scholarly journals January 2022 medical image of the month: bronchial obstruction due to pledget in airway following foregut cyst resection

2022 ◽  
Vol 24 (1) ◽  
pp. 6-7
Author(s):  
Prasad Panse ◽  
◽  
Kenneth Sakata
Keyword(s):  
Lower Lobe ◽  
First Trimester ◽  
Duplication Cyst ◽  
Bronchial Obstruction ◽  
Air Leak ◽  
Lobe Bronchus ◽  
Prolonged Air Leak ◽  
Bronchogenic Cysts ◽  
Foregut Cyst

No abstract available. Article truncated after 150 words. A 37-year-old woman complaining of chest pain and cough underwent resection of a mediastinal foregut duplication cyst complicated by a 10-day hospitalization with a prolonged air leak. Seven years later, she presented with worsening cough and shortness of breath, complaining of similar symptoms intermittently in the 7 years between her surgery and presentation. Chest CT showed a hyperattenuating lesion obstructing the medial basal segmental airways, with bronchoscopy revealing suture and a pledget obstructing the medial basal segmental right lower lobe bronchus. The pledget and suture were successfully removed. Repeat bronchoscopy several months later showed no residual airway foreign body, although medial basal subsegmental bronchial stenosis prevented advancement of the bronchoscope distally; this finding correlated with the CT impression of airway stenosis or occlusion in this region on the follow up CT. Bronchogenic cysts result from abnormal lung budding and development of the ventral foregut during the first trimester (1). Many …

scholarly journals Analysis of pneumothorax recurrence risk factors in 843 patients who underwent videothoracoscopy for primary spontaneous pneumothorax: results of a multicentric study

2020 ◽  
Vol 31 (1) ◽  
pp. 78-84
Author(s):  
Maria Cattoni ◽  
Nicola Rotolo ◽  
Maria Giovanna Mastromarino ◽  
Giuseppe Cardillo ◽  
Mario Nosotti ◽  
...  
Keyword(s):  
Risk Factors ◽  
Spontaneous Pneumothorax ◽  
Primary Spontaneous Pneumothorax ◽  
Chest Drain ◽  
Air Leak ◽  
Old Patients ◽  
Multicentric Study ◽  
Prolonged Air Leak ◽  
Pleural Abrasion

Abstract OBJECTIVES Risk factors for pneumothorax recurrence after videothoracoscopy for primary spontaneous pneumothorax are still being debated. The goal of this study was to assess whether the pleurodesis technique and other variables are possibly associated with the postoperative ipsilateral recurrence of pneumothorax. METHODS We retrospectively collected data of 1178 consecutive ≤40-year-old patients who underwent videothoracoscopy for primary spontaneous pneumothorax in 9 centres between 2007 and 2017. We excluded patients with hybrid pleurodesis and/or incomplete follow-up, leaving for analysis 843 cases [80% men; median age (interquartile range) 22 (18–28) years]. Univariable and multivariable analyses were performed by logistic regression and tested by Cox regression model to assess factors related to ipsilateral pneumothorax recurrence including age, gender, body mass index, smoking habit, cannabis smoking, respiratory comorbidity, dystrophic severity score, surgical indication, videothoracoscopy port number and side, lung resection, pleurodesis technique and postoperative prolonged air leak (>5 days). RESULTS Blebs/bullae resection was performed in 664 (79%) patients. Pleurodesis was achieved by partial pleurectomy in 228 (27%) cases; by pleural electrocauterization in 176 (21%); by pleural abrasion in 121 (14%); and by talc poudrage in 318 (38%). During a median follow-up period of 70.0 months (95% confidence interval 66.6–73.4), pneumothorax recurred in 79 patients (9.4%); among these, 29 underwent redo surgery; 34, chest drain/talc slurry; and 16, clinicoradiological observation. The only independent risk factor for recurrence was postoperative prolonged air leak (P < 0.001) that was significantly related to blebs/bullae resection (P = 0.03). CONCLUSIONS In this multicentric series, postoperative ipsilateral pneumothorax recurrence was remarkable and independently related to prolonged postoperative air leak; besides the retrospective study setting, the pleurodesis method did not have an impact on recurrence. To prevent prolonged air leak, blebs/bullae treatment should be accurate and performed only if indicated.

