2.Hemopericardium Following Acupuncture.
Jung Heon KIM ; Sun Hyu KIM ; Yong Jik LEE ; Jung Seok HONG ; Ryeok AHN ; Eun Seog HONG
Yonsei Medical Journal 2011;52(1):207-209
Acupuncture-related hemopericardium is a rare but potentially fatal complication. We describe a hemopericardium that occurred shortly after acupuncture in a 55-year-old woman. A chest CT scan and echocardiography revealed a hemopericardium, and pericardiocentesis was then immediately and successfully performed. Subsequently, her clinical course improved. This case increases the attention of emergency physicians for acupuncture-related complications, especially hemopericardium, and the necessity of rapid diagnosis and management.
Acupuncture Therapy/*adverse effects
;
Echocardiography
;
Female
;
Humans
;
Middle Aged
;
Pericardial Effusion/*diagnosis/*etiology/surgery
;
Pericardiocentesis
3.Hemopericardium Following Acupuncture.
Jung Heon KIM ; Sun Hyu KIM ; Yong Jik LEE ; Jung Seok HONG ; Ryeok AHN ; Eun Seog HONG
Yonsei Medical Journal 2011;52(1):207-209
Acupuncture-related hemopericardium is a rare but potentially fatal complication. We describe a hemopericardium that occurred shortly after acupuncture in a 55-year-old woman. A chest CT scan and echocardiography revealed a hemopericardium, and pericardiocentesis was then immediately and successfully performed. Subsequently, her clinical course improved. This case increases the attention of emergency physicians for acupuncture-related complications, especially hemopericardium, and the necessity of rapid diagnosis and management.
Acupuncture Therapy/*adverse effects
;
Echocardiography
;
Female
;
Humans
;
Middle Aged
;
Pericardial Effusion/*diagnosis/*etiology/surgery
;
Pericardiocentesis
5.Clinical analysis of 49 cases of childhood pericardil effusion.
Li WEI ; Tong-Fu ZHOU ; Bing LIU ; Xian-Min WANG
Chinese Journal of Contemporary Pediatrics 2006;8(1):71-72
Adolescent
;
Child
;
Child, Preschool
;
Female
;
Humans
;
Infant
;
Male
;
Pericardial Effusion
;
diagnosis
;
etiology
;
therapy
6.Cardiac Tamponade Complicated by Acupuncture: Hemopericardium due to Shredded Coronary Artery Injury.
Ae Young HER ; Yong Hoon KIM ; Se Min RYU ; Jun Hwi CHO
Yonsei Medical Journal 2013;54(3):788-790
We report a case of 62-year-old man with cardiac tamponade due to coronary artery injury after acupuncture into the substernum. After resuscitation of cardiac arrest, we performed emergent pericardiocentesis. Nevertheless, the cardiac arrest recurred, and the emergent operation on cardiopulmonary bypass was performed. We identified hemopericardium due to shredded acute marginal branch of right coronary artery, and it was ligated leading to termination of bleeding. The patient was discharged without any other complications.
Acupuncture Therapy/*adverse effects
;
Cardiac Tamponade/*diagnosis/etiology
;
Coronary Vessels/*injuries
;
Humans
;
Male
;
Middle Aged
;
Pericardial Effusion/*diagnosis/etiology
7.Tuberculous Pericarditis Presenting as Multiple Free Floating Masses in Pericardial Effusion.
Shin Ae YOON ; Youn Soo HAHN ; Jong Myeon HONG ; Ok Jun LEE ; Heon Seok HAN
Journal of Korean Medical Science 2012;27(3):325-328
Pericarditis is a rare manifestation of tuberculosis (Tb) in children. A 14-yr-old Korean boy presented with cardiac tamponade during treatment of pulmonary tuberculosis. He developed worsening anemia and persistent fever in spite of anti-tuberculosis medications. Echocardiography found free floating multiple discoid masses in the pericardial effusion. The masses and exudates were removed by pericardiostomy. The masses were composed of pink, amorphous meshwork of threads admixed with degenerated red blood cells and leukocytes with numerous acid-fast bacilli, which were confirmed as Mycobacterium species by polymerase chain reaction. The persistent fever and anemia were controlled after pericardiostomy. This is the report of a unique manifestation of Tb pericarditis as free floating masses in the effusion with impending tamponade.
Adolescent
;
Cardiac Tamponade/etiology
;
Echocardiography
;
Humans
;
Male
;
Pericardial Effusion/*diagnosis/etiology/surgery/ultrasonography
;
Pericardiectomy
;
Pericarditis, Tuberculous/complications/*diagnosis/ultrasonography
8.Primary Idiopathic Chylopericardium Associated with Cervicomediastinal Cystic Hygroma.
Byoung Chul CHO ; Seok Min KANG ; Seung Chul LEE ; Jeong Geun MOON ; Dong Hyung LEE ; Sang Hyun LIM
Yonsei Medical Journal 2005;46(3):439-444
Chylopericardium is a rare clinical entity in which chylous fluid accumulates in the pericardial cavity. We report a case of primary idiopathic chylopericardium associated with multiple, small cervicomediastinal cystic hygromas occurring in an asymptomatic 43-year-old woman with no history of trauma, thoracic surgery, malignancy, infection or tuberculosis. Echocardiography showed a large amount of pericardial effusions and pericardial fluid analysis revealed inappropriately elevated triglyceride. We did not demonstrate communication between the thoracic duct and the pericardial sac by lymphangiography and chest computed tomography. She successfully responded to 30 days of continuous pericardial drainage and 15 days of a medium-chain triglyceride diet after 30 days of total parenteral nutrition. Follow-up echocardiography 6 months after treatment commencement showed a minimal reaccumulation of pericardial fluid without symptom. We conclude that if a patient is asymptomatic and can well tolerate daily life, surgery including pericardiectomy or ligation of the thoracic duct is not necessarily required.
