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pneumothorax management

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https://www.readbyqxmd.com/read/28934831/pneumoretroperitoneum-pneumomediastinum-pneumothorax-and-subcutaneous-emphysema-after-diagnostic-colonoscopy
#1
Hee Sung Lee, Hwan Hee Park, Ju Seok Kim, Sun Hyung Kang, Hee Seok Moon, Jae Kyu Sung, Byung Seok Lee, Hyun Yong Jeong
Colonoscopy is a commonly performed endoscopic procedure. Although it is generally considered to be safe, serious complications, such as colorectal perforation, can occur. Most colonic perforations are intraperitoneal and cause pneumoperitoneum with acute abdominal pain as the initial symptom. However, extraperitoneal perforations with pneumoretroperitoneum may happen, albeit rarely, with atypical initial symptoms. We report a rare case of rectosigmoid perforation occurring after diagnostic colonoscopy that developed into pneumoretroperitoneum, pneumomediastinum, pneumothorax, and subcutaneous emphysema, with a change in voice and neck swelling as the initial symptoms...
September 25, 2017: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
https://www.readbyqxmd.com/read/28925655/pleuritic-chest-pain-sorting-through-the-differential-diagnosis
#2
Brian V Reamy, Pamela M Williams, Michael Ryan Odom
Pleuritic chest pain is characterized by sudden and intense sharp, stabbing, or burning pain in the chest when inhaling and exhaling. Pulmonary embolism is the most common serious cause, found in 5% to 21% of patients who present to an emergency department with pleuritic chest pain. A validated clinical decision rule for pulmonary embolism should be employed to guide the use of additional tests such as d-dimer assays, ventilation-perfusion scans, or computed tomography angiography. Myocardial infarction, pericarditis, aortic dissection, pneumonia, and pneumothorax are other serious causes that should be ruled out using history and physical examination, electrocardiography, troponin assays, and chest radiography before another diagnosis is made...
September 1, 2017: American Family Physician
https://www.readbyqxmd.com/read/28913628/delayed-bronchocutaneous-fistula-without-pneumothorax-following-a-microwave-ablation-of-a-recurrent-pulmonary-metastasis
#3
Arnaud Thivolet, Badis Menassel, Gérard Chatté, Mayeul Tabutin, Amine Bouhamama, Frank Pilleul, Charles Mastier
Percutaneous tumor ablations are rather safe and effective treatments in selected patients for non-operable non-small cell lung carcinomas or lung metastases. However, there are major complications such as bronchopleural or bronchocutaneous fistula, which it is important to know in order to manage them safely. We describe in this report a case of bronchocutaneous fistula without pneumothorax following a microwave ablation of a recurrent pulmonary metastasis and its management.
September 14, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28890747/sclerotherapy-for-the-management-of-seromas-a%C3%A2-systematic-review
#4
Aditya Sood, Vasanth S Kotamarti, Paul J Therattil, Edward S Lee
Objective: Despite improved recognition of risk factors, plastic surgeons commonly encounter seromas postoperatively and must decide upon management. Current recommendations for minimally invasive, chemical management originate from the literature on management of pneumothorax and pleural effusions. A handful of published reports have suggested the efficacy of sclerotherapy in seroma management. The aim of this study was to assess the literature on the use of sclerosants to treat subcutaneous fluid collections...
2017: Eplasty
https://www.readbyqxmd.com/read/28881006/simple-aspiration-versus-intercostal-tube-drainage-for-primary-spontaneous-pneumothorax-in-adults
#5
REVIEW
Kristin V Carson-Chahhoud, Abel Wakai, Joseph Em van Agteren, Brian J Smith, Grainne McCabe, Malcolm P Brinn, Ronan O'Sullivan
BACKGROUND: For management of pneumothorax that occurs without underlying lung disease, also referred to as primary spontaneous pneumothorax, simple aspiration is technically easier to perform than intercostal tube drainage. In this systematic review, we seek to compare the clinical efficacy and safety of simple aspiration versus intercostal tube drainage for management of primary spontaneous pneumothorax. This review was first published in 2007 and was updated in 2017. OBJECTIVES: To compare the clinical efficacy and safety of simple aspiration versus intercostal tube drainage for management of primary spontaneous pneumothorax...
