scholarly journals P039 INTERCOSTAL HERNIA FOLLOWING DIEP RECONSTRUCTION: A CASE PRESENTATION

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Jordan Robinson ◽  
John Robinson
Keyword(s):  
Thoracic Surgery ◽  
Breast Reconstruction ◽  
Pulmonary Disease ◽  
Early Recognition ◽  
Thoracic Wall ◽  
Bilateral Mastectomy ◽  
Lung Herniation ◽  
Intercostal Hernia ◽  
Lung Hernia ◽  
History Of

Abstract Aim Intercostal lung herniation is a rare clinical condition defined as the protrusion of lung parenchyma beyond the anatomic boundaries of the thoracic wall. Acquired lung hernias are typically occur secondary to trauma or are associated with severe pulmonary disease. We present a case of lung herniation following DIEP breast reconstruction which is the first reported case to date. Material and Methods 40-year-old woman with a history of bilateral mastectomy for breast cancer and subsequent delayed, bilateral DIEP breast reconstruction. She returned to the emergency department four days after her reconstruction with chest pain, shortness of breath and swelling of her chest. CT angiography of her chest demonstrated a focal protrusion of her right lung into her anterior chest wall (Figure 1). Thoracic surgery was consulted for repair which was achieved with a patch technique using Allomax dermal matrix. Results We describe the first reported intercostal lung hernia following DIEP breast reconstruction reported in scientific literature. Our patient had no history of trauma, thoracic surgery or pulmonary disease which are considered the greatest risk factors for acquired intercostal lung herniation. Much like abdominal wall hernias, protrusion of tissue through a small defect places tissue at risk for ischemia. Early recognition is thus essential to avoid tissue loss. Conclusions Intercostal lung hernia is an uncommon clinical entity that has not previously been described as a complication of DIEP breast reconstruction. Its development is associated with significant morbidity including flap loss in this case. Early recognition of this rare complication is essential to avoid more severe sequelae of tissue ischemia.

Mortality in Geriatric Psychiatric Inpatients

1998 ◽  
Vol 28 (3) ◽  
pp. 327-331 ◽  
Author(s):  
Jen-Ping Hwang ◽  
Shih-Jen Tsai ◽  
Cheng-Hung Yang
Keyword(s):  
Mortality Rate ◽  
Pulmonary Disease ◽  
Cause Of Death ◽  
Early Recognition ◽  
Psychiatric Inpatients ◽  
Psychiatric Ward ◽  
Case Record ◽  
Male Veterans ◽  
History Of ◽  
Case Data

Objective: This study investigated the deaths of patients sixty-five and older on a psychiatric ward to determine the mortality rate, the characteristics of illness, and the cause of death. Methods: We analyzed the case record of patients sixty-five and older who had died during hospitalization on a psychiatric ward during a seventeen-year period. Case data was collected by review of chart records. Results: The mortality rate in the patients sixty-five and older was 18/1208 (1.5%). Eight of these eighteen patients died of pneumonia. Mortality in the acutely ill geropsychiatric inpatients was difficult to predict. Age, sex, and diagnosis did not predict mortality. Conclusions: To reduce mortality, especially in male veterans, management of geropsychiatric patients should include early recognition of pneumonia symptoms, especially for patients with history of pulmonary disease.

scholarly journals Congenital pulmonary hernia secondary to absence of ribs

2021 ◽  
Vol 7 (2) ◽  
pp. 108-111
Author(s):  
Sujoy Neogi ◽  
Arka Banerjee ◽  
Shasanka S Panda ◽  
Simmi K Ratan
Keyword(s):  
Respiratory Failure ◽  
Surgical Treatment ◽  
Chest Trauma ◽  
Lower Lobe ◽  
Clinical Scenario ◽  
Recurrent Pneumonia ◽  
Severe Respiratory Distress ◽  
Lung Herniation ◽  
Lung Hernia ◽  
History Of

Congenital lung hernia is extremely rare with less than 50 reported cases.We report two cases of lung hernia, secondary to congenital absence of ribs – A 4‐year‐old girl without any antecedent history of chronic cough or chest trauma presenting with a left lower lobe hernia secondary to an absent left 9th rib; a 7 month‐old girl with recurrent pneumonia presenting with severe respiratory distress, fever and severe malnourishment, found to have absent 6th-9th ribs on right side with associated liver and lung herniation. The older girl has been kept on observation without surgery but the infant expired within 48 hours of admission due to respiratory failure. The clinical scenario is a rarity and can be managed conservatively in most cases. Surgical treatment should be considered in symptomatic patients and in those with severe complications. Repair for cosmetic reasons is sometimes justified.

