Bullous lung disease in pediatric patients is a rare case. The etiology of lung bullae is cigarette smoking history, pulmonary sarcoidosis, alpha 1-antitrypsin deficiency and many more. One of the treatments for lung bulla is surgical approach. We present a case of 4-year-old girl with lung bulla due to septic pulmonary embolism. Primarily the patient was admitted with a decrease in consciousness, fever, cough and dyspnea. A CT scan revealed bilateral bullae, multiple nodules in various size, mostly with internal cavities and feeding vessel sign suggestive of a septic pulmonary embolism accompanied by a pneumothorax. We did thoracotomy, wedge resection and pleurodesis, the outcome was clinical improvement and no postoperative complication occurred. Thoracotomy, wedge resection and pleurodesis can be considered as a treatment for lung bulla in pediatric population, so this case report may provide guidance on management of these cases for clinicians.
Background: Acute limb ischemia (ALI) is a sudden decrease in leg perfusion that threatens the viability of the limb with symptom onset within 2 weeks. In peripheral artery disease (PAD) conditions, occlusion of blood vessels can occur due to thrombosis or atherosclerotic plaque embolism, which is called "acute on chronic ischemia". The development of endovascular therapy has made this therapy an important role in restoring leg perfusion. The aim of this study to demonstrate the safety and feasibility of therapeutic combination of catheter-directed thrombolysis, rheolytic thrombectomy and percutaneous transluminal angioplasty in acute on chronic limb ischemia.
Case Description: We report a case of a 51-year-old man, came to the hospital with complaints of pain in the left extremity that persisted at rest or activity and cold in the left extremity which has been felt since 2 weeks ago. A year ago, the patient started to feel pain in the left extremity that persist in activity. Physical examination revealed cold feet and muscle atrophy.
Conclusion: Therapeutic combination of catheter-directed thrombolysis, rheolytic thrombectomy and percutaneous transluminal angioplasty are considered to be safe and feasible to do in acute on chronic limb ischemia.
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