September 7, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28868599/diving-with-pre-existing-medical-conditions
#6
John Lippmann, David McD Taylor, Christopher Stevenson, Jo Williams, Simon J Mitchell
INTRODUCTION: This is the second report based on a survey of Divers Alert Network Asia-Pacific (DAN AP) members who dive with cardiovascular and respiratory conditions and diabetes. It examines the medical management of the divers' conditions, any diving modifications used to mitigate the risk and outcomes. METHODOLOGY: An online cross-sectional survey was sent to 833 divers who had declared a targeted medical condition when applying for DAN AP membership between July 2009 and August 2013...
September 2017: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/28866847/successful-conservative-management-of-an-anastomotic-airway-dehiscence-at-the-left-main-bronchus-following-bilateral-cadaveric-lung-transplantation
#7
Ryo Miyata, Toyofumi F Chen-Yoshikawa, Masatsugu Hamaji, Fumiaki Gochi, Hideki Motoyama, Toshi Menju, Akihiro Aoyama, Toshihiko Sato, Makoto Sonobe, Hiroshi Date
There is a dearth of data on management of anastomotic airway dehiscence following lung transplantation. Herein we report a case of successful conservative management of an anastomotic airway dehiscence after cadaveric donor lung transplantation. A 41-year-old woman with primary ciliary dyskinesia underwent cadaveric bilateral lung transplantation without cardiopulmonary bypass. On the postoperative day 25, left pneumothorax developed and bronchoscopy demonstrated a localized anastomotic dehiscence at the left main bronchus...
September 2, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28864054/quality-gaps-and-comparative-effectiveness-of-management-strategies-for-recurrent-malignant-pleural-effusions
#8
David E Ost, Jiangong Niu, Hui Zhao, Horiana B Grosu, Sharon H Giordano
BACKGROUND: Guidelines for recurrent malignant pleural effusions (MPE) recommend definitive procedures, such as indwelling pleural catheters (IPC) or pleurodesis, over repeat thoracentesis. We hypothesized that many patients have multiple thoracenteses rather than definitive procedures and that this results in more procedures and complications. METHODS: Retrospective cohort study using SEER-Medicare data from 2007-2011. Patients age 66-90 with a MPE were included...
August 29, 2017: Chest
https://www.readbyqxmd.com/read/28852454/minimally-invasive-management-of-traumatic-lung-herniation
#9
Pablo Pérez Castro, Felipe Undurraga Machicao, Raimundo Santolaya Cohen, Raul Berrios Silva, Francisco Rivera
Post-traumatic pulmonary hernia can occur immediately after thoracic trauma or it may also appear months or even years after the onset. We report a case of a seventeen year-old male patient with thoracic blunt trauma secondary to high energy bicycle accident. Chest CT shows moderate hemothorax and pneumothorax, displaced fracture of the fifth left rib, and protusion of pulmonary tissue through a chest wall defect. In the Emergency Room the patient presents with chest pain (7/10 in Visual Analog Scale) and respiratory distress...
July 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28845456/outcome-analysis-of-congenital-diaphragmatic-hernia-cohort-before-and-after-implementation-of-standardized-protocol-in-a-tertiary-neonatal-unit
#10
Amitava Sur, Adjemoke Awoseliya, Alok Sharma
Despite evolving evidence and increased understanding, there is a strong argument that best outcomes in managing congenital diaphragmatic hernia (CDH) patients are achieved in centers which have a high admission rate of such patients and follow standardized operating protocols of management. Pneumothorax and air leak syndromes are one of the main causes of pre- and postoperative morbidity in these patients and experts believe that delivery room sedation and gentle ventilation strategies can minimize this. We observed a significant drop in incidence of pneumothorax and reduction of mortality following implementation of standardized guidelines at the neonatal unit at Southampton which is a tertiary-level neonatal care in the southern United Kingdom and a regional referral center for CDH patients...
