Case of the Month: Case 2

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Joseph L Nates MD*
Assistant Professor
Departments of Neurosurgery and Anesthesiology
Health Science Center Medical School
The University of Texas-Houston

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Citation: J. L. Nates : Case of the Month: Case 2 . The Internet Journal of Thoracic and Cardiovascular Surgery. 2000 Volume 3 Number 1

Keywords: emergency medicine | critical care | intensive care medicine | medicine | education | patient care | ventilation | cardiac | neuro | pediatric | cardio-pulmonary support | ards | respiratory failure | multiorgan failure | hemodynamics | intensivecare unit | surgical i

History

A 55 y.o. latino-american male was admitted to the hospital with previous medical history of cysticercosis diagnosed in his country of residence in south-america. He had an intracranial mass, and he consulted for a second opinion. A chest X-ray showed this:

What is your diagnosis?

Answer

No, it is not a pulmonary cyst. This is a hiatal hernia with stomach and bowel in the chest. There is a nasogastric tube going into the stomach (looking similar to a pulmonary artery catheter inserted too far into the right pulmonary artery).

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