PMC6636488_01
Patients' extremities.
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fig1
The physical exam is remarkable for polydactyly with syndactyly (Figure 1) and obesity.
A macroscopic preparation of the resected esophagus.
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On the posterior wall, along with the thoracic esophagus, a discrete seal near 6 cm in length was palpated (Figure 2).
Section of the macroscopic preparation with ulcerative changes.
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During the section of the macroscopic preparation, ulcerative changes with a length of about 6 cm were visualized (Figure 3), the same with definitive histological preparation showing a moderately differentiated adenocarcinoma.
Chest CT:a massive pleural effusion on the right side and a small one on the left.
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There were clinical, laboratory, chest X-ray, and CT data for spontaneous bilateral hemorrhagic pleural effusions; the bigger one was on the right side (Figure 4).
Ultrasound examination of the chest:a pleural effusion with a liquid and a solid (axillary and interlobar) component, evaluated as a hematoma, confirmed in the following surgical revision.
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Three days later because of chest X-ray and ultrasound data (Figure 5) for a coagulated right-sided hemothorax, a posterior-lateral right thoracotomy followed.
Chest X-ray after the decortication.
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The patient was discharged in a clinically stable general condition after a smooth postoperative period (Figure 6).