scholarly journals Full medical treatment of COVID-19 associated large pneumothorax - A case report

2021 ◽  
Author(s):  
Alberto Fantin ◽  
Nadia Castaldo ◽  
Paolo Vailati ◽  
Giuseppe Morana ◽  
Vincenzo Patruno
Keyword(s):  
Lung Parenchyma ◽  
Air Leakage ◽  
Talc Pleurodesis ◽  
Thoracoscopic Approach ◽  
Recurrent Pneumothorax ◽  
Medical Thoracoscopy ◽  
Blood Patch ◽  
Lung Condition ◽  
History Of ◽  
Multi Phase

A 52-year-old man was re-admitted two weeks after recovering from severe COVD-19 following a 3-days history of cough and worsening shortness of breath. The chest radiograph showed a large right-sided pneumothorax. The first attempt at drainage, performed through a large bored tube, failed. Due to the large dimension of the pneumothorax, and the lung condition (extensive consolidation and diffuse bullous dystrophies), the only thoracic surgical approach prospected was a pneumonectomy. Willing to preserve the lung, the pulmonology team attempted a multi-phase medical-oriented strategy based on medical thoracoscopy. Therefore, the patient underwent 5 chest tube insertions, 2 talc pleurodesis, and an intrapleural blood patch. Air leakage resolution was progressively achieved, and the patient became asymptomatic.             We strongly encourage a medical thoracoscopic approach for the patient presenting with recurrent pneumothorax in order to ensure complete lung re-expansion and preserve lung parenchyma.

scholarly journals Thoracoscopic Treatment of Pneumothorax in Marfan Syndrome: Hemostatic Patch to Support Lung Resection Recovery

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Gloria Pelizzo ◽  
Eloisa Arbustini ◽  
Noemi Pasqua ◽  
Patrizia Morbini ◽  
Valeria Calcaterra
Keyword(s):  
Marfan Syndrome ◽  
Spontaneous Pneumothorax ◽  
Lung Resection ◽  
Pulmonary Involvement ◽  
High Rate ◽  
Supportive Treatment ◽  
Air Leakage ◽  
Recurrent Pneumothorax ◽  
Previous Diagnosis ◽  
History Of

Introduction. In selected patients, the absorbable fibrin patch TachoSil® is superior to standard surgical treatment in reducing air leakage after pulmonary lobectomy. Pulmonary involvement is not considered a main feature of Marfan syndrome (MFS); however, spontaneous pneumothorax (SP) with a high rate of recurrence is frequently reported. We describe the use of TachoSil® in the supportive treatment of recurrent pneumothorax in a girl with MFS. Case Report. A 12-year-old girl with a previous diagnosis of MFS and recurrent history of left spontaneous pneumothorax was submitted to thoracoscopic atypical lung resection. Two patches (9.5 × 4.8 cm) were cut from the adhesive/foam complex (TachoSil®) and were pressed against the sutured area as supportive treatment. The patient recovered with no further SP recurrences. Conclusions. The use of the TachoSil® surgical patch may be useful in pneumothorax supportive treatment, particularly in pediatric MFS by ameliorating the mechanical strength of the lung.

Chronic obstructive pulmonary disease

2020 ◽  
pp. 4098-4141
Author(s):  
Nicholas S. Hopkinson
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Tobacco Smoke ◽  
Lung Parenchyma ◽  
Airflow Limitation ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Variable Extent ◽  
Lung Condition ◽  
History Of

Chronic obstructive pulmonary disease (COPD) is a lung condition caused by the inhalation of noxious materials, principally tobacco smoke, and characterized by airflow limitation that is not fully reversible. Key features are cough, sputum production, and breathlessness. There are chronic progressive symptoms and acute exacerbations. The term COPD incorporates several pathological processes, present to a variable extent in any given individual, involving both the airways (chronic bronchitis) and the lung parenchyma (emphysema). Most COPD patients will have one or more other long-term conditions. COPD is the third leading cause of death worldwide. COPD should be considered in those over the age of 35 who have (1) exposure to risk factors, usually, but not exclusively, tobacco smoke; (2) a history of chronic progressive respiratory symptoms; (3) airflow limitation that is not fully reversible.

