The European respiratory journal : official journal of the European Society for Clinical Respiratory Physiology
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Case Reports
Spontaneous cervical subcutaneous and mediastinal emphysema secondary to occult sigmoid diverticulitis.
We present a case of spontaneous mediastinal and subcutaneous cervical emphysema due to perforation of an occult sigmoid diverticulitis. Mediastinal emphysema should alert the physician to the possibility of retroperitoneal gastrointestinal perforation, even in patients without signs of distinct peritoneal irritation.
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Mediastinal bronchogenic cysts are usually identified on computed tomography (CT) as well-defined masses of variable density that may contain rim calcifications. Pleural effusion has never been described in association with these cysts. We report two cases of bronchogenic cysts with unusual presentation because of an association with a pleural effusion not explained by pulmonary infection. ⋯ Inflammatory reaction was also suspected on the CT scan, which showed enhancement of the cyst edge. In both cases, surgical excision of the cyst was difficult because of pericystic adhesions to adjacent organs. Therefore, solely on the finding of a pleural effusion, pericystic inflammation had to be suspected.
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Reflex-mediated bronchoconstriction in cold climates may be more important than it has previously been thought. This issue has seldom been studied using physiological methods. We wanted to investigate, using physiological methods, what triggers the bronchoconstriction occurring at cold ambient temperature during resting nasal ventilation: cooling of the skin of the face or cooling of the nasal cavity. ⋯ Only the two experiments in the environmental chamber induced significant bronchoconstriction. All responses were of similar magnitude in the asthmatic and the healthy subjects. The cooling of the skin of the face seems to be the trigger for the bronchoconstriction during resting nasal ventilation at cold ambient temperature both in asthmatic and nonasthmatic subjects.