Subject(s)
Humans , Female , Middle Aged , Respiratory Distress Syndrome, Newborn/therapy , Subcutaneous Emphysema/complications , Hydropneumothorax/complications , Respiratory Distress Syndrome, Newborn/complications , Chest Pain/etiology , Tomography, X-Ray Computed , Drainage, Postural/methods , Hydropneumothorax/surgerySubject(s)
Gloves, Surgical , Pneumothorax/surgery , Thoracostomy/methods , Adult , Aerospace Medicine , Aviation , Chest Tubes , Humans , Hydropneumothorax/etiology , Hydropneumothorax/surgery , Influenza A Virus, H1N1 Subtype , Influenza, Human/complications , Male , Pneumothorax/diagnosis , Recurrence , Thoracostomy/instrumentationABSTRACT
Malignant mesothelioma is an uncommon form of neoplastic transformation of the mesothelial cells that line the serosal surfaces of the body. It most commonly affects the pleura and is often associated with pleural effusions and pleural-based masses. The annual incidence in the United States is only 3300 cases, representing less than 0.3% of all cancers worldwide, although this is likely underestimated. We present a case of diffuse epithelioid malignant pleural mesothelioma in a patient with remote, short-term asbestos exposure complicated by recurrent left-sided hydropneumothoraces and pleural-based invasion of the T12 vertebral body, which represent two rare coexisting complications. This case illustrates the importance of maintaining a broad differential for hydropneumothorax, particularly as the risk factors may be decades removed and the degree of asbestos exposure to induce a malignant mesothelioma may be smaller than has been traditionally thought.
Subject(s)
Asbestos/adverse effects , Hydropneumothorax/surgery , Lung Neoplasms/therapy , Mesothelioma/therapy , Pleural Neoplasms/therapy , Thoracic Neoplasms/therapy , Aged , Diagnosis, Differential , Humans , Male , Mesothelioma, Malignant , Neoplasm Invasiveness , Thoracic Neoplasms/secondaryABSTRACT
Bochdalek hernia (BH) in an adult may manifest clinically with a myriad of abdominal or chest symptoms or a combination of them. Diagnosis of an adult BH is usually delayed in view of rarity of the lesion and its varied presentation. A 30-year-old adult gentleman presented to us with a left thoracostomy which was draining pus and ingested food particles. The tube thoracostomy had been performed in another hospital for an apparent left hydropneumothorax before he arrived in our hospital. Computed tomography of Chest and abdomen revealed a left diaphragmatic defect with herniation of stomach, spleen and omentum into the chest with organo-axial volvulus of the stomach. A thoracostomy tube was seen to be traversing through the stomach with its tip located close to the left pulmonary artery. The patient underwent left thoraco-abdominal exploration with dissection and reposition of the hernial contents in the abdominal cavity. The gastric perforations and the diaphragmatic defect were repaired. This case reiterates a well-known fact that an adult type BH must find a place in the differential diagnosis of a hydropneumothorax. Though the adult BH is a rare diagnosis, unawareness or reluctance to consider the possibility of adult BH may prolong the suffering of the patient as it happened in our patient who had iatrogenic perforation of the stomach due to tube thoracostomy.