Incidence of postural headache after lumbar puncture requiring epidural blood patch: Effects of needle caliber; 2-year experience

2021 ◽  
pp. 197140092110006
Author(s):  
Warren Chang ◽  
Ajla Kadribegic ◽  
Kate Denham ◽  
Matthew Kulzer ◽  
Tyson Tragon ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lumbar Puncture ◽  
Conservative Management ◽  
Epidural Blood Patch ◽  
Female Gender ◽  
Regional Hospital ◽  
Younger Age ◽  
Blood Patch ◽  
History Of ◽  
The Difference

Purpose A common complication of lumbar puncture (LP) is postural headaches. Epidural blood patches are recommended if patients fail conservative management. Owing to a perceived increase in the number of post-lumbar puncture headaches (PLPHs) requiring epidural blood patches at a regional hospital in our network, the decision was made to switch from 20 to 22 gauge needles for routine diagnostic LPs. Materials and methods Patients presenting for LP and myelography at one network regional hospital were included in the study. The patients were contacted by nursing staff 3 days post-procedure; those patients who still had postural headaches after conservative management and received epidural blood patches were considered positive cases. In total, 292 patients were included; 134 underwent LP with 20-gauge needles (53 male, 81 female, average age 57.7) and 158 underwent LP with 22-gauge needles (79 male, 79 female, average age 54.6). Results Of 134 patients undergoing LP with 20-gauge needles, 15 (11%) had PLPH requiring epidural blood patch (11 female, 3 male, average age 38). Of 158 patients undergoing LP with 22-gauge needles, only 5 (3%) required epidural blood patches (all female, average age 43). The difference was statistically significant ( p < 0.01). Risk factors for PLPH included female gender, younger age, lower body mass index, history of prior PLPH and history of headaches. Conclusion Switching from 20-gauge to 22-gauge needles significantly decreased the incidence of PLPH requiring epidural blood patch. Narrower gauge or non-cutting needles should be considered in patients with risk factors for PLPH, allowing for CSF requirements.

Late diagnosis of pulmonary agenesis

2021 ◽  
Vol 14 (10) ◽  
pp. e245233
Author(s):  
Diana Alexandra Pimenta ◽  
Filipa Lemos Aguiar ◽  
Beatriz Celeiros Fernandes ◽  
Rui Rolo
Keyword(s):  
Early Childhood ◽  
Clinical Presentation ◽  
Lung Parenchyma ◽  
Asthma Diagnosis ◽  
Cardiovascular Malformations ◽  
Surgical Interventions ◽  
Pulmonary Agenesis ◽  
History Of ◽  
Lung Infections ◽  
Respiratory Complaints

Pulmonary agenesis is defined as the complete absence of one or both lungs, including the bronchi, bronchioles, vasculature and lung parenchyma. Most of these malformations are detected in early childhood. A residual number remains asymptomatic and undiagnosed until adulthood. The clinical presentation is wide, ranging from asymptomatic to respiratory complaints like dyspnoea, respiratory distress and a history of recurrent lung infections. This case presents a 54-year-old woman with complaints of coughing, dyspnoea for medium exertion and wheezing for a couple of months. Based on the results of complementary diagnosis methods, right pulmonary agenesis was diagnosed without other malformations. Simultaneously, an asthma diagnosis was also performed. The treatment of pulmonary agenesis is symptomatic. Simultaneous cardiovascular malformations could require surgical interventions. This case demonstrates that pulmonary agenesis may remain undiagnosed, be identified incidentally, and have a good and long prognosis.