Pulmonary herniation 3 years after video-assisted thoracic surgery lobectomy

2021 ◽  
Vol 13 (2) ◽  
pp. 186
Author(s):  
Jonathan West ◽  
Christian Hulett ◽  
Ankur Gupta
Keyword(s):  
Case Reports ◽  
Lung Parenchyma ◽  
Thoracic Wall ◽  
Vats Lobectomy ◽  
Video Assisted ◽  
Lung Herniation ◽  
History Of ◽  
Surgical Emphysema ◽  
The Right

ABSTRACT Pulmonary herniation is defined as protrusion of lung parenchyma through thoracic wall weakness. We present a case of a 69-year-old male who presented to a rural hospital with a 4-day history of cough, right-sided chest pain and exertional shortness of breath. His past medical history included right lung adenocarcinoma treated with right upper lobe lobectomy via video-assisted thorascopic surgery (VATS) 3 years prior. Chest inspection revealed decreased chest wall movements on the right side with no visible chest bulge and on palpation non-tender chest bilaterally with palpable crepitus of the right anterior chest. Chest expansion was reduced on the right side associated with hyper-resonant percussion. Auscultation revealed diffuse bilateral rhonchi. A CT of the chest showed herniation of the right lung through a post-operative defect in the thoracic wall. The patient was initiated on codeine linctus for cough suppression and remained haemodynamically stable for his 3-day admission. He remained asymptomatic at his 4-week follow up with complete resolution of surgical emphysema. We could find no other case reports of VATS lobectomy where lung herniation presented years after surgery.

scholarly journals Lung herniation through the thoracic wall after persistent sneezing and coughing in an obesity and COPD Patient

2020 ◽  
Vol 2020 (9) ◽  
Author(s):  
Mohammed Ibrahim ◽  
Bernd Linsmeier
Keyword(s):  
Atrial Fibrillation ◽  
Severe Pain ◽  
Anticoagulation Therapy ◽  
Thoracic Wall ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Sandwich Technique ◽  
Lung Herniation ◽  
History Of ◽  
The Right

Abstract We present the case of a 61-year-old male patient with a known medical history of morbid obesity, chronic obstructive pulmonary disease and atrial fibrillation, who was receiving anticoagulation therapy with enoxaparin natrium prescribed by his family physician. The patient presented himself to the emergency department of our hospital with a complaint of severe pain in the right hemithorax, dyspnea, and diffuse cutaneous and subcutaneous haematoma in the inferior part of the right hemithoracic region. The patient underwent right-side video-assisted thoracic surgery on the second day to evacuate the haematothorax. Thoracic wall repair was achieved using a sandwich technique with a sublay reinforced with pericostal sutures and onlay insertion of bovine pericardium mesh.

Congenital Intercostal Hernia: A Rare Entity

JMS SKIMS ◽  
2018 ◽  
Vol 21 (1) ◽  
pp. 48
Author(s):  
Syed Muzamil Andrabi ◽  
Mohd Yousuf Dar ◽  
Javid Ahmad Bhat
Keyword(s):  
Male Patient ◽  
General Surgery ◽  
Rare Entity ◽  
Intercostal Hernia ◽  
History Of ◽  
Lateral Chest ◽  
Patient Department

A 35-year-old male patient presented to the General Surgery Out Patient Department with a history of swelling on the left lateral chest since birth. The swelling appeared during inspiration and disappeared during expiration. JMS 2018;21(1):48 

scholarly journals History of cardiac and thoracic surgery The beginnings of thoracic surgery in Poland – a resection of an enormous tumor of the clavicle in Gdañsk in 1730

2013 ◽  
Vol 3 ◽  
pp. 305-308
Author(s):  
Jacek Zielinski ◽  
Radoslaw Jaworski ◽  
Ninela Irga-Jaworska ◽  
Ireneusz Haponiuk ◽  
Janusz Jaskiewicz
Keyword(s):  
Thoracic Surgery ◽  
History Of

scholarly journals Implementation of a Targeted Screening Program to Detect Airflow Obstruction Suggestive of Chronic Obstructive Pulmonary Disease within a Presurgical Screening Clinic

2015 ◽  
Vol 22 (4) ◽  
pp. 209-214 ◽  
Author(s):  
Chantal Robitaille ◽  
Esther Dajczman ◽  
Andrew M Hirsch ◽  
David Small ◽  
Pierre Ernst ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Screening Program ◽  
Tertiary Care ◽  
Airflow Obstruction ◽  
University Hospital ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Targeted Screening ◽  
History Of

BACKGROUND: Targeted spirometry screening for chronic obstructive pulmonary disease (COPD) has been studied in primary care and community settings. Limitations regarding availability and quality of testing remain. A targeted spirometry screening program was implemented within a presurgical screening (PSS) clinic to detect undiagnosed airways disease and identify patients with COPD/asthma in need of treatment optimization.OBJECTIVE: The present quality assurance study evaluated airflow obstruction detection rates and examined characteristics of patients identified through the targeted screening program.METHODS: The targeted spirometry screening program was implemented within the PSS clinic of a tertiary care university hospital. Current or ex-smokers with respiratory symptoms and patients with a history of COPD or asthma underwent prebronchodilator spirometry. History of airways disease and smoking status were obtained during the PSS assessment and confirmed through chart reviews.RESULTS: After exclusions, the study sample included 449 current or ex-smokers. Abnormal spirometry results were found in 184 (41%) patients: 73 (16%) had mild, 93 (21%) had moderate and 18 (4%) had severe or very severe airflow obstruction. One hundred eighteen (26%) new cases of airflow obstruction suggestive of COPD were detected. One-half of these new cases had moderate or severe airflow obstruction. Only 34% of patients with abnormal spirometry results had reported a previous diagnosis of COPD. More than one-half of patients with abnormal spirometry results were current smokers.CONCLUSIONS: Undiagnosed airflow obstruction was detected in a significant number of smokers and ex-smokers through a targeted screening program within a PSS clinic. These patients can be referred for early intervention and secondary preventive strategies.

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