RESUMO
Intrathoracic hemorrhage following surgical intervention that needs rethoracotomy has a low rate in the daily practice of thoracic surgery. Hemothorax in the contralateral site is definitely unexpected after thoracotomy. We present a case of contralateral hematoma after left posterolateral thoracotomy as a rare and enigmatic complication.
Assuntos
Carcinoma de Células Escamosas/cirurgia , Hemotórax/etiologia , Neoplasias Pulmonares/cirurgia , Toracotomia/efeitos adversos , Carcinoma de Células Escamosas/patologia , Hematoma/etiologia , Hemotórax/diagnóstico , Humanos , Neoplasias Pulmonares/patologia , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios XRESUMO
Most parathyroid glands in hyperparathyroidism can be resected through a cervical approach. In approximately 2% of cases, the ectopic gland is in the mediastinum in a location that requires a thoracic approach. Advancement in video-assisted thoracoscopic surgical (VATS) techniques has decreased the need for sternotomy to successfully remove these ectopic glands. We describe a case involving a 29-year-old woman with hyperparathyroidism resulting from an ectopic mediastinal parathyroid adenoma that caused neonatal hypocalcemia, which was removed through VATS.
Assuntos
Adenoma/cirurgia , Coristoma/cirurgia , Hipocalcemia/etiologia , Doenças do Recém-Nascido/etiologia , Neoplasias do Mediastino/cirurgia , Glândulas Paratireoides , Neoplasias das Paratireoides/cirurgia , Complicações Neoplásicas na Gravidez/cirurgia , Cirurgia Torácica Vídeoassistida , Adenoma/complicações , Adenoma/patologia , Adulto , Coristoma/patologia , Feminino , Humanos , Hiperparatireoidismo Primário/etiologia , Hiperparatireoidismo Primário/cirurgia , Hipocalcemia/terapia , Recém-Nascido , Doenças do Recém-Nascido/terapia , Imageamento por Ressonância Magnética , Neoplasias do Mediastino/complicações , Neoplasias do Mediastino/patologia , Neoplasias das Paratireoides/complicações , Neoplasias das Paratireoides/patologia , Gravidez , Complicações Neoplásicas na Gravidez/patologia , Tomografia Computadorizada de Emissão de Fóton Único , Resultado do TratamentoRESUMO
BACKGROUND: Hydatid cyst still remains an important health problem in our country as in many Mediterranean countries. The disease may affect children, and its treatment may be challenging in this age group. Surgery is the primary way of treatment. In the current study, the features unique to childhood pulmonary hydatid disease are emphasized. METHODS: Between 1992 and 2003, 301 patients were operated on because of pulmonary hydatid cyst in our hospital; 44 of them were 14 years or younger. They were categorized as pediatric patients. We retrospectively evaluated the clinical data of the patients. RESULTS: The mean age of the patients was 10.6 +/- 3.7 years (5-14 years) in children and 32.2 +/- 14 years (16-75 years) in adults. The rate of intact cyst was 71% in children and 57% in adults (P = .07). The mean diameter of the cyst was 8.5 +/- 3.1 cm (3-15 cm) and 6.6 +/- 3 cm (2-16 cm) in children and adults, respectively (P < .001). The rate of parenchyme-saving procedures was 84.1% in children, whereas 94.9% in adults. Lobectomy was performed in 16% of children, whereas it was performed in 1.5% of adults (P < .001). Morbidity rates were 13.6% in children and 11.6% in adults. No children but 1 adult died. Long-term follow-up revealed the recurrence rates as 4.5% in children and 4.3% in adults. CONCLUSIONS: Surgery, the primary method of treatment of hydatid cyst, is safe. Parenchyma-saving procedures such as cystotomy and capitonnage should be performed as much as possible. Nevertheless, hydatid cyst can reach relatively larger dimensions in children than in adults, which causes parenchyme destruction eventually leading to lung resection.
