ABSTRACT
UNLABELLED: During the period 1984-1993, we experienced 11 operated cases of spontaneous hemopneumothorax, which correspond 7.3% of total 150 cases of operated spontaneous pneumothorax. All cases were male, 19-36 years of age. From admission to the end of operation, 6 cases with hemorrhagic shock had bleeding of 2,305-6,670 ml, the average 3,708 ml, whereas 5 cases without shock had bleeding of 1,209-2,405 ml, the average 1,979 ml. In 9 cases operated within 5 days after admission (6 cases with shock and 3 cases without shock), the source of bleeding was detected, but in 2 cases operated over 6 days after admission, the source was not detected. For the emergency operation of hemopneumothorax, we employed axillary thoracotomy by half lateral position in order to avoid the blood pressure depression due to position changing of the patient. The operation performed safely with enough exposure, and all the patients recovered without severe complication. CONCLUSION: the treatment of spontaneous hemopneumothorax is better to choose early operation by axillary thoracotomy with half lateral position.
Subject(s)
Hemopneumothorax/surgery , Adult , Hemopneumothorax/complications , Humans , Male , Shock, Hemorrhagic/complications , Supine Position , Thoracotomy/methods , Time FactorsABSTRACT
Fifty patients with extrapulmonary tuberculosis were diagnosed at 4 community hospitals in Tokyo during 1981 to 1992. The percentage of extrapulmonary tuberculosis among the all types of tuberculosis was 10.5% as a whole, and 16% in females and 7.9% in males. The number of patients older than fifth generation was about two times more than that of younger generations. And the patients were more in males than in females under the forties, but were more in females than in males over the sixties. On chest radiogram, there was no pathological findings in 52% of the patients and active pulmonary tuberculosis was detected in 32% of the patients. The majority of the extrapulmonary tuberculosis (30 cases, 60%) was of lymph nodes, especially of cervical lymph nodes, and the remaining were 10 cases of tuberculosis in bone and joint, 4 each in intestine and pericardium, 2 each in liver, peritoneum, kidney, urinary bladder, epididymis and skin. Among 30 cases with tuberculous lymphadenopathy, the disease were observed in cervical lymph nodes by 19 cases, in pulmonary hilar and axillary node by each 4 cases and in abdominal cavity by 3 cases.
