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José Roberto Missel Corrêa

Bio: José Roberto Missel Corrêa is an academic researcher from Universidade Federal de Santa Maria. The author has contributed to research in topics: Physical examination & Subcutaneous emphysema. The author has an hindex of 3, co-authored 5 publications receiving 27 citations.

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TL;DR: From postadmission day two onward, the subcutaneous emphysema gradually improved, and the patient received conservative treatment, including rest, unrestricted diet, and analgesia, if necessary.
Abstract: A previously healthy, 21-year-old female nonsmoker sought emergency room treatment complaining of recent and progressive swelling of the face, neck, and chest (Figure 1). The patient reported no pain, dyspnea, or dysphagia at admission. She reported a brief history of odynophagia in the previous week, when, during an episode of cough, she felt intense (dissecting) retrosternal pain, which subsided within a few minutes after its onset. After that episode, she had no symptoms other than the abovementioned swelling.Physical examination revealed extensive subcutaneous emphysema, which extended from the xiphoid process to the temporal muscle and involved the entire neck and face. Pulmonary percussion and auscultation revealed no abnormalities. Cardiac auscultation revealed the presence of Hamman’s sign (crackles—as was the case in our patient—or bubbling sounds, synchronous with the heartbeat). Oral endoscopy revealed no abnormalities, and the remainder of the physical examination was normal.A CT scan of the skull, neck, and chest confirmed the presence of pneumomediastinum, pneumothorax (Figure is known as the Macklin effect or phenomenon, 2A), and extensive soft tissue emphysema in the cervical region (Figure having been named after Charles C. Macklin, 2B)—involving the face, periorbital tissues, and temporal muscles (Figure 2C)—as well as revealing the presence of pneumorrhachis (Figure in the case reported here, spontaneous 2D).From postadmission day two onward, the subcutaneous emphysema gradually improved. The patient received conservative treatment, including rest, unrestricted diet, and analgesia, if necessary. The results of routine laboratory tests, including blood workup and urinalysis, were normal. Follow-up chest X-rays revealed a sustained reduction in the abovementioned signs and symptoms. The patient remained under observation for another five days, being asymptomatic and showing nearly complete resolution of the clinical picture at discharge (Figure 1).Spontaneous pneumomediastinum, also known as Hamman’s syndrome, is defined as the presence of free air in the mediastinum, being unrelated to trauma or procedures (surgical or otherwise).

10 citations

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TL;DR: A case of spontaneous biloma was described, whose diagnosis was radiologically confirmed, and the patient progressed well and was discharged.
Abstract: Biloma is defined as any collection of bile outside the biliary tree, usually resulting from surgery complications and abdominal trauma. Spontaneous occurrence of bilomas is rare, occasionally associated with choledocolithiasis. The present report describes a case of spontaneous biloma, whose diagnosis was radiologically confirmed. At laparotomy, the presence of a retroperitoneal biloma was observed. Intraoperative cholangiography has not demonstrated the presence of fistula. After drainage, the patient progressed well and was discharged.

8 citations

Journal ArticleDOI
TL;DR: Doctors should consider the diagnostic role of CT in this underdiagnosed challenging disease, which is usually followed by inflammation.
Abstract: Epiploic appendagitis is a self-limited condition secondary to torsion or thrombosis of the epiploic appendages, usually followed by inflammation. The clinical findings are non-specific, leading to frequent misdiagnosis situations. On the other hand, the Computed Tomography (CT) features of epiploic appendagitis are quite typical and well described. Therefore, physicians should consider the diagnostic role of CT in this underdiagnosed challenging disease.

3 citations

Journal Article
TL;DR: A 76-year-old woman presented with a painful growing mass on her left lower back since 10 months, which had become worse during the last 10 days.
Abstract: A 76-year-old woman presented with a painful growing mass on her left lower back since 10 months. The pain was intermittent, but had become worse during the last 10 days. No history of previous procedures and trauma was reported. Physical examination showed a left lumbar tender mass which

3 citations


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TL;DR: The use of hepatobiliary contrast agents increases the diagnostic accuracy of magnetic resonance imaging and reduces the number of non-specific liver lesions, and may reduce the need for invasive diagnostic procedures and further investigations with other imaging methods.
Abstract: The characterization of focal liver lesions is very important. Magnetic resonance imaging is considered the best imaging method for evaluating such lesions, but does not allow for the diagnosis in all cases. The use of hepatobiliary contrast agents increases the diagnostic accuracy of magnetic resonance imaging and reduces the number of non-specific liver lesions. The main indications for the method include: differentiation between focal nodular hyperplasia and adenoma; characterization of hepatocellular carcinomas in cirrhotic patients; detection of small liver metastases; evaluation of biliary anatomy; and characterization of postoperative biliary fistulas. The use of hepatobiliary contrast agents may reduce the need for invasive diagnostic procedures and further investigations with other imaging methods, besides the need for imaging follow-up.

