Bronchiectasis: congenital and acquired

In all developed countries, it is gratifying that the incidence of bronchiectasis has become so reduced that resection for this disease is currently almost none existent. It is regrettable that thoracic surgeons in developing countries still see many bronchiectatic lesions. This paper is based on personal observations and surgical experience with 440 patients seen and managed at the Medical City Teaching Hospital during twenty years period [1977-1994]

Pulmonary sequestration: a poorly recognized clinical syndrome

Recently I reviewed my personal records of all patients who underwent pulmonary resection at the Thoracic Surgical Department of Medical City Teaching Hospital in Baghdad between 1974 and 1994, and from such records six with pulmonary sequestration were identified. Their ages ranged from 6 months to 50 years. Two infants presented with life-threatening respiratory distress. The other group of four patients were adults and presented with recurrent chest infection. This paper illustrates the pathophsiology of pulmonary sequestration and emphasizes the urgency of precise diagnosis and surgical management of this poorly recognized clinical entity

Plain radiographic findings in bronchogenic carcinoma

There are little available radiological studies concerning bronchogenic carcinoma in the Middle East and very few series have been reported. This urged us to begin a survey for the purpose of studying the disease as it appears on a plain chest film. The project was carried on 116 patients and for a period of nearly two years. The diagnosis was confirmed cytologically, histologically or both on all patients. Pulmonary mass [81%] and atelectasis [29%] were the most common radiographic presentation of bronchogenic carcinoma with higher incidence of both in squamous cell type. It should be emphasized that despite the availability of simple and sophisticated diagnosis methods, the standard chest radiograph remains the simplest and the most helpful and useful diagnosis procedure

trapped lung

Pulmonary trapping is not an uncommon condition. The aetiological factors and clinical aspects of trapping in various age groups are discussed. This report reviews the errors and complications in management of fluid in the pleural cavity that resulted in "Trapped" Lung and presents our indications to "release" the lung from its "Captivity" with special reference to personal experience with 252 cases over the past 34 years

Apudoma of the lung in Iraq

172 patients with documented pulmonary APUDOMAS are presented. These represent 22.9% of patients with the histologic diagnosis of primary tumors of the lung seen during a recent ten years period at the Department of Thoracic and Cardiovascular of Medical City Teaching Hospital in Baghdad. The purpose of this paper is to trace the cellular origin of these tumors and relate the lesions to current means of pathological classification. The series reported here is the only so far reported from Iraq. My personal experience in the diagnosis and management of these cases are discussed

Bronchial carcinoid tumors

Bronchial carcinoid tumors are rare, but they have received increasing attention over the past two decades. This has resulted in a more meaningful classification and accurate definition of their character, but there still remains some dispute about their degree of malignancy and this has created some controversy concerning the adequacy of resection. Our experience with these tumors is described in this report of 14 patients seen at the Department of Thoracic and Cardiovascular Surgery of Medical City Teaching Hospital in Baghdad between 1975 and 1985. To our knowledge, this is the first reported series from Iraq

Individual Hypersensitivity to ergot

Two cases of ergotism following oral use of ergotamine tartrate in small doses are reported. Both had severe vasospastic symptoms. The recovery was quick and the symptoms disappeared after cessation of the drug. A state of "individual" hypersensitivity that enhances drug intoxication and responsible for such symptoms is presented and discussed

Bronchial carcinoma in Iraq

For several decades the problem of bronchogenic carcinoma has been underestimated in the developing world. This situation is, however, gradually changing and in some countries the true size of the problem became obvious. In Iraq bronchogenic carcinoma has peen increasing with alarming frequency, gaining the unenviable reputation of being the commonest malignant tumor in men, and the ninth most common tumor in women. For this reason a detailed study of 750 patients from Iraq is presented and the findings revealed that the peak incidence lies between the ages of 50 and 70 years with a male to female ratio of 4.4: 1. In male it is higher among cigarette smokers [83.9%]. 38% of the patients presented with metastatic symptoms. Thoracotomy was possible in only 146 patients [19.4%], and resection was accomplished in 104 patients [71.3%]. This is a low over all exploration and resection rates than those of Western countries. Factors responsible for these low rates are identified and analyzed, and problems pertaining to management are discussed

Thymolipoma: a rare thymic tumour: report of two cases

Among 100 mediastinal tumors that were removed in the past twenty years, I have encountered two thymolipomas. The first in a 21-year-old lady who presented with myasthenia gravis, and the second in a 7-year-old boy who presented with progressive dyspnoea. Thymolipoma is an uncommon benign tumor of the thymus, and its association with myasthenia gravis is a rarity. Only two previous cases of thymelipoma presenting as myasthenia gravis have been reported. This short report describes an additional case history of such association. The pathogenesis of this rare tumor and its clinical presentations are also discussed

asymptomatic mediastinal cyst

A review of 15 patients with mediastinal cysts seen over a five-year period is presented. Thirteen patients were asymptomatic, the lesion being originally diagnosed on a routine chest X-ray: the other 2 patients had no symptoms referable to the chest. Complete excision was accomplished in all cases. Operative morbidity was negligible, no patient died, and there has been no instance of local recurrence. Since most of the patients were asymptomatic, the importance of routine chest radiography is stressed

Primary mediastinal tumors Clinicopathological evaluation of 50 patients

This paper presents various surgical and pathological problems of primary mediastinal tumors in 50 patients seen and managed during a period of 5 years. Twenty were women. The ages ranged from 9 months to 60 years. Ten patients included in this study were asymptomatic, the presenting symptoms in the remaining patients were diverse depending primarily on the nature of the lesions, their location and size. The various diagnostic procedures used could only characterize the lesion, the exact diagnosis however was established at operation and confirmed histologically in all of the patients. There were 16 seperate varieties, and 62% of the lesions were found to be malignant. Our experience in diagnostic evaluation and operative management is described and discussed

Idiopathic pulmonary hemosiderosis: case report

Idiopathic pulmonary haemosiderosis is an uncommon disease. The following report documents the first case of this nature to be recorded from Iraq