scholarly journals Contralateral spontaneous rupture of the esophagus following severe emesis after non-intubated pulmonary wedge resection

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Lei Liu ◽  
Wenbin Wu ◽  
Longbo Gong ◽  
Miao Zhang
Keyword(s):  
Spontaneous Rupture ◽  
Wedge Resection ◽  
Tube Feeding ◽  
Fast Track Surgery ◽  
Serratus Anterior ◽  
Case Presentation ◽  
Chest X Ray ◽  
The Right ◽  
Pulmonary Wedge Resection ◽  
Anterior Plane

Abstract Background Non-intubated thoracoscopic lung surgery has been reported to be technically feasible and safe. Spontaneous rupture of the esophagus, also known as Boerhaave’s syndrome (BS), is rare after chest surgery. Case presentation A 60-year-old female non-smoker underwent non-intubated uniportal thoracoscopic wedge resection for a pulmonary nodule. Ultrasound-guided serratus anterior plane block was utilized for postoperative analgesia. However, the patient suffered from severe emesis, chest pain and dyspnea 6 h after the surgery. Emergency chest x-ray revealed right-sided hydropneumothorax. BS was diagnosed by chest tube drainage and computed tomography. Besides antibiotics and tube feeding, a naso-leakage drainage tube was inserted into the right thorax for pleural evacuation. Finally, the esophagus was healed 40d after the conservative treatment. Conclusions Perioperative antiemetic therapy is an indispensable item of fast-track surgery. Moreover, BS should be kept in mind when the patients complain of chest distress following emesis after thoracic surgery.

scholarly journals Contralateral spontaneous rupture of the esophagus following severe emesis after non-intubated pulmonary wedge resection

2020 ◽  
Author(s):  
Lei Liu ◽  
Wenbin Wu ◽  
Longbo Gong ◽  
Miao Zhang
Keyword(s):  
Spontaneous Rupture ◽  
Wedge Resection ◽  
Tube Feeding ◽  
Fast Track Surgery ◽  
Serratus Anterior ◽  
Case Presentation ◽  
Chest X Ray ◽  
The Right ◽  
Pulmonary Wedge Resection ◽  
Anterior Plane

Abstract Background: Non-intubated thoracoscopic lung surgery has been reported to be technically feasible and safe. Spontaneous rupture of the esophagus, also known as Boerhaave's syndrome (BS), is rare after chest surgery.Case Presentation: A 60-year-old female non-smoker underwent non-intubated uniportal thoracoscopic wedge resection for a pulmonary nodule. Ultrasound-guided serratus anterior plane block was utilized for postoperative analgesia. However, the patient suffered from severe emesis, chest pain and dyspnea 6h after the surgery. Emergency chest x-ray revealed right-sided hydropneumothorax. BS was diagnosed by chest tube drainage and computed tomography. Besides antibiotics and tube feeding, a naso-leakage drainage tube was inserted into the right thorax for pleural evacuation. Finally, the esophagus was healed 40d after the conservative treatment.Conclusions: Perioperative antiemetic therapy is an indispensable item of fast-track surgery. Moreover, BS should be kept in mind when the patients complain of chest distress following emesis after thoracic surgery.

scholarly journals Contralateral Spontaneous Rupture of the Esophagus Following severe Vomiting After Non-intubated Pulmonary Wedge Resection

2020 ◽  
Author(s):  
Lei Liu ◽  
Wenbin Wu ◽  
Longbo Gong ◽  
Miao Zhang
Keyword(s):  
Spontaneous Rupture ◽  
Wedge Resection ◽  
Tube Feeding ◽  
Lung Surgery ◽  
Serratus Anterior ◽  
Severe Vomiting ◽  
Chest X Ray ◽  
The Right ◽  
Pulmonary Wedge Resection ◽  
Anterior Plane

