Case Presentation7-month-old girl with a chronic lung disease presented for a routine check-up. The patient's medical history included extreme prematurity, bronchopulmonary dysplasia requiring home oxygen therapy, retinopathy of prematurity, congenital hypothyroidism, and multiple hemangiomas. Findings of the patient's physical examination and the results of routine laboratory tests were within normal limits. A radiograph of the chest revealed an opacity resembling pneumonia near the left chest wall. The opacity was initially diagnosed as round pneumonia, and the patient was treated with a course of antibiotics. However, because the opacity did not resolve, computed tomography (CT) of the chest was performed two months later. Chest CT examination revealed a 2.4-cm rounded lesion with soft-tissue density overlying the
Malignant infantile osteopetrosis is a rare inherited disease of bone metabolism, in which osteoclast dysfunction and diminished bone turnover lead to diffuse sclerosis with obliteration of the medullary cavities and narrowing of the skull base neural foramina. We report a case of malignant infantile osteopetrosis with bone marrow failure and optic atrophy that co-occurred with hypophosphatasia, another rare inherited bone disease, in a 6-year-old boy. Key imaging signs of these rare diseases are discussed.
Case Presentationuring her fifth week of life, an infant girl was transferred to our institution from an outside facility for surgical intervention to relieve thoracic duct obstruction identified on lymphangiography. The patient was born on the 32nd week of gestation (birth weight 2 120 g, height 41.5 cm, head circumference 30.5 cm) via emergency lower-segment transverse cesarean delivery prompted by multiple fetal anomalies and category III fetal heart rate tracings with recurrent late decelerations. Pregnancy had been complicated by polyhydramnios. At the time of delivery, the patient was intubated, and bilateral thoracenteses and paracentesis were performed. The patient had a complex medical history that included trisomy 21, hydrops fetalis (including pleural effusion, pericardial effusion, ascites, and anasarca) with negative infection titers for toxoplasmosis, rubella cytomegalovirus, herpes simplex, and HIV, as well as pneumothorax requiring chest tube placement, right D Abstract: Pneumoperitoneum is the abnormal presence of air in the peritoneal cavity. In cases of massive pneumoperitoneum, abdominal radiographs may reveal "the football sign," which results from air outlining the abdominal cavity and surrounding the falciform ligament. Although most cases of pneumoperitoneum result from visceral perforation, there is increased awareness of other causes, resulting in an entity referred to as nonsurgical pneumoperitoneum (NSP). We report a case of nonsurgical pneumoperitoneum with a football sign on supine radiographs in a preterm 1-month-old infant who had a complex medical history.The patient developed sepsis and underwent an exploratory laparotomy, which ruled out perforation as well as any intra-abdominal cause for the pneumoperitoneum and infection.
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