Adult
;
Female
;
Humans
;
Lymphangioma, Cystic/*complications/pathology
;
Mediastinal Cyst/*complications/pathology
;
Neck/pathology
;
Pericardial Effusion/*etiology/pathology/therapy
9.A case of prominent epicardial fat mimicking a tumor on echocardiography.
Young Keun AHN ; Jong Chun PARK ; Woo Suck PARK ; Nam Ho KIM ; Jun Woo KIM ; Sung Hee KIM ; Jang Hyun CHO ; Myung Ho JEONG ; Jeong Gwan CHO ; Jung Chaee KANG
Journal of Korean Medical Science 1999;14(5):571-574
Epicardial fat may anteriorly produce an echo-free space that can be mistaken for pericardial fluid. We recently experienced a 67-year-old woman with prominent epicardial fat which was presented as an echogenic tumor-like mass. She underwent open pericardiostomy to relieve large amount of pericardial effusion. Operative findings revealed only prominent epicardial fat. Biopsy of the pericardial and fat tissues revealed an inflammation and normal fat cells without any malignant cell infiltration.
Adipose Tissue/ultrasonography*
;
Adipose Tissue/radiography
;
Adipose Tissue/pathology
;
Aged
;
Biopsy
;
Case Report
;
Diagnosis, Differential
;
Echocardiography
;
Female
;
Heart Neoplasms/diagnosis
;
Human
;
Pericardial Effusion/etiology
;
Pericardial Effusion/diagnosis
;
Pericardium/ultrasonography*
;
Pericardium/radiography
;
Pericardium/pathology
10.Clinical analysis of 2 cases with chylothorax due to primary lymphatic dysplasia and review of literature.
Jinrong LIU ; Chunmei YAO ; Baoping XU ; Wenbin SHEN ; Chunju ZHOU ; Xiaomin DUAN ; Jin ZHOU ; Ran AN ; Wei WANG ; Zhaolu DING ; Shunying ZHAO
Chinese Journal of Pediatrics 2014;52(5):362-367
OBJECTIVETo analyze the clinical characteristics and diagnosis of 2 cases with chylothorax due to primary lymphatic dysplasia and to elevate pediatrician's recognition level for this disease.
METHODClinical manifestations of the children were retrospectively analyzed. Primary lymphatic dysplasia was diagnosed by lymphoscintigraphy.
RESULTThe first patient was a male aged 2-year-7-month who presented with a history of tachypnea for 43 days, fever and sore throat for 5 days at the early stage of the illness. He had a history of external injury before his illness. Physical examination showed his left chest bulging and left side diminished breath sound. His pleural effusion showed dark red (It was divided into two layers after standing, the upper layer turned into milky white, and the lower turned into hemorrhagic liquid) . White blood cell (WBC) count was 9 000×10(6)/L, mononuclear cell was 0.9, polykaryocytes was 0.1, triglyceride was 12.37 mmol/L in the pleural effusion. Contrast-enhanced lung CT (revascularization) showed pericardial effusion and a massive left sided pleural effusion. The second patient was a male aged 9 years and 6 months, who presented with a history of cough for 24 days, intermittent fever, vomiting, abdominal pain for 19 days, and edema of lower limbs for 4 days. Physical examination showed edema in both eyelids, lower extremities and scrotum. The level of albumin was 14 g/L and the titer of Mycoplasma pneumoniae IgM was 1: 320 in the serum. His hydrothorax pleural effusion showed milk white. White blood cell (WBC) count was 74×10(6)/L, mononuclear cell was 0.78, polykaryocytes was 0.22, triglyceride was 1.01 mmol/L in the pleural effusion. Chyle test showed positive in his pleural effusion and seroperitoneum. High-resolution CT of the lung revealed bilateral interstitial and parenchymal infiltration and both sided pleural effusion. Abdominal ultrasound showed giant hypertrophy of the gastric mucosa and massive ascites. Gastroscopy showed giant hypertrophy of the gastric mucosa. Lymphoscintigraphy revealed primary lymphatic dysplasia in both children.
CONCLUSIONPrimary lymphatic dysplasia might occur in children and result in dropsy of serous cavity (chylothorax, chylopericardium, chylous ascites). Dropsy of serous cavity showed bloody or milk white. WBC count might elevate with lymphocyte increasing mostly, triglyceride was often higher than 1.0 mmol/L in dropsy of serous cavity. Primary lymphatic dysplasia can be diagnosed by lymphoscintigraphy.
Child ; Child, Preschool ; Chylothorax ; diagnosis ; etiology ; pathology ; Humans ; Leukocyte Count ; Lymphatic Abnormalities ; complications ; diagnosis ; pathology ; Lymphoscintigraphy ; Male ; Pericardial Effusion ; diagnosis ; etiology ; Pleural Effusion ; diagnosis ; etiology ; pathology ; Tomography, X-Ray Computed