Faculty of Medicine

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    UNEXPECTED FOREIGN BODY AS A REASON OF LOBAR PNEUMONIA IN A 6,5 YEARS OLD BOY – CASE REPORT
    (Macedonian Association of Anatomists, 2022)
    Mitrovska Josifova, Veselinka
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    ;
    Chakalaroska, Irena
    ;
    ;
    Spasova, Olga
    We present a case of a foreign body as a reason for right lobar pneumonia in 6,5 years old boy. He was admitted in our hospital because of 6 day high fever (up to 40 Cͦ), malaise, cough, stomach ache. Clinically he had impaired breathing in the basis of the right lung, and laboratory findings were with elevated inflammatory markers. The radiogram of the chest showed round consolidation in the right low lung lobus. Microbiologicaly, we isolated Mycoplasma pneumonia (IgM) from pneumoslide, and also Staphylococcus aureus – MRSA from the sputum. Additional immunology tests like immunoelectrophoresis ( IgA, IgG, IgM) were done, all of them with results in normal ranges. After one week of therapy with parenteral rehydration, wide spectral antibiotics (according to antibiogram), inhalatory bronchodilatator and systemic corticosteroid, the child presented with scarce haemoptysis, with consecutive clear haemoptysis on the 10-th day. This set for bronchoscopy and Mx-test with PPD5, which was negative. Flexibile bronchoscopy was made at 11th day of the stay, with visualized foreign body- grass like structure in the openings of the arm of middle and lower right bronchus. We continued with rigid bronchoscopy, with successfully removed grass- Hordeum murinum. After the intervention we observed completely clinical recovery of the lung findings, as well as radiological improvement
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    Tracheal diverticulum – a possibility of intraoperative and postoperative complications
    (Department of Anaesthesia and Reanimation, Faculty of Medicine, “Ss. Cyril and Methodius” University Skopje, R.N.Macedonia, 2019-12)
    Tusheva Ivana
    ;
    Adjami Bekim
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    ;
    ;
    Poposki Bozidar
    During preoperative anesthesiology examination of a 39 year old female patient, it was noticed a suspected tracheal diverticula, as seen on the CT scan. Bronchoscopy was required to assess the risk of intubation, which did not confirm the presence of the tracheal diverticulum, but a demarcation of the posterior wall of the trachea was observed. Due to a diagnosed kidney tumor, the patient was intubated and operated without complications from the intubation. However postoperatively, in order to confirm the presence of a tracheal diverticulum, the Radiology Clinic was consulted, where a 3D reconstruction of a pre-made CT scan revealed a tracheal diverticulum with dimensions of 1.83 cm x 5.42 mm. Conclusion: Diagnosis of tracheal diverticulum is established with high resolution CT with 1 mm cross sections and 3D reconstruction. Bronchoscopy cannot exclude the presence of tracheal diverticulum. If we have evidence of the presence of a tracheal diverticulum during anesthesiology, it is desirable to determine the level of the tracheal diverticulum to avoid placing the cuff at that level. The airway pressure needs to be strictly controlled and the ventilation mode adequate