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Ghanad E, Reissfelder C, Yang C. Acupuncture-Induced Hemothorax with Hypovolemic Shock: A Case Report. J Integr Complement Med 2024; 30:310-312. [PMID: 37967387 DOI: 10.1089/jicm.2023.0461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2023]
Abstract
This report describes a very rare but life-threatening complication that occurred in a 43-year-old woman after an acupuncture (AC) for lumbago. The patient presented to the emergency department displaying symptoms indicative of shock. Physical examination revealed the absence of breath sounds on the right thoracic side, further investigations indicated the presence of a hemothorax. Emergency surgery was performed to evacuate the hemothorax and control bleeding from two intercostal veins. Although AC is often considered a gentle form of medicine, it is important to recognize that it can occasionally result in severe complications, especially when acupoints are used on the thorax.
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Affiliation(s)
- Erfan Ghanad
- Department of Surgery, Medical Faculty Mannheim, University Medicine Mannheim, University of Heidelberg, Mannheim, Germany
| | - Christoph Reissfelder
- Department of Surgery, Medical Faculty Mannheim, University Medicine Mannheim, University of Heidelberg, Mannheim, Germany
| | - Cui Yang
- Department of Surgery, Medical Faculty Mannheim, University Medicine Mannheim, University of Heidelberg, Mannheim, Germany
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2
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Beyer CA, Byrne JP, Moore SA, McLauchlan NR, Rezende-Neto JB, Schroeppel TJ, Dodgion C, Inaba K, Seamon MJ, Cannon JW. Predictors of initial management failure in traumatic hemothorax: A prospective multicenter cohort analysis. Surgery 2023; 174:1063-1070. [PMID: 37500410 DOI: 10.1016/j.surg.2023.06.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 06/06/2023] [Accepted: 06/23/2023] [Indexed: 07/29/2023]
Abstract
BACKGROUND Traumatic hemothorax is common, and management failure leads to worse outcomes. We sought to determine predictive factors and understand the role of trauma center performance in hemothorax management failure. METHODS We prospectively examined initial hemothorax management (observation, pleural drainage, surgery) and failure requiring secondary intervention in 17 trauma centers. We defined hemothorax management failure requiring secondary intervention as thrombolytic administration, tube thoracostomy, image-guided drainage, or surgery after failure of the initial management strategy at the discretion of the treating trauma surgeon. Patient-level predictors of hemothorax management failure requiring secondary intervention were identified for 2 subgroups: initial observation and immediate pleural drainage. Trauma centers were divided into quartiles by hemothorax management failure requiring secondary intervention rate and hierarchical logistic regression quantified variation. RESULTS Of 995 hemothoraces in 967 patients, 186 (19%) developed hemothorax management failure requiring secondary intervention. The frequency of hemothorax management failure requiring secondary intervention increased from observation to pleural drainage to surgical intervention (12%, 22%, and 35%, respectively). The number of ribs fractured (odds ratio 1.12 per fracture; 95% confidence interval 1.00-1.26) and pulmonary contusion (odds ratio 2.25, 95% confidence interval 1.03-4.91) predicted hemothorax management failure requiring secondary intervention in the observation subgroup, whereas chest injury severity (odds ratio 1.58; 95% confidence interval 1.17-2.12) and initial hemothorax volume evacuated (odds ratio 1.10 per 100 mL; 95% confidence interval 1.05-1.16) predicted hemothorax management failure requiring secondary intervention after pleural drainage. After adjusting for patient characteristics in the logistic regression model for hemothorax management failure requiring secondary intervention, patients treated at high hemothorax management failure requiring secondary intervention trauma centers were 6 times more likely to undergo an intervention after initial hemothorax management failure than patients treated in low hemothorax management failure requiring secondary intervention trauma centers (odds ratio 6.18, 95% confidence interval 3.41-11.21). CONCLUSION Failure of initial management of traumatic hemothorax is common and highly variable across trauma centers. Assessing patient selection for a given management strategy and center-level practices represent opportunities to improve outcomes from traumatic hemothorax.
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Affiliation(s)
- Carl A Beyer
- Division of Traumatology, Surgical Critical Care, and Emergency Surgery, Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - James P Byrne
- Division of Acute Care Surgery, Department of Surgery, The Johns Hopkins Hospital, Baltimore, MD. https://twitter.com/DctrJByrne
| | - Sarah A Moore
- Division of Acute Care Surgery, Department of Surgery, University of New Mexico School of Medicine, Albuquerque, NM. https://twitter.com/AnnieMooreMD
| | - Nathaniel R McLauchlan
- Division of Traumatology, Surgical Critical Care, and Emergency Surgery, Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Joao B Rezende-Neto
- Department of Trauma and Acute Care Surgery, St. Michael's Hospital, University of Toronto, Ontario, Canada
| | - Thomas J Schroeppel
- Department of Surgery, University of Colorado School of Medicine, UCHealth Memorial Hospital, Colorado Springs, CO
| | - Christopher Dodgion
- Division of Trauma and Critical Care, Department of Surgery, Medical College of Wisconsin, Milwaukee, WI. https://twitter.com/ChrisDodgion
| | - Kenji Inaba
- Division of Trauma and Surgical Critical Care, Department of Surgery, LAC+USC Medical Center, Los Angeles, CA
| | - Mark J Seamon
- Division of Traumatology, Surgical Critical Care, and Emergency Surgery, Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. https://twitter.com/MarkSeamonMD
| | - Jeremy W Cannon
- Division of Traumatology, Surgical Critical Care, and Emergency Surgery, Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
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3
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Foo A, Pozza C. Thoracic aortic dissection presenting with bilateral haemothoraces: a potentially missed diagnosis. BMJ Case Rep 2023; 16:e254866. [PMID: 37567738 PMCID: PMC10423798 DOI: 10.1136/bcr-2023-254866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/13/2023] Open
Abstract
Thoracic aortic dissection is a life-threatening diagnosis, which should not be missed. We present a case in which a patient who presented to the emergency department with chest pain was assessed and referred for admission for treatment of pneumonia, due to misinterpretation of a chest radiograph finding. The patient was re-reviewed and subsequently underwent further investigation, which confirmed aortic dissection. She underwent emergency thoracic endovascular aortic graft repair with stent graft insertion. This case demonstrates haemothorax as an uncommon complication of aortic dissection.