Subject(s)
Hernias, Diaphragmatic, Congenital/diagnostic imaging , Hernias, Diaphragmatic, Congenital/surgery , Stomach Volvulus/diagnostic imaging , Stomach Volvulus/surgery , Adult , Diagnosis, Differential , Diagnostic Errors , Humans , Hydropneumothorax/diagnosis , Hydropneumothorax/surgery , Male , Thoracostomy , Tomography, X-Ray ComputedSubject(s)
Esophageal Neoplasms , Esophageal Squamous Cell Carcinoma , Esophagectomy , Hydropneumothorax , Postoperative Complications , Respiratory Distress Syndrome , Stomach/diagnostic imaging , Adult , Esophageal Neoplasms/pathology , Esophageal Neoplasms/surgery , Esophageal Squamous Cell Carcinoma/pathology , Esophageal Squamous Cell Carcinoma/surgery , Esophagectomy/adverse effects , Esophagectomy/methods , Female , Humans , Hydropneumothorax/diagnostic imaging , Hydropneumothorax/etiology , Hydropneumothorax/surgery , Intubation, Gastrointestinal/methods , Jejunostomy/methods , Pneumonia/diagnosis , Pneumonia/etiology , Point-of-Care Systems , Postoperative Complications/diagnosis , Postoperative Complications/physiopathology , Postoperative Complications/therapy , Respiratory Distress Syndrome/diagnosis , Respiratory Distress Syndrome/etiology , Respiratory Distress Syndrome/physiopathology , Respiratory Distress Syndrome/therapy , Risk Adjustment/methods , Thoracentesis/methods , Treatment Outcome , Ultrasonography/methodsSubject(s)
Choristoma/etiology , Choristoma/pathology , Gastroscopy , Heart , Liver Abscess, Pyogenic/complications , Liver Abscess, Pyogenic/pathology , Stomach Diseases/etiology , Stomach Diseases/pathology , Choristoma/surgery , Humans , Hydropneumothorax/etiology , Hydropneumothorax/pathology , Hydropneumothorax/surgery , Liver Abscess, Pyogenic/surgery , Male , Pericardium/pathology , Pericardium/surgery , Stomach Diseases/surgery , Treatment OutcomeSubject(s)
Abdominal Pain/etiology , Hydropneumothorax/diagnosis , Aged , Emergency Service, Hospital/organization & administration , Enterococcus faecium/pathogenicity , Esophageal Perforation/complications , Esophageal Perforation/physiopathology , Female , Gram-Positive Bacterial Infections , Humans , Hydropneumothorax/surgery , Klebsiella Infections , Klebsiella oxytoca/pathogenicity , Mediastinal Diseases/complications , Mediastinal Diseases/physiopathology , Radiography/methods , Stents/trends , Thoracotomy/methodsSubject(s)
Hydropneumothorax/etiology , Mycobacterium avium-intracellulare Infection/diagnosis , Pleurisy/diagnosis , Antitubercular Agents/therapeutic use , Coinfection , Combined Modality Therapy , Disease Susceptibility , Drainage , Drug Therapy, Combination , Humans , Hydropneumothorax/diagnostic imaging , Hydropneumothorax/drug therapy , Hydropneumothorax/surgery , Klebsiella Infections/etiology , Klebsiella Infections/microbiology , Klebsiella pneumoniae/isolation & purification , Male , Middle Aged , Mycobacterium avium Complex/isolation & purification , Mycobacterium avium-intracellulare Infection/complications , Mycobacterium avium-intracellulare Infection/drug therapy , Mycobacterium avium-intracellulare Infection/surgery , Paraplegia/complications , Pleural Effusion/etiology , Pleural Effusion/microbiology , Pleurisy/complications , Pleurisy/drug therapy , Pleurisy/surgery , Reunion , Urinary Bladder, Neurogenic/etiology , Urinary Tract Infections/etiology , Urinary Tract Infections/microbiologyABSTRACT
Myiasis refers to a parasitic infestation of vertebrate mammals by dipterous larvae (maggots) of higher flies. Infections in humans typically occur in tropical and subtropical regions, regions with limited medical access, and areas with poor hygiene and living conditions. Infestations in humans have been described in subcutaneous, nasal, ocular, oropharyngeal, and orotracheal cases; however, reports of pulmonary myiasis in humans in the United States and other developed countries are extremely rare. We describe a patient with recently diagnosed primary pleural angiosarcoma who presented to our clinic for the management of a thoracostomy tube and was diagnosed with pleural myiasis.
