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empyema management

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https://www.readbyqxmd.com/read/29342487/-application-of-intrabronchial-valves-in-high-risk-patients-with-bronchopleural-fistula-an-alternative-therapeutic-option
#1
Ali Akil, Jan Reichelt, Stefan Freermann, Ilias Karfis, Michael Semik, Stefan Fischer
OBJECTIVES: Persistent air leak or bronchopleural fistula (BPF) is a challenging and frequently observed problem after pulmonary resection and may lead to prolonged chest tube therapy. One efficient nonsurgical approach to manage such a fistula is the application of intrabronchial valves. This may support earlier chest tube removal and hospital discharge. METHODS: Between 04/2015 and 03/2017, n = 8 patients (n = 4 female) with severe pleural empyema and necrotising lung tissue defects developed prolonged air leak and persistent BPF after surgery...
January 17, 2018: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/29337715/labyrinthine-sequestrum-a-case-report-and-review-of-the-literature
#2
Julie B Guerin, Diana L Vork, Lourdes Eguiguren, Alexander P Marston, Colin L W Driscoll, Matthew L Carlson, Nancy K Henry, John I Lane
OBJECTIVE: To report the presentation, diagnosis, management, and convalescence of labyrinthine sequestrum (LS) and summarize all previously published cases. PATIENT(S): Eleven-year-old female with LS. INTERVENTION(S): Multidisciplinary diagnostic evaluation and treatment. MAIN OUTCOME MEASURES: Imaging and laboratory findings, medical and surgical treatment. RESULTS: We describe a case of LS secondary to medically recalcitrant suppurative otitis media in an 11-year-old female and review all eight previously reported cases...
January 15, 2018: Otology & Neurotology
https://www.readbyqxmd.com/read/29298241/is-observation-for-traumatic-hemothorax-safe
#3
Leah Demetri, Myriam M Martinez Aguilar, Jordan D Bohnen, Ryan Whitesell, D Dante Yeh, David King, Marc de Moya
BACKGROUND: EAST guidelines suggest tube thoracostomy (TT) be considered for all traumatic hemothoraces. However, previous research has suggested that some traumatic hemothoraces may be observed safely. We sought to 1) determine the safety of selective observation for traumatic hemothorax, and 2) identify predictors of failed observation. METHODS: All patients with traumatic hemothorax from 2000-2014 at a Level I Trauma Center were identified and categorized by size as small (<300cc) or large (≥300cc) based on chest CT-scan measurements...
January 2, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29297142/bacterial-infections-of-the-central%C3%A2-nervous-system
#4
REVIEW
Renu Suthar, Naveen Sankhyan
Bacterial infections of the central nervous system (CNS) continue to be an important cause of morbidity and mortality in children. The spectrum of bacterial infection of CNS includes; focal or multifocal infections like brain abscesses or subdural empyema; or more generalized or diffuse infections like pyogenic meningitis or ventriculitis. Focal and generalized infections may co-exist in an individual patient. Prompt and adequate antibiotic therapy and occasionally neurosurgical interventions are the cornerstone of effective management...
January 3, 2018: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/29290492/-prognostic-factors-in-pleuropulmonary-decortications-for-tuberculous-pyothorax
#5
I Issoufou, M Lakranbi, L Belliraj, F Z Ammor, H Harmouchi, Y Ouadnouni, M Smahi
INTRODUCTION: Tuberculous pyothorax or empyema is one of the serious forms of tuberculosis and still poses public health problems. Through a series of patients who undergone pleuropulmonary decortication, we propose our model of management and determine the main factors prognostic. METHOD: We retrospectively retrieved for 8 years 93 cases of patients with pleuropulmonary decortication for tuberculous pyothorax confirmed by histological examination pre- or postoperatively...
