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empyema management

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https://www.readbyqxmd.com/read/28529685/computed-tomography-guided-catheter-drainage-with-urokinase-and-ozone-in-management-of-empyema
#1
Bing Li, Chuan Liu, Yang Li, Han-Feng Yang, Yong Du, Chuan Zhang, Hou-Jun Zheng, Xiao-Xue Xu
AIM: To retrospectively compare the outcomes of catheter drainage, urokinase and ozone in management of empyema. METHODS: Retrospective study included 209 patients (111 males and 98 females; age range 19 to 72 years) who were diagnosed with empyema. The patients were divided into 3 groups based on the therapy instituted: catheter drainage only (group I); catheter drainage and urokinase (group II); catheter drainage, urokinase and ozone (group III). Drainage was considered successful if empyema was resolved with closure of cavity, clinical symptoms were resolved, and need for any further surgical procedure was avoided...
April 28, 2017: World Journal of Radiology
https://www.readbyqxmd.com/read/28528049/an-old-solution-for-a-new-problem-eloesser-flap-management-of-infected-defibrillator-patches
#2
Heidi B Schubmehl, Huan Huan Sun, Jessica S Donington, Deane E Smith, Eugene A Grossi
Cardiac surgery patients with infected implantable cardioverter defibrillator hardware face high morbidity with both surgical and nonoperative management options. We present a case of infected epicardial patch defibrillator leads in a patient with prohibitively high risk of death with open surgical removal. As a less morbid alternative, an Eloesser flap was used to convert his presenting mediastinal empyema necessitans into a chronic, manageable wound.
June 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28474099/a-three-step-diagnosis-of-pediatric-pneumonia-at-the-emergency-department-using-clinical-predictors-c-reactive-protein-and-pneumococcal-pcr
#3
Gabriel Alcoba, Kristina Keitel, Veronica Maspoli, Laurence Lacroix, Sergio Manzano, Mario Gehri, René Tabin, Alain Gervaix, Annick Galetto-Lacour
Recommendations for the management of community-acquired pneumonia (CAP) advocate that, in the absence of the clinical and laboratory findings typical of bacterial CAP, antibiotics are not required. However, the true value of the clinical and laboratory predictors of pediatric CAP still needs to be assessed. This prospective cohort study in three emergency departments enrolled 142 children with radiological pneumonia. Pneumonia with lung consolidation was the primary endpoint; complicated pneumonia (bacteremia, empyema, or pleural effusion) was the secondary endpoint...
May 4, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28460565/early-simultaneous-esophagopleural-and-bronchopleural-fistula-after-right-pneumonectomy
#4
Marek Szkorupa, Josef Chudacek, Olga Klementová, Cestmir Neoral, Martin Stasek
BACKGROUND: Esophagopleural and bronchopleural fistulas represent a rare, but life-threatening complication after lung resections, most often after a right pneumonectomy. CASE STUDY: A 64 years old woman was indicated for right pulmectomy for local recurrence of initially stage IIB lung cancer treated by lower lobectomy. On the postoperative day 34, an esophagopleurobronchial fistula occurred. Further course required thoracostomy with closure of the bronchial stump and vacuum-assisted closure therapy and two-phase esophagectomy with 6 weeks interval to the esophageal reconstruction...
May 2, 2017: Acta Chirurgica Belgica
https://www.readbyqxmd.com/read/28458144/gastropleural-fistula-after-single-anastomosis-gastric-bypass-a-case-report-and-review-of-the-literature
#5
Haider Al-Shurafa, Saleh Alghamdi, Ali Albenmousa, Haifa Alolayan, Zahraa Al-Shurafa
INTRODUCTION: Pulmonary complications after bariatric surgeries are rare but usually serious. They often occur early after surgery but the presentation might be delayed for several months. Gastropleural fistula after bariatric surgery is extremely rare and has been reported in a very small number of patients post sleeve gastrectomy and gastric bypass. CASE PRESENTATION: A 37-year-old lady presented with left sided pleural effusion and empyema 2 years post single anastomosis gastric bypass surgery...
April 4, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28449481/procalcitonin-as-preoperative-marker-for-surgery-in-advanced-parapneumonic-empyema
#6
Claudio Caviezel, Philipp Schuetz, Stephan Gerdes, Franco Gambazzi
BACKGROUND: The optimal time point for surgical management of advanced parapneumonic empyema in need of open pleurectomy and decortication remains unclear. We hypothesized that surgical outcomes will be better when procalcitonin (PCT) levels have dropped to normal ranges as evidence for resolution of the underlying pneumonia. METHODS: We retrospectively analyzed outcomes of 38 patients with advanced parapneumonic empyema who underwent open decortication and pleurectomy with available preoperative PCT (pPCT) values...
