scholarly journals Successful video-assisted thoracoscopic management of the right middle lobe torsion: A rare complication of right upper lobectomy – A report of two cases

Lung India ◽  
2020 ◽  
Vol 37 (6) ◽  
pp. 530
Author(s):  
MohanVenkatesh Pulle ◽  
BelalBin Asaf ◽  
HarshVardhan Puri ◽  
Arvind Kumar
2007 ◽  
Vol 135 (7-8) ◽  
pp. 461-464 ◽  
Author(s):  
Jelena Stojsic ◽  
Branislava Milenkovic ◽  
Jelena Radojicic ◽  
Malina Percinkovski

Introduction Alveolar adenoma belongs to the group of benign epithelial tumors. Histogenesis of alveolar adenoma is a combination of proliferation of alveolar pneumocytes and fibrous tissue originating from septal mesenchyma. Case outline A sixty-nine-year old female patient was hospitalized for clinical examination and surgery of well defined and homogenous timorous lesion in the right middle lobe causing pleural pain. Bronchoscopic examination with biopsy did not resolve etiology of the disease. Tumorectomy was performed. Timorous nodule had a multicystic appearance and histologically, histochemically and immunohistochemically, an alveolar adenoma was estimated. Five years after surgery, the patient feels well, without respiratory symptoms and signs of recurrence or malignant alteration, respectively. Conclusion Alveolar adenoma is a rare benign lung tumor, most frequently presented as a solitary pulmonary nodule. After complete surgery, the tumor neither relapses nor malignantly alters. Surgical excision is curative. It is necessary to take into consideration alveolar adenoma, too, when a solitary pulmonary nodule is diagnosed.


2019 ◽  
Vol 31 (3) ◽  
pp. 223-226 ◽  
Author(s):  
Shakilu Jumanne

BackgroundNecrotizing pneumonia and hyperleukocytosis, to the extent of that seen in leukaemia, is a rarely reported presentation. The commonest trigger of such a presentation is an inflammatory process caused by an overwhelming infection which leads to bone marrow irritation. However, the misdiagnosis of this clinical entity as leukaemia should be avoided at all costs so as to avoid the anxiety associated with a diagnosis of cancer, both to the patients and their families.Case presentationHere, we report the case of a 22-month-old boy who was referred to our Pediatric Oncology Unit (POU). Owing to a high total leukocyte count (TLC) of 98,000 cells/µl, there was a strong suspicion of leukaemia. The boy had been reviewed at another hospital where he presented with fever and cough refractory to the commencement of tuberculosis medications as a result of chest radiography findings. Laboratory investigations performed on admission in the POU were negative for leukaemia and other myeloproliferative disorders. A chest computer tomography (CT) scan was performed to delineate opacification in the right middle lobe. This revealed multiple necrotic and emphysematous foci in line with a diagnosis of necrotizing pneumonia. Subsequently, the patient responded well to a course of piperacillin- tazobactam. The TLC normalized and the cough and fever resolved over a period of 2 weeks. ConclusionHere, we describe a particularly rare case of leukaemoid reaction with a massive leukocyte count. Such patients can be easily misdiagnosed as having leukaemia or other myeloproliferative disorders, especially in settings with limited diagnostic availability. Such misdiagnosis can cause undue stress on the patient and their families. Thus, it is important that patients presenting with these symptoms should undergo a thorough review of history, physical examination and a structured workup.


Author(s):  
Yutaka Miyawaki ◽  
Yasuaki Nakajima ◽  
Yutaka Tokairin ◽  
Kenro Kawada ◽  
Taichi Ogo ◽  
...  

Abstract Introduction: Lobar torsion is a rare but fatal complication, with such cases being mostly treated with pulmonary resection. Only a few cases of pulmonary torsion following esophagectomy have thus far been reported, and all cases occurred subsequent to transthoracic esophagectomy. Case presentation: We herein present the case of a patient with the right middle lobe torsion after thoracoscopic esophagectomy in a 64-year-old male.As the patient exhibited a hemodynamically unstable condition immediately after surgery and bronchoscopy and computed tomography revealed right middle lobe torsion, urgent surgery was performed.As torsion of right middle lobe was confirmed during a second operation, repositioning for torsion was performed. Fortunately, right middle lobe was aerated and exhibited a good complexion immediately after repositioning; therefore, pneumonectomy was not performed. Conclusion: Because it is difficult to observe the process of reinflation of a collapsed lung under direct vision in order to prevent lobar torsion when performing thoracoscopic esophagectomy, it is imperative to confirm the patency of the proximal bronchi during the operation using bronchoscopy.


