Thorax
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Case Reports
The pulmonary angiographic appearance of pleurisy associated with subdiaphragmatic inflammation.
In two patients who had recently undergone major abdominal operations and were later suspected of having pulmonary emboli, pulmonary angiography showed no evidence of embolism, but in both cases one of the hemidiaphragms was clearly outlined by contrast material. It is suggested that subdiaphragmatic inflammation was responsible for this unusual appearance.
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A technique for the management of anterior flail chest consisting of osteosynthesis and the positioning of two long Kirschner wires behind the sternum in the form of a St Andrew's cross is described. The procedure is easy to perform, the patient is ambulant early, and the results are good.
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Hydropneumopericardium is a very rare and usually fatal complication of peptic oesophageal ulceration. The patient reported here survived and the report resembles one previously made about a child. In both patients failure to show the fistula radiologically or on endoscopy suggests that rapid spontaneous healing had occurred, and that this was responsible for survival.