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N F Majola, V Y Kong, H Mangray, V Govindasamy, G L Laing, D L Clarke
BACKGROUND: The ingestion or aspiration of foreign bodies (FBs) by children is a common problem around the world. Our centre in Pietermaritzburg, South Africa, has a dedicated paediatric surgical service, and all patients with an ingested or aspirated FB are managed under the direct care of a paediatric surgeon. OBJECTIVES: To review our centre's experience with this problem by means of a retrospective audit and use the data to develop and refine appropriate local management guidelines...
February 27, 2018: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
Tomoyuki Naito, Hiroki Hayashi, Takeru Kashiwada, Yoshinobu Saito, Shinji Abe, Kaoru Kubota, Akihiko Gemma
A 41-year-old woman presented complaining of cough and purpura for one month. On her first visit, a blood test demonstrated peripheral blood eosinophilia, but chest radiography showed no abnormalities. However, 2 days after the first visit, she went to the emergency room because of fever and right-sided chest pain. Contrast-enhanced computed tomography of the chest showed pulmonary embolism and air space consolidation. Thrombosis was present in the popliteal vein. Bronchoscopy revealed alveolar hemorrhage and increased eosinophils in the bronchoalveolar lavage fluid, and a skin biopsy demonstrated a perivascular eosinophilic infiltrate...
2018: Respiratory Medicine Case Reports
M I Shafi, S Liaquat, D Auckley
Diffuse alveolar hemorrhage (DAH) can be a serious and life threating condition. Illicit substance use has been associated with DAH, with cocaine being the most widely reported. Marijuana use has been associated with pulmonary complications in the form of pneumomediatsium, pneumothorax, bullous disease, and pulmonary aspergillosis. We present a case of diffuse alveolar hemorrhage (DAH) resulting from marijuana inhalation, a finding rarely described in the literature. A 21-year-old male presented with several episodes of hemoptysis after drinking alcohol and smoking marijuana...
2018: Respiratory Medicine Case Reports
Wen-Chien Cheng, Biing-Ru Wu, Chia-Hung Chen, Wei-Chih Liao, Chih-Yen Tu
Pleuroscopy, also known as medical thoracoscopy (MT), is an important tool for pleural disease management. Removal of foreign body (FB) by MT was reported in a few reports because it can identify the position of a FB in the pleural cavity and can be used for its urgent removal. In this study, we describe the case of a male patient with a ruptured lung abscess and a rare complication of self-expandable metallic stent (SEMS) migration into the pleural cavity via a bronchopleural fistula after the management of obstructive airway disease...
May 2018: Journal of Thoracic Disease
Maria Teresa Ruiz Tsukazan, Ricardo Mingarini Terra, Frank Detterbeck, Ilka Lopes Santoro, Bruno Hochhegger, Gustavo de Souza Portes Meirelles, Gustavo Fortunato, Gustavo Faibischew Prado
Background: Pulmonary nodules are common; some are inconsequential while others are malignant. Management of solitary pulmonary nodule (SPN) in Brazil appears to be highly variable, potentially leading to suboptimal outcomes. Assessment of the variability and the association with the degree of availability of resources can provide a foundation for development of clinical guidelines for management of SPN specific for the Brazilian setting. Methods: A web-based survey was developed by thoracic surgeons, pulmonologists and radiologists to evaluate SPN perception and management...
May 2018: Journal of Thoracic Disease
X G Niu, K P Liu, X F Ren, J Li
Objective: To analyze the clinical applications of high frequency jet ventilation(HFJV) in cryotherapy of the trachea and bronchial neoplasms by the rigid bronchoscope. Methods: The clinical data of 35 patients who were treated with tracheal neoplasms cryotherapy by the rigid bronchoscopy under HFJV were collected in China-Japan Friendship Hospital from August 2008 to February 2015.Under general anesthesia, HFJV was used in all patients. The mean arterial pressure (MAP), heart rates (HR), pulse oxygen saturation (SpO(2)), results of arterial blood gas analysis and the incidence of complications during the procedure were recorded...
June 26, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Daizo Yaguchi, Motoshi Ichikawa, Masato Shizu, Noriko Inoue, Daisuke Kobayashi, Naoyuki Imai
RATONALE: Cicatricial bronchial stenosis or obstruction occurring in the healing process of endobronchial tuberculosis (ET) is a problematic complication of tuberculous airway lesions. Prevention by internal medical treatment is desired. PATIENT CONCERNS: This case series describes four patients who diagnosed ET with Type IIIb (protruding ulcer-type) based on Arai's classification of bronchoscopic findings of bronchial tuberculosis. DIAGNOSES: Endobronchial tuberculosis...