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Affiliation(s)
- Aaron Foo
- South Australia Medical Imaging, The Queen Elizabeth Hospital, Woodville South, South Australia, Australia
| | - Christopher Pozza
- South Australia Medical Imaging, The Queen Elizabeth Hospital, Woodville South, South Australia, Australia
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AlQatari AA, Ahmed A, AlHije F, Sabry M, Elbawab H. Primary Pulmonary Synovial Sarcoma with Hemothorax: a Case Report. Med Arch 2023; 77:496-499. [PMID: 38313103 PMCID: PMC10834050 DOI: 10.5455/medarh.2023.77.496-499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 11/25/2023] [Indexed: 02/06/2024] Open
Abstract
Background Synovial sarcoma is a rare and aggressive soft tissue malignancy most commonly arises from periarticular tissue of the extremities. Although several cases in the literature have reported different origins, primary pulmonary synovial sarcoma (PPSS) is an exceedingly rare and underrecognized entity, accounting for 0.5% of all lung malignancies. Clinical presentation includes chest pain, dyspnea, cough, and hemoptysis. The finding of hemothorax is a rare presentation and was barely reported in the literature. Due to its rarity and aggressive nature, the optimal treatment is unclear, while the mainstay remains surgical resection with chemo- and/or radiation therapy. Objective To report a case of hemorrhagic effusion subsequently diagnosed with primary pulmonary synovial sarcoma with the main objective of enriching the literature regarding this rare malignancy. Case report A 52-year-old male smoker with a background of coronary artery disease, hypertension, and diabetes mellitus was referred to our hospital. The patient presented with a history of chest pain, dyspnea, and massive right-sided pleural effusion. Laboratory investigations were unremarkable except for anemia. Chest x-ray showed a complete opacity on the right lower zone with right-sided pleural effusion. Thoracentesis was done and revealed hemorrhagic exudative effusion. Computed tomography (CT) scan showed a right heterogeneous lung mass compressing the medial segment of the middle lobe. Subsequently, the patient underwent bronchoscopy, which showed compression and edema on the right middle lobe bronchus with traces of blood coming from the right lower lobe. The patient underwent a right posterolateral thoracotomy, a fungating mass eroding the medial segment of the middle lobe was resected that was diagnosed as high-grade primary pulmonary synovial sarcoma. Radiotherapy was instituted. The patient died after two years due to recurrence. Conclusion PPSS is an aggressive disease with poor prognostic outcomes, and Its presentation is almost similar to other lung malignancies. Meanwhile, there is no definitive management guideline, and most management depends on surgical resection if feasible with adjuvant chemo-radiation therapy.
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Affiliation(s)
- Abdullah Abdulaziz AlQatari
- Thoracic Surgery Division, Department of General Surgery, King Fahad Hospital of The University, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Ayesha Ahmed
- Department of Pathology, King Fahad Hospital of The University, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Fatima AlHije
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Mohammed Sabry
- Associate consultant Thoracic surgery, King Fahad Hospital University, Imam Abdulrahman Bin Faisal University. Assistant Professor of Cardiothoracic Surgery Faculty of Medicine, Menoufia University
| | - Hatem Elbawab
- Thoracic Surgery Division, Department of General Surgery, King Fahad Hospital of The University, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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5
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Chernova DV, Zherdev NN, Chernov AV, Kudaev IA, Cherniavskiĭ MA. [Treatment of a patient with acute thoracoabdominal aortic dissection complicated by haemothorax]. Angiol Sosud Khir 2021; 27:140-145. [PMID: 34528598 DOI: 10.33529/angio2021322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Total left-sided haemothorax is a rare and severe complication of acute DeBakey type III aortic dissection. The primary aim of treatment is immediate arrest of haemorrhage and stabilization of the haemodynamic status of the patient. Endovascular isolation of the ruptured thoracic portion of the aorta using a stent graft (TEVAR) has recently become the 'gold standard' in treatment of acute, rupture-complicated aortic dissections of this localization. Described in the article is a clinical case report concerning successful endovascular treatment of a seriously ill patient with dissection of the thoracoabdominal portion of the aorta, rupture and massive haemorrhage into the left pleural cavity. The patient underwent endoprosthetic repair of the descending aorta in the setting of a hybrid operating room under local anaesthesia, followed by drainage of the left pleural cavity. The postoperative period was uneventful with no complications. The patient was discharged in a satisfactory condition on day 10 after the emergency surgical intervention. An important advantage of TEVAR for aortic ruptures is a minimally invasive nature of the procedure, consisting in no need to perform either sternothoracotomy or to connect a heart-lung machine, thus decreasing surgical wound, reducing the risk of perioperative life-threatening haemorrhage, and contributing to early activation of the patient.