July 2017: Surg J (N Y)
https://www.readbyqxmd.com/read/28816011/lessons-learnt-from-incidents-involving-the-airway-and-breathing-reported-from-australasian-emergency-departments
#11
Carmel Crock, Kim Hansen, Toby Fogg, Angela Cahill, Anita Deakin, William B Runciman
OBJECTIVE: To review incident reports relating to problems encountered during the ED management of patients with 'airway or breathing' problems, with the aim of finding and highlighting common themes within these rare events, and making recommendations to further improve patient safety in the areas in which deficiencies have been identified. METHODS: Thematic analysis of 36 incidents reported from Australasian EDs, which were related to problems with airway and breathing...
August 16, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28810113/an-unusual-presentation-of-an-unusual-disease-spontaneous-pneumomediastinum
#12
Kalyan Chakravarthy Potu, Maheedhar Gedela, Kashif Abbas Shaikh, Sujithasree Ketineni, Eric Larson
We report a case of spontaneous pneumomediastinum with unusual clinical presentation. The most common symptoms of spontaneous mediastinum are chest pain and shortness of breath. Our patient presented with neck swelling and change in voice, an unusual presentation for spontaneous pneumothorax. A 30-year-old previously healthy man presented with complaints of neck swelling and hoarseness of voice beginning after an intense coughing spell. He had no other complaints. He denied any trauma to the chest, nausea, vomiting, recent air travel, scuba diving or recreational drug use...
November 2016: South Dakota Medicine: the Journal of the South Dakota State Medical Association
https://www.readbyqxmd.com/read/28795034/chemical-pleurodesis-using-doxycycline-and-viscum-album-extract
#13
Kyung Sub Song, DongYoon Keum, Jae Bum Kim
BACKGROUND: In chemical pleurodesis for managing pulmonary air leak, tetracycline derivatives are commonly used, and their effectiveness has been established in many studies. Recently, a Viscum album extract was used in chemical pleurodesis. We compared the effects of V. album with those of a tetracycline derivative (doxycycline) to demonstrate the therapeutic effectiveness of the V. album extract in chemical pleurodesis for managing pulmonary air leak. METHODS: Between October 2010 and October 2016, chemical pleurodesis was performed using doxycycline in 40 patients and the V...
August 2017: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28761804/partial-ambulatory-management-of-severe-secondary-spontaneous-pneumothorax
#14
Izhaq Masih, Yusuf Vali, Muhammed Naeem, R V Reddy
Secondary spontaneous pneumothorax can be difficult to manage especially in patients with advanced lung disease and respiratory failure. Such patients are unfit for surgery and may endure prolonged hospital stays with chest drains in situ. We describe two such cases where the air leak was persistent despite conventional management. Ambulatory devices which we ordinarily use to manage pneumothoraces in patients with a good lung reserve, were employed as a palliative measure. The strategy not only allowed the patients to return home, but also resulted in healing of the air leak which had persisted with conventional management...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28752438/-blunt-and-penetrating-thoracic-trauma
#15
B Mühling
In most cases blunt chest trauma leads to fractures of the bony thorax, i. e. ribs. In the case of accompanying hemothorax or pneumothorax initial management consists of chest tube drainage by mini-thoracotomy. Subsequently patients with blunt chest trauma have to be transferred to the intensive care unit as these patients are at risk of pulmonary insufficiency or persistent blood loss via the chest tube. Injury to the great vessels or heart requires trauma care in specialized centers. Penetrating trauma is always surgically treated and the foreign body is removed in the operating room (OR)...
