Southern medical journal
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Southern medical journal · Aug 2006
Case ReportsRenal artery stenting for intimal flap injury in a 2-year-old child after blunt abdominal trauma.
Injury to the renal vasculature is an uncommon occurrence in the setting of blunt abdominal trauma. The authors report the case of a 2-year-old girl who developed occlusion from an intimal flap in a renal artery (grade IV renal injury) after blunt abdominal trauma that was treated with a stent placement. ⋯ However, several months after the procedure, the patient developed stenosis within the stent and ultimately required a nephrectomy. To the authors' knowledge, this is the first report of percutaneous management of an acute intimal flap in a renal artery in a 2-year-old.
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Southern medical journal · Aug 2006
Case ReportsA woman with cough, fever, and micronodular infiltrates on chest radiograph.
Hot tub lung is a form of hypersensitivity pneumonitis (HP) reported to be associated with exposure to large aerosolized inocula of Mycobacterium avium complex (MAC). Although the pathogenesis of the disease is still poorly understood, the pathology of MAC-related HP can be similar to that of sarcoidosis, with well-formed granulomas. We describe a patient with HP featuring well-formed granulomas on transbronchial biopsy specimens, a finding believed to be unique to MAC-related HP, also referred to as "hot tub lung".
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Southern medical journal · Aug 2006
Case ReportsSpontaneous pneumomediastinum due to achalasia: a case report.
Spontaneous pneumomediastinum (SPM) is a rare and benign clinical entity characterized by free air around mediastinal structures. Precipitating factors include violent cough, asthma, inhalational drugs, labor and exercise. We report a case of SPM due to achalasia which to the best of our knowledge, has never been reported. ⋯ Air tracks along the mediastinal spaces cause SPM. In our patient, there was no evidence of esophageal perforation. Tension pneumomediastinum and pneumothorax are complications of SPM.
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Southern medical journal · Aug 2006
Case ReportsA case of early onset normotensive scleroderma renal crisis in a patient with diffuse cutaneous systemic sclerosis.
Scleroderma renal crisis (SRC) has classically been defined as a new onset of accelerated arterial hypertension associated with a rapid increase in serum creatinine concentration and/or microangiopathic hemolytic anemia. SRC occurs in approximately 20% of patients with systemic sclerosis who have diffuse cutaneous manifestations. In addition, 10% of reported cases of SRC with diffuse cutaneous involvement have normal blood pressures; in the majority of these cases, SRC occurs after treatment with corticosteroids. We describe a patient who presented with an early onset SRC in the setting of diffuse cutaneous systemic sclerosis in evolution without prior accelerated arterial hypertension or corticosteroid use.