A 6-y-old girl developed fever, soft-tissue mass in the right chest wall, osteomyelitis of the 10th rib and hepatic granuloma. Cat scratch disease was diagnosed by histological examination of the mass and serological tests. The patient was treated successfully with antibiotics and recovered completely, as shown by a 10 month follow-up.

We report a subtle-discrete aortic dissection, without bulging of the aortic wall or aneurysm or valve pathology or periaortic effusion, which resulted in a lethal cardiac tamponade to a 35-year-old male.

No abstract

Spontaneous coronary artery dissection constitutes a rare entity that affects mostly women, especially those less than 40 years of age. Treatment of choice is a matter of discussion. It is suggested by many that the therapeutic strategy should be individualized based on each patient's clinical and angiographic manifestations. We present the case of a young woman who underwent surgical revascularization for dissection of the left main stem by using both internal thoracic arteries. Angiographic follow-up revealed resolution of the dissection, obstruction of the right internal thoracic artery graft, and reverse flow in the left internal thoracic artery graft.

A 52-year-old female was admitted with sudden onset sharp, retrosternal pain, six months following an uncomplicated Nissen fundoplication performed for a hiatal hernia. On admission, she was tachycardic (110 bpm) and hypotensive (90/65 mm). A chest X-ray revealed a hydropneumopericardium ( Figure 1a). An upper gastrointestinal (GI) endoscopy and computed tomography (CT) scan with oral contrast did not reveal any GI pathology (Figure 1b and c). The patient underwent an emergent subxiphoid pericardiocentesis using a pigtail catheter inserted under echocardiographic guidance and her vital signs normalized. Pericardial fluid cultures were negative for any pathogens.The catheter was removed after three days and a follow-up chest Xray showed no recurrence (Figure 1d). The patient remained asymptomatic and follow-up CT imaging and GI endoscopy one month later were normal. FIGURE 1 Tension hydropneumopericardium. a: Chest Xray on admission showing the pericardial air and fluid accumulation (black arrows). The white arrows point to the pericardium. b: CT view of the thorax confirming the hydropneumopericardium. c: CT view of the chest in supine position. d: Chest Xray after insertion of a pigtail catheter (white arrow) and complete air-fluid drainage. CT, computed tomography J Card Surg 2016; 31: 589 wileyonlinelibrary.com/jocs