RESUMO
A case of intercostal herniation of the greater omentum occurring 36 years after a penetrating chest injury is presented. The hernia was successfully treated by operative reduction and repair of the diaphragm and chest wall. This rare complication of thoracic injury is discussed and the literature reviewed.
Assuntos
Hérnia Diafragmática/etiologia , Traumatismos Torácicos/complicações , Ferimentos por Arma de Fogo/complicações , Hérnia Diafragmática/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Omento , CostelasRESUMO
Two hundred and fifty men admitted to a thoracic surgical centre and matched controls were questioned in detail about their occupations after leaving school and their smoking habits. Of 201 men with confirmed bronchial carcinoma 58 gave a history of occupational exposure to asbestos, whereas only 29 out of 201 men matched for age and residential area who were admitted with other diseases gave such a history. This difference was statistically highly significant. The usual association of bronchial carcinoma with heavy smoking was observed, but asbestos exposure increased the risk of carcinoma whatever the level of smoking. These results are consistent with the hypothesis that asbestos exposure and the level of smoking act independently in causing bronchial carcinoma. The patients with carcinoma who had been exposed to asbestos presented on average three years earlier than those who had not been exposed. Asbestos regulations have eliminated the risk of exposure to workers in scheduled industries, so asbestos-induced diseases will probably be increasingly found among the many workers who have had incidental exposure to asbestos. It is therefore important to take a full occupational history.
Assuntos
Amianto/efeitos adversos , Neoplasias Brônquicas/induzido quimicamente , Doenças Profissionais/etiologia , Adenocarcinoma/induzido quimicamente , Idoso , Neoplasias Brônquicas/epidemiologia , Carcinoma de Células Escamosas/induzido quimicamente , Inglaterra , Exposição Ambiental , Humanos , Masculino , Pessoa de Meia-Idade , Fumar/complicaçõesRESUMO
An analysis is made of the results of pleuropneumonectomy for diffuse malignant pleural mesothelioma in 29 patients and a comparison is made with the results of non-surgical treatment in a further 17 patients. A system of tumour staging is proposed, and the results are correlated with tumour stage and with histological type. Pleuropneumonectomy does not appear materially to affect the course of the disease in cases of mixed epithelial and mesenchymal histological type. However, stage I cases of pure epithelial histological type appear to carry a better prognosis, especially those whose histological structure consists entirely of abundant oedematous mucoid stroma with loosely arranged tumour cells. It is suggested therefore that only epithelial cases should be subjected to pleuropneumonectomy. Means of reducing operative mortality are discussed and alternative methods of treatment described.
Assuntos
Mesotelioma/cirurgia , Neoplasias Pleurais/cirurgia , Pneumonectomia , Adulto , Fatores Etários , Idoso , Humanos , Masculino , Mesotelioma/patologia , Mesotelioma/terapia , Pessoa de Meia-Idade , Neoplasias Pleurais/patologia , Neoplasias Pleurais/terapia , Complicações Pós-Operatórias , PrognósticoRESUMO
A case is reported of spontaneous rupture of an intercostal artery at its origin from the aorta in a patient with neurofibromatosis and scoliosis. The possible role played by each of these conditions in the pathogenesis of the spontaneous rupture is discussed. Comment is made on the unusual radiologic appearances of extrapleural hemorrhage.
