Signs

To determine the most useful clinical symptoms and signs for detection of pneumonia in children, we carried out a prospective clinical study at Queen Alia Hospital, Amman, on 147 children admitted between August 2002 and January 2003 with clinical pneumonia. All the children had chest X-rays, which were read by the same radiologist. The most sensitive and specific signs and symptoms for prediction of pneumonia were coughing, tachypnoea [respiratory rate > 50/min] and chest wall indrawing. We found that presence of tachypnoea and lower chest wall indrawing can detect most cases of pneumonia. If all clinical signs are negative, chest X-ray findings are unlikely to be positive

scholarly journals A Prospective Observational Study to Investigate Performance of a Chest X-ray Artificial Intelligence Diagnostic Support Tool Across 12 U.S. Hospitals

2021 ◽  
Author(s):  
Ju Sun ◽  
Le Peng ◽  
Taihui Li ◽  
Dyah Adila ◽  
Zach Zaiman ◽  
...  
Keyword(s):  
Real Time ◽  
Clinical Decision Making ◽  
External Validation ◽  
Model Performance ◽  
Signs And Symptoms ◽  
Clinical Decision ◽  
Indiana University ◽  
X Ray ◽  
Emory University ◽  
Chest X Ray

Importance: An artificial intelligence (AI)-based model to predict COVID-19 likelihood from chest x-ray (CXR) findings can serve as an important adjunct to accelerate immediate clinical decision making and improve clinical decision making. Despite significant efforts, many limitations and biases exist in previously developed AI diagnostic models for COVID-19. Utilizing a large set of local and international CXR images, we developed an AI model with high performance on temporal and external validation. Objective: Investigate real-time performance of an AI-enabled COVID-19 diagnostic support system across a 12-hospital system. Design: Prospective observational study. Setting: Labeled frontal CXR images (samples of COVID-19 and non-COVID-19) from the M Health Fairview (Minnesota, USA), Valencian Region Medical ImageBank (Spain), MIMIC-CXR, Open-I 2013 Chest X-ray Collection, GitHub COVID-19 Image Data Collection (International), Indiana University (Indiana, USA), and Emory University (Georgia, USA) Participants: Internal (training, temporal, and real-time validation): 51,592 CXRs; Public: 27,424 CXRs; External (Indiana University): 10,002 CXRs; External (Emory University): 2002 CXRs Main Outcome and Measure: Model performance assessed via receiver operating characteristic (ROC), Precision-Recall curves, and F1 score. Results: Patients that were COVID-19 positive had significantly higher COVID-19 Diagnostic Scores (median .1 [IQR: 0.0-0.8] vs median 0.0 [IQR: 0.0-0.1], p < 0.001) than patients that were COVID-19 negative. Pre-implementation the AI-model performed well on temporal validation (AUROC 0.8) and external validation (AUROC 0.76 at Indiana U, AUROC 0.72 at Emory U). The model was noted to have unrealistic performance (AUROC > 0.95) using publicly available databases. Real-time model performance was unchanged over 19 weeks of implementation (AUROC 0.70). On subgroup analysis, the model had improved discrimination for patients with severe as compared to mild or moderate disease, p < 0.001. Model performance was highest in Asians and lowest in whites and similar between males and females. Conclusions and Relevance: AI-based diagnostic tools may serve as an adjunct, but not replacement, for clinical decision support of COVID-19 diagnosis, which largely hinges on exposure history, signs, and symptoms. While AI-based tools have not yet reached full diagnostic potential in COVID-19, they may still offer valuable information to clinicians taken into consideration along with clinical signs and symptoms.

scholarly journals A STUDY ON RIGHT ILIAC FOSSA MASS

2019 ◽  
Vol 3 (9) ◽  
Author(s):  
Dr. Pradeep Kumar Verma ◽  
Dr. Sanvar Mal Kantva
Keyword(s):  
Iliac Fossa ◽  
Signs And Symptoms ◽  
Clinical History ◽  
Pathological Process ◽  
Accurate Diagnosis ◽  
X Ray ◽  
Detailed Clinical History ◽  
Chest X Ray ◽  
The Right ◽  
Appendicular Mass

Background: Patients with mass in the right iliac fossa may confront the surgeon, pediatrician or gynecologist. Thus, thorough understandings of the anatomy and pathological process that may occur within the abdomen are essential for an accurate diagnosis and plan of treatment. Methods: 100 patients with signs and symptoms of right iliac fossa mass admitted Hospital were identified and were studied by taking detailed clinical history, physical examination and were subjected o various investigations like x ray erect abdomen, chest x-ray, contrast x-ray. Results: In this study of 100 cases 86 % of cases were related to appendicular pathology either in the form of appendicular mass or appendicular abscess. There were 3 cases of ileocaecal tuberculosis. Conclusion: This study showed that appendicular mass is the commonest pathology in right iliac foss. Keywords: Appendicular mass, ileocaecal tuberculosis, carcinoma caecum, right iliac fossa mass

scholarly journals Automatic Lung Segmentation in Chest X-ray Images Using Improved U-Net

2021 ◽  
Author(s):  
Wufeng Liu ◽  
Jiaxin Luo ◽  
Yan Yang ◽  
Wenlian Wang ◽  
Junkui Deng ◽  
...  
Keyword(s):  
High Efficiency ◽  
Region Of Interest ◽  
Activation Function ◽  
Montgomery County ◽  
Lung Field ◽  
Lung Segmentation ◽  
X Ray ◽  
The Face ◽  
Chest X Ray ◽  
Residual Block

Abstract Automatic and highly accurate lung segmentation in chest X-ray (CXR) images is the basis of computer-aided diagnosis systems, because the lung is the region of interest of many diseases, and it can show useful information through its contours. However, automatic lung segmentation is immensely challenging due to extreme variations in the shape, obscure lung area, or opacity caused by lung diseases reaches high-intensity values. In the face of these severe situations, the model may segment the lung boundary incorrectly. We designed an improved U-Net network: using the pre-training Efficientnet-b4 as the encoder, and the residual block and LeakyRelu activation function are used in the decoder. The network can not only extract features with high efficiency but also avoid the gradient explosion caused by the multiplication effect in gradient backpropagation. We constructed a CXR lung field segmentation dataset (Haut) based on the NIH CXR dataset. In particular, this lung segmentation dataset contains some serious abnormal cases, such as lung deformation, pleural effusion, covered by foreign matters, or CXR blur caused by severe lung disease. The improved U-Net is evaluated on Haut, JSRT, and Montgomery County (MC) datasets. Experimental results show that our network can achieve high-precision lung segmentation.

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