The orthopedic metallic pins and wires migration for the chest cavity is uncommon and rarely reported in medical literature although it is potentially lethal, especially when they reach the heart or mediastinum great vessels. We reported a case of Kirschner wire withdrawal, for right postero-lateral thoracotomy, which were transfixanting ascendent thoracic aorta artery, in its due to its migration of left clavicle, where it was placed to fix an occurred fracture 10 years before. Resumo A migração de pinos e hastes metálicas ortopédicos para a cavidade torácica é rara e pouco descrita na literatura médica, embora seja potencialmente fatal, principalmente quando atingem o coração ou grandes vasos intratorácicos. Reportamos um caso de migração de fio de Kirschner, implantado na clavícula direita há 10 anos, transfixando a aorta torácica em sua porção ascendente, sendo retirado por toracotomia póstero-lateral esquerda. DescriptorsDescritores: Fios ortopédicos. Dor no peito. Migração de corpo estranho.

OBJETIVO: Relatar uma série de casos de pacientes com mediastinite descendente necrosante (MDN) tratados com cirurgia torácica minimamente invasiva. MÉTODOS: Relatamos os casos de três pacientes com MDN submetidos à desbridamento mediastinal através de cirurgia torácica videoassistida no Hospital São Paulo, São Paulo (SP), desde a sua admissão até o desfecho final. RESULTADOS: Os três pacientes apresentaram boa evolução pós-operatória, com tempo médio de internação de 16,7 dias. CONCLUSÕES: Concluímos que a videotoracoscopia é uma técnica efetiva para a drenagem mediastinal no tratamento da MDN, com os benefícios da cirurgia minimamente invasiva: menos dor pós-operatória, menor liberação de fatores inflamatórios, retorno precoce às atividades diárias e melhores resultados estéticos.

Advanced age, greater maximum SPN diameter, and spiculated margins were significantly associated with the diagnosis of SPN malignancy. Our analysis shows that, although both mathematical models were effective in determining SPN malignancy in our population, the 1997 model was superior.

Background. Bilateral femoral neuropathy is an uncommon complication of various surgical and nonsurgical procedures, such as pelvic/abdominal surgery or vaginal delivery. Case Report. We report a case of a 41-year-old male who was found unresponsive against the wall in a “lithotomy-type” position with both knees flexed at approximately 90 degrees and both hips flexed and externally rotated at approximately 90 and 60 degrees, respectively, 24–48 hours after a drug overdose (combination of dihydrocodeine, paracetamol, diazepam, and amitriptyline). During his recovery, he complained of severe bilateral proximal lower limb weakness and bilateral distal lower limb pain and allodynia. His symptoms were initially attributed to critical illness myopathy/neuropathy (CIMN). However, thorough clinical and neurophysiological evaluation revealed that his symptoms were due to severe bilateral femoral neuropathies. Conclusions. To our knowledge, this is the first reported case of bilateral femoral nerve palsy due to prolonged posturing in a “lithotomy-type” position in the context of a drug overdose.