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Affiliation(s)
- D V Chernova
- Research Laboratory of Vascular and Hybrid Surgery of the Research Department of Vascular and Interventional Surgery, National Almazov Medical Research Centre, RF Ministry of Public Health, Saint Petersburg, Russia
| | - N N Zherdev
- Research Laboratory of Vascular and Hybrid Surgery of the Research Department of Vascular and Interventional Surgery, National Almazov Medical Research Centre, RF Ministry of Public Health, Saint Petersburg, Russia
| | - A V Chernov
- Research Laboratory of Vascular and Hybrid Surgery of the Research Department of Vascular and Interventional Surgery, National Almazov Medical Research Centre, RF Ministry of Public Health, Saint Petersburg, Russia
| | - Iu A Kudaev
- Research Laboratory of Vascular and Hybrid Surgery of the Research Department of Vascular and Interventional Surgery, National Almazov Medical Research Centre, RF Ministry of Public Health, Saint Petersburg, Russia
| | - M A Cherniavskiĭ
- Research Laboratory of Vascular and Hybrid Surgery of the Research Department of Vascular and Interventional Surgery, National Almazov Medical Research Centre, RF Ministry of Public Health, Saint Petersburg, Russia
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Abstract
BACKGROUND Prompt drainage of traumatic hemothorax is recommended to prevent empyema and trapped lung. Some patients do not present the day of their trauma, leading to their delayed treatment. Delayed drainage could be challenging as clotted blood may not evacuate through a standard chest tube. We hypothesized that such delays would increase the need for surgery or secondary interventions. METHODS Our trauma registry was reviewed for patients with a hemothorax admitted to our level 1 trauma center from 1/1/00 to 4/30/19. Patients were included in the delayed group if they received a drainage procedure >24 hours after injury. These patients were matched 1:1 by chest abbreviated injury score to patients who received drainage <24 hours from injury. RESULTS A total of 19 patients with 22 hemothoraces received delayed drainage. All but 3 patients had a chest tube placed as initial treatment. Four patients received surgery, including 3 who initially had chest tubes placed. Longer time to drainage increased the odds of requiring intrathoracic thrombolytics or surgery. In comparison, 2 patients who received prompt drainage received thrombolytics (P = .11) and none required surgery (P = .02). Patients needed surgery when initial drainage was on or after post-injury day 5, but pigtail catheter drainage was effective 26 days after injury. DISCUSSION Longer times from injury to intervention are associated with increased likelihood of needing surgery for hemothorax evacuation, but outcomes were not uniform. A larger, multicenter study will be necessary to provide better characterization of treatment outcomes for these patients.
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Affiliation(s)
- Jessica L Weaver
- University of California San Diego Division of Trauma, Surgical Critical Care, Burn, and Acute Care Surgery, San Diego, CA, USA
| | - Elinore J Kaufman
- University of Pennsylvania Division of Traumatology, Surgical Critical Care, and Emergency Surgery, Philadelphia, PA, USA
| | - Andrew J Young
- University of Pennsylvania Division of Traumatology, Surgical Critical Care, and Emergency Surgery, Philadelphia, PA, USA
| | - Jane J Keating
- University of Pennsylvania Division of Traumatology, Surgical Critical Care, and Emergency Surgery, Philadelphia, PA, USA
| | - Madhu Subramanian
- University of Pennsylvania Division of Traumatology, Surgical Critical Care, and Emergency Surgery, Philadelphia, PA, USA
| | - Jeremy W Cannon
- University of Pennsylvania Division of Traumatology, Surgical Critical Care, and Emergency Surgery, Philadelphia, PA, USA
| | - Adam Shiroff
- University of Pennsylvania Division of Traumatology, Surgical Critical Care, and Emergency Surgery, Philadelphia, PA, USA
| | - Mark J Seamon
- University of Pennsylvania Division of Traumatology, Surgical Critical Care, and Emergency Surgery, Philadelphia, PA, USA
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7
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Low QJ, Hatta Z, Cheo SW, Syed RSH, Goh KS. Case series of haemothorax secondary to avulsed bullae vessel. Med J Malaysia 2019; 74:431-432. [PMID: 31649221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Haemothorax refer to the bleeding in the pleural space. It is commonly due to iatrogenic, blunt or penetrating chest trauma. Non-traumatic haemothorax is a rare entity that can potentially lead to life threatening complications. The initial management of both traumatic and non-traumatic haemothorax includes resuscitation and stabilisation of the patient. We would like to present two cases of non-traumatic haemothorax secondary to an avulsed bullae vessel.
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Affiliation(s)
- Q J Low
- Hospital Sultanah Nora Ismail, Department of Internal Medicine, Batu Pahat, Johor, Malaysia.
| | - Z Hatta
- Hospital Sultanah Nora Ismail, Department of Radiology, Batu Pahat, Johor, Malaysia
| | - S W Cheo
- Hospital Lahad Datu, Department of Internal Medicine, Lahad Datu, Sabah, Malaysia
| | - R S H Syed
- Hospital Sultanah Aminah, Department of Cardiothoracic Surgery, Johor Bahru, Johor, Malaysia
| | - K S Goh
- Ara Damansara Medical Centre, Department of Respiratory Medicine, Shah Alam, Selangor, Malaysia
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8
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Bannour I, Yassine M, Fodha M, Ouaz M, Haddad B, Majdoub A. Blunt chest trauma : clinical difficulties and limitations of radiological examinations. Tunis Med 2019; 95:972-975. [PMID: 29877555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Blunt chest trauma remains a public health problem due to the severity of caused injuries, diagnostic difficulties and therapeutic orientation. There is no correlation between the parietal lesions and endothoracic abnormalities. Instead radiological examinations are far from accurate. Through a study of 72 cases of closed chest trauma and a literature review we propose to identify risk factors of endothoracic lesions, to clarify the role of radiological examinations in the exploration of these injuries and propose a decisional algorithm.