March 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28443599/a-pott-s-puffy-tumor-associated-with-epidural-cutaneous-fistula-and-epidural-abscess-case-report
#7
Aleksandar Perić, Milanko Milojević, Dražen Ivetić
BACKGROUND: Pott's puffy tumor is characterized by a fluctuate swelling of the frontal region as a result of osteomyelitis of the frontal bone. This inflammatory lesion may propagate endocranially resulting in acute meningitis, epidural abscess, subdural empyema, cavernous sinus trombophlebitis, cerebritis, and frontal lobe abscess of the brain. CASE REPORT: We present an unusual case of a 33-year-old man suffering from the Pott's puffy tumor whose condition was further complicated by a draining epidural-cutaneous fistula and an epidural abscess...
April 13, 2017: Balkan Medical Journal
https://www.readbyqxmd.com/read/28442965/unusual-airways-management-during-one-lung-ventilation-in-thoracic-surgery
#8
Paolo Primieri, Paolo Ancona, Elisabetta Gualtieri
Airways management in thoracic surgery is usually more difficult than in other surgery. We reported a case of a patient who underwent surgery of evacuation of empyema where after a correct insertion of a left double-lumen tube 37 Fr (DLT), one-lung ventilation was not permitted by the high airways pressure. In fact, the hole of bronchial tip was just against the left bronchial wall retracted probably from inflammatory process. We introduced blindly an Arndt blocker 9 Fr inside the tracheal lumen of DLT until the orifice of the right upper lobe bronchus, the distance was checked before...
April 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28418364/-evolution-of-complex-treatment-of-patients-with-non-specific-pleural-empyema
#9
O O Yasnogorodsky, A M Shulutko, T P Pinchuk, E G Gandybina, A S Kachikin, F N Nasirov, A Yu Moiseev, S E Gryaznov
AIM: To analyze long-term own experience of NPE treatment in view of evolution of surgical sanitation of pleural cavity. MATERIAL AND METHODS: The analysis included 5115 patients with NPE for the last 39 years (1977-2015). Morbidity, features of microflora of purulent exudate, changes in the structure of surgical methods were assessed. The role of computed tomography in the diagnostic algorithm and treatment of NPE was studied. RESULTS: The evolution of NPE surgical management includes introduction of video technologies, thermal surgical instruments and widespread use of computed tomography in the diagnosis of pleural empyema...
2017: Khirurgiia
https://www.readbyqxmd.com/read/28403094/less-invasive-management-of-deep-neck-infection-and-descending-necrotizing-mediastinitis-a-single-center-retrospective-study
#10
Dong Wei, Ling Bi, Huiyong Zhu, Jianfeng He, Huiming Wang
By a 7-year retrospective review, we reported our experience in management of descending necrotizing mediastinitis (DNM) and deep neck infection (DNI). A retrospective design was used to reveal the clinical characteristics of DNI and DNM. The clinical outcome was analyzed to validate less invasive management. We reviewed 82 patients between 2009 and 2016, 12 of which were diagnosed as DNM by clinical and computed tomography findings. A total of 35 patients had relevant systemic conditions, mainly diabetes mellitus (19 patients)...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28396722/laparoscopic-retrosternal-gastric-pull-up-for-fistulized-mediastinal-mass
#11
Benedetto Mungo, Arianna Barbetta, Anne O Lidor, Miloslawa Stem, Daniela Molena
We describe the case of a patient successfully reconstructed with laparoscopic retrosternal gastric pull-up after esophagectomy for unresectable posterior mediastinal inflammatory myofibroblastic tumor, eroding into the esophagus and compressing the airways. A partial esophagectomy with esophagostomy was performed for treatment of esophageal pleural fistula and empyema, while the airways were managed with the placement of an endobronchial stent. Gastrointestinal reconstruction was performed using a laparoscopic approach to create a retrosternal tunnel for gastric conduit pull-up and cervical anastomosis...
March 27, 2017: World Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28386509/successful-treatment-of-recurrent-pulmonary-mucormycosis-in-a-renal-transplant-patient-a-case-report-and-literature-review
#12
Morgan S Martin, Alison A Smith, Monica Lobo, Anil S Paramesh
Background. We describe the unusual case of a recently transplanted cadaveric renal transplant recipient who presented with recurrent pulmonary mucormycosis. Case Report. An 18-year-old man with end stage renal disease secondary to congenital renal agenesis status after cadaveric kidney transplant 4 months before presented with acute onset of fever, hemoptysis, and back pain. The patient underwent an emergent left lower lobectomy due to the critical nature of his illness. He was also treated with amphotericin with resolution of his symptoms...
2017: Case Reports in Transplantation
https://www.readbyqxmd.com/read/28337576/robotic-video-assisted-thoracoscopy-minimally-invasive-approach-for-management-of-mediastinal-tumors
#13
Pejman Radkani, Devendra Joshi, Tushar Barot, Roy Williams
In spite of difficult anatomic access for tumors of mediastinum, surgical resection remains the best diagnostic and therapeutic approach. Widespread acceptance of video-assisted thoracoscopy (VATS) is restricted by the limiting nature of instruments and suboptimal visualization. Robotic assisted minimally invasive surgery seems to hold most promise in remote, narrow anatomical regions. After obtaining approval from Institutional Review Board (IRB), a retrospective review of prospectively collected database on patients that underwent Robotic VATS between 2009 and 2013 was conducted...