Applying Fibrin Glue under Pleurography for Intractable Secondary Spontaneous Pneumothorax

2019 ◽  
Author(s):  
Jeong Cho ◽  
Yeong Kim ◽  
Hoseok I. ◽  
Jung Eom ◽  
Hyo Ahn
Keyword(s):  
Fibrin Glue ◽  
Spontaneous Pneumothorax ◽  
Air Leakage ◽  
Air Leak ◽  
Short Term ◽  
Secondary Spontaneous Pneumothorax ◽  
Prolonged Air Leak ◽  
Postoperative Drainage ◽  
The Mean

Background Prolonged air leakage is a problem that can frequently develop in patients with a secondary spontaneous pneumothorax (SSP) or in those who undergo thoracic surgery. However, the management of an air leak is difficult and reoperation might be avoided due to several reasons including adhesions. Herein, we introduce a fibrin glue application under pleurography (FGAP) and short-term outcomes in patients who underwent this procedure. Methods FGAP was performed in 20 patients with an intractable persistent air leakage who had poor lung function, comorbidities to undergo general anesthesia and were expected severe adhesions due to previous surgery. All medical records were retrospectively reviewed. Results Eighteen cases sealed soon after dropping the glue. One patient had a prolonged air leak for 12 days and another patient required an operation to control air leakage 16 days after the procedure. The mean duration of postoperative drainage was 4.17 ± 2.11 days (range: 3–14 days). No postprocedural complications were recorded. The mean duration of follow-up was 12.01 ± 5.02 months (range: 4–22 months). Conclusion FGAP could be a treatment option to seal air leaks, especially in cases with intractable air leakage.

scholarly journals A tactics of surgical treatment of a lung echinococcal cyst ruptured into the bronchus

2021 ◽  
Vol 24 (6) ◽  
pp. 409-412
Author(s):  
A. M. Sharipov ◽  
H. A. Shamszoda ◽  
U. A. Akbarov ◽  
S. A. Mazabshoev ◽  
A. R. Zoirov
Keyword(s):  
Lower Lobe ◽  
Tracheobronchial Tree ◽  
Early Postoperative Period ◽  
Lobe Bronchus ◽  
Residual Cavity ◽  
The Right ◽  
Cyst Rupture ◽  
Pulmonary Echinococcosis ◽  
Positive Effect

Relevance. The most severe complication of pulmonary echinococcosis is cyst rupture with contaminated leakage into the tracheobronchial tree.Material and methods. A 10-year-old boy was admitted to the clinic with diagnosis of fibroatelectasis of the lower lobe of the right lung. Anamnesis revealed that the boy was not well for more than 2 years. His treatment in several hospitals did not have any positive effect. Fibrobronchoscopy was performed during which a fragment of chitinous membrane was found in the orifice of lower lobe bronchus. Histological examination confirmed pulmonary echinococcosis.Results. A hydatid cyst in the projection of 9th and 10th segments of the lower lobe was revealed after thoracotomy on the right. Cystectomy with capitonage of the residual cavity was performed. Early postoperative period was uneventful. The child had conventional etiotropic therapy. A follow-up examination in 2 years with radiological and serological findings revealed no relapse of the disease. Child’s development corresponded to his age.Conclusion. The description of this case indicates that it is extremely important to have a detailed information about disease manifestations. In case of long-lasting lung disease , a diagnostic tracheobronchoscopy is recommended since radiological signs in complicated pulmonary echinococcosis may be not informative.

scholarly journals OUTCOMES OF OPEN THORACIC SURGICAL DECORTICATION IN PATIENTS WITH TUBERCULOUS EMPYEMA

2020 ◽  
Vol 70 (6) ◽  
pp. 1799-1803
Author(s):  
Tahir Aslam ◽  
Amer Bilal ◽  
Manzoor Ahmed ◽  
Mohammad Abid ◽  
Abdul Baseer ◽  
...  
Keyword(s):  
Cross Sectional Study ◽  
Late Presentation ◽  
Air Leak ◽  
Cross Sectional ◽  
Lung Expansion ◽  
Prolonged Air Leak ◽  
Disease Condition ◽  
Delayed Recovery ◽  
Delayed Referral