24 citations

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TL;DR: The authors will approach five uncommon liver tumors - angiosarcoma, angiomyolipoma, cystadenoma/biliary carcinoma, epithelioid hemangioendothelioma, and fibrolamellar hepatocellular carcinoma -, describing their main characteristics and image findings with focus on computed tomography and magnetic resonance imaging.
Abstract: Most malignant liver tumors are represented by hepatocellular carcinoma and cholangiocarcinoma; however a variety of other uncommon hepatic lesions might also be found. Common lesions such as hemangioma, focal nodular hyperplasia and metastases are well known and have already been extensively documented in the literature. The diagnosis of typical hepatic lesions may be done with some reliability by means of several imaging methods; on the other hand, uncommon lesions normally represent a diagnostic challenge for the radiologist. In this first part of the study, the authors will approach five uncommon liver tumors - angiosarcoma, angiomyolipoma, cystadenoma/biliary carcinoma, epithelioid hemangioendothelioma, and fibrolamellar hepatocellular carcinoma -, describing their main characteristics and image findings with focus on computed tomography and magnetic resonance imaging.

20 citations

Journal ArticleDOI
TL;DR: The Sandwich technique has demonstrated good outcomes in the management of the Grynfelt-Lesshaft's hernia and should be according to the classification proposed and to the experience of the surgeon.
Abstract: Introduction Lumbar hernia account for less than 2% of al abdominal hernias, been the Grynfelt-Lesshaft's hernia (GLH) more frequent than the others. With approximately 300 cases published in the literature, the general surgeon may have the chance of treat it ones in their professional life. Case report A 42-years old male with human immunodeficiency virus and Diabetes Mellitus presented to the outpatient clinic with a GLH. Preoperative classified as a type “A” lumbar hernia an open approach was scheduled. We performed a Sandwich technique with a sublay and onlay ULTRAPRO® mesh fixed with PDS® II suture without complications and discharged the patient 24-h after. After six months, the patient denied any complication. Discussion Primary (spontaneous) lumbar hernias represent 50–60% of all GLH. The preoperative classification of a lumbar hernia is mandatory to propose the best surgical approach. According to the classification of Moreno-Egea A et al., the best technique for our patient was an open approach. The Sandwich technique has demonstrated good outcomes in the management of the GLH. Conclusion The surgical approach should be according to the classification proposed and to the experience of the surgeon. The Sandwich technique has good outcomes.

15 citations

Journal ArticleDOI
19 Jun 2020-Chest
TL;DR: A large number of cough complications are identified and thematically categorized primarily by organ system so that future studies of each system or each complication can be conducted and identify gaps in the literature for future research.

15 citations

Journal ArticleDOI
TL;DR: Although uncommon, the association between pulmonary function testing and air leak syndromes has been increasingly reported in the literature, and lung diseases, such as interstitial lung disease, include structural changes that facilitate the occurrence of this complication.
Abstract: Spontaneous pneumomediastinum is an uncommon event, the clinical picture of which includes retrosternal chest pain, subcutaneous emphysema, dyspnea, and dysphonia. The pathophysiological mechanism involved is the emergence of a pressure gradient between the alveoli and surrounding structures, causing alveolar rupture with subsequent dissection of the peribronchovascular sheath and infiltration of the mediastinum and subcutaneous tissue with air. Known triggers include acute exacerbations of asthma and situations that require the Valsalva maneuver. We described and documented with HRCT scans the occurrence of pneumomediastinum after a patient with bleomycin-induced interstitial lung disease underwent pulmonary function testing. Although uncommon, the association between pulmonary function testing and air leak syndromes has been increasingly reported in the literature, and lung diseases, such as interstitial lung diseases, include structural changes that facilitate the occurrence of this complication.

10 citations