TOPIC: Critical Care TYPE: Medical Student/Resident Case Reports INTRODUCTION: Spontaneous esophageal perforation or Boerhaave's syndrome is characterized by rupture of the esophagus due to rapid and spontaneous rise in intraluminal pressure. Only 14% patients present with Meckler's triad, which includes severe vomiting, chest pain subcutaneous emphysema. Approximately 90% perforations occur at...

To cite: Sagdeo P, Gattimallanahali Y, Kakade G, et al. BMJ Case Rep Published online: [please include Day Month Year] doi:10.1136/bcr-2015213083 DESCRIPTION A 61-year-old woman was under treatment with a combination of methotrexate and leflunomide for seropositive rheumatoid arthritis (RA) for the past 6 years. She presented to us 6 months earlier with grade 1 dyspnoea of 3-month duration. She...

STUDY OBJECTIVE Patients with symptomatic malignant pleural effusion are usually treated with large-bore chest tube placement and pleurodesis requiring > or = 3 days of hospitalization. We sought to demonstrate the feasibility of ambulatory drainage and sclerosis using a small-bore pigtail catheter in patients with malignant pleural effusions. We reasoned that this approach would improve sympto...

1Senior Registrar, 2Senior Specialist and Head, 3Registrar, Department of Medicine, Tata Main Hospital, Jamshedpur, Jharkhand Received: 07.11.2013; Revised: 28.01.2014; Accepted: 04.03.2014 A 58 year old male was admitted wi th complain of sudden onset severe central chest pain following a bout of vomiting after lunch. He was having a constricting feeling in the chest and upper abdomen associat...

TOPIC: Chest Infections TYPE: Medical Student/Resident Case Reports INTRODUCTION: Coccidioidomycosis is transmitted by inhalation of fungal spores commonly found in southwestern border United States and South America. Most primary coccidioidomycosis cases are asymptomatic do not require treatment. Symptomatic progressive affect people with certain risk factors: ethnic origin, advanced age, preg...

Iatrogenic hemothorax is a rare complication after chest tube insertion. It is mainly caused by injury to the intercostal blood vessels. Treatment involves pleural drainage, and thoracotomy is usually required for hemostasis. Occasionally, embolization of the intercostal arteries is an effective therapeutic alternative. We present the case of a 21-year-old male patient who smoked one packet of ...

Blind placement of gastric tubes is commonly done at the bedside, and is associated with significant risk. Inadvertent placement of gastric tubes into the lungs may lead to some dreaded and serious complications including intrapulmonary infusion of fluids, pneumothorax, pneumonitis, hydropneumothorax, bronchopleural fistula, empyema, and pulmonary hemorrhage. Although the reported frequency of ...

TOPIC: Disorders of the Pleura TYPE: Medical Student/Resident Case Reports INTRODUCTION: Trapped lung is an uncommon complication malignant pleural effusion (MPE). It presents as post-thoracentesis hydropneumothorax (known pneumothorax ex vacuo, PEV) or that cannot be completely drained due to development chest pain [1]. important recognize PEV, although it may appear alarming, asymptomatic pro...

To cite: Atie M, Dunn G, Falk GL. BMJ Case Rep Published online: [please include Day Month Year] doi:10.1136/bcr-2016217391 DESCRIPTION A 45-year-old, cognitively impaired, morbidly super obese male patient is described with a delayed presentation of Boerhaave’s syndrome. The patient had been mistakenly treated elsewhere for an empyema of the left thorax. The primary diagnosis had been based on...

A 39-year-old female was admitted for antibiotic treatment of sepsis of unknown origin, which had been empirically treated with piperacillin-tazobactam. The patient had previously (five months prior) been diagnosed with renal cell carcinoma with clear cell histological features and had undergone a left partial nephrectomy without excision of the entire tumor. Three months before admission, the ...