in the mediastinum becomes excessive and embarrasses the action of the heart. This can be fatal, especially if tension pneumothorax coexists. Other modes of entry of air into the mediastinum include rupture of the trachea, bronchus, or oesophagus from any cause and penetrating wounds of the lung and mediastinal pleura. These are clearly formidable conditions and must always be considered in pat...

BACKGROUND Intestinal obstructions/pseudo-obstruction of the small/large bowel are frequent conditions but their management could be challenging. Moreover, a general agreement in this field is currently lacking, thus SICUT Society designed a consensus study aimed to define their optimal workout. METHODS The Delphi methodology was used to reach consensus among 47 Italian surgical experts in tw...

having esophageal cancer. She was given neoadjuvant chemoradiotherapy and esophagectomy was carried out. Reconstruction was accomplished with a gastric pull-up through the posterior mediastinal route. After 6 years of the treatment, the patient had high grade fever, which was refractory to treatment with antibiotics. A chest computed tomography (CT) scan demonstrated mixed fluid and soft tissue...

BACKGROUND Acute mediastinitis is a serious medical condition with a mortality rate of 30 to 40% or even higher. Early diagnosis with prompt and aggressive treatment is essential to prevent its rapid progression. We evaluated acute mediastinitis cases and analyzed the outcomes. MATERIALS AND METHODS A retrospective chart review was conducted on patients diagnosed with acute mediastinitis who ...

A 52-year-old female visited the outpatient department of Sapporo Medical University hospital in 1984 due to a refractory rash on the skin of the trunk. Histological findings of a skin biopsy specimen indicated a diagnosis of lupus erythematosus profundus (LEP). The eruption remained quiescent with moderate doses of prednisolone. In October 2003, she was suddenly admitted to our hospital with a...

To cite: Carvalho AF, Rodrigues AJ, Sousa N, et al. BMJ Case Rep Published online: [please include Day Month Year] doi:10.1136/bcr-2014204678 DESCRIPTION A 32 years-old woman with a history of depression, visited her doctor for heartburn and postprandial fullness with 2 months of evolution, possibly due to the consumption of non-steroid antiinflammatory drugs due to knee pain. Upper endoscopy (...

Background and study aims  Endoscopic treatment of Zenker's diverticulum has proven feasible, but electrocautery and CO 2 laser technology carry the risk of collateral thermal injury. Thulium laser septum incision may overcome this limitation. We describe for the first time the use of thulium laser through flexible endoscopy in a small cohort of patients with Zenker diverticulum. Patients and...

Hypopharyngeal perforation is mainly reported in association with high velocity road traffic accidents, or with low velocity direct blows to the neck. We report a case of hypopharyngeal perforation following a low velocity motorcycle accident where neither of these mechanisms of injury was apparent. A 52 year old man was referred from the emergency department (ED) with a sore throat and dysphag...

G A T C Nonsense mutations frequently cause severe illness because premature termination of messenger RNA translation usually creates unstable truncated proteins. However, Cutting et al' described two patients carrying nonsense mutations in each cystic fibrosis gene (G542X/ S1255X and R553X/W1316X) with severe pancreatic involvement but mild pulmonary disease. Furthermore, Cuppens et aP and Bon...

Background: Since the treatment of meconium ileus is very different from other types of intestinal obstruction, it is very important to distinguish these two entities. The aim of this study was to assess sonographic findings to differentiate meconium ileus from other types of obstruction. Methods: This study was performed in Dr. Sheikh and Akbar hospitals, Mashhad Medical University of Science...