Pleuroscopy early experience in the exudative pleural effusion of unknown etiology

2021 ◽  
Vol 17 ◽  
Author(s):  
Atefeh Fakharian ◽  
Hamidreza Jabbardarjani ◽  
Mohamad Reza Masjedi ◽  
Masoud Shamaei
Keyword(s):  
Pleural Effusion ◽  
Previous History ◽  
Invasive Procedure ◽  
Therapeutic Interventions ◽  
Unknown Etiology ◽  
Safe Procedure ◽  
Pathologic Diagnosis ◽  
Medical Thoracoscopy ◽  
History Of ◽  
Exudative Pleural Effusion

Background: Pleuroscopy (medical thoracoscopy) is a minimally invasive procedure to inspect and perform a biopsy of the pleural space as well as to perform therapeutic interventions; pleural fluid drainage and pleurodesis. Material and Methods: In a retrospective study in Kasra Hospital, Tehran-Iran, the patients with exudative pleural effusion of unknown etiology who underwent pleuroscopy, were evaluated. These patients had negative smear and culture for infective agents. Also, the cytological review was negative for malignancy. Results: 62 patients had undergone pleuroscopy, of which 29 (46.7) were men. After the final evaluation, 47 patients (75.8%) had a definite pathologic diagnosis, of which 39 (82.9%) were cancer. Through these 39 cases, 18 cases (46.1%) had a history of the previously confirmed cancer, in which pleural pathology was consistent with the initial diagnosis. In 21 cases (53.9%), metastatic cancers were detected without a previous history. From a total of 47 cases with definite pathologic diagnosis, 8 cases (17%) had histopathologic evidence of granulomatous lesions consistent with tuberculosis and 15 patients (24%) showed non-specific inflammatory lesions. There was no morbidity and mortality among these patients. Discussion: Considering that pleuroscopy is a safe procedure with high diagnostic accuracy, malignancy is the most finding in the exudative pleural effusion of unknown etiology. This increases the importance of this procedure in these cases to prevent wasting the time and smear-negative anti-TB treatment.

Uniportal thoracoscopic right anterior basal (S8) segmentectomy using unidirectional dissection

2021 ◽  
Keyword(s):  
Minimally Invasive ◽  
Surgical Procedure ◽  
Lower Lobe ◽  
Lung Parenchyma ◽  
Surgical Instruments ◽  
Thoracoscopic Approach ◽  
Minimally Invasive Surgical Procedure ◽  
Small Incision ◽  
Minimally Invasive Surgical ◽  
The Right

Anterior basal (S8) segmentectomy is one of the most challenging procedures among the uncommon pulmonary segmentectomies because the surgeon has to identify dominant pulmonary vein branches located deep in the lung parenchyma. Moreover, with the uniportal thoracoscopic approach, the angulation of inserted surgical instruments via a single small incision is extremely limited, which causes technical difficulties. However, adoption of a suitable procedure such as unidirectional dissection enables us to perform this type of minimally invasive surgical procedure. We describe the successful results of a patient undergoing uniportal thoracoscopic S8 segmentectomy of the right lower lobe and explain the nuances of performing it.

A SPH Implementation with Ignition and Growth and Afterburning Models for Aluminized Explosives

2017 ◽  
Vol 14 (04) ◽  
pp. 1750046 ◽  
Author(s):  
Guangyu Wang ◽  
Guirong Liu ◽  
Qing Peng ◽  
Suvranu De
Keyword(s):  
Growth Model ◽  
Detonation Front ◽  
High Explosives ◽  
Combustion Chemistry ◽  
Metal Combustion ◽  
Military Industry ◽  
Particle Hydrodynamics ◽  
Long Time ◽  
History Of ◽  
Multi Phase