December 28, 2017: Revue de Pneumologie Clinique
https://www.readbyqxmd.com/read/29282439/diffuse-nocardial-spinal-subdural-empyema-diagnostic-dilemma-and-treatment-options
#6
Zaid Aljuboori, Mayur Sharma, Thomas Altstadt
Nocardiosis of the central nervous system and spine, in particular, is a rare infection with significant morbidity and mortality. Treatment is usually with antibiotics and surgical drainage or biopsy. The authors report a case of a 49-year-old man who presented with chronic lower back pain and paraplegia. He was found to have spinal subdural empyema caused by Nocardia farcinica. Laminectomy and sampling of the subdural collection were performed, and the patient was treated with triple intravenous antibiotics (linezolid, amikacin and ciprofloxacin)...
October 24, 2017: Curēus
https://www.readbyqxmd.com/read/29207796/clinico-aetiological-study-of-severe-and-very-severe-pneumonia-in-two-months-to-five-years-children-in-a-tertiary-health-care-centre-in-odisha-india
#7
Jyotiranjan Champatiray, Jyotiranjan Satapathy, Baikunthanath Kashyap, Dipankar Mondal
Introduction: Pneumonia is a major cause of mortality under five-year-old children. In spite of recent advances in management, there is paucity of data on clinical, aetiological profile of severe and very severe pneumonia among under five-year-old children in developing countries. Aim: To determine the clinico-aetiological factors of severe and very severe pneumonia and its outcome in children aged two -months to five-years in a tertiary health care centre in Odisha, India...
September 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/29192622/subdural-empyema-clinical-presentations-and-management-options-for-an-uncommon-neurosurgical-emergency-in-a-developing-country
#8
M C Chikani, W Mezue, E Okorie, C Mbachu, C Ndubisi, U N Chikani
BACKGROUND: Controversy regarding the best management strategy for subdural empyema (SDE) attests to the persisting poor outcomes for this uncommon life threatening intracranial suppurative process. Late presentation confounds the problem in developed countries. While craniotomy is commonly recommended, it is not always possible in late presentation with advanced morbidity. The aim of this study was to identify the pattern of clinical presentation and explore the outcomes following management of SDE using burr hole, aspiration, and drainage (BAAD) in resource poor settings...
October 2017: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/29182741/off-label-use-of-thoracic-aortic-endovascular-stent-grafts-to-simplify-difficult-resections-and-procedures-in-general-thoracic-surgery
#9
Tanja Walgram, Nicolas Attigah, Igor Schwegler, Markus Weber, Omer Dzemali, Christian Berthold, Dirk Wagnetz, Giovanni L Carboni
OBJECTIVES: Tumour infiltration, or gross infectious involvement of the thoracic aortic wall, poses a significant intraoperative risk for fatal bleeding and therefore could compromise adequate resection or efficient surgical management of pleural infection in a considerable amount of cases. We present 3 successful cases of off-label thoracic aortic endografting to safeguard thoracic aortic wall integrity. METHODS: After all patients received thoracic stent grafts through femoral access into the descending aorta, the first patient underwent a resection of a locally advanced squamous cell carcinoma of the left inferior lobe cT4cN0-1cM0 after neoadjuvant chemoradiation, which had infiltrated the descending aortic wall...
November 22, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29174228/rare-concurrent-retroclival-and-pan-spinal-subdural-empyema-review-of-literature-with-an-uncommon-illustrative-case
#10
REVIEW
Martin M Mortazavi, Syed A Quadri, Sajid S Suriya, Salman A Fard, Shahram Hadidchi, Farzad H Adl, Ian Armstrong, Richard Goldman, R Shane Tubbs
BACKGROUND: Subdural empyema can present as a spinal subdural empyema (SSE) or a cranial subdural empyema (CSE). Though they differ somewhat in epidemiology, etiology, pathophysiology, and symptomatology and occur separately, they rarely manifest together. The aim of this article is to review the literature concerning the clinical presentation, clinical course and treatment options for managing concurrently-occurring SSE and CSE. METHODS: The literature in the Medline database was reviewed with keywords including but not limited to subdural empyema, retroclival empyema, and Streptococcus mitis...
