Spontaneous pneumomediastinum (PNM) is presence of free air within the mediastinum not preceded by any cause such as chest trauma or medical or surgical procedure, which causes symptoms such as retrosternal pain, dyspnea, hoarseness and odynophagia. It is usually a benign and self-limiting condition, which often goes unnoticed by doctors. It has an incidence that ranges from one in 8,005 to one in 42,000 emergency admissions. It may not be identified on physical examination; however, its presence is
RESUMEN.La neumonía por COVID-19 está asociada con falla respiratoria severa que requiere intubación orotraqueal y ventilación mecánica asistida. Dentro de los riesgos de la ventilación mecánica prolongada, uno de los más temidos y desafiantes es el desarrollo de fistula traqueoesofágica por las alteraciones respiratorias y nutricias que conlleva. El método diagnóstico de elección es la broncoscopia. El cierre espontáneo de la fístula traqueoesofágica es raro y por lo general se requiere manejo quirúrgico para su corrección definitiva. Presentamos el caso de una paciente con neumonía por COVID-19 que desarrolló fístula traqueoesofágica y requirió manejo quirúrgico como tratamiento definitivo.
El neumomediastino espontáneo es la presencia de aire libre en el mediastino sin el antecedente de alguna causa como trauma de tórax. Es una condición benigna autolimitada que se trata en forma conservadora. El diagnóstico clínico se basa en dos síntomas: dolor torácico y disnea; y en un signo en particular: enfisema subcutáneo. Ha sido reportado en pacientes con influenza A (H1N1) y síndrome respiratorio agudo grave; sin embargo, ha sido raramente observado en pacientes con COVID-19. En este trabajo describimos seis pacientes del sexo masculino con COVID-19, con edades entre 27 y 82 años, que presentaron neumomediastino espontáneo y enfisema subcutáneo; ambos se reabsorbieron totalmente con manejo conservador.
Lung carcinoid tumors are a rare pathology, representing only 1-5% of all pulmonary neoplasms, with estimated incidence of 5-10/1,000,000 people/year. The purpose of this study is to describe the incidence, clinical and pathological characteristics, and their outcomes, in patients diagnosed with carcinoid tumor in a single institution. Material and methods: Retrospective analysis of patients diagnosed with carcinoid tumor undergoing surgical resection at the National Institute of Respiratory Diseases (INER) from March 2013-to December 2019. Demographic, pathological, clinical, treatment and follow-up data were collected and analyzed. Results: 30 patients diagnosed with carcinoid tumor were found. The median age was 47.2 years. The most common symptoms of presentation were progressive dyspnea and hemoptysis. The tumor appeared predominantly on the right side and lower lobes. Diagnosis was made preoperatively through bronchoscopy in most cases. Conclusions: Pulmonary carcinoid tumors (PCT) are relatively rare pulmonary neoplasms that occur with nonspecific and long-evolving symptoms. Surgical resection is required for treatment, and where feasible, with the greatest preservation of lung tissue possible. This leads to excellent local control and high long-term survival.
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