Abstract Background: Non-intubated thoracoscopic lung surgery has been widely applied as it is technically feasible and safe. Spontaneous rupture of the esophagus, also known as Boerhaave's syndrome (BS), is rare after chest surgery.Case Presentation: A 60-year-old female non-smoker underwent non-intubated uniportal thoracoscopic wedge resection assisted with a laryngeal mask for a solitary pulmonary nodule. Ultrasound-guided serratus anterior plane block was utilized for analgesia. The patient complained of hyperemesis followed by chest pain and acute dyspnea 6 hours after the surgery. Emergency chest x-ray revealed the right-sided hydropneumothorax. BS was confirmed by further chest tube drainage and computed tomography. The patient refused surgical intervention; therefore, conservative procedures including pleural evacuation through a naso-leakage drainage tube, antibiotics and tube feeding were administered. The healing of the esophagus was recorded 40 days later.Conclusions: Perioperative antiemetic is an indispensable item of tubeless thoracic surgery. BS should be kept in mind when the patients suffer from sudden chest distress following severe vomiting after tubeless lung surgery.

Successful weaning from mechanical ventilation after Serratus Anterior Plane block in a chest trauma patient

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Cristiano D’Errico ◽  
Manuela Sellini ◽  
Tullio Cafiero ◽  
Giovanni Marco Romano ◽  
Antonio Frangiosa
Keyword(s):  
Pain Control ◽  
Chest Trauma ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Serratus Anterior ◽  
Case Presentation ◽  
Mortality And Morbidity ◽  
Normal Breathing ◽  
Successful Weaning ◽  
Anterior Plane

Abstract Objectives Chest trauma is associated with severe pain, which can hamper normal breathing. Serratus Anterior Plane block (SAPB) is a novel technique, which provides analgesia for chest wall surgery. We describe an interesting clinical case about the use of SAPB to improve pain and pulmonary function in a patient with severe chest trauma. Case presentation We report the pain management and the clinical evolution of a patient in ICU, with a severe chest trauma, after performing the SAPB. Following the SAPB, the patient had a reduction in pain intensity and an improvement in both respiratory mechanics and blood gas analysis allowing a weaning from mechanical ventilator. Conclusions Pain control greatly affects mortality and morbidity in patients with chest trauma. SAPB seems to be safer and equally effective in pain control compared to epidural analgesia in patients with chest trauma.

scholarly journals Perplexing case of lung mass perfectly mimicking a malignancy

2019 ◽  
Vol 12 (7) ◽  
pp. e229273
Author(s):  
Eid Humaid Alqurashi ◽  
Ahmed Sayeed ◽  
Hasheema Hasheem Alsulami ◽  
Hadeel Mashhour Al-Qurashi
Keyword(s):  
Connective Tissue ◽  
Connective Tissue Disease ◽  
Wedge Resection ◽  
Biopsy Result ◽  
X Ray ◽  
Breath Sounds ◽  
History Of ◽  
Chest X Ray ◽  
The Right ◽  
Histopathology Examination

A 35-year-old man, a known asthmatic and with a history of smoking presented with a history of recurrent episodes of mild haemoptysis. On examination, there was decreased intensity of breath sounds on the right infraclavicular area. The chest X-ray and CT chest showed a mass in right upper lobe with nodules in the other lobe. The VAT showed large heavily vascularised mass with surface laden with multiple nodules. The wedge resection of the mass was taken and sent for histopathology examination. The biopsy result showed picture suggestive of connective tissue disease associated follicular bronchiolitis. The patient did not have any signs or symptoms of connective tissue disease. However he was positive for Rheumatoid factor, ANA, anti-RO, anti-CCP antibodies. He was started on steroids and azathioprine. After 6 months of treatment, the size of the mass and nodules reduced by 50% and ESR was reduced to 5 from 75.

scholarly journals A survived case of penetrating neck injury with intrathoracic organ damage

