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Surgical emphysema

Ashwant Kumar Vadepally, Ramen Sinha, A V S S Subramanya Kumar
Background: Patients with limited mouth opening (LMO) often associated with difficult intubation. Retrograde intubation is an alternative technique of establishing definitive airway in these patients when blind nasal intubation fails and fiberoptic bronchoscope is not available. We tested the retrograde intubation through nasal route in patients with LMO less than 2 cm. Materials and methods: The procedure was performed with some modification with regard to retrograde guide on 18 patients requiring maxillofacial surgical procedures to increase mouth opening...
January 2018: Journal of Oral Biology and Craniofacial Research
Mazin Merdad, Nitin Bhatia, Elie E Rebeiz
Our objectives were to review our experience with laser-assisted diverticulotomy (LAD) in the treatment of Zenker diverticulum (ZD) and compare our results with those in published literature on other endoscopic and surgical techniques. We conducted a retrospective chart review of 57 patients who underwent LAD treatment of ZD in a single tertiary care institution. Data on surgical complications, length of stay, and follow-up were collected. Age ranged from 56 to 89 years. Endoscopic exposure of the diverticulum was not possible in 2 patients...
March 2018: Ear, Nose, & Throat Journal
Yojiro Makino, Yoshihisa Shimada, Masaru Hagiwara, Masatoshi Kakihana, Jinho Park, Naohiro Kajiwara, Tatsuo Ohira, Norihiko Ikeda
OBJECTIVES: Emphysema is one of the main causes of respiratory complications in patients operated on for lung cancer. We have used three-dimensional computed tomography (3D CT) for surgical simulations, as well as for depicting emphysematous areas as low attenuation areas (LAAs) and visual scores based on the Goddard classification (Goddard score), which is a visual scale of the area of vascular disruption and LAA for each lung field. This study aimed to investigate the effectiveness of the 3D CT function for assessing emphysema severity and its association with respiratory complications...
March 12, 2018: European Journal of Cardio-thoracic Surgery
Quoc Tran, Ryo Mizumoto, Daniel Mehanna
INTRODUCTION: Subcutaneous emphysema (SE) is a frequent and often self-limiting complication of tube thoracostomy or other cardiothoracic procedures. On rare occasions, severe and extensive surgical emphysema marked by palpable cutaneous tension, dysphagia, dysphonia, palpebral closure or associated with pneumoperitoneum, airway compromise, "tension phenomenon" and respiratory failure require treatment. PRESENTATION OF CASE: A 67 year old lady presented with a large spontaneous pneumothorax on the background of end-stage chronic obstructive pulmonary disease (COPD) and newly diagnosed lung cancer, developed extensive surgical emphysema following insertion of a chest drain...
February 9, 2018: International Journal of Surgery Case Reports
Toshihiro Ikeda, Jun Nakano, Hiroyasu Yokomise
A 73-year-old man was injured after crashing his automobile into a concrete wall, and was admitted to our hospital with breathing difficulties. Chest computed tomography showed extensive mediastinal emphysema, right traumatic pneumothorax, and a suspected tracheal injury at the membranous region. Because of the associated tracheomalacia, the site of the tracheal injury was difficult to find by bronchoscopy. In addition, as the patient's respiratory condition was stable, surgical treatment was not chosen. Due to the continuous air leakage from the right lung, the patient underwent surgery after mediastinal and subcutaneous emphysema improved...
February 2018: Kyobu Geka. the Japanese Journal of Thoracic Surgery
S A Colgan, L A Green
OBJECTIVE: To develop a technique for permanent sterilisation of female eastern grey kangaroos (Macropus giganteus) and red kangaroos (M. rufus) as part of a large-scale macropod management program on an enclosed 1545-ha site in western Sydney. METHODS: Free-ranging female kangaroos (n = 1409: 1285 eastern grey kangaroos, 124 red kangaroos) were anaesthetised via remote anaesthetic drug delivery of tiletamine/zolazepam, medetomidine and acepromazine prior to inhalational anaesthesia using isoflurane-oxygen...
