Clinical, paraclinical images of patients with pneumomediastium tracheoesophageal fistula treated at Department of Respiratory, Bach Mai Hospital

Background: Pneumomediastium Tracheoesophageal Fistula (PTF) is a less common respiratory disease. Recently, the Department of Respiratory at Bach Mai Hospital has identified a number of cases with PTF with x-ray tomography. Objective:(1) To describe clinical - paraclinical symptoms, cause, treatment methods of PTF. (2) Study methods for treating PTF. Subject and Method: A descriptive study included 3 male patients between 45 and 58 years of age. Result: One patient with difficult airway due to abscessed esophageal fistula was treated by surgical therapy. One patient with pyogenic-pneumo was identified with fistula perforation and had surgery. One patient with PTF due to carcinome epidermoide had nutritional gastrostomy. Conclusion:PTF can stem from different causes. In Vietnam, surgical treatment by nutritional gastrostomy is often used but this is a temporary method. 02 stent indwelling (digestive tract and respiratory tract) should be considered if possible. Combination of clinical, CT scan and diagnostic technique will benefit diagnosis and treatment. \r\n', u'\r\n', u'

Clinical and laboratory features of the pulmonary aspergillosis in the Respiratory Department of Bach Mai Hospital

Introduction: Nowadays, the pulmonary mycosis is becoming more and more frequent because of the increase in risk factors. Pulmonary aspergillus is not an uncommon disease, but it often comes together with other lung diseases so it is easily missed. Objectives: This study aims to 1. Determine the clinical and laboratory characteristics of pulmonary mycosis. 2. Comment on the results of the treatment. Material and method: 15 patients with symptoms and signs of pulmonary aspergillosis were included in a retrospective study. Patients were given blood tests, sputum cytology, flexible bronchoscopy, chest X-ray and Ct scanner, transbronchial biopsy and transthoracic biopsy. Findings from these studies showed Aspergillus pulmonary mycosis. The patients were treated in Respiratory Department of Bach Mai hospital in 2007. Results: Male: 7 cases, female: 8 cases. Hemoptysis: 9 cases (60%). 12 cases (80%) had definitive diagnosis, while 5 cases were confirmed diagnosis by transbronchial and/or transthoracic biopsy. 7 cases were treated by surgery. Conclusion: Pulmonary mycosis often occurs in patients with immunodeficiency or pulmonary cavities secondary to tuberculosis. The most common symptom of pulmonary mycosis is hemoptysis. Surgery is the most effective treatment for aspergilloma, as well as antifungal therapy for immunodeficiency patients.

Causes of the acute exacerbation of COPD treated at Department of Respiratory of Bach Mai Hospital in the first six months of the year 2005

Background: Chronic obstructive pulmonary disease (COPD) remains a major public health problem. Objective: To find the causes and the treatment results for acute exacerbation of COPD at Department of Respiratory of Bach Mai Hospital. Subjects and method: A study conducted in 87 patients treated by an acute exacerbation of COPD at Department of Respiratory of Bach Mai Hospital from March to August 2005. Results and conclusions: 88.5% of patients were men. Severe patients were most common in age over 55 years. The risk factor was smoking (over 66.7%). 47.8% of patients were in III stage and 37.7% were in IV stage. The cause of acute exacerbation of COPD was bronchial surinfection (83.9%); and 37.9% of them refused an antibiotic or bronchodilatators at home when they had severe symptoms of exacerbation. Most of them did not have enough condition in their homes for treatment (oxygen, aerosol machine). After 20 days (16.69 \xb1 8.7 days) treated by antibiotics, bronchodilatators, corticoid and oxygen, 90.8% of our patients were at good health. 2 of them were died by severe disease.

The role of transbronchial fine needle aspiration in the diagnosis of submucosal bronchogenic carcinoma

Transbronchial needle aspiration in the diagnosis of submucosal bronchogenic carcinoma. Although exophytic endobronchial lesions can readily be diagnosed by forceps biopsy through the rigid bronchoscope. The lesion of submucosal or peribronchial by forceps biopsy difficult to diagnose by biopsy. The utility of transbronchial fine needle aspiration through rigid bronchoscope was made in 98 patients presenting with endoscopic abnormalities suggestive of submucosal bronchigenic carcinoma of respiratory department of Bachmai hospital from 3/1991 to 7/1996. Forceps biopsy was positive in 48 patients (58.77%). Transbronchial needle aspiration was positive in 88 patients (88.79%) and detected 6 cases additional carcinomas (who were treated by anti-tuberculosis of the lung). We concluded that TBNA significantly increases the yield, more effective than forceps biopsy alone in the detection of the infiltration of submucosal bronchogenic carcinoma.