November 23, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29152039/hepatic-hydrothorax-an-update-and-review-of-the-literature
#11
REVIEW
Dmitry Victorovich Garbuzenko, Nikolay Olegovich Arefyev
This review considers the modern concepts of pathogenesis, diagnostic methods, and treatment principles of hepatic hydrothorax (HH). HH is the excessive (> 500 mL) accumulation of transudate in the pleural cavity in patients with decompensated liver cirrhosis but without cardiopulmonary and pleural diseases. It causes respiratory failure which aggravates the clinical course of liver cirrhosis, and the emergence of spontaneous bacterial pleural empyema may be the cause of death. The information was collected from the PubMed database, the Google Scholar retrieval system, the Cochrane reviews, and the reference lists from relevant publications for 1994-2016 using the keywords: "liver cirrhosis", "portal hypertension", "hepatic hydrothorax", "pathogenesis", "diagnostics", and "treatment"...
November 8, 2017: World Journal of Hepatology
https://www.readbyqxmd.com/read/29150042/empyema-from-obstructing-lung-cancer
#12
REVIEW
Julian Guitron
Pleural collections on the side of an obstructing bronchial cancer pose a particular challenge. All efforts should be placed into determining whether the collection is malignant or para-malignant with its significant implications on cancer staging. This article discusses various diagnostic modalities and therapeutic interventions needed for the optimal management of patients presenting with this situation. The order of interventions is dictated by the individual circumstances that patients present with, often requiring the pleural interventions to take place ahead of the bronchial obstruction management...
February 2018: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/29150031/thoracic-surgery-in-the-pregnant-patient
#13
REVIEW
Brian Whang
Thoracic surgeons are sometimes asked to consult on the management of a patient who is pregnant. Conditions commonly encountered are empyema, spontaneous pneumothorax, and diaphragmatic hernia. Lung cancer is rarely seen in pregnancy, but its incidence is rising. Diagnostic imaging and perioperative management involve the navigation of fetal risks and nuances in maternal physiology. Shared decision making within a multidisciplinary framework will optimally guide the course of management.
February 2018: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/29143089/surgical-treatment-of-gastro-pulmonary-fistula-following-bariatric-surgery-possible-and-safe
#14
Alon Ben Nun, David Simansky, Merav Rokah, Nona Zeitlin, Nir Golan, Ramez Abu Khalil, Michalle Soudack
BACKGROUND: Laparoscopic sleeve gastrectomy is a common surgical management of morbid obesity. Major complication rate is 3-8%. Staple line leak is one of the most serious complications. In a small group of patients, a gastro-pulmonary fistula is formed. Endoscopic and minimally invasive measures are the first line of treatment with considerable success rate. There are very poor data in the literature what should be done in cases of failure. In this paper, we report our positive experience with definitive surgical repair...
November 15, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29132116/the-outcome-of-laparoscopic-subtotal-cholecystectomy-in-difficult-cases-a-case-series
#15
Caroline Supit, Tommy Supit, Yarman Mazni, Ibrahim Basir
INTRODUCTION: Laparoscopic subtotal cholecystectomy (LSC) is a widely used technique for managing cholelithiasis with severe cholecystitis. The increasing popularity its utilization is due to the good safety profile and acceptable results. This case series evaluates the short- and long-term results of Indonesian patients who underwent LSC with an objective to determine whether the procedure can be a standard approach for difficult cholecystectomy in our institution. PRESENTATION OF CASE: Thirty-four Indonesian patients (26 men, 8 women) with the mean age of 54...
November 8, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29131135/interhemispheric-and-infratentorial-subdural-empyema-with-preseptal-cellulitis-as-complications-of-sinusitis-a-case-report
#16
Muhammad Reza Arifianto, Achmad Zuhro Ma'ruf, Arie Ibrahim, Abdul Hafid Bajamal
Intracranial complications of paranasal sinusitis have become rare due to the use of antibiotics nowadays. However, several cases have been reported due the ability of paranasal sinusitis to cause serious complications. Once the infection spreads over the cranial structure, it could infect the orbits, underlying bones, meninges, adjacent veins, and brain. Subdural empyema is a rare but potentially life-threatening complication following paranasal sinusitis and should be considered as a neurological emergency...
