ABSTRACT
@#Reported here is the case of a 6 year old male child with a left Congenital Diaphragmatic Hernia who underwent thoracoscopic repair. The use of continuous low pressure CO2 insufflation pneumothorax during the procedure not only made manipulation during the reduction of bowel contents back into the abdomen easier, but also facilitated repair of the defect as it maintained bowel reduction during suturing. Although prolonged CO2 has been hypothesized to be hazardous leading to hypercapnea and aggravating pulmonary hypertension in Congenital Diaphragmatic Hernia patients. The authors found it to be a safe modification of the technique as long as pre-operative planning, patient selection and intra-operative maneuvers were proprely performed.
Subject(s)
Hernias, Diaphragmatic, CongenitalABSTRACT
Pulmonary Alveolar Microlithiasis (PAM) is a rare disease of unknown origin. It is characterized by the presence of small calculi within the alveolar spaces, and has various clinical manifestations. Some patients may be asymptomatic for a long period of time with subsequent occurrence of dyspnea, dry cough, chest pain, and eventually, respiratory failure. Recurrent spontaneous pneumothorax episodes are a late complication of the disease. We report the case of an alveolar microlithiasis episode in a 42-year-old male, admitted to Tohid Hospital, Iran, whose first clinical presentation was symptoms of pneumothorax. He was admitted with sudden onset dyspnea and right-sided pleuretic chest pain. Following treatment of pneumothorax after chest tube placement, the pulmonary function revealed normal indices, and chest radiograph demonstrated diffuse confluence of dense micronodular infiltrate. High-resolution computerized tomography scan showed diffuse ground glass attenuation and calcifications along the interlobular septa and subpleural regions. Transbronchial lung biopsy confirmed the diagnosis of PAM.
