Analgesia for pleural biopsy.
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Biomedical subjects
Publications and source records attributed to J G Tredoux.
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A 16-year-old girl had had a splenic abscess for approximately 20 months with minimal symptoms and signs. Progressive elevation of the left hemidiaphragm could be traced on chest radiographs from 20 months before admission, and was shown on ultrasonography, radionuclide scintigraphy and computed tomography to be secondary to massive splenomegaly. The presence of splenic abscesses was confirmed by laparotomy and she was cured by splenectomy. The nonspecific clinical presentation and potential high mortality of this condition are stressed, and the role of diagnostic aids is discussed. Ultrasonography is a good screening procedure in terms of cost and speed, but splenic scintigraphy is more sensitive. Computed tomography is the most sensitive and specific non-invasive procedure for the diagnosis of splenic abscesses.
A case of 'primary' mitral valve prolapse is documented. The patient was admitted with right-sided hemiplegia of sudden onset, probably caused by a cerebral embolus from the mitral valve. He also had a painless transmural inferior myocardial infarction (MI) of indeterminate age which was diagnosed electrocardiographically and on left ventricular cine angiography. Since selective coronary arteriography delineated the absence of fixed obstructive atherosclerotic disease, and since coronary vasospasm could not be provoked with the ergonovine (ergometrine) maleate test, it is further postulated that a coronary embolus from the abnormal mitral valve apparatus was responsible for the painless MI. A percutaneous right ventricular endomyocardial biopsy specimen displayed findings not indicative of a 'cardiomyopathy'.