March 2018: Australian Veterinary Journal
Lynn De Roeck, Lauranne Van Assche, Veronique Verhoeven, Ina Vrints, Jana Van Thielen, Thierry Tondu, Filip Thiessen
OBJECTIVE: Subcutaneous emphysema can be an alarming sign of a necrotizing soft tissue infection. However, non-infectious etiologies exist that can be treated conservatively. This case report describes a subcutaneous emphysema of unknown origin and highlights the importance of distinguishing these clinical entities. METHODS: We present a 17-year old female with pain and subcutaneous emphysema of the left arm. There were no systemic symptoms. Inflammatory parameters were slightly elevated...
February 23, 2018: Acta Chirurgica Belgica
Patricia A Thistlethwaite, Jonathan R Gower, Moises Hernandez, Yu Zhang, Andrew C Picel, Anne C Roberts
BACKGROUND: Lung nodules that are small and deep within lung parenchyma, and have semisolid characteristics are often challenging to localize with video-assisted thoracoscopic surgery (VATS). We describe our cumulative experience using needle localization of small nodules before surgical resection. We report procedural tips, operative results, and lessons learned over time. METHODS: A retrospective review of all needle localization cases between July 1, 2006, and December 30, 2016, at a single institution was performed...
January 17, 2018: Journal of Thoracic and Cardiovascular Surgery
Francesco Guerrera, Pier Luigi Filosso, Cecilia Pompili, Stefania Olivetti, Matteo Roffinella, Andrea Imperatori, Alessandro Brunelli
Background: The presence of air leak following lung resection remains a frequent problem, which may prolong hospital stay and increase hospital costs. In the past, some studies documented the efficacy of soft and flexible chest tube in patients who underwent thoracic surgery. Nevertheless, safety in case of post-operative large air or liquid leak remains questionable. The objective of this study was to verify through a multicentre study the safety and the effectiveness of the coaxial chest tube in a consecutive series of selected patients who underwent anatomical pulmonary resection and with an active and large air leak...
2018: Journal of Visualized Surgery
Ashraf Nabeel Mahmood
No abstract text is available yet for this article.
February 14, 2018: BMJ Case Reports
Shilpa Ojha, Julian Gaskin
Spontaneous pneumomediastinum is the presence of free air within the mediastinum that is not associated with trauma. It is a rare, self-limiting condition that can cause widespread subcutaneous surgical emphysema. We present the case of a 12-year-old boy who presented with widespread spontaneous surgical emphysema and pneumomediastinum, with no history of trauma or respiratory tract disease. We discuss our assessment of him and management with our multidisciplinary team (MDT), and whether radiological investigations including CT are helpful in such cases...
February 11, 2018: BMJ Case Reports
Javier Flandes, Francisco J Soto, Rosa Cordovilla, Enrique Cases, Javier Alfayate
Since the publication of the National Emphysema Treatment Trial study, lung volume reduction (LVR) has been considered a therapeutic alternative for patients with advanced obstructive lung disease. The high complication rate of surgical LVR has led to the development of bronchoscopic LVR (BLVR). Of the currently available BLVR alternatives, coils and unidirectional endobronchial valves lead the list. The choice of each device depends on emphysema characteristics and presence of collateral ventilation. Evaluation of these patients at centers with expertise in interventional pulmonology and management of BLVR is strongly recommended...
March 2018: Clinics in Chest Medicine
Hideaki Yamakawa, Tamiko Takemura, Tae Iwasawa, Yumie Yamanaka, Satoshi Ikeda, Akimasa Sekine, Hideya Kitamura, Tomohisa Baba, Shinichiro Iso, Koji Okudela, Kazuyoshi Kuwano, Takashi Ogura
BACKGROUND: Pulmonary emphysema combined with systemic sclerosis (SSc)-associated interstitial lung disease (ILD) occurs more often in smokers but also in never-smokers. This study aimed to describe a new finding characterized by peculiar emphysematous change with SSc-associated ILD (SSc-ILD). METHODS: We conducted a retrospective review of 21 consecutive patients with SSc-ILD diagnosed by surgical lung biopsy and focused on the radio-pathological correlation of the emphysematous change...