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MESH Headings
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Child
- Child, Preschool
- Diagnosis, Differential
- Female
- Hemothorax/diagnosis
- Hemothorax/epidemiology
- Hemothorax/etiology
- Humans
- Infant
- Infant, Newborn
- Lung Diseases/diagnosis
- Lung Diseases/epidemiology
- Lung Diseases/etiology
- Male
- Middle Aged
- Radiography, Thoracic/standards
- Retrospective Studies
- Rib Fractures/diagnosis
- Rib Fractures/epidemiology
- Rib Fractures/etiology
- Risk Factors
- Thoracic Injuries/complications
- Thoracic Injuries/diagnosis
- Thoracic Injuries/epidemiology
- Thoracic Injuries/therapy
- Tomography, X-Ray Computed
- Wounds, Nonpenetrating/complications
- Wounds, Nonpenetrating/diagnosis
- Wounds, Nonpenetrating/epidemiology
- Wounds, Nonpenetrating/therapy
- Young Adult
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Gunßer JC, Potratz P, Helfritzsch H. Hematothorax with Cutaneous Emphysema and Dysphonia Following "Trivial Trauma" During Treatment With Dabigatran. Dtsch Arztebl Int 2019; 116:252. [PMID: 31092316 PMCID: PMC6541744 DOI: 10.3238/arztebl.2019.0252b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- Jan-Christoph Gunßer
- *Thüringen Kliniken Saalfeld, Zentrum für Unfallchirurgie, Orthopädie und Wirbelsäulentherapie, Saalfeld,
| | - Philipp Potratz
- **Thüringen Kliniken Saalfeld, Abteilung für Allgemein-, Viszeral-, und Thoraxchirurgie, Saalfeld
| | - Herry Helfritzsch
- **Thüringen Kliniken Saalfeld, Abteilung für Allgemein-, Viszeral-, und Thoraxchirurgie, Saalfeld
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10
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Abstract
Thoracic trauma in China was scarcely reported. This study aimed to summarize the clinical profiles and to analyze the management approaches of patients with traumatic thoracic injury.Data for consecutive patients with thoracic trauma from January 2003 to January 2018 were retrospectively collected and analyzed. Patients' profiles and clinical outcomes were compared between those patients treated with a dedicated thoracic trauma team and those without.The study included 4168 patients with mean age of 49.0 years, of whom 82.1% were male. Traffic accident accounted for 42.7% of the injuries. Most of the patients (66.8%) had rib fractures. Associated injuries were present in 48.3% of the patients; of them 86.0% were extremity fractures. Majority of the patients were managed without surgical procedures other than tube thoracostomy (33.2%). ICU service was needed in 12.0% of the patients. Patients treated with thoracic trauma team were older (53.59 ± 16.8 year vs 45.1 ± 18.0 year, P < .001), less male (78.3% vs 85.2%, P < .001), with higher injury severity scores (17.5 ± 10.1 vs 13.7 ± 8.2, P < .001), required more ventilator support (48.3% vs 25.3%, P < .001) and underwent more tube thoracostomy and other surgeries (43.8% vs 24.2%, and 34.4% vs 14.1%, respectively, all P < .001), yet with a shorter hospital stay (11.7 ± 9.0 days vs 12.7 ± 8.8 days, P < .001), and numerically lower ICU usage and mortality when compared to those without.Thoracic trauma in China usually affects mid-age males. Traffic accident is the top one etiology. The most common type of thoracic injuries is rib fracture. Associated injuries occur frequently. Nonoperative treatment and tube thoracostomy are effective for majority of the patients. A multidisciplinary approach with a dedicated thoracic trauma team could improve the treatment for these patients.
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Affiliation(s)
| | - Meiwen Tang
- Department of Hematology
- Institute of Clinical Science, Zhongshan Hospital, Fudan University, China
| | | | | | | | - Wei Jin
- Department of Thoracic Surgery
| | - Jin Qian
- Department of Respiration
- Emergency Department, Zhongshan Hospital Qingpu Branch
| | - Feng Li
- Department of Hematology
- Department of Hematology
| | - Yunfeng Cheng
- Department of Hematology
- Department of Hematology
- Institute of Clinical Science, Zhongshan Hospital, Fudan University, China
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Narasimman S, Govindasamy H, Seevalingam KK, Paramasvaran G, Ramasamy U. Spontaneous massive haemothorax in the peri-partum period of an undiagnosed neurofibromatosis type 1 patient - A surgical perspective. Med J Malaysia 2019; 74:99-101. [PMID: 30846675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Acute massive haemothorax is a life-threatening situation, which is often associated with a preceding trauma. However, spontaneous haemothorax is a rare occurrence, especially in pregnancy. Spontaneous haemothorax in the immediate post-partum period secondary to a ruptured intercostal AVM is extremely rare more so in the background of an undiagnosed neurofibromatosis. This is a report of a young lady presenting with pleuritis and breathlessness after the delivery of her 1st child. Her management is discussed.
