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Pneumothorax and Congenital Diaphragmatic Hernia: An Unusual Combination
Neumotórax y hernia diafragmática congénita, una asociación infrecuente
José Soro, Montserrat Blanco
, Eva García-Fontán
Corresponding author
Servicio de Cirugía Torácica, Complejo Hospitalario Universitario de Vigo, Hospital Xeral-Cíes, Vigo, Pontevedra, España
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Se observa además la existencia de una lobulación diafragmática (flecha). b) Herniación diafragmática derecha vista por videotoracoscopia en la que se puede observar la cúpula hepática. c) Herniación cerrada con puntos sueltos de monofilamento.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "José Soro, Montserrat Blanco, Eva García-Fontán" "autores" => array:3 [ 0 => array:2 [ "nombre" => "José" "apellidos" => "Soro" ] 1 => array:2 [ "nombre" => "Montserrat" "apellidos" => "Blanco" ] 2 => array:2 [ "nombre" => "Eva" "apellidos" => "García-Fontán" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S1579212915003249" "doi" => "10.1016/j.arbr.2015.10.011" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212915003249?idApp=UINPBA00003Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289615001891?idApp=UINPBA00003Z" "url" => "/03002896/0000005100000012/v2_201511280826/S0300289615001891/v2_201511280826/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S1579212915001469" "issn" => "15792129" "doi" => "10.1016/j.arbr.2015.05.009" "estado" => "S300" "fechaPublicacion" => "2015-12-01" "aid" => "1177" "copyright" => "SEPAR" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Arch Bronconeumol. 2015;51:656-7" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 1918 "formatos" => array:3 [ "EPUB" => 131 "HTML" => 1327 "PDF" => 460 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Immunomodulating Effects of Glatiramer Acetate and Its Potential Role in Pulmonary Tuberculosis Reactivation" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "656" "paginaFinal" => "657" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Efectos inmunomoduladores del glatirámero acetato y su potencial papel en la reactivaciónde la tuberculosis pulmonar" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2264 "Ancho" => 2502 "Tamanyo" => 207412 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A simplified scheme of the cellular immune response to <span class="elsevierStyleItalic">M. tuberculosis</span>. The (+) and (−) signs indicate the positive or negative feedback induced by each cell or cytokine under normal circumstances. The main sites where glatiramer acetate (GA) directly participates are marked with a black dot (•) and arrow to indicate the induced effect (increase or decrease). It directly affects macrophage activation (M act) by inhibiting T-helper 1 (Th1) response and thus, reducing levels of circulating interferon (IFN) γ, which plays an important role in their activation. It inhibits production of interleukin (IL) 12 which amplifies the Th1 response.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">3</span></a> The IL-10 production is increased, directly inhibiting macrophage activation, and blocking the effects of dendritic cells (DC) and the differentiation of naive T cells into Th1 cells.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">4</span></a> It blocks the migration of Th1 cells from lymph nodes back to the lungs, and inhibits the expression and release of tumor necrosis factor (TNF)-α.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">4</span></a> Finally, it stimulates T-regulatory (T-reg) cells which also block the Th1 response.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">4</span></a></p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Pablo Sanchez-Salcedo, Juan P. de-Torres" "autores" => array:2 [ 0 => array:2 [ "nombre" => "Pablo" "apellidos" => "Sanchez-Salcedo" ] 1 => array:2 [ "nombre" => "Juan P." 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B and C–chest CT (coronal and axial planes): bulky heterogeneous mass of about 110<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>94<span class="elsevierStyleHsp" style=""></span>mm invading the right scapula and the adjacent muscles, with periosteal reaction of the scapula, and heterogeneous nodular formation in the apical posterior segment of the left upper lobe, with central cavitation, of about 88<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>80<span class="elsevierStyleHsp" style=""></span>mm, with invasion of the mediastinal fat and the chest wall. 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Diaphragmatic lobulation is also seen (arrow). (b) Right diaphragmatic herniation on video-assisted thoracoscopy, showing the hepatic dome. (c) Herniation closed by separate monofilament sutures.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 41-year-old woman with a history of spontaneous right pneumothorax, treated with thoracic drainage, was evaluated in our department for a relapse of the same condition. Chest X-ray revealed, in addition to pneumothorax, diaphragmatic lobulation (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>a, arrow). Video-assisted thoracoscopy revealed congenital diaphragmatic hernia (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>b), which was repaired with separate monofilament sutures. No other lesions were identified that could explain the origin of the pneumothorax (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>c). The patient was discharged on day 4 after surgery, with no complications.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Soro J, Blanco M, García-Fontán E. Neumotórax y hernia diafragmática congénita, una asociación infrecuente. Arch Bronconeumol. 2015;51:655.</p>" ] ] "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 971 "Ancho" => 1666 "Tamanyo" => 160629 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(a) Posterolateral chest X-ray showing complete right pneumothorax with no mediastinal shift. Diaphragmatic lobulation is also seen (arrow). (b) Right diaphragmatic herniation on video-assisted thoracoscopy, showing the hepatic dome. (c) Herniation closed by separate monofilament sutures.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "Reference" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:1 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Catamenially recurring pneumothorax with partial liver herniation: a particular view" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "S. Sanna" 1 => "M. Taurchini" 2 => "M. Monteverde" 3 => "V. Agnoletti" 4 => "G.L. Casoni" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1159/000328724" "Revista" => array:6 [ "tituloSerie" => "Respiration" "fecha" => "2011" "volumen" => "82" "paginaInicial" => "476" "paginaFinal" => "477" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21757874" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15792129/0000005100000012/v1_201512080104/S1579212915003249/v1_201512080104/en/main.assets" "Apartado" => array:4 [ "identificador" => "21342" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Clinical Image" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/15792129/0000005100000012/v1_201512080104/S1579212915003249/v1_201512080104/en/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212915003249?idApp=UINPBA00003Z" ]
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