November 11, 2017: Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29131094/pleurodesis-using-mistletoe-extract-delivered-via-a-spray-catheter-during-semirigid-pleuroscopy-for-managing-symptomatic-malignant-pleural-effusion
#17
Jung Seop Eom, Hyo Yeong Ahn, Jeong Ha Mok, Geewon Lee, Eun-Jung Jo, Mi-Hyun Kim, Kwangha Lee, Ki Uk Kim, Hye-Kyung Park, Min Ki Lee
BACKGROUND: Talc poudrage during thoracoscopy is considered the standard procedure for patients with symptomatic malignant pleural effusion (MPE). Until now, no alternative technique other than talc poudrage for pleurodesis during medical thoracoscopy has been proposed. Liquid sclerosants, such as mistletoe extract, have been sprayed evenly into the pleural cavity during semirigid pleuroscopy for chemical pleurodesis. OBJECTIVE: We conducted a retrospective study using the database of semirigid pleuroscopy to identify the usefulness of pleurodesis using a mistletoe extract delivered via a spray catheter during semirigid pleuroscopy for symptomatic MPE...
November 7, 2017: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/29119067/experience-with-ambulatory-management-of-pleural-pathologies-utilizing-small-bore-indwelling-pleural-catheters
#18
Imad-Ud-Din Saqib, Mobeen Iqbal, Atif Rana, Saira Hassan
Introduction Pleural effusion is the excess fluid that accumulates in the pleural space. Pneumothorax is the collection of free air in the pleural cavity, while empyema is the collection of pus in the pleural cavity. Such pleural pathologies pose a great challenge to patients and health care professionals alike. While multiple management options exist, the major portion of it is carried out in the inpatient setting. We sought to evaluate the ambulatory use of indwelling pleural catheters for pleural pathologies, including malignant pleural effusion, empyema, and primary spontaneous pneumothorax...
September 1, 2017: Curēus
https://www.readbyqxmd.com/read/29114998/early-and-delayed-post-pneumonectomy-empyemas-microbiology-management-and-prognosis
#19
Jean-Baptiste Stern, Ludovic Fournel, Benjamin Wyplosz, Philippe Girard, Malik AlNakib, Dominique Gossot, Agathe Seguin-Givelet
INTRODUCTION: Post-pneumonectomy empyema (PPE) is the most severe complication of pneumonectomy. Microbiology and its impact on management and prognosis have rarely been reported Methods: We retrospectively reviewed the files of a series of 37 consecutive patients with PPE over a 10-year period with a special focus on microbiology, means used to treat empyema, and prognosis. RESULTS: PPE occurred within 14 days of pneumonectomy in 17 cases (early PPE) and after postoperative day 16 in 20 patients (delayed PPE)...
November 8, 2017: Clinical Respiratory Journal
https://www.readbyqxmd.com/read/29106507/pedicled-and-free-flaps-for-intrathoracic-fistula-management
#20
Alba Fricke, Holger Bannasch, Henriette F Klein, Sebastian Wiesemann, Patrick Samson-Himmelstjerna, Bernward Passlick, Friedhelm Beyersdorf, Jens Hoeppner, Vincenzo Penna, Steffen U Eisenhardt, Björn G Stark, Georgios Koulaxouzidis
OBJECTIVES: Intrathoracic fistulae are among the potential sequelae of radiation therapy, empyema and abscess clearance and surgical tumour resections. Interdisciplinary plastic-reconstructive flap surgery is a helpful tool for the successful treatment of intrathoracic fistulae. METHODS: From February 2006 to April 2016, 13 patients (3 females and 10 males) underwent flap surgery for bronchial (n = 5), tracheal (n = 2), oesophageal (n = 2), post-pneumonectomy bronchopleural fistula (n = 2), tracheo-oesophageal (n = 1), gastrobronchial (n = 1) and oesophagobronchial (n = 1) fistulae...
December 1, 2017: European Journal of Cardio-thoracic Surgery
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