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Affiliation(s)
- S Narasimman
- Hospital Sultan Abdul Halim, Department of Surgery, Thoracic Surgery Unit, Sg Petani, Kedah, Malaysia.
| | - H Govindasamy
- Hospital Sultan Abdul Halim, Department of Surgery, Thoracic Surgery Unit, Sg Petani, Kedah, Malaysia
| | | | - G Paramasvaran
- Hospital Taiping, Department of Surgery, Perak, Malaysia
| | - U Ramasamy
- Hospital Taiping, Department of Surgery, Perak, Malaysia
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12
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Khan Z, Khan MS. Right-sided hemothorax from leaking saphenous vein right coronary artery bypass graft aneurysm due to incomplete coiling masquerading as right lower lobe pneumonia. Intern Emerg Med 2018; 13:951-953. [PMID: 29619768 DOI: 10.1007/s11739-018-1847-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2018] [Accepted: 03/29/2018] [Indexed: 10/17/2022]
Affiliation(s)
- Zubair Khan
- Department of Internal Medicine, University of Toledo Medical Center, 3000 Arlington Avenue, MS 1150, Toledo, OH, 43614, USA.
| | - Mohammad Saud Khan
- Department of Internal Medicine, University of Toledo Medical Center, 3000 Arlington Avenue, MS 1150, Toledo, OH, 43614, USA
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13
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Niang S, Dia AD. [Aneurysm of the pulmonary artery]. Rev Pneumol Clin 2018; 74:263-264. [PMID: 29748066 DOI: 10.1016/j.pneumo.2018.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Revised: 02/25/2018] [Accepted: 03/04/2018] [Indexed: 06/08/2023]
Affiliation(s)
- S Niang
- Service de pneumologie du centre hospitalier régional universitaire de Saint-Louis (CHRU SL), Saint-Louis, Sénégal.
| | - A D Dia
- Service de médecine interne du CHRU SL, Saint-Louis, Sénégal
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14
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Gil Vázquez PJ, Arroyo Tristán ADA, Martínez Baños J, Torres Lanzas J. Massive spontaneous hemothorax in patients with neurofibromatosis type 1. Emergencias 2018; 30:190-193. [PMID: 29687675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Spontaneous hemothorax is an uncommon event that can occur in patients with a history of neurofibromatosis type 1 because of intrathoracic vascular malformations that predispose to aneurysms or bleeding from thoracic tumors. Only 53 cases of this rare association have been reported in the literature since 1975. We described 2 cases: one patient was a 73-year-old man with a right hemothorax secondary to an intercostal neurofibroma; the other was a 35-year-old woman with a left hemothorax secondary to a neurofibroma that compromised the internal mammary artery. Our review of the literature found that 61.8% of cases involved women with a mean age of 43.9 years. There was a certain tendency toward left-sided (56.4%) hemothorax, and the intercostal space was the most common site of bleeding. Treatment was most often surgical (58.2%) in reported cases, although selective artery embolization is also a valid choice. Exitus occurred during 30.9% of the reported episodes, and survival was higher in patients who were treated with surgery or arterial embolization than in those in whom only a thoracic drain was placed or who received no invasive treatment (P=.02).
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Affiliation(s)
- Pedro José Gil Vázquez
- Servicio Cirugía General y Aparato Digestivo. Hospital Clínico Universitario Virgen de la Arrixaca, El Palmar, Murcia, España
| | - Andrés Del Amor Arroyo Tristán
- Servicio Cirugía General y Aparato Digestivo. Hospital Clínico Universitario Virgen de la Arrixaca, El Palmar, Murcia, España
| | - Jesús Martínez Baños
- Servicio Cirugía General y Aparato Digestivo. Hospital Clínico Universitario Virgen de la Arrixaca, El Palmar, Murcia, España
| | - Juan Torres Lanzas
- Servicio Cirugía General y Aparato Digestivo. Hospital Clínico Universitario Virgen de la Arrixaca, El Palmar, Murcia, España
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15
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Sangani NK, Naliath SM. Pseudomesotheliomatous Type of Sarcomatoid Squamous Cell Lung Cancer Presenting With Hemothorax. Ann Thorac Surg 2018; 106:e201-e203. [PMID: 29689238 DOI: 10.1016/j.athoracsur.2018.03.050] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 03/05/2018] [Accepted: 03/08/2018] [Indexed: 11/17/2022]
Abstract
A 44-year-old man presented with spontaneous massive hemothorax. Computed tomographic scan revealed thickened and nodular pleura with no evidence of lung tumor. The patient underwent right open total pleurectomy. Histopathologic and immunohistochemical studies of the pleura confirmed poorly differentiated sarcomatoid squamous cell carcinoma of the lung with metastasis to the pleura. The carcinoma was psuedomesothelimatous type because of its presentation as diffuse pleural thickening. This presentation of sarcomatoid cancer as pseudomesotheliomatous type with massive hemothorax is rare and can be considered as a differential diagnosis in diffuse pleural thickening or hemothorax, especially in the absence of a clinically identifiable primary lung tumor.
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Affiliation(s)
- Niravkumar K Sangani
- Department of Cardiothoracic Surgery, Ahalia Hospital-Mussafah, Abudhabi, United Arab Emirates.
| | - Santosh Mathew Naliath
- Department of Cardiothoracic Surgery, Ahalia Hospital-Mussafah, Abudhabi, United Arab Emirates
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16
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Frazão Vieira V, Faria C, Barroso MDR, Mota Tavares F. [Hemothorax - a conservative approach in a patient with multiple comorbidities]. Rev Port Cir Cardiotorac Vasc 2018; 25:83-86. [PMID: 30317717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Indexed: 06/08/2023]
Abstract
The authors present the case of an elderly woman with multiple comorbidities hospitalized with the diagnosis of community- acquired pneumonia with pleural effusion. However, there was a history of fall with chest trauma 1 week before, coinciding with the onset of symptoms. The patient had a massive hemothorax that could not be drained. There was a progressive worsening of the patient clinical status with sustained fever and arising of inflammatory parameters, despite broad-spectrum antibiotic therapy and antipyretics. The case was discussed in a multidisciplinary team, and the possibility of surgical intervention was rejected. As life-saving therapy, it was decided to perform fibrinolysis with tissue plasminogen activator, through the thoracic drain, which occurred successfully and without complications. The hemothorax was drained completely allowing recovery of the patient.
