No abstract

Gastroenteritis is the inflammation of intestines and stomach which presents with vomiting, fever, abdominal pain and diarrhea. It could be persistent, acute, or chronic, and can also be classified as infectious or non-infectious. Despite improvement in management, the mortality can reach up to 17,000. In this study, our aim was to understand the various etiologies that cause gastroenteritis in adults, and also discuss methods of management. We conducted this review using a comprehensive search of MEDLINE, PubMed and EMBASE from January 1994 to March 2017. The following search terms were used: acute gastroenteritis, diarrheal disease, viral gastroenteritis, bacterial gastroenteritis, diagnoses of gastroenteritis. Each year, more than 350 million cases of acute gastroenteritis occur in the United States only. The largest portion of gastroenteritis cases is due to viral infections. Therefore, the empiric use of antibiotics is usually not recommended. However, in selected patients, empiric antibiotics therapy is indicated and is associated with significant improvement and decrease in mortality. The primary goal of management of gastroenteritis is treating dehydration.

Chest wall tumors are uncommon and include a variety of Cartilaginous, bony, and soft tissue lesions. The clinical presentation varies from asymptomatic to chest pain or ulcerating chest mass. Retro mammary chondrosarcoma of the chest wall can present as a painless breast mass and may be mistaken for a breast tumor. A careful clinical examination and relevant investigations are a cornerstone to plan an appropriate surgical procedure.

A five year girl had eczema and allergic rhinitis in the past, presented with a history of cough, shortness of breath for the last one month. Her chest -X-ray showed a left side pleural effusion, and a computed tomographic scan (CT) of the chest showed left side hydropneumothorax. Left side 21 Fr drain was inserted. Her clinical condition deteriorated despite antimicrobial therapy, and she required mechanical ventilatory support due to respiratory distress. She also developed a right-sided pneumothorax that was managed by inserting a 21 Fr chest drain. A video-assisted thoracoscopic VATS procedure was done to staple the lung bullae and drain the empyema. Her post-operative chest X-ray showed good lung expansion. Pleural fluid culture report was positive for candida. She was commenced on antifungal microbial therapy. Two days later, she developed again left side pneumothorax, which was again managed by left intercostal drain. We were unable to wean her off from mechanical ventilatory support due to a significant air leak due to bronchopleural fistula. A posterolateral thoracotomy was performed, and the bronchopleural fistula was closed. She was extubated the next day, and intercostal drains were removed on the 4th post-operative day.