2020 ◽  
Vol 13 (9) ◽  
pp. e237720
Author(s):  
Firas El-Baba ◽  
Danielle Gabe ◽  
Allan Frank

A 33-year-old man with paranoid schizophrenia and a ventriculoperitoneal (VP) shunt was sent to our institution from an inpatient psychiatric facility due to concerns for the 2019 novel coronavirus (COVID-19). Per the facility, the patient had a fever and non-productive cough. On admission, the patient was afebrile and lacked subjective symptoms. A RNA reverse transcriptase PCR (RNA RT-PCR) test for COVID-19 was positive. A chest X-ray contained a small patchy opacity in the right middle lobe and another in the retrocardiac region concerning for pneumonia. Inflammatory markers were mildly elevated. He remained COVID-19 positive and asymptomatic for 36 days. This case details one asymptomatic carrier’s course with persistently positive COVID-19 nasopharyngeal swabs. It demonstrates that a VP shunt could be a possible predisposition for prolonged viral shedding.


CHEST Journal ◽  
2019 ◽  
Vol 156 (4) ◽  
pp. A635
Author(s):  
Dawn Maldonado ◽  
Michael Megally ◽  
Terence McGarry

1983 ◽  
Vol 55 (1) ◽  
pp. 236-242 ◽  
Author(s):  
R. T. Yen ◽  
F. Y. Zhuang ◽  
Y. C. Fung ◽  
H. H. Ho ◽  
H. Tremer ◽  
...  

Morphometric data of the pulmonary veins in the cat right lung are presented. Silicone elastomer casts of the right lungs of five cats were made, measured, counted, and analyzed. The Strahler system is used to describe the branching pattern of the vascular tree. These data are needed for the physicomathematical approach to pulmonary circulation. For all the pulmonary blood vessels lying between the left atrium and the capillary beds, there are a total of 10 orders of vessels in the right upper lobe, 9 orders of vessels in the right middle lobe, and 11 orders of vessels in the right lower lobe. The ratios of the diameters, lengths, and the number of branches in successive orders of vessels are called the diameter, length, and branching ratios, respectively. For the cat pulmonary venous tree, the average branching ratio is 3.521, the average diameter ratio is 1.727, and the average length ratio is 2.402 for vessels of orders 1-3 and 1.532 for vessels of orders 4-10.


2014 ◽  
Vol 2014 ◽  
pp. 1-4
Author(s):  
Hideki Ota ◽  
Hideki Kawai ◽  
Shuntaro Togashi ◽  
Tsubasa Matsuo

Severe intrathoracic hemorrhage from pulmonary parenchyma is the most serious complication of pulmonary laceration after blunt trauma requiring immediate surgical hemostasis through open thoracotomy. The safety and efficacy of video-assisted thoracoscopic surgery (VATS) techniques for this life-threatening condition have not been fully evaluated yet. We report a case of pulmonary laceration with a massive hemothorax after blunt trauma successfully treated using a combination of muscle-sparing minithoracotomy with VATS techniques (video-assisted minithoracotomy). A 22-year-old man was transferred to our department after a falling accident. A diagnosis of right-sided pneumothorax was made on physical examination and urgent chest decompression was performed with a tube thoracostomy. Chest computed tomographic scan revealed pulmonary laceration with hematoma in the right lung. The pulmonary hematoma extending along segmental pulmonary artery in the helium of the middle lobe ruptured suddenly into the thoracic cavity, resulting in hemorrhagic shock on the fourth day after admission. Emergency right middle lobectomy was performed through video-assisted minithoracotomy. We used two cotton dissectors as a chopstick for achieving compression hemostasis during surgery. The patient recovered satisfactorily. Video-assisted minithoracotomy can be an alternative approach for the treatment of pulmonary lacerations with a massive hemothorax in hemodynamically unstable patients.


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