Objective: To analyze the outcome of open surgical decortication of tuberculous empyema patients at their late presentation. Study Design: Cross sectional study. Place and Duration of Study: Patients (n = 128) with tuberculous empyema were subjected to decortication for one and half year starting from July 2017 to December 2018. Pre, intra, and post-operative characteristics of all patients were studied thoroughly with a 6-month follow up evaluation of the surgical outcomes.  Results: Preoperative conditions were as follows:  6.25% patient had Broncho pleural fistula, 90.9% patients were diagnosed with cough, 34.7 with night sweating, 64.2% chest pain and 79.6% chest tightness. Decortication was performed in all cases, with debridement of necrotic tissue and repair of air leaks in some patients. 70 (54.7%) patients went through right side decortication, whereas 56 (43.7%) patients went through left sided decortication and 2 (1.56%) patients had bilateral. Mortality was 2 (1.56%), 1 patient died of septicemia while 1 of pulmonary embolism. Whereas morbidity was 9 (7%), 3 patients had wound infection, 4 had incomplete lung expansion, 1 patient each had prolonged air leak and post-operative bleeding. Conclusions: Delayed referral for surgery causes irreversible changes in the lung, and prolonged disease condition, which causes increased thickness of the pleura and injury to the underlying lung with a delayed recovery. Open decortication gives satisfactory results.

Effect of bronchial and arterial constriction on alveolar gas concentrations in a lobe of the dog's lung

1959 ◽  
Vol 14 (5) ◽  
pp. 743-752 ◽  
Author(s):  
J. B. West ◽  
P. Hugh-Jones
Keyword(s):  
Mechanical Properties ◽  
Carbon Dioxide ◽  
Lower Lobe ◽  
Bronchial Obstruction ◽  
Lobe Bronchus ◽  
Gas Concentration ◽  
Pressure Cycle ◽  
Argon Concentration ◽  
Arterial Constriction ◽  
Ventilation Perfusion Ratio

Gas concentration tracings were obtained with a mass spectrometer by sampling in the left lower lobe bronchus of open-chested dogs ventilated by a plethysmograph. Partial bronchial obstruction and/or arterial obstruction could be produced by tightening clamps on the bronchus and the branch of the pulmonary artery supplying the lobe. Characteristic patterns of oxygen, carbon dioxide and argon concentration (following a single inspiration of an argon-air mixture) were found with partial bronchial obstruction, arterial obstruction and a combination of both. The patterns were explained by alterations in the ventilation-perfusion ratio and in the phase of ventilation of the obstructed lobe. By relating the tracing taken during mixed obstruction to the pressure cycle of the plethysmograph, some mechanical properties of the obstructed lobe were derived. Submitted on September 3, 1958

Tüdőlebeny-eltávolítást követő kemoterápia tolerabilitását befolyásoló perioperatív tényezők

2018 ◽  
Vol 159 (19) ◽  
pp. 748-755 ◽  
Author(s):  
Aurél Ottlakán ◽  
Balázs Pécsy ◽  
Edit Csada ◽  
Gábor Ádám ◽  
Anikó Maráz ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Performance Status ◽  
Lower Lobe ◽  
Middle Lobe ◽  
Postoperative Chemotherapy ◽  
Air Leak ◽  
Vats Lobectomy ◽  
Postoperative Fever ◽  
Prolonged Air Leak ◽  
Duration Of Surgery

