Caso clínico 1: absceso cervical profundo secundario a celulitis por síndrome de Ramsay Hunt. Caso clínico 2: hernia diafragmática traumática multivisceral, causa inusual de hemotorax: reporte de caso

Abstract

Introduction: Ramsay Hunt syndrome represents an unusual complication of the reactivation of the varicella zoster virus, which if perpetuated can give a localized infection and this in turn an abscess, no clinical cases have been described at the moment that present as an additional complication a cervical abscess, by analyzing this case we can guide the clinical and diagnostic suspicion in cases that present clinical characteristics similar to this one.Clinical case: We present the case of a patient with a history of type II diabetes mellitus and arterial hypertension under treatment, with pain and a mass in the cervical region of 12 days of evolution, plus paralysis of the left side of the face due to said findings and history. Ramsay Hunt with secondary complication; deep cervical abscess, administering medical treatment without finding improvement, so exploration plus surgical washing is performed in the affected area after treatment evolves favorably.Conclusion: Deep cervical abscess is an unusual form of complication due to superinfection of a tissue, its association with Ramsay Hunt syndrome is not frequent, and it should be suspected in cases of elderly patients, immunodeficiency with impaired motor function. in face. Introduction: Traumatic diaphragmatic hernia is defined as the passage of organs from the abdominal cavity to the thoracic cavity due to discontinuity at the level of the diaphragm. It is a rare lesion, most of the time not suspected and for this reason not diagnosed, this being a condition by itself with high morbidity and mortality. Constituting a diagnostic challenge for the personal physician. In this case report, one of the most striking findings was the presence of a grade II-III hemotórax as a result of a grade IV splenic lesion due to its protrusion into the thorax.Clinical case: the case of a patient with polytrauma due to high-speed traffic accident due to impact on a rigid surface, on admission diffuse chest and abdominal pain, on physical examination dullness to percussion in the left lung base resolved with insertion of a tube of chest with initial blood flow 1000 cc. Tomography was performed showing rupture and diaphragmatic hernia made up of stomach, omentum and spleen, laparotomy plus reduction of herniated viscera, splenectomy for grade IV injury and diaphragm raffia was performed, presenting favorable evolution.Expected conclusions: through the following report, it is sought to guide the diagnostic suspicion in all trauma with high energy exchange that compromises the thoracoabdominal area, given the case, a diaphragmatic lesion must be ruled out, for which the current case is made available for evaluation and conduct in similar cases