scholarly journals Pericardial flap to repair a pulmonary laceration in a cat with pyothorax

2018 ◽  
Vol 4 (2) ◽  
pp. 205511691881738
Author(s):  
Pablo Pérez López ◽  
Stefania Martinoli
Keyword(s):  
Antibiotic Therapy ◽  
Left Lung ◽  
Lung Parenchyma ◽  
Acute Onset ◽  
Tube Placement ◽  
Lung Lobe ◽  
Fluid Analysis ◽  
Lung Lobectomy ◽  
Pulmonary Laceration ◽  
The Right

Case summary A 2-year-old female neutered domestic shorthair cat was presented for investigation of acute onset tachypnoea and dyspnoea. Pyothorax was diagnosed based on thoracic radiographs and fluid analysis. Medical treatment consisted of bilateral thoracostomy tube placement, antibiotic therapy and thoracic lavage. After 12 days of medical management infection was still present, warranting exploratory thoracotomy. At surgery, encapsulated abscesses were found in the left lung, right cranial and right middle lobes. The right caudal lobe was the only macroscopically non-abscessated lobe, and appeared to have a parenchymal laceration 8 mm long over the dorsolateral surface. Following partial pericardiectomy, mediastinectomy and debridement of abscesses, a pericardial flap was reflected caudolaterally and apposed over the laceration to seal the affected lung lobe. This flap was sutured to a rim of fibrinous adhesion that was partially covering this lobe. After 8 days the cat was discharged with antibiotic therapy for 3 more weeks. Follow-up assessment at 19 and 38 weeks postoperatively confirmed the cat to have good exercise tolerance. Thoracic radiographs at 19 weeks revealed good bilateral aeration of the pulmonary parenchyma without pleural effusion. Relevance and novel information Lung lobe laceration can be treated by lung lobectomy or direct suturing of the lung parenchyma. This is the first report using a pericardial flap to repair a lung laceration. Pericardial flap was successfully used to treat this lung laceration where lobectomy was contraindicated. Encouraging results were present at 8 months postoperatively.

Haemiballism/haemichorea: an atypical presentation of ischaemic stroke

2021 ◽  
Vol 14 (6) ◽  
pp. e240439
Author(s):  
Raman Nohria ◽  
Stacey Bennett ◽  
Yasmin Ali O'Keefe
Keyword(s):  
Brain Mri ◽  
Acute Onset ◽  
Cerebral Peduncle ◽  
Atypical Presentation ◽  
Cerebrospinal Fluid Analysis ◽  
Medication Therapy ◽  
Fluid Analysis ◽  
Ct Head ◽  
The Right ◽  
Distressing Condition

A 76-year-old man was admitted to the hospital with acute onset of involuntary movements of the left side of his body. His neurological examination revealed he was oriented only to himself, and aforementioned movements of his left arm and leg. CT head demonstrated old infarcts in his right aspect of his pons and basal ganglia. Cerebrospinal fluid analysis was unremarkable. He initially had a normal blood glucose with an elevated anion gap and elevated creatine kinase. Brain MRI showed a small lacunar-type ischaemic infarct within the anteromedial aspect of the right cerebral peduncle, which localised to his haemiballism. To prevent worsening rhabdomyolysis associated with his haemiballism, the primary team initiated both tetrabenazine and diazepam. His movements improved after 1 week of medication therapy. This report discusses a thorough workup for this movement disorder and when to intervene for this distressing condition.

scholarly journals Emergency Repair of an Isolated Traumatic Avulsion of the Right Main Stem Bronchus in a 7-Year-Old Girl

2019 ◽  
Vol 07 (01) ◽  
pp. e1-e4 ◽  
Author(s):  
Tatjana Tamara König ◽  
Eva Wittenmeier ◽  
Oliver J. Muensterer
Keyword(s):  
Endotracheal Intubation ◽  
Left Lung ◽  
Clinical Signs ◽  
Tension Pneumothorax ◽  
Main Stem ◽  
Tube Placement ◽  
Air Leak ◽  
Main Stem Bronchus ◽  
Horse Riding ◽  
The Right