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Atsushi Kagimoto ◽  
Takeshi Mimura ◽  
Nanami Hiraiwa ◽  
Yoshinori Yamashita
Keyword(s):  
Wedge Resection ◽  
Median Sternotomy ◽  
Organ Damage ◽  
Case Presentation ◽  
Stab Wounds ◽  
Lung Lobe ◽  
Penetrating Neck Injury ◽  
Blade Tip ◽  
The Right ◽  
Tomography Scan

Abstract Background Thoracic surgeons rarely encounter stab wounds with injury to the intrathoracic organs. However, such sudden and urgent situations could arise; therefore, experiences in managing such cases are invaluable. Case presentation An 84-year-old woman with depression who had a stab injury in the neck caused by a broad-bladed kitchen knife was brought to our facility by ambulance. She was stable in the emergency room; however, a computed tomography scan revealed that the blade had penetrated the right thoracic cavity. A right hemopneumothorax was seen. Considering the possibility of injury to the major vessels, a median sternotomy was performed. During the dissection around the blade, the patient started bleeding profusely, which required repair of an injury to the right internal jugular vein. The blade tip had penetrated the dorsal right upper lung lobe; however, it did not reach the hilum, and the knife was carefully removed. The damaged area of the lung was removed by wedge resection. Conclusion Patients with deep stab wounds from knives are often hemodynamically stable because the blade acts as tamponade and prevents hemorrhage. Therefore, a surgical approach that allows for good visualization should be considered for the extraction of the blade.

scholarly journals Right-sided strangulating diaphragmatic hernia in an adult without history of trauma: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Konstantinos G. Spiridakis ◽  
Mathaios E. Flamourakis ◽  
Ioannis G. Gkionis ◽  
Eleni I. Kaloeidi ◽  
Anthoula I. Fachouridi ◽  
...  
Keyword(s):  
Diaphragmatic Hernia ◽  
Clinical Status ◽  
Traumatic Injury ◽  
Postoperative Recovery ◽  
Case Presentation ◽  
Uneventful Postoperative Recovery ◽  
History Of ◽  
Chest X Ray ◽  
The Right ◽  
Diaphragmatic Hernias

Abstract Background Diaphragmatic hernia involves protrusion of abdominal contents into the thorax through a defect in the diaphragm. This defect can be caused either by developmental failure of the posterolateral foramina to fuse properly, or by traumatic injury of the diaphragm. Left-sided diaphragmatic hernias are more common (80–90%) because the right pleuroperitoneal canal closes earlier and the liver protects the right diaphragm. Diaphragmatic hernias in adults are relatively asymptomatic, but in some cases may lead to incarcerated bowel, intraabdominal organ dysfunction, or severe pulmonary disease. The aim of this report is to enlighten clinical doctors about this rare entity that can have fatal consequences for the patient. Case presentation We present a rare case of a right-sided strangulating diaphragmatic hernia in an adult Caucasian patient without history of trauma. Clinical examination revealed bowel sounds in the right hemithorax, which were confirmed by the presence of loops of small intestine into the right part of the thorax through the right diaphragm, as was shown on chest X-ray and computerized tomography. Deterioration of the clinical status of the patient led to an operation, which revealed strangulated necrotic small bowel. Approximately 1 m of bowel was removed, and laterolateral anastomosis was performed. The patient had an uneventful postoperative recovery and was discharged 8 days later. Conclusions Surgery is required to replace emerged organs into the abdomen and to repair diaphragmatic lesion. A delayed approach can have catastrophic complications for a patient.

Abstract 16795: Fate of Dislodged Micra Transcatheter Pacing System in Coronary Sinus

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Sangeeta Prabhakar Bhat ◽  
Vijay Pratap Singh ◽  
Wilson Young
Keyword(s):  
Atrial Fibrillation ◽  
Coronary Sinus ◽  
Persistent Atrial Fibrillation ◽  
Case Presentation ◽  
Leadless Pacemaker ◽  
Device Implantation ◽  
Ventricular Response ◽  
Chest X Ray ◽  
Symptomatic Bradycardia ◽  
The Right