July 27, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28745853/pneumothorax-in-pediatric-patients-management-strategies-to-improve-patient-outcomes-digest
#16
Matthew Harris, Joshua Rocker, Kathryn H Pade
The clinical presentation of pneumothorax is highly variable. Spontaneous pneumothoraces may present with subtle symptoms when a small air leak is present, but can progress to hemodynamic instability in the setting of tension physiology. The etiologies are broad and the severity can vary greatly. A trauma patient with a pneumothorax may also have the added complexity of other potentially life-threatening injuries. While there is a wealth of evidence-based guidelines for the management of pneumothoraces in the adult literature, the approach to pediatric patients is largely extrapolated from that literature without a significant evidence base...
March 22, 2017: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/28741012/management-of-computed-tomography-detected-pneumothorax-in-patients-with-blunt-trauma-experience-from-a-community-based-hospital
#17
Ashraf F Hefny, Fathima T Kunhivalappil, Nikolay Matev, Norman A Avila, Masoud O Bashir, Fikri M Abu-Zidan
INTRODUCTION: With near-routine use of computed tomography (CT) for imaging trauma patients, the diagnosis of pneumothorax, especially occult pneumothorax, has increased. However, the need for chest tube insertion remains controversial. We aimed to study the management of pneumothorax detected on CT among patients with blunt trauma, including the decision for tube thoracostomy, in a community-based hospital. METHODS: Chest CT scans of patients with blunt trauma treated at Al Rahba Hospital, Abu Dhabi, from October 2010 to October 2014 were retrospectively studied...
July 25, 2017: Singapore Medical Journal
https://www.readbyqxmd.com/read/28735736/postoperative-pulmonary-complications-following-laparoscopy
#18
REVIEW
P G Paul, Thampi Mathew, Hemant Shintre, Saumya Bulusu, George Paul, Sumina Mannur
Postoperative pulmonary complications unrelated to anesthesia, especially hydropneumothorax, after gynecological laparoscopy is rare. Hydropneumothorax can cause respiratory failure and be life-threatening. Awareness, prompt diagnosis, and timely intervention are important for clinical management. We review the literature for postoperative pulmonary complications including pneumothorax, hydrothorax, hydropneumothorax, and pleural effusion following laparoscopy along with a recent case of hydropneumothorax at our institution...
July 20, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28728546/successful-rescue-combination-of-extracorporeal-membrane-oxygenation-high-frequency-oscillatory-ventilation-and-prone-positioning-for-the-management-of-severe-methicillin-resistant-staphylococcus-aureus-pneumonia-complicated-by-pneumothorax-a-case-report-and
#19
Hangyong He, Hao Wang, Xuyan Li, Xiao Tang, Rui Wang, Bing Sun, Zhaohui Tong
BACKGROUND: To describe the experience of combination therapy with extracorporeal membrane oxygenation(ECMO), high-frequency oscillatory ventilation(HFOV) and prone positioning in treating severe respiratory failure caused by community acquired methicillin resistant Staphylococcus aureus(CA-MRSA). CASE PRESENTATION: A 30-year-old female presented with fever and dyspnea for 3 days. She was diagnosed CA-MRSA pneumonia complicated by severe respiratory failure, pneumothorax and neutropenia...
July 20, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/28724308/eus-guided-recanalization-of-complete-gastrointestinal-strictures
#20
Miguel Martínez-Guillén, Joan B Gornals, Claudia F Consiglieri, Josep M Castellvi, Carme Loras
BACKGROUND AND AIM: Complete gastrointestinal strictures are a technically demanding problem. In this setting, an anterograde technique is associated with a high risk of complications and a combined anterograde-retrograde technique requires a prior ostomy. Our aim was to assess the outcome of a first case series for the management of complete gastrointestinal strictures using endoscopic ultrasound (EUS)-guided puncture as a novel endoscopic approach. PATIENTS AND METHODS: This retrospective case-series describes four cases that were referred for treatment of complete benign gastrointestinal strictures, three upper and one lower...
July 14, 2017: Revista Española de Enfermedades Digestivas
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