Aluminized explosives have been applied in military industry since decades ago. Compared with ideal explosives such as TNT, HMX, RDX, aluminized explosives feature both fast detonation and slow metal combustion chemistry, generating a complex multi-phase reactive flow. Though aluminized explosives have been employed for a long time, the mechanism underneath the chemical process is still not thoroughly understood. In this paper, a smooth particle hydrodynamics (SPH) method incorporated ignition and growth model, and afterburning model has been proposed for the simulation of aluminized explosive. Ignition and growth model is currently the most popular model for the simulation of high explosives, which is capable of accurately reproducing arrival time of detonation front and pressure history of high explosives. It has been integrated in commercial software such as ANSYS-LS DYNA. In addition, an afterburning model has been integrated in the SPH code to simulate the combustion of aluminum particles. Simulation is compared with experiment and good agreement is observed. The proposed mathematical model can be used to study the detonation of aluminized explosives.

Treatment of Spontaneous Pneumothorax: Why Not Simple Talc Pleurodesis by Medical Thoracoscopy?

Respiration ◽  
2000 ◽  
Vol 67 (1) ◽  
pp. 108-111 ◽  
Author(s):  
J.-M. Tschopp ◽  
C.T. Bolliger ◽  
C. Boutin
Keyword(s):  
Spontaneous Pneumothorax ◽  
Talc Pleurodesis ◽  
Medical Thoracoscopy

scholarly journals Unusual Life-Threatening Pneumothorax Complicating a Ruptured Complex Aspergilloma in an Immunocompetent Patient in Cameroon

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Bernadette Ngo Nonga ◽  
Bonaventure Jemea ◽  
Angele O. Pondy ◽  
Daniel Handy Eone ◽  
Marie Claire Bitchong ◽  
...  
Keyword(s):  
Aspergillus Fumigatus ◽  
Lung Resection ◽  
Tension Pneumothorax ◽  
Immunocompetent Patient ◽  
Air Leakage ◽  
Quick Recovery ◽  
Life Threatening ◽  
History Of ◽  
Main Complication

An aspergilloma is a well-recognized lesion of the lung caused most of the time by the fungus Aspergillus fumigatus. Its main complication is hemoptysis and has been very rarely associated with tension pneumothorax. We present the case of a 47-year-old man with a history of treated and healed tuberculosis, which was successfully managed in our service for a ruptured right upper lobe complexed aspergilloma, complicated by a massive and tension pneumothorax. The patient underwent thoracotomy and lung resection with quick recovery. Conclusively, although rare, an aspergilloma may rupture and cause a life-threatening air leakage.

scholarly journals Tumor collision of uterine adenocarcinoma and leiomyosarcoma in a goat

2017 ◽  
Vol 29 (5) ◽  
pp. 696-699 ◽  
Author(s):  
Jenna C. Dockweiler ◽  
Brieuc Cossic ◽  
Sean P. McDonough ◽  
Susan L. Fubini ◽  
Kayla M. Le ◽  
...  
Keyword(s):  
Lung Parenchyma ◽  
Collision Tumor ◽  
Biological Behavior ◽  
Primary Adenocarcinoma ◽  
Speculum Examination ◽  
Mixed Breed ◽  
History Of ◽  
The Masses ◽  
Strong Suspicion ◽  
Uterine Adenocarcinoma

An aged mixed-breed goat doe was presented with a 9-mo history of serosanguineous vaginal discharge. Vaginal speculum examination revealed serosanguineous discharge but otherwise no abnormalities. Transrectal ultrasonography showed normal ovaries and multifocal cystic lesions within the uterus. Ovariohysterectomy was recommended because of a strong suspicion of neoplasia. Multiple, non-resectable masses were noted in and around the uterus intraoperatively, and euthanasia was elected. Autopsy revealed multiple masses within the uterus, cervix, and lung parenchyma. Histologically, the masses within the uterus represented a likely collision tumor of primary adenocarcinoma and leiomyosarcoma. Our report highlights the importance of obtaining biopsy samples of all masses because the lesions described showed significantly different biological behavior. This information is vital to guide treatment and prognosis.

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