Abstract: Introduction: Lung cancer is the leading cause of malignancy-related deaths in Hungary, involving complex surgical and oncological treatment. Aim: Factors influencing the tolerability of complete/planned and incomplete postoperative chemotherapy after surgery were analyzed. Method: During a 6-year period (January 1, 2011–December 31, 2016), data of 72 patients operated with lung cancer (adenocarcinoma and squamous cell carcinoma), receiving complete (4 cycles) and incomplete (<4 cycles) postoperative chemotherapy were analyzed. The following factors among the two groups [complete: n = 53; incomplete: n = 19] were analyzed: gender, mean age, body mass index, Malnutrition Universal Screening Tool, Charlson Comorbidity Index, second malignant tumor, atrial fibrillation, Forced Expiratory Volume 1 sec, Performance Status, open/Video-Assisted Thoracic Surgery (VATS) lobectomy, duration of surgery, postoperative fever, need for transfusion, prolonged air leak, redo surgery, histology, tumor stage. Results: The rate of complete postoperative cycles obtained from logistic regression analysis, were substantially higher after VATS lobectomies [n = 26 (83.87%)] compared to open procedures [n = 27 (65.85%)]; (p = 0.092; OR = 0.356), without significance. Multivariate analysis (open/VATS lobectomy, upper/middle-lower lobe resection, diabetes, prolonged air leak, postoperative fever) showed significantly increased successful uptake of complete cycles after VATS (p = 0.0495), while upper/middle lobe resections (p = 0.0678) and the lack of diabetes (p = 0.0971) notably increased the number of complete cycles, without significance. Conclusion: Twenty-six percent of patients were unable to receive complete planned postoperative chemotherapy. VATS lobectomy patients received significantly higher number of complete cycles of postoperative chemotherapy. Diabetes and lower lobe lobectomies had a negative effect on the tolerability of postoperative chemotherapy. Orv Hetil. 2018; 159(19): 748–755.

Evaluation of Normal Heart Rate in Early Pregnancy Corresponding to Gestational Age between Six to Eight Weeks

Med Phoenix ◽  
2017 ◽  
Vol 2 (1) ◽  
pp. 34-37
Author(s):  
Akhilesh Kumar Jha ◽  
Bikranta Rimal ◽  
Tarannum Khatun
Keyword(s):  
Heart Rate ◽  
Early Pregnancy ◽  
Well Being ◽  
Clinical Decision ◽  
First Trimester ◽  
Normal Heart ◽  
Normal Heart Rate ◽  
First Trimester Of Pregnancy ◽  
Singleton Pregnancies

Background: Ultrasonography is the reliable and safe way for the evaluation of pregnancy. Heart rate can be detected more confidently from the Ultrasonography. Heart rate is an important parameter for the evaluation of early pregnancy. The purpose of this study was to evaluate the normal heart rate in embryos/fetuses between 6 and 8 weeks of gestation.Method: In our region people are poor and most of them do not know the benefit of regular follow up examination during pregnancy. So most of pregnant women come to our centre at late stage of pregnancy. The number of pregnancy cases is good in our centre but the number of early pregnancy cases coming to regular follow up examination is low. Thus the study was conducted in 51 normal singleton pregnancies undergoing routine ultrasound examination during the first trimester of pregnancy. The duration of study was 6 weeks.Result: Out of 51 singleton pregnancies, 20 cases (39.2%) heart rate were between 131-150 beat per minute and 25 cases (49.0 %) heart rate were between 151-170 beat per minute. However 4 cases (7.8%) were between 110-120 beat per minute and 2 cases (3.9%) were more than 171 beat per minute. There were zero cases above the 180 beat per minute.Conclusion: The result of this study will help to evaluate abnormal and normal fetal heart rate so that early clinical decision whether to continue the pregnancy or terminate it can be taken, as Ultrasonography is only the method used in screening fetal well being in most of the region of our country.Med Phoenix Vol.2(1) July 2017, 34-37

scholarly journals Identifying Patterns of Symptom Distress in Pregnant Women: A Pilot Study

2021 ◽  
Vol 18 (12) ◽  
pp. 6333
Author(s):  
Ching-Fang Lee ◽  
Fur-Hsing Wen ◽  
Yvonne Hsiung ◽  
Jian-Pei Huang ◽  
Chun-Wei Chang ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Healthcare Providers ◽  
First Trimester ◽  
Symptom Distress ◽  
Teaching Hospitals ◽  
Lower Back ◽  
Distress Symptoms ◽  
Related Symptom ◽  
Experienced Symptom

