Chest injuries in Alexandria

This report deals with 354 patients with chest injuries. Cardiac injuries [23 patients] are excluded and will be discussed in a separate report. The striking feature in this series is the high incidence of stab wounds with knives. The clinical picture and management of different types of chest injuries are discussed with special stress on flail chest and thoracic-abdominal injuries

Mitral valvotomy under 20 years

Out of 450 mitral valvotomies, 165 patients [36.6%] submitted for closed mitral valvotomy with an average age 17 years. All of them were in sinus rhythm with no history of embolisation, 83% had dyspnea Grade II to III. The mitral valve orifice was 0.5-1 cm in 69.2% and calcified valve in 6%. In 25 patients the lung biopsy showed parenchymal and vascular changes in most of them. The follow-up of 115 patients [70%] from 6 months to 20 years showed excellent, good and fair results in 87.7% and restenosis in 4.3%

Iatrogenic perforation in caustic esophagitis

Perforation of the oesophagus is a serious complication of dilatation of caustic strictures. This report illustrated the value of early conservative treatment [within 12 hours] in 40 patients with iatrogenic perforation of the oesophagus after corrosive intake. Conservative treatment reduced the mortality from 60% to 15% provided these patients are managed within 12 hours from perforation. Dilatation after healing of the perforation is risky in corrosive strictures, as an alternative retrosternal colon interposition was performed for 22 patients

Thymectomy for myasthenia gravis

This report is to illustrate the place of intermittent positive pressure ventilation immediately after thymectomy for myasthenia gravis and during the early post-operative period for 16 patients without a single mortality or morbidity. The role of thymectomy in myasthenia gravis is discussed and the results are correlated with the pathological changes in the thymus of 8 patients. Satisfactory results are obtained in patients with lymphoid hyperplasia in the thymus