Introduction Isolated tracheobronchial injury after blunt trauma of the chest is rare. Because of the high elasticity of the chest in children, they occur mainly in the pediatric population. Case Report We report a case of a 7-year-old girl who experienced complete avulsion of the right main bronchus at the level of the carina after a horse-riding accident. The patient presented with extensive emphysema of the upper chest, neck, and face and severe respiratory distress. Endotracheal intubation led to tension pneumothorax. After insertion of two 17-mm thoracostomy tubes, pneumothorax and a massive air leak persisted. Isolated central bronchial injury was confirmed by computed tomography of the chest. Bronchoscopically guided selective intubation of the left main stem bronchus failed and the patient desaturated, requiring immediate salvage right posterolateral thoracotomy. Simultaneous occlusion of the defect, stabilization, and subsequent selective left lung intubation was possible only after placing a suture at the tracheal rim of the defect for retraction allowing compression of the defect and keeping the lumen open at the same time. Conclusion A cluster of clinical signs with subcutaneous emphysema and refractory pneumothorax with air leak of the thoracotomy tube is indicative of bronchial injury. Endotracheal intubation should be postponed in these cases until after thoracostomy tube placement, if possible. Placing a retraction suture during repair is a maneuver that helps to occlude the defect and keep the remaining tracheobronchial lumen open at the same time to establish crucial ventilation of the contralateral lung.

A feedback system to control blood flow in dog lung lobes

1982 ◽  
Vol 53 (6) ◽  
pp. 1650-1652
Author(s):  
R. E. Drake ◽  
D. K. Adcock ◽  
R. L. Scott ◽  
J. C. Gabel
Keyword(s):  
Blood Flow ◽  
Left Lung ◽  
Electromagnetic Flowmeter ◽  
Feedback System ◽  
Relative Magnitude ◽  
Left Lobe ◽  
Lung Lobe ◽  
Flow Signal ◽  
Right Pulmonary Artery ◽  
The Right

We have developed an electromechanical feedback system to control blood flow to the lower left lung lobe of dogs. Blood flow is measured with an electromagnetic flowmeter. The feedback system compares the blood flow signal to an adjustable reference voltage and causes a motor to turn. The direction of motor rotation depends on the relative magnitude of the flow signal and the reference. The motor pushes the plunger of a syringe that is attached to a balloon in the right pulmonary artery. Inflation of the balloon causes increased blood flow to the lower left lobe. We have used the system to control lobe blood flow in three dogs.

scholarly journals Empyema associated with a cough-induced rib fracture

2021 ◽  
Vol 14 (5) ◽  
pp. e242656
Author(s):  
Satoshi Hayano ◽  
Masayuki Kashima
Keyword(s):  
Chest Pain ◽  
Antibiotic Therapy ◽  
Sudden Onset ◽  
Rib Fracture ◽  
Tube Placement ◽  
Oral Antibiotic ◽  
Clinical Relapse ◽  
Oral Antibiotic Therapy ◽  
Thoracic Drainage ◽  
The Right

A 44-year-old man presented to the emergency department with fever and right anterior chest pain. He reported a persistent cough and the development of sudden-onset right anterior chest pain after coughing. The inspiratory pain in the right lung was severe, and therefore deep breathing was impossible. Chest CT revealed a fracture in the right seventh rib with consolidation and pleural effusion. A pleural fluid culture test result was positive for methicillin-susceptible Staphylococcus aureus. He was diagnosed with empyema associated with a cough-induced rib fracture. Thoracic drainage tube placement and intravenous antibiotic therapy successfully ameliorated his condition. He was discharged on day 13 and switched to an 8-week course of oral antibiotic therapy. There was no clinical relapse at the 6-month follow-up.

scholarly journals Thoracoscopic-assisted lung lobectomy using hem-o-lok clips in a dog with lung lobe torsion: a case report

2014 ◽  
Vol 59 (No. 6) ◽  
pp. 315-318
Author(s):  
SY Lee ◽  
SJ Park ◽  
SH. Seok ◽  
YK. Kim ◽  
HC. Lee ◽  
...  
Keyword(s):  
Clinical Signs ◽  
Lung Ventilation ◽  
Middle Lobe ◽  
One Lung Ventilation ◽  
Presumptive Diagnosis ◽  
Lung Lobe ◽  
Lung Lobectomy ◽  
Minimally Invasive Surgical ◽  
Time Period ◽  
The Right