July 2018: Medicine (Baltimore)
José Colleti Junior, Tâmara Eleamen Longui, Werther Brunow de Carvalho
OBJECTIVE: To report a case of a patient who required tracheal intubation in a pediatric emergency department due to acute laryngitis and that, after the planned extubation, has successfully used the high-flow nasal cannula, which possibly prevented extubation failure. CASE DESCRIPTION: A male 8-month-old child was admitted to the pediatric emergency room with acute respiratory distress due to a high airway obstruction secondary to severe acute laryngitis. He was immediately intubated and referred to the pediatric intensive care unit...
July 10, 2018: Revista Paulista de Pediatria: Orgão Oficial da Sociedade de Pediatria de São Paulo
Dirk-Jan Slebos, Nick H Ten Hacken, Martin Hetzel, Felix J F Herth, Pallav L Shah
Endobronchial coils are an additional treatment option for lung volume reduction in patients with severe emphysema. Patient selection should be focused on patients with severe emphysema on optimal medical therapy and with evidence of severe hyperinflation. The technique is suitable in a broad range of patients with emphysema; however, patients with paraseptal emphysema, large focal (giant) bullae, significant co-morbidity and airway-predominant disease should be avoided. Treatment involves placing between 10 and 14 coils by bronchoscopy in the selected treatment lobe, with 2 lobes being treated sequentially...
July 10, 2018: Respiration; International Review of Thoracic Diseases
Ashley Gray, Paul Do
This case report is one of the only known cases of Actinomyces odontolyticus causing thoracic disease in an immunocompetent pediatric patient. This case also exemplifies how bronchoscopy was able to remove the nidus of infection and prevent the potential for significant morbidity associated with a lobectomy.
July 2018: Clinical Case Reports
Kenneth K Sakata, Darlene R Nelson, John J Mullon, David E Midthun, Eric S Edell, Ryan M Kern
Introduction: Central airway obstruction (CAO) often requires repeated interventional procedures which offer variable efficacy, a time-limited effect, and have inherent limitations. Paclitaxel has been used to prevent restenosis in blood vessels. The literature describing the use of paclitaxel to prevent recurrent airway stenosis is limited. We sought to describe our experience using a paclitaxel-coated balloon (PCB) for CAO. Material and methods: We performed a retrospective review of all patients who underwent PCB airway dilation...
2018: Respiratory Medicine Case Reports
Mikhail Kazachkov, Bianca C Kapoor, Patrick W Malecha, Benjamin G Wu, Yonghua Li, Jeremiah Levine, Jessica Erkman, Kathryn Fitzgerald, Libia Moy, Leopoldo N Segal
In pediatric patients with chronic cough, respiratory culture techniques commonly yield negative results. Studies using culture-independent methods have found a high relative abundance of oral microbes in the lower airways, suggesting that the topographical continuity, and dynamics of the intraluminal contents of the aerodigestive system likely influence the lower airway microbiota. We hypothesize that in subjects with chronic cough, clinical diagnosis will correlate with distinct microbial signatures detected using culture-independent methods...
July 8, 2018: Pediatric Pulmonology
Kartikeya Rajdev, Abdul Hasan Siddiqui, Uroosa Ibrahim, Shivika Agarwal, Juan Ding, Michel Chalhoub
Sarcomatoid carcinoma (SC) of the lung is a rare and aggressive biphasic lung tumor with a 5-year survival of 20%. Early detection and treatment is the only way to improve outcomes in patients with SC of the lung. We present a case of primary SC identified early based on high suspicion. A 56-year-old female with a history of chronic obstructive pulmonary disease (COPD) presented with hemoptysis and exertional dyspnea. Chest X-ray revealed right upper lobe (RUL) opacity and patient was started on antibiotics for pneumonia...