March 23, 2017: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/28324171/risk-factors-for-delayed-gastric-emptying-after-esophagectomy
#14
Frank Benedix, Tobias Willems, Siegfried Kropf, Daniel Schubert, Patrick Stübs, Stephanie Wolff
PURPOSE: Delayed gastric emptying (DGE) is a common functional disorder after esophagectomy with gastric tube reconstruction. Little is known about risk factors that can predict this debilitating complication. METHODS: Patients who underwent elective esophagectomy from 2008 to 2016 in a single center were retrospectively reviewed. Diagnosis of DGE was based on clinical, radiological, and endoscopic findings. Uni- and multivariate analyses were performed to identify patient-, tumor-, and procedure-related factors that increase the risk of DGE...
May 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28304084/surgical-versus-non-surgical-management-for-pleural-empyema
#15
REVIEW
Mark D Redden, Tze Yang Chin, Mieke L van Driel
BACKGROUND: Empyema refers to pus in the pleural space, commonly due to adjacent pneumonia, chest wall injury, or a complication of thoracic surgery. A range of therapeutic options are available for its management, ranging from percutaneous aspiration and intercostal drainage to video-assisted thoracoscopic surgery (VATS) or thoracotomy drainage. Intrapleural fibrinolytics may also be administered following intercostal drain insertion to facilitate pleural drainage. There is currently a lack of consensus regarding optimal treatment...
March 17, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28274565/the-american-association-for-thoracic-surgery-consensus-guidelines-for-the-management-of-empyema
#16
K Robert Shen, Alejandro Bribriesco, Traves Crabtree, Chad Denlinger, Joshua Eby, Patrick Eiken, David R Jones, Shaf Keshavjee, Fabien Maldonado, Subroto Paul, Benjamin Kozower
No abstract text is available yet for this article.
February 4, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28265966/pyocystis-a-systematic-review
#17
REVIEW
Mohamed H Kamel, Ramsey Gardner, Ali Tourchi, Karen Tart, Omer Raheem, Bradley Houston, Nabil Bissada, Rodney Davis
Pyocystis, empyema cystis, vesical empyema are all terms that describe the purulent filled bladder that may develop in patients with defunctionalized bladders such as after supravesical urinary diversion without cystectomy or in patients with end-stage renal disease with anuria. It is a severe form of lower urinary tract infection. In addition to the local symptoms of suprapubic pain and malodorous discharge, the condition can be more serious with bacterial dissemination into the blood stream and ensuing sepsis and even mortality...
March 7, 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/28259070/effective-treatment-of-empyema-with-bronchopleural-fistula-after-esophagectomy-by-endobronchial-embolization-using-endobronchial-watanabe-spigots
#18
Shinsuke Uchida, Hiroyasu Igaki, Takehiro Izumo, Yuji Tachimori
INTRODUCTION: Empyema and bronchopleural fistula are well known complications after thoracic surgery. We report a case of refractory air leakage of bronchopleural fistula in a patient with empyema that was successfully treated by endobronchial embolization using Endobronchial Watanabe Spigots (EWSs). PRESENTATION OF CASE: A 71-year-old man underwent esophagectomy for primary esophageal cancer. A right empyema with bronchopleural fistula (BPF) developed four months after surgery...
January 24, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28203500/reconstructive-surgery-for-bronchopleural-fistula-and-empyema-new-application-of-free-fascial-patch-graft-combined-with-free-flap
#19
Minoru Sakuraba, Hiroki Umezawa, Shimpei Miyamoto, Masahide Fujiki, Takuya Higashino, Azusa Oshima, Masahiro Tsuboi
BACKGROUND: Postoperative bronchopleural fistula (BPF) and empyema are not uncommon after lung cancer surgery. Some patients require reconstructive surgery to achieve wound healing. In this report, we describe a novel method of reconstructive surgery for BPF and empyema. METHODS: From 1996 through 2014, we performed reconstructive surgery for the treatment of BPF and empyema in 13 cases. BPF or a pulmonary fistula was present in 11 patients at the time of reconstruction...
January 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28187809/management-of-bacterial-central-nervous-system-infections
#20
REVIEW
M C Brouwer, D van de Beek
Bacterial infections of the central nervous system present as a medical emergency, thus requiring rapid diagnosis and immediate treatment. The most prevalent bacterial infections seen in the intensive care unit can be summarized as acute bacterial meningitis, subdural empyema, intracerebral abscess, and ventriculitis, which all commonly involve the brain parenchyma. The infections can either be community-acquired or hospital-acquired, e.g., after neurosurgical intervention, as a complication of severe neurotrauma or related to indwelling cerebrospinal fluid drains...
2017: Handbook of Clinical Neurology
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