An eleven-year-old, 3-kg, intact female Maltese was presented for depression, anorexia and dyspnoea. Thoracic radiographs showed right-side pleural effusion, a vesicular emphysema pattern and consolidation of the right middle lung lobe. A presumptive diagnosis of lung lobe torsion (LLT) in the right middle lobe was made using a computed tomography scan. Thoracoscopic exploration was performed without one-lung ventilation in the right hemithorax. Pleural fluid and engorgement of the torsed lung lobe were observed. A total lung lobectomy of the right middle lung lobe was performed with a thoracoscopic-assisted procedure using hem-o-lok clips applied to the hilus. The dog was discharged three days after surgery, and no recurrence of the clinical signs of disease related to the respiratory system was observed during the follow-up time period of six months. Based on these findings, we conclude that thoracoscopic-assisted lung lobectomy using hem-o-lok clips is a minimally invasive surgical alternative to thoracotomy and successful operative intervention for lung lesions in small breed dogs.  

Update on Effectiveness of an Electromagnetic Feeding Tube–Placement Device in Detecting Respiratory Placements

2017 ◽  
Vol 26 (2) ◽  
pp. 157-161 ◽  
Author(s):  
Norma A. Metheny ◽  
Kathleen L. Meert
Keyword(s):  
Respiratory Tract ◽  
Case Reports ◽  
Left Lung ◽  
Feeding Tube ◽  
Brand Names ◽  
Tube Placement ◽  
Success Rates ◽  
User Facility ◽  
The Right ◽  
Feeding Tube Placement

Background Radiography is the accepted gold standard for testing feeding tube placement; however, an electromagnetic tube-placement device (ETPD) is sometimes used in lieu of radiography for this purpose. High success rates have been reported when the device was used by well-trained individuals. However, authors previously described 20 cases that occurred between 2007 and 2012 in which clinicians voluntarily reported inability to detect inadvertent tube insertions in the respiratory tract while using an ETPD. Objective To describe case reports to the US Food and Drug Administration’s Manufacturer and User Facility Device Experience (MAUDE) database between 2013 and 2015 regarding inadvertent respiratory placement of feeding tubes by operators using an ETPD. Methods The MAUDE database was searched for cases dated from January 1, 2013, through December 31, 2015, along with selected brand names. A total of 34 cases (25 after removal of duplicates) were located in which a feeding tube was inserted into the respiratory tract during insertions assisted by an ETPD. Results Sites of the malpositioned tubes included the right lung (n = 13), left lung (n = 6), unspecified lung (n = 4), and bronchus (n = 2). A pneumothorax occurred in 17 of the 25 misplacements; feedings were administered in 6 cases. Conclusions Many case reports involved clinicians failing to recognize tube misplacements in the respiratory tract while using an ETPD. These reports provide evidence that not all clinicians can use the device effectively to detect malpositioned tubes. Thus, one must continue to question the wisdom of eliminating radiographic confirmation of tube position before starting feedings.

Right lung agenesis in a one-year-old Chihuahua

2020 ◽  
Vol 8 (3) ◽  
pp. e001175
Author(s):  
Carlos Martinez ◽  
Conor Rowan
Keyword(s):  
Left Lung ◽  
Lung Parenchyma ◽  
Respiratory Pattern ◽  
Chest Drain ◽  
Mediastinal Shift ◽  
Lung Agenesis ◽  
Cardiac Silhouette ◽  
Digital Manipulation ◽  
One Year ◽  
The Right

A one-year-old neutered male Chihuahua was referred for further investigations of spontaneous pneumothorax. Before referral, thoracocentesis and chest drain placement was performed. On presentation, the dog was dull and dyspnoeic displaying a restrictive respiratory pattern. Thoracic radiography and CT findings performed at the referral centre were consistent with right lung agenesis and pneumothorax. Retrospective review of the radiographs obtained at the referring practice identified right-sided mediastinal shift, separation of the cardiac silhouette from the sternum and overinflated left lung lobes. Neither free intrathoracic gas nor subcutaneous emphysema was identified. The initial images were suboptimally displayed resulting in artefactual ‘blackening’ of the lung parenchyma, necessitating digital manipulation to identify lung markings. The combination of mediastinal shift and separation of the cardiac silhouette from the sternum as a result of the right lung agenesis could potentially lead to a false impression of pneumothorax.