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Affiliation(s)
- Vera Frazão Vieira
- Assistente Medicina Interna, Medicina Interna 2, Centro Hospitalar Leiria, Leiria, Portugal
| | - Catarina Faria
- Assistente Medicina Interna, Medicina Interna 2, Centro Hospitalar Leiria, Leiria, Portugal
| | | | - Fernando Mota Tavares
- Assistente Graduado Sénior Medicina Interna, Centro Hospitalar Leiria, Leiria, Portugal
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17
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18
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Sahin IO, Güven AS, Kaya A, Güney C, Cevit O, Arslan M. A child with an unusual complication of Crimean-Congo hemorrhagic fever: Hemorrhagic pleural effusion. J Vector Borne Dis 2016; 53:87-89. [PMID: 27004585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023] Open
Affiliation(s)
- Irfan Oguz Sahin
- Division of Pediatric Cardiology, Department of Pediatrics, Faculty of Medicine, Cumhuriyet University, Sivas, Turkey
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19
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Khmehl VV, Mayetniy EM, Levshov YA. [THE TREATMENT OF INJURED PERSONS WITH COMPLICATED PENETRATING THORACIC WOUNDINGS ON TERTIARY LEVEL OF THE MEDICAL CARE DELIVERY]. Klin Khir 2016:47-49. [PMID: 27249928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The results of examination and treatment of 36 injured persons with complicated penetrating thoracic woundings in tertiary centres were analyzed. Own experience of the pulmonary woundings surgical treatment, using application of videothoracoscopic and welding-coagulating equipment, was summarized.
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MESH Headings
- Abdominal Injuries/diagnosis
- Abdominal Injuries/diagnostic imaging
- Abdominal Injuries/pathology
- Abdominal Injuries/surgery
- Electrocoagulation/instrumentation
- Electrocoagulation/methods
- Emergency Service, Hospital
- Head Injuries, Penetrating/diagnosis
- Head Injuries, Penetrating/diagnostic imaging
- Head Injuries, Penetrating/pathology
- Head Injuries, Penetrating/surgery
- Hemothorax/diagnosis
- Hemothorax/diagnostic imaging
- Hemothorax/pathology
- Hemothorax/surgery
- Hospitals
- Humans
- Pneumothorax/diagnosis
- Pneumothorax/diagnostic imaging
- Pneumothorax/pathology
- Pneumothorax/surgery
- Thoracic Injuries/diagnosis
- Thoracic Injuries/diagnostic imaging
- Thoracic Injuries/pathology
- Thoracic Injuries/surgery
- Thoracic Surgery, Video-Assisted/instrumentation
- Thoracic Surgery, Video-Assisted/methods
- Trauma Severity Indices
- Ukraine
- Ultrasonography
- Wounds, Gunshot/diagnosis
- Wounds, Gunshot/diagnostic imaging
- Wounds, Gunshot/pathology
- Wounds, Gunshot/surgery
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20
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Li CC, Hsu CW, Li CZ, Kuo SM, Wu YC. Successful treatment of a pancreatic pseudocyst accompanied by massive hemothorax: a case report. J Med Case Rep 2015; 9:295. [PMID: 26714770 PMCID: PMC4696274 DOI: 10.1186/s13256-015-0791-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Accepted: 12/11/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND It is rare to encounter massive hemothorax as a complication of pancreatic pseudocyst. In addition, as no obvious hypotension and abdominal discomfort were noted, it was difficult to consider gastrointestinal lesion a possibility. CASE PRESENTATION A 54-year-old Taiwanese man had tightness on the left side of his chest and shortness of breath for 3 days. He had a history of acute pancreatitis 3 months ago. After history taking and a series of examinations including thoracocentesis and computed tomography of his abdomen and chest, the diagnosis was finally confirmed based on the high amylase levels in his pleural fluid. CONCLUSIONS Treatment with distal pancreatectomy and splenectomy was subsequently successfully performed. Based on our experience, we briefly discuss the currently available treatment options for pancreatic pseudocyst.
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Affiliation(s)
- Chiao-Ching Li
- Division of General Surgery, Department of Surgery, Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan.
| | - Chin-Wen Hsu
- Division of General Surgery, Department of Surgery, Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan.
| | - Chiao-Zhu Li
- Division of General Surgery, Department of Surgery, Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan.
- Department of Neurological Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
| | - Shyh-Ming Kuo
- Department of Biomedical Engineering, I-Shou University (Yanchao Campus), Kaohsiung, Taiwan.
| | - Yu-Chiuan Wu
- Division of General Surgery, Department of Surgery, Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan.
- Yuh-Ing Junior College of Health Care and Management, Kaohsiung, Taiwan.
- National Kaohsiung University of Hospitality and Tourism, Kaohsiung, Taiwan.