During pregnancy, a woman’s enlarged uterus and the developing fetus lead to symptom distress; in turn, physical and psychological aspects of symptom distress are often associated with adverse prenatal and birth outcomes. This study aimed to identify the trends in the trajectory of these symptoms. This longitudinal study recruited 95 pregnant women, with a mean age of 32 years, from the prenatal wards of two teaching hospitals in northern Taiwan. Symptom distress was measured by a 22-item scale related to pregnancy-induced symptoms. The follow-up measurements began during the first trimester and were taken every two to four weeks until childbirth. More than half of the pregnant women experienced symptom distress manifested in a pattern depicted to be “Decreased then Increased” (56.8%). Other noticeable patterns were “Continuously Increased” (28.4%), “Increased then Decreased” (10.5%) and “Continuously Decreased” (4.2%), respectively. It is worth noting that most pregnant women recorded a transit and increase in their symptom distress, revealed by their total scores, at the second trimester (mean 22.02 weeks) of pregnancy. The participants’ major pregnancy-related distress symptoms were physical and included fatigue, frequent urination, lower back pain, and difficulty sleeping. The mean scores for individual symptoms ranged from 2.32 to 3.61 and were below the “moderately distressful” level. This study provides evidence that could be used to predict women’s pregnancy-related symptom distress and help healthcare providers implement timely interventions to improve prenatal care.

scholarly journals Maternal and Fetal Outcomes in Women with Brain Arteriovenous Malformation Rupture during Pregnancy

2021 ◽  
pp. 1-7
Author(s):  
Kimberly L. Yan ◽  
Nerissa U. Ko ◽  
Steven W. Hetts ◽  
Shantel Weinsheimer ◽  
Adib A. Abla ◽  
...  
Keyword(s):  
San Francisco ◽  
Treatment Strategies ◽  
First Trimester ◽  
Interventional Treatment ◽  
Maternal Outcomes ◽  
Fetal Outcomes ◽  
Brain Avm ◽  
Risk Of Hemorrhage ◽  
The University

Background: Sporadic brain arteriovenous malformations (BAVM) are a major cause of hemorrhagic stroke in younger persons. Prior studies have reported contradictory results regarding the risk of hemorrhage during pregnancy, and there are no standard guidelines for the management of pregnant women who present with BAVM rupture. The purpose of this study is to describe maternal and fetal outcomes and treatment strategies in patients with BAVM hemorrhage during pregnancy. Methods: We performed a retrospective review of the University of California, San Francisco Brain AVM Project database for female patients who were pregnant at the time of BAVM hemorrhage between 2000 and 2017. Clinical and angiographic characteristics at presentation, BAVM treatment, and maternal outcomes using modified Rankin scale (mRS) score at presentation and 2-year follow-up were recorded. Fetal outcomes were abstracted from medical records and maternal reports. Results: Sixteen patients presented with BAVM hemorrhage during pregnancy, 81% (n = 13) of whom were in their second or third trimester. Three patients (19%) who were in their first trimester terminated or miscarried pregnancy prior to BAVM intervention. Of the remaining 13 patients, 77% (n = 10) received emergent BAVM treatment at time of hemorrhage prior to delivery, and 85% of patients achieved BAVM obliteration and good maternal outcomes (mRS 0–2) at 2-year follow-up. All patients had uncomplicated deliveries (69% cesarean and 23% vaginal) with no reports of postnatal cognitive or developmental delays in infants at 2-year follow-up. Conclusions: Our study shows good long-term maternal and fetal outcomes in ruptured BAVM patients presenting during pregnancy, the majority who received BAVM interventional treatment prior to delivery.

scholarly journals Small intestine duplication cyst with recurrent hematochezia: a case report and literature review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zhicheng Zhang ◽  
Xiaowei Huang ◽  
Qian Chen ◽  
Demin Li ◽  
Qi Zhou ◽  
...  
Keyword(s):  
Small Intestine ◽  
Case Report ◽  
Literature Review ◽  
Ct Scan ◽  
Duplication Cyst ◽  
Abdominal Ct ◽  
Case Presentation ◽  
Abdominal Ct Scan ◽  
Capsule Endoscopes

Abstract Background Small intestine duplication cysts (SIDCs) are rare congenital anatomical abnormalities of the digestive tract and a rare cause of hematochezia. Case presentation We describe an adult female presented with recurrent hematochezia. The routine gastric endoscope and colonic endoscope showed no positive findings. Abdominal CT scan indicated intussusception due to the "doughnut" sign, but the patient had no typical symptoms. Two subsequent capsule endoscopes revealed a protruding lesion with bleeding in the distal ileum. Surgical resection was performed and revealed a case of SIDC measuring 6 * 2 cm located inside the ileum cavity. The patient remained symptom-free throughout a 7-year follow-up period. Conclusion SIDCs located inside the enteric cavity can easily be misdiagnosed as intussusception by routine radiologic examinations.

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