Subject(s)
Hemangiosarcoma , Myiasis , Paclitaxel/administration & dosage , Pleural Neoplasms , Thoracic Surgery, Video-Assisted/methods , Thoracostomy/methods , Aged , Anti-Bacterial Agents/administration & dosage , Antineoplastic Agents, Phytogenic/administration & dosage , Disease Management , Empyema, Pleural/etiology , Empyema, Pleural/microbiology , Empyema, Pleural/parasitology , Empyema, Pleural/therapy , Hemangiosarcoma/complications , Hemangiosarcoma/pathology , Hemangiosarcoma/physiopathology , Hemangiosarcoma/therapy , Humans , Hydropneumothorax/etiology , Hydropneumothorax/surgery , Male , Myiasis/complications , Myiasis/diagnosis , Myiasis/physiopathology , Myiasis/therapy , Pleural Cavity/parasitology , Pleural Cavity/pathology , Pleural Neoplasms/complications , Pleural Neoplasms/pathology , Pleural Neoplasms/physiopathology , Pleural Neoplasms/therapyABSTRACT
The objective of this study is to assess the efficacy of superior calyceal access versus inferior calyceal access for inferior calyceal calculi with or without pelvic calculi. A total of 100 patients with inferior calyceal calculi or inferior calyceal calculi with pelvic calculi were included in this prospective randomized study. In 50 patients (Group 1), a fluoroscopy-assisted superior calyceal puncture was made, and in other 50 patients (Group 2), access was obtained through a fluoroscopy-assisted inferior calyceal puncture. The stone-free rates, hemoglobin drop, operative duration, requirement for additional tracts, complications, and auxiliary procedures in the two groups were compared. Stone clearance rates and hemoglobin drop values were better in group 1, though they were not statistically significant. The mean operative duration, number of tracts required, and the relook procedure rate were significantly in favor of Group 1. Only one patient (2%) in Group 1 developed hydropneumothorax related to supracostal puncture and required intercostal tube drainage. Superior calyceal puncture (supracostal or infracostal) provides favorable access to inferior calyceal stones, providing better and faster clearance with less requirement of secondary tracts and auxiliary procedures.
Subject(s)
Kidney Calculi/surgery , Kidney Calices/surgery , Nephrostomy, Percutaneous/methods , Pelvis/surgery , Adult , Female , Fluoroscopy , Hemoglobins/analysis , Humans , Hydropneumothorax/etiology , Hydropneumothorax/surgery , Kidney Calculi/diagnostic imaging , Kidney Calices/diagnostic imaging , Male , Middle Aged , Nephrostomy, Percutaneous/adverse effects , Operative Time , Prospective Studies , Random Allocation , Thoracentesis , Treatment OutcomeSubject(s)
Acidosis, Lactic/etiology , Dyspnea/etiology , Enteral Nutrition/methods , Hydropneumothorax/complications , Hypoxia/etiology , Intubation, Gastrointestinal/methods , Malnutrition/therapy , Pleural Effusion/etiology , Akinetic Mutism , Bipolar Disorder , Comorbidity , Enteral Nutrition/adverse effects , Female , Humans , Hydropneumothorax/diagnostic imaging , Hydropneumothorax/surgery , Intubation, Gastrointestinal/adverse effects , Intubation, Gastrointestinal/instrumentation , Middle Aged , Pleural Effusion/diagnostic imaging , Pleural Effusion/surgery , RadiographySubject(s)
Esophageal Perforation/complications , Esophageal Perforation/surgery , Hernia, Hiatal/complications , Hernia, Hiatal/surgery , Hydropneumothorax/etiology , Thoracotomy , Aged, 80 and over , Esophageal Perforation/etiology , Female , Hernia, Hiatal/diagnostic imaging , Humans , Hydropneumothorax/diagnostic imaging , Hydropneumothorax/pathology , Hydropneumothorax/surgery , Tomography, X-Ray Computed , Treatment OutcomeABSTRACT
Swallowed button batteries (BB) which remain lodged in the oesophagus are at risk of serious complications, particularly in young children. The authors report a 3-year-old child, who rapidly developed an oesophageal perforation, following the ingestion of a 20-mm lithium BB which was initially mistaken for a coin. A thoracotomy and T-tube management of the perforation led to a positive outcome. BBs (20 mm) in children should be removed quickly and close observation is required as the damage initiated by the battery can lead to a significant injury within a few hours.
