Hola amigos, hoy os presento el caso de un varón de 29 años con historia de dolores torácicos previos.
¿Veis alguna anormalidad en la radiografía PA?
Podéis dar vuestra opinión hasta el viernes, día en el que se publicará la solución.
Haz click aquí para ver la respuesta
Hallazgos: la radiografía PA muestra una masa en el fórnix gástrico (A, flecha), no visible en un estudio hecho seis meses previamente (B). La masa está bien definida y no parece corresponder a pliegues gástricos. El diagnóstico diferencial incluye tumores benignos (leiomioma), duplicaciones congénitas, varices gástricas y carcinoma gástrico, poco probable dada la edad del paciente.
Revisada la historia clínica, se vio que el paciente había sido operado de hernia de hiato con reflujo severo y espasmo esofágico.
Diagnóstico final: cambios secundarios a cirugía de hernia de hiato.
Felicidades a Cristina y Lourdes, que fueron las primeras en sugerir el diagnóstico.
Teaching point: es importante mirar el abdomen superior en la radiografía de tórax porque pueden encontrarse hallazgos insospechados.
-Algún leve engrosamiento pleuroparenquimatoso en ambos ápex.
-Desviación a la derecha de la línea paravertebral, por posible escoliosis.
Y algo más
El botón aórtico no lo veo del todo bien, poco marcado, y creo que la aorta torácica descendente puede estar en el lado derecho.
Which side of the thorax is the pain? Any trauma history?
CVII axilary arch fracture
I cant see the sternum joining the clavicles!?!
left infra- diaphragmatic opacity
abnormal contour of the azygoesophageal interface – posterior mediastinal lymphadenopathy ??
Traqueobroncomegalia
Algo más!
isee a oppacity at the nivel of fornix gastric tumoral?
Good!
Something’s not right about the RLL. There’s a sharply marginated line medially. Some segmental collapse? A lateral view might help
Cambios por funduplicatura, no se sí hay algo más en epigastrio, prominencia de intersticio .
Ole!
eso-cardio-tuberozitary tumour with posterior inferior mediastinal lymphadenopathy
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