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21
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Abstract
BACKGROUND Percutaneous lead extraction represents one of the most difficult and challenging interventions in the therapy with cardiac implantable electronic devices (CIEDs). Despite the progress in outcome and safety of these procedures in the last decade, the first published results of the ELECTRa registry point out that the risk of life-threatening complications should not be underestimated. Therefore, pre-operative screening for indications, present infections, pacemaker dependency, age and type of implanted leads, previous cardiac surgery and presence of anatomic variations are prerequisite to assess the individual operation risk. RESULTS Apart from the decision for any particular operative approach, the risk-adjusted settings should be selected in order to enable intraoperative escalation of extraction methods, if needed. A good theoretical knowledge of potential perioperative problems and complications as well as the intraoperative use of TEE enables early detection and management of complications. Furthermore, preoperative arrangements with other professionals and a team approach in emergency management enable fast and structured action when needed, thus, reducing mortality in case of life-threatening complications.
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Affiliation(s)
- Heiko Burger
- Abteilung für Herzchirurgie, Kerckhoff-Klinik GmbH, Benekestraße 2-8, 61231, Bad Nauheim, Deutschland.
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22
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Dua A, Dua A, Jechow S, Desai SS, Kuy S. Idiopathic spontaneous rupture of an intercostal artery. WMJ 2014; 113:116-118. [PMID: 25118440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Spontaneous rupture of an intercostal artery is exceptionally rare without an inciting event such as trauma or nontraumatic arterial wall weakening. This report details the diagnosis and treatment of a 47-year-old man who presented with a spontaneous hemothorax from an intercostal artery. There are very few reports in the literature documenting spontaneous intercostal artery rupture without associated illness or injury.
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Sochala M, Aïssou L, Sorbets E, Pop N, Sleiman C, Goudot FX, Meune C. Delayed cardiac tamponade following management of a massive hemothorax related to a penetrating thoracic trauma. Int J Cardiol 2014; 172:e69-70. [PMID: 24412463 DOI: 10.1016/j.ijcard.2013.12.049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2013] [Accepted: 12/21/2013] [Indexed: 11/19/2022]
Affiliation(s)
- Maximilien Sochala
- Department of Cardiology, Avicenne Hospital, Hopitaux Universitaires Paris-Seine-Saint-Denis, APHP, France
| | - Linda Aïssou
- Department of Cardiology, Avicenne Hospital, Hopitaux Universitaires Paris-Seine-Saint-Denis, Université Paris XIII, APHP, France.
| | - Emmanuel Sorbets
- Department of Cardiology, Avicenne Hospital, Hopitaux Universitaires Paris-Seine-Saint-Denis, APHP, France; Department of Cardiology, Bichat Hospital, Université Paris Diderot, APHP, France
| | - Natalia Pop
- Department of Cardiology, Avicenne Hospital, Hopitaux Universitaires Paris-Seine-Saint-Denis, APHP, France
| | - Carla Sleiman
- Department of Cardiology, Avicenne Hospital, Hopitaux Universitaires Paris-Seine-Saint-Denis, APHP, France
| | - François-Xavier Goudot
- Department of Cardiology, Avicenne Hospital, Hopitaux Universitaires Paris-Seine-Saint-Denis, APHP, France
| | - Christophe Meune
- Department of Cardiology, Avicenne Hospital, Hopitaux Universitaires Paris-Seine-Saint-Denis, APHP, France; Department of Cardiology, Cochin Hospital, Université Paris Descartes, APHP, France
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24
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Tsuzuku A, Asano F, Murakami A, Masuda A, Sobajima T, Matsuno Y, Matsumoto S, Mori Y, Takiya H, Iwata H. Hemothorax with a high carbohydrate antigen 19-9 level caused by a bronchogenic cyst. Intern Med 2014; 53:1981-4. [PMID: 25175134 DOI: 10.2169/internalmedicine.53.2401] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
A 58-year-old man presented with right-sided chest pain. Radiography and computed tomography showed a pleural effusion in the right chest and a mass in the right hilum. Thoracentesis showed a hemothorax. The carbohydrate antigen (CA) 19-9 level in the pleural effusion was very high, requiring differentiation from malignancy. Positron emission tomography showed no significant fluorodeoxy glucose (FDG) accumulation. Magnetic resonance imaging revealed a cystic lesion. The tumor was resected for both a diagnosis and treatment. A pathological examination demonstrated a bronchogenic cyst. An immunohistochemical study suggested that the cyst was the source of the hemothorax and the high CA19-9 level.
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Affiliation(s)
- Akifumi Tsuzuku
- Department of Pulmonary Medicine, Gifu Prefectural General Medical Center, Japan
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25
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Tatarinova EV, Pogodina AN, Korovkina EN. [Postoperative complications in patients with cervicothoracic injuries]. Khirurgiia (Mosk) 2014:10-14. [PMID: 25484145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The results of the diagnosis and treatment of 117 patients with cervicothoracic injuries were analyzed. Different complications were observed in 51 (43.6%) cases. The main reasons contributing to the development of complications included late diagnosis of lesions of trachea and esophagus, acute blood loss, inadequate hemostasis during surgery.
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26
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Plaksin SA, Petrov ME. [Optimization of surgical strategy in complications after thoracic operations demanding recurrent surgical interventions]. Vestn Khir Im I I Grek 2014; 173:54-59. [PMID: 25823336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
A frequency of postoperative complications varied from 1-2% after endoscopic thoracal operations to 4-12% after open operations using thoracotomic access. There isn't any common approach to indications and terms of the recurrent endoscopic intervention. An analysis of postoperative complications was made after 2795 thoracothomies and 3632 videothoracoscopies required the recurrent operation in 139 patients (2.2%). The rethoracoscopies were performed on 62 patients (44.6%), thoracoscopies were carried out after thoracotomies in 40 cases (28.8%) and rethoracotomies were in 37 cases (26.6%). The more frequent indication to recurrent operation was bleeding (26.6%), pleural empyema (20.9%), fragmented pleuritis (11.5%). It was shown that thoracoscopy was an alternative to rethoracotomy as the rethoracoscopy in case of nonmassive intrapleural bleeding, clotted hemothorax, postoperative fragmented pleuritis, non-sanitized empyema region, the presence of sequestrums in this area, limited postoperative pleuritis, chylothorax, bronchopleural fistula of the size of 1-2 mm, leakage of the lung, a foreign body in pleural cavity. The lethality consisted of 35.1% after rethoracotomies and it was 12.7% after recurrent endoscopic operations.