Background: Micra Transcatheter Pacing System is a leadless pacemaker for treatment of symptomatic high-grade atrioventricular block and persistent atrial fibrillation. We present a case report of dislodgement of a Micra device into the coronary sinus. Case presentation: An 87 year old man with permanent atrial fibrillation presented to the hospital with dizziness and fall. His medications included Lasix and Metoprolol. Electrocardiogram revealed atrial fibrillation with slow ventricular response. Metoprolol was held. During the hospital stay, telemetry monitoring revealed heart rates of 30-40 bpm. Micra device implantation was indicated for symptomatic bradycardia. After deployment, the Micra dislodged into the right atrium. Efforts to retrieve the device led to its embolism into mid-coronary sinus and dissection of the coronary sinus. Given comorbidities, the Micra was deactivated and a single chamber pacemaker was implanted with serial radiographic monitoring of Micra. Post procedure Chest X-ray (Fig. 1) and Computed Tomography Angiography of the chest (Fig. 2) confirmed location of Micra in the coronary sinus. Discussion: This is the first described case of dislodged Micra device in the coronary sinus. Device retrieval attempts resulted in dissection of the coronary sinus and there was no myocardial capture when pacing from the device. Serial CXR showed stable Micra position over the next two years. Conclusion: Embolization and dislodgement of Micra leadless pacemaker into the coronary sinus is possible and chronic management with serial imaging after abandoning the device is feasible.

scholarly journals Streptococcus anginosus bacteremia: a septic IVC thrombus and a large empyema requiring decortication

2021 ◽  
Vol 9 (4) ◽  
pp. 1196
Author(s):  
Niaz A. Shaikh ◽  
Ayesha H. Alshamsi ◽  
Khalid O. Alattar ◽  
Jehangir A. Mobushar ◽  
Ranjana Pradeep ◽  
...  
Keyword(s):  
Vena Cava ◽  
Case Presentation ◽  
Streptococcus Anginosus ◽  
Septic Embolization ◽  
Intravenous Antibiotics ◽  
Ivc Thrombus ◽  
Lower Lung ◽  
Chest X Ray ◽  
The Right ◽  
Work Up

A previously healthy 39 year old male presented with complaints of cough, fever, abdominal pain and chills. The patient was found to be in active sepsis with hypotension on presentation so was resuscitated while a full septic work-up was ordered. Initial chest X-ray showed only increased broncho-alveolar markings and no consolidations, but blood cultures eventually revealed Streptococcus anginosus bacteremia. Intravenous antibiotics were started and infective endocarditis was ruled out. Computerized tomography scan of the abdomen with contrast revealed findings suggestive of a septic hepatic inferior vena cava thrombus and right lower lung findings suggestive of septic embolization and an empyema. Later on during admission, CT scan of the chest with contrast revealed a moderate-sized empyema of the right lung which eventually required decortication. Discovering such findings concurrently in a single patient is extremely rare, particularly an embolizing septic IVC thrombus with confirmed bacteremia. For this reason it is described in the following case presentation

scholarly journals Congenital cystic adenomatoid malformation of lung mimicking lung cancer: a case report

2018 ◽  
Vol 2 (3) ◽  
Author(s):  
Ying Zhao ◽  
Yongxiang Zhang ◽  
Leng Qi ◽  
Zhenwu Li ◽  
Pang Peng ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Case Report ◽  
Thoracoscopic Surgery ◽  
Wedge Resection ◽  
Congenital Cystic Adenomatoid Malformation ◽  
Radiological Imaging ◽  
Cystic Adenomatoid Malformation ◽  
Thin Walled ◽  
The Right ◽  
Pulmonary Wedge Resection

Abstract: We report a case of a 66-year-old woman with congenital cystic adenomatoid malformation (CCAM) that presented as a thin walled cyst on radiological imaging and mimicked lung cancer. The right pulmonary wedge resection was performed via thoracoscopic surgery. Pathologic results proved CCAM which though, uncommon may be misdiagnosed in adults.

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