tailieunhanh - Báo cáo y học: "A colonic splenic flexure tumour presenting as an empyema thoracis: a case report"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: A colonic splenic flexure tumour presenting as an empyema thoracis: a case report | Journal of Medical Case Reports BioMed Central Open Access Case report A colonic splenic flexure tumour presenting as an empyema thoracis a case report K Murphy M Chaudry and HP Redmond Address Department of Surgery Cork University Hospital Wilton Cork Ireland Email K Murphy - thekpm@ M Chaudry - mzch666@ HP Redmond - redmondhp@ Corresponding author Published 13 January 2009 Received 28 December 2007 Journal of Medical Case Reports 2009 3 9 doi 1752-1947-3-9 Accepted 13 January 2009 This article is available from http content 3 1 9 2009 Murphy et al licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License http licenses by which permits unrestricted use distribution and reproduction in any medium provided the original work is properly cited. Abstract Introduction The case report describes the rare presentation of a 79-year-old patient with a locally perforated splenic flexure tumour of the colon presenting with an apparent empyema thoracis in the absence of abdominal signs or symptoms. Case presentation Initial presentation was with a non-productive cough anorexia and general malaise. An admission chest X-ray and subsequent computed tomographic image of the thorax showed a loculated pleural effusion consistent with an empyema. The computed tomography also showed a thickened splenic flexure. Thoracotomy was performed and a defect in the diaphragm was revealed after the abscess had been evacuated. A laparotomy was carried out at which point a tumour of the splenic flexure of the colon was found to be invading the spleen and locally perforated with subsequent collection in communication with the thorax. The tumour and spleen were resected and a transverse end colostomy was fashioned. Conclusion One must consider the diagnosis of pathology inferior to the diaphragm when an apparent empyema thoracis is .