January 30, 2018: BMC Pulmonary Medicine
William J Boggess, Jeanine Ronan, Neeraj Panchal
Subcutaneous emphysema is a rare possible complication of dental procedures. The majority of the dental literature describes cases of localized areas of subcutaneous emphysema following various dental procedures, with a large number of these cases seen following intraoral surgical procedures. Classically, subcutaneous emphysema occurs within minutes to hours after conclusion of dental procedures and is commonly misdiagnosed as either an allergic reaction or acute post-operative swelling. This case report describes a four-year-old male who underwent dental rehabilitation for routine restorative dentistry without extractions under general anesthesia...
November 1, 2017: Pediatric Dentistry
Federico Venuta, Dirk Van Raemdonck
Lung transplantation nowadays is a well-accepted and routine treatment for well selected patients with terminal respiratory disease. However, it took several decades of experimental studies and clinical attempts to reach this success. In this paper, we describe the early experimental activity from the mid-forties until the early sixties. The first clinical attempt in humans was reported by Hardy and Webb in 1963 followed by others with short survival only except for one case by Derom et al. who lived for 10 months...
December 2017: Journal of Thoracic Disease
Jingxu Li, Xinguan Yang, Tingting Xia, Yubao Guan, Nanshan Zhong
Background: Studies have reported that up to 8% of non-small cell lung cancers (NSCLC) involve multiple lesions; no detailed study has assessed the prognosis of early synchronous multiple primary non-small cell lung cancer (SMPNSCLC) (T1N0M0, T2aN0M0). We aimed to assess the spiral CT manifestations of SMPNSCLC during stage I and evaluate the effect of TNM staging with the 7th and 8th editions on the prognosis. Methods: We retrospectively analyzed the data of patients who were examined, operated, and pathologically confirmed as having NSCLC from January 1, 2009, to December 31, 2010, and were followed-up for 5 years...
December 2017: Journal of Thoracic Disease
Seung Hwan Seol, Woon Jeong Lee, Seon Hee Woo, Dae Hui Kim, Jong Hui Suh
Tracheobronchial disruption is one of the most severe injuries caused by blunt chest trauma. It may cause airway obstruction and resulting life-threatening respiratory deficiency. However, the clinical presentations are variable and frequently difficult to diagnose. We report a case of a previously healthy 16-year-old man with complete right main bronchial transection sustained after a vehicular accident, who had progressive dyspnea, subcutaneous emphysema in the neck and anterior chest wall, and bilateral tension pneumothorax...
December 2017: Clinical and Experimental Emergency Medicine
Naozumi Hashimoto, Akira Ando, Shingo Iwano, Koji Sakamoto, Shotaro Okachi, Asuka Matsuzaki, Yu Okada, Kenji Wakai, Kohei Yokoi, Yoshinori Hasegawa
BACKGROUND: There is only limited information on the impact of thin-section computed tomography (TSCT)-determined usual interstitial pneumonia (UIP) pattern in the decision-making for resection in newly diagnosed lung cancer patients. METHODS: In this retrospective analysis, data were reviewed from 499 newly diagnosed lung cancer patients who received bronchoscopy between 2010 and 2014. The clinical impact of TSCT-determined UIP pattern on the decision-making process for resection in this cohort was evaluated...
January 5, 2018: BMC Pulmonary Medicine
Madeline Cancian, Joseph Brito, Vincent Harisaran
Gross hematuria is a common urologic problem which often requires surgical intervention. While generally a safe procedure, clot evacuation can have serious complications. Here we describe the case of an 85-year-old male who developed extensive subcutaneous emphysema following a small extraperitoneal bladder perforation during a clot evacuation. While our patient did well with expectant management, subcutaneous emphysema can lead to serious complications and any endourologic procedure should be stopped once crepitus is noted...
December 2017: Canadian Journal of Urology
S Bakkar, M Al Hyari, M Naghawi, C Corsini, P Miccoli
PURPOSE: To report the clinical implications of an initial experience with transoral endoscopic thyroidectomy vestibular approach (TOETVA). METHODS: From March to November 2017, five cases of TOETVA were performed. Data reported include patient demographics, indication for surgery, extent of surgery, operative time, the need to convert to cervicotomy, the length of hospital stay and post-operative pain and morbidity. Unconventional complications regarded as specific for TOETVA were reported...
December 14, 2017: Journal of Endocrinological Investigation
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