TRALI And Foreign Body in The Trachea: As a Cause Of Acute Dyspnea in The Same Patient

Yıl 2018, Cilt: 10 Sayı: 1, 45 - 48, 01.04.2018

Şeyma Başlılar Bengü Şaylan Nesrin Sarıman

Öz

Dyspnea is one of the most frequent symptomps in pulmonology practice. Pulmonary consultance is frequently demanded for both in-patients and patients in emergency room with acute dyspnea. Foreign bodies in trachea and bronchi may be skipped easily in patients who applied emergency room with acute dyspnea denying history of aspiration, Transfusion related acute lung injury TRALI is a condition of pulmonary edema developes following transfusion and results in acute respiratory dystress. As it is a rare condition misdiagnosis is probable. 44 years old male developed acute and severe respiratory dystress following transfusion applied for perirenal hematoma and intubated in intensive care unit. He recovered fast clinically and radiologically, so he was discharged from hospital 2 days after extubation. But in a few days he applied emergency service with a compliant of acute dyspnea again. The foreign body in trachea was skipped in radiological examinations, Finally he self-expectorated the piece of intubation tube by coughing and dyspnea was resolved.

Anahtar Kelimeler

dyspnea, foreign body, TRALI

Aynı Olguda İki Nadir Akut Dispne Nedeni: TRALI ve Trakeada Yabancı Cisim

Öz

Nefes darlığı, göğüs hastalıkları pratiğinde en sık karşılaşılan semptomlardan biridir. Yatarak takip edilen ve acile başvuran olgularda akut dispne nedeni ile sıklıkla konsültasyon istenmektedir. Acil polikliniğe solunum sıkıntısı ile başvuran olgu aspirasyon öyküsü tariflemiyorsa, trakea ve bronşta yabancı cisim varlığı gözden kaçabilir. Transfusion related acute lung injury TRALI transfüzyon sonrası gelişen akut solunum sıkıntısına neden olan akciğer ödemi tablosudur. Bu patoloji de nadir görülmesi nedeni ile ilk sırada akla gelmeyebilir. 44 yaşında erkek hasta, perirenal hematom nedeni ile yapılan kan transfüzyonu sonrasında ani ve ciddi solunum sıkıntısı gelişmesi üzerine yoğun bakım ünitesine alınarak entübe edilmiş, klinik ve radyolojik olarak hızla düzelen hasta ekstübasyondan iki gün sonra taburcu edilmiş, ancak acil polikliniğe tekrar nefes darlığı ile başvurmuştur. Trakea içinde entübasyon tüpünün parçası tetkiklerde gözden kaçmış, hasta öksürerek “self ekspektorasyon” ile yabancı cismi çıkardıktan sonra nefes darlığı düzelmiştir.

Anahtar Kelimeler

dispne, yabancı cisim, TRALI

Kaynakça

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