Torsion of lobes of the lung is a rare complication following lung transplantation. We present a case of counterclockwise torsion of the right lung allograft and review of nine additional cases in the literature of lobar torsion following lung transplantation. A high degree of suspicion is needed for early diagnosis with rapid surgical intervention to preserve lung viability.

Clinical, radiographic, and functional outcome parameters were analyzed before and after treatment of eight individuals with lumbosacral chordomas studied over a 3-year period. Emphasis was placed upon correlation of multiplane images and the pathoanatomy of the gross specimen. Surgical resections achieving wide margins can be curative. Magnetic resonance imaging of lumbosacral chordomas has revolutionized the preoperative anatomic localization of these tumors. Therefore, it is critical that the operating surgeon scrutinize the three-dimensional location of the tumor and its spatial relationship to surrounding structures prior to surgical eradication. A systematic approach for the radiographic analysis of tumor extent in lumbosacral chordomas is presented. Four strategic areas of preoperative analysis are identified for sacral chordomas and two for lumbar neoplasms. Functional outcome after resection is predicted by Stener's work. Contamination-free surgery is facilitated by accurate preoperative radiographic interpretation of the pathoanatomy by the surgeon.

Multiple injuries resulting from the use of nail guns have been described in the literature; however, to date there has been no report of a nail gun injury to the abdomen. We describe the case of a 30-year-old male tradesperson who suffered a penetrating nail gun injury to the epigastrium, resulting in multiple injuries to the bowel and an inferior vena caval injury with massive haemorrhage. This case demonstrates the wide range of injuries capable of being inflicted by a single penetrating injury, and emphasizes the need for proper training and safety measures in the use of nail guns.

Constrictive pericarditis is a rare entity following lung transplant, with only seven previous cases reported in the literature. We present two additional cases and review the literature on this subject. Constrictive pericarditis should be considered in lung transplant patients who present with dyspnea and evidence of cardiac failure. Pericardiectomy remains the treatment of choice irrespective of the etiology.

No abstract