2018: Respiratory Medicine Case Reports
Francesco Menzella, Mirco Lusuardi, Carla Galeone, Gloria Montanari, Alberto Cavazza, Nicola Facciolongo
Background: Bronchial thermoplasty (BT) is an endoscopic procedure for the treatment of severe refractory asthma, based on the local airways delivery of radio-frequency at 65 °C. Several controlled clinical studies demonstrated the effectiveness of BT on clinical outcomes, particularly the reduction of asthma exacerbations. During procedure or shortly after, significant but transient respiratory adverse events have been reported. Case report: We describe the case of a male, caucasian, 56-year-old, non-smoker patient with non-allergic severe asthma...
2018: Allergy, Asthma, and Clinical Immunology
T Kaneko, H Tanaka, S Yamada, M Kitada, T Sakurai, M Harada, F Kimura, T Takahashi, S Kasaoka
Inhalation burn injury (IBI) is a risk factor for mortality in burn patients. However, it is difficult to diagnose IBI using traditional physical examination alone, especially in prehospital settings. Therefore, facial burn patients are usually treated for suspected IBI. In the present study, we investigated whether fire site information could predict IBI as an alternative to traditional physical examination. This retrospective single-centre analysis involved 27 facial burn patients with suspected IBI who were admitted between 2014 and 2016...
December 31, 2017: Annals of Burns and Fire Disasters
Luca Ampollini, Luigi Ventura, Letizia Gnetti, Paolo Carbognani, Enrico Maria Silini, Michele Rusca
PURPOSE: To describe a case of giant intercostal nerve schwannoma successfully resected in a patient with neurofibromatosis type 2. METHODS: A 44-year-old woman, with a history of neurofibromatosis type 2, presented with chest discomfort and mild dyspnea. She had undergone a recent resection of a large frontal parasagittal benign meningioma. Radiologic examinations showed a large lesion (9×12×9 cm) of the left hemithorax causing a complete atelectasis of left upper lobe...
June 1, 2018: Tumori
Darsana Viswam, Simon Trotter, P Sherwood Burge, Gareth I Walters
A young female vaper presented with insidious onset cough, progressive dyspnoea on exertion, fever, night sweats and was in respiratory failure when admitted to hospital. Clinical examination was unremarkable. Haematological tests revealed only thrombocytopenia, which was long standing, and her biochemical and inflammatory markers were normal. Chest radiograph and high-resolution CT showed diffuse ground-glass infiltrates with reticulation. She was initially treated with empirical steroids and there was improvement in her oxygenation, which facilitated further tests...
July 6, 2018: BMJ Case Reports
M Gómez Cervantes, C A de la Torre Ramos, J Jiménez Gómez, J L Encinas Hernández, F Hernández Oliveros, M Dore Reyes, J Serradilla Rodríguez, V Núñez Cerezo, M López Santamaría
INTRODUCTION: Foreign body aspiration (FBA) is a potentially life-threatening event, and is the leading cause of death in children after road traffic injuries. If suspected, a prompt exploration of the airway should be performed. We present our experience in FBA treatment in the last 10 years. MATERIAL AND METHODS: A retrospective study of patients admitted in our center with suspected FBA between 2005 and 2015 was performed. Clinical history, physical findings, radiologic imaging, treatment and evolution were assessed...
April 20, 2018: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
Lakshmi Saladi, Dmitry Lvovsky
Central airway obstruction, a frequently encountered emergency, is usually associated with blood clots, tumors, foreign bodies or mucus plugs. Airway obstruction due to blood clots can be seen as a complication of lung malignancies, infections, bronchiectasis, arteriovenous malformations or pulmonary infarction. In patients with long standing blood clots, the thrombus gets organized and firmly adherent to the airway. The diagnosis is often misleading as these clots mimic tumors clinically and on imaging. Hemoptysis is the most common presenting symptom though many patients can be asymptomatic...
2018: Respiratory Medicine Case Reports
Rodolfo Barrios, Adriana Serna, Carlos Carvajal, Juan Villate, Luis Felipe Cabrera Vargas, Eric Vinck, Sebastian Sanchez Ussa, Mauricio Pedraza Ciro
Thoracic spinal surgery has many complications ranging from surgical site infection, chronic pain, periarticular arthrosis, displacement of spinal screws and hardware migration to a lesser degree. Reports of spinal implants penetrating the aorta have been described in the literature, however to our knowledge, lower airway obstruction due to spinal hardware migration has not been reported. Here we describe a case of a patient presenting with a right main stem bronchial obstruction and pneumonia secondary to the migration of the surgical spinal hardware into the lower airway 18 years after his initial intervention...
2018: Respiratory Medicine Case Reports
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