Subject(s)
Electric Power Supplies/adverse effects , Esophageal Perforation , Foreign Bodies/complications , Hydropneumothorax , Child, Preschool , Esophageal Perforation/etiology , Esophageal Perforation/surgery , Esophagoscopy , Foreign Bodies/diagnostic imaging , Humans , Hydropneumothorax/diagnostic imaging , Hydropneumothorax/etiology , Hydropneumothorax/surgery , Lithium , Male , Radiography , Thoracotomy , Treatment OutcomeABSTRACT
For 7 years videothoracoscopies for diseases and traumas of the chest were fulfilled in 2075 patients, abscessoscopy in 27 patients. Repeated videothoracoscopies were fulfilled in 41 (2%) patients operated for spontaneous pneumothorax, pleural empyema, exudative pleurisy and injuries to the chest due to recurrent hydropneumothorasx, prolonged abundant release by drainage, bleedings by drainage or formation of clotted hemothorax, not effectiveness of sanation, of the empyema cavity, reabscessoscopy - in 2 patients. Revideothoracoscopies were divided into groups with the presence of drainages or removed drainages according to the terms - into emergent (on the first day, immediately after the development of complications), urgent (from 2 to5 days), postponed (from 6 to 15 days), and late (more than 15 days). In 4 cases the conversion to minithoracotomy had to be done due to continuing bleeding, the absence of lung hermetism. All patients with spontaneous pneumothorax, pleuritis and chest trauma recovered. Lethal outcome was in 1 (2.4%) case from lung artery thromboembolism. It was concluded that revideothoracoscopy was an alternative thoracotomy of full value in reinterventions.
Subject(s)
Thoracic Diseases/diagnosis , Thoracic Diseases/surgery , Thoracic Injuries/diagnosis , Thoracic Injuries/surgery , Thoracic Surgery, Video-Assisted/standards , Drainage/adverse effects , Female , Humans , Hydropneumothorax/diagnosis , Hydropneumothorax/etiology , Hydropneumothorax/surgery , Male , Outcome and Process Assessment, Health Care , Pleural Cavity/pathology , Pleural Cavity/physiopathology , Pleural Cavity/surgery , Postoperative Hemorrhage/diagnosis , Postoperative Hemorrhage/etiology , Postoperative Hemorrhage/surgery , Recurrence , Reoperation , Thoracic Diseases/physiopathology , Thoracic Injuries/physiopathology , Thoracic Surgery, Video-Assisted/adverse effects , Thoracic Wall/pathology , Thoracic Wall/physiopathology , Thoracic Wall/surgerySubject(s)
Cardiac Surgical Procedures , Echocardiography, Transesophageal/adverse effects , Esophageal Perforation/etiology , Esophagus/injuries , Hydropneumothorax/etiology , Contrast Media , Delayed Diagnosis , Diatrizoate Meglumine , Esophageal Perforation/diagnostic imaging , Esophageal Perforation/surgery , Esophagoscopy , Esophagus/diagnostic imaging , Esophagus/surgery , Humans , Hydropneumothorax/diagnostic imaging , Hydropneumothorax/surgery , Iatrogenic Disease , Intraoperative Care , Radiography , Time FactorsABSTRACT
Oesophageal injury is an extremely rare complication of intra-operative transoesophageal echocardiography (TOE) associated with cardiac surgery. We report a case of delayed presentation (19 days after surgery) of oesophageal injury that was likely due to TOE following an aortic valve replacement. Lack of suspicion led to a delay in diagnosis but the patient fortunately survived. We advocate that in the event of postoperative hydropneumothorax, the differential diagnosis must include iatrogenic oesophageal injury from transoesophageal echo.
Subject(s)
Echocardiography, Transesophageal/adverse effects , Esophageal Perforation/etiology , Esophagus/injuries , Heart Valve Prosthesis Implantation , Hydropneumothorax/etiology , Aged , Contrast Media , Delayed Diagnosis , Diatrizoate Meglumine , Esophageal Perforation/diagnostic imaging , Esophageal Perforation/surgery , Esophagoscopy , Esophagus/diagnostic imaging , Esophagus/surgery , Humans , Hydropneumothorax/diagnostic imaging , Hydropneumothorax/surgery , Iatrogenic Disease , Intraoperative Care , Male , Thoracic Surgery, Video-Assisted , Time Factors , Tomography, X-Ray ComputedABSTRACT
As manifestações pulmonares catameniais apresentam-se de maneira variada. Podem ser identificadas como quadro de dor torácica, hidrotórax, hidropneumotórax ou pneumotórax, que acontecem durante o período menstrual. O pneumotórax catamenial, a manifestação mais freqüente, é um tipo pouco comum de pneumotórax espontâneo no qual há acúmulo recorrente de ar na cavidade torácica durante a menstruação. Foi descrito inicialmente em 1958 por Maurer et al. Incide principalmente entre a terceira e a quarta décadas de vida. Várias hipóteses são aventadas para explicar as possíveis causas dessa afecção. Também são várias as controvérsias acerca do tratamento mais adequado.