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Respiratory distress syndrome. A suggestive pattern of shunt effect detected by means of macroparticles

Maldonado A, Domper M, Garcia MJ [ES], Arbizu J [ES], Martin S, Richter J. [ES]
Department of Nuclear Medicine, Clínica Universitaria de Navarra, Pamplona, Spain.

Revisão:Clinical Nuclear Medicine

Data: 1/Jan/1993

Medicina Nuclear [ES]

An esophagobronchial fistula developed in a patient who had well-differentiated squamous carcinoma of the lung that was treated with chemotherapy.

Because the esophagobronchial fistula could not be surgically repaired, it was isolated with a mechanical stitch above and below it. Forty-eight hours after initiation of enteral nutrition, a perfusion lung scan was performed because of clinical suspicion of pulmonary embolism. Because the scan showed reduced pulmonary radioactivity and accumulation of activity in the kidneys and spine, an arteriovenous shunt was suspected.

However, subsequent digital subtraction angiography ruled out this possibility and a recurrence of the esophagobronchial fistula was confirmed with an esophagogram. The unusual extrapulmonary activity could be related to a reversible capillary shunt in the pulmonary vasculature, secondary to acute respiratory distress syndrome.

CITAÇÃO DO ARTIGO  Clin Nucl Med. 1993 Jan;18(1):19-21

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