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27
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Plourde M, Émond M, Lavoie A, Guimont C, Le Sage N, Chauny JM, Bergeron É, Vanier L, Moore L, Allain-Boulé N, Fratu RF, Dufresne M. [Cohort study on the prevalence and risk factors of late pulmonary complications in adults following a closed minor chest trauma]. CAN J EMERG MED 2013; 15:337-344. [PMID: 24176457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
OBJECTIVES The objectives of this study are to determine the prevalence, risk factors, and time to onset of delayed hemothorax and pneumothorax in adults who experienced a minor blunt thoracic trauma. METHOD A prospective cohort of 450 consecutive patients was recruited. Eligible patients had to be over 16 years of age, consulted within 72 hours for a trauma, and available for outpatient follow-up at 2, 7, and 14 days posttrauma. The clinical outcome investigated was the presence of delayed pneumothorax or hemothorax on the follow-up chest x-ray. OUTCOMES Delayed hemothorax occurred in 11.8% (95% CI 8.8-14.8), and delayed pneumothorax occurred in 0.9% (95% CI 0.2-2.3) of participants. During the 14-day follow-up period, 87.0% of these delayed complications developed in the first week. In the multivariate analysis, the only statistically significant risk factor for delayed complications was the location of fractures on the x-ray of the hemithorax. The adjusted odds ratio was 1.52 (95% CI 0.62-3.73) for the lower ribs (tenth to twelfth rib), 3.11 (95% CI 1.60-6.08) for the midline ribs (sixth to ninth rib), and 5.05 (95% CI 1.80-14.19) for the upper ribs (third to fifth rib) versus patients with no fractures. CONCLUSION The presence of at least one rib fracture between the third and ninth rib on the x-ray of the hemithorax is a significant risk factor for delayed hemothorax and pneumothorax.
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28
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Türkmen N, Eren B, Aydin ŞA. Aortic arch blunt injury in front-seat passenger. Soud Lek 2013; 58:61-62. [PMID: 24289526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Aortic arch blunt injury has highly lethal nature. Because the physical examination findings are subtle, immediate medical evaluation is very important. The case was a 72-year-old woman. Massive haemorrhage in the left haemotorax, contusion area in the left lung and a traumatic transection of the distal aortic arch was observed during autopsy. We described intersting autopsy case of aortic arch blunt injury.
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Masuda R, Ikoma Y, Oiwa K, Nakazato K, Takeichi H, Iwazaki M. Delayed hemothorax superimposed on extrapleural hematoma after blunt chest injury: a case report. Tokai J Exp Clin Med 2013; 38:97-102. [PMID: 24030485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 03/08/2013] [Accepted: 06/17/2013] [Indexed: 06/02/2023]
Abstract
We report a case showing delayed hemothorax superimposed on extrapleural hematoma after blunt chest injury. The patient was a 56-year-old man with a medical history of alcoholic hepatopathy who presented with a chief complaint of dyspnea on exertion. One month prior to presentation, he had sustained a fall that had resulted in left simple rib fracture. A chest radiograph taken at the time of injury showed notable reduction in the permeability of the left lung field along with high pulmonary collapse as well as rightward deviation of the shadow of the inferior mediastinum. Chest CT images showed a region of low absorption in the thoracic cavity with septi. Thoracic drainage was performed (1,300 mL total) and hemothorax was diagnosed. Thoracoscopic examination was then performed. When the inside of the thorax was observed, what had been presumed to be the septi of a multilocular fluid collection was found to be actually the parietal pleura, and a hematoma was confirmed inside the extrapleural cavity. The hematoma inside the extrapleural cavity was managed with lavage and drainage, and drainage tubes were placed inside both the thoracic cavity and extrapleural cavity at the end of the procedure. The patient's postoperative course was uneventful, and he was discharged on postoperative day 4.
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Affiliation(s)
- Ryota Masuda
- Department of General Thoracic Surgery, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193 Japan.
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30
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Oh SY, Seo KW, Jegal Y, Ahn JJ, Min YJ, Park CR, Hwang JC. Hemothorax caused by spontaneous rupture of a metastatic mediastinal lymph node in hepatocellular carcinoma: a case report. Korean J Intern Med 2013; 28:622-5. [PMID: 24009462 PMCID: PMC3759772 DOI: 10.3904/kjim.2013.28.5.622] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2008] [Revised: 11/18/2008] [Accepted: 11/24/2008] [Indexed: 11/27/2022] Open
Affiliation(s)
- Ssang Yong Oh
- Department of Internal Medicine, Ulsan University Hospital, Ulsan, Korea
| | - Kwang Won Seo
- Department of Internal Medicine, Ulsan University Hospital, Ulsan, Korea
| | - Yangjin Jegal
- Department of Internal Medicine, Ulsan University Hospital, Ulsan, Korea
| | - Jong-Joon Ahn
- Department of Internal Medicine, Ulsan University Hospital, Ulsan, Korea
| | - Young Joo Min
- Department of Internal Medicine, Ulsan University Hospital, Ulsan, Korea
| | - Chang Ryul Park