SA Medical - General Medicine And Imaging of Disease

AN UNEXPECTED CHEST XRAY Mrs MacLeod was a rather prudent 54 year old women, that presented with a shortness of breath, a chronic cough and recurrent pneumonia. She had an obstructive lung pattern on pulmonary function tests. She come in for an xray of the chest. The chest XRAY was rather different. There was unequal lung volumes, with the right lung volume being larger than the left. There was also decreased left lung vessels noted. There were no pleural effusions and no pneumothorax present either. The right lung was perfectly normal. Upon further investigation she reported to have had a significant childhood viral infection that resulted in distal airspace obstruction, probably secondary to an adenovirus or and RSV viral infection. A case of Sweyer-James syndrome was diagnosed. She was treated with influenza vaccinations, but in this case no lobectomy was performed as the no specific lung segment was identified.

A CASE OF A VERY DIFFICULT UNSUSPECTED PREGNANCY 35 year Jane who struggled to fall pregnant, had multiple miscarriages. She was known to have a left asbcent kidney. She had pain with intercourse and struggled in her relationships as a result. She came for an abdominal and gynecological sonar examination. The findings were surprising. Janes uterus was different. Her uterus was separated by a deep cleft, and two separate cavities. In one of the uterine cavities she had a viable pregnancy. The second uterus was empty. The diagnosis was uterine didelphys with a pregnancy. An amazing but rare finding. Uterus didelphys is a type of Müllerian duct anomaly (class III) where there is a complete duplication of uterine horns as well as duplication of the cervix, with no communication between them.   8% of women may that have uterine didelphys have painful sex (dysparenia) due to a vaginal septum.  The chances of a good outcome to this pregnancy are dismal.  Onl