scholarly journals Pulmonary Lobe Segmentation in CT Images Based on Lung Anatomy Knowledge

2021 ◽  
Vol 2021 ◽  
pp. 1-15
Author(s):  
Yuanyuan Peng ◽  
Hualan Zhong ◽  
Zheng Xu ◽  
Hongbin Tu ◽  
Xiong Li ◽  
...  
Keyword(s):  
Left Lung ◽  
Region Of Interest ◽  
Ground Truth ◽  
Ct Images ◽  
Lung Lobe ◽  
Lung Anatomy ◽  
Lobe Segmentation ◽  
The Right ◽  
Anatomy Knowledge ◽  
High Median

In computed tomography (CT) images, pulmonary lobe segmentation is an arduous task due to its complex structures. To remedy the problem, we introduce a new framework based on lung anatomy knowledge for lung lobe segmentation. Firstly, the priori knowledge of lung anatomy is used to identify the fissure region of interest. Then, an oriented derivative of stick filter is applied to isolate plate-like structures from clutters for lobar fissure verification. Finally, a surface fitting model is employed to complete the incomplete fissure surface for lung lobe segmentation. Compared with manually segmented fissure references, the designed approach obtained a high median F1-score of 0.8865 in the left lung and obtained a high median F1-score of 0.9200 in the right lung. The average percentages of the segmented lung lobes in the lung lobe ground truth are 0.960, 0.989, 0.973, 0.920, and 0.985 for the left upper, left lower, right upper, right middle, and right lower lobes, respectively. The perfect performance of the proposed scheme is tested by visual inspection and quantitative evaluation.

Lung Parenchyma Segmentation Based on Contourlet Transform and Harris Corner Detection

2013 ◽  
Vol 333-335 ◽  
pp. 998-1001
Author(s):  
Li Nan Fan ◽  
He Huang ◽  
Dan Tian
Keyword(s):  
Left Lung ◽  
Lung Parenchyma ◽  
Detection Algorithm ◽  
Corner Detection ◽  
Contourlet Transform ◽  
Average Accuracy ◽  
Harris Corner ◽  
The Common ◽  
The Right ◽  
Harris Corner Detection

This paper presents a new automatic lung segmentation method. Harris corner detection algorithm is used to solve the problem of separating the left lung from the right one, and contourlet transform and mathematical morphology hybrid algorithm are used to solve the problem that the nodules at lung edge is easy to be missed. Through the simulation results of multiple lung CT images, compared with the common algorithms, the results show that the average sensitivity and average accuracy become much better.

scholarly journals Use of an Endobronchial Blocker and Selective Lung Ventilation to Aid Surgical Removal of a Lung Lobe Abscess in a Dog

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
Carl Bradbrook ◽  
Louise Clark ◽  
Martina Mosing
Keyword(s):  
Lung Ventilation ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Surgical Removal ◽  
Arterial Blood Gas ◽  
Lung Lobe ◽  
Lung Lobectomy ◽  
Arterial Blood ◽  
Endobronchial Blocker ◽  
The Right

This paper documents use of an endobronchial blocker (EBB) to achieve selective lung ventilation (SLV) for the purpose of lung lobectomy with thoracoscopy. A 3-year-old female neutered Labrador Retriever, body mass of 18.5 kg, was presented for exploratory thoracoscopy. Acepromazine and methadone were administered as premedication, and anaesthesia was induced with propofol and maintained with isoflurane in 100% oxygen and continuous infusions of fentanyl and lidocaine. Mechanical ventilation of the dog’s lungs was performed prior to placement of an Arndt EBB caudal to the right cranial bronchus to allow SLV. Successful SLV was achieved with this technique, allowing continued inflation of the right cranial lobe. A reduction in the arterial partial pressure of oxygen to fractional inspired oxygen ratio (PaO2 : FiO2) of 444 to 306 occurred after placement of the EBB, with no change in monitored cardiopulmonary variables. F-shunt increased from 17.4% to 23.7% with a reduction in oxygen content (CaO2) of 20.0 to 18.7 mg dL-1, remaining within the physiologic range. Due to lung adhesions to the diaphragm, conversion to thoracotomy was required for completion of the procedure. This technique is challenging to perform in the dog. Arterial blood gas analysis should be performed to allow adequate monitoring of ventilation.

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