Right-sided pericardio-diaphragmatic rupture with complete liver and partial heart herniation after blunt trauma

Rupture of the diaphragm and pericardium is an uncommon injury, most frequently caused by high velocity trauma. We present a rare case of right-sided pericardio-diaphragmatic rupture [PDR] with complete herniation of the liver which prevented the complete herniation of the heart. Diagnostic pitfalls and possible mistakes in the treatment strategy are discussed

Pulmonary complications following major lung resection for benign and malignant lung diseases

To assess the incidence and to identify the possible associated risk factors for postoperative pulmonary complications after major lung resection. One hundred and sixty-eight consecutive patients undergoing major lung resection for benign and malignant lung disease over a 3-year period were included in the study. Preoperative assessment clinical parameters, intraoperative and postoperative events were recorded. Pulmonary complications were noted according to a precise definition. The risk of complications associated with age, comorbidity, forced vital capacity [FVC], blood transfusion and extended operation was evaluated using logistic regression analysis. The mean age of the patients was 47.1 years [range 16-80 years], 137 [77%] patients underwent lobectomy, 23 [14%] pneumonectomy, and 15 [9%] bilobectomy. Forty-six [27%] patients developed postoperative pulmonary complications and 2 [1.1%] died within 30 days following the operation. Age =/>65 years [OR 3.7, 95% CI: 1.5-8.6, p = 0.002], the presence of comorbid cardiopulmonary disease [OR 0.2, 95% CI: 0.1-0.5, p = 0.001], FVC <50% [OR 0.2, 95% CI: 0.1-0.8, p = 0.02], blood transfusion [OR 0.2, 95% CI: 0.1-0.4, p = 0.0001], and extended operation [OR 0.2, 95% CI: 0.07-0.6, p = 0.005] were the identified factors associated with the development of postoperative pulmonary complications, which necessitated an increased length of hospital stay. Postoperative pulmonary complications are more likely to develop in patients with age =/>65 years with comorbid cardiopulmonary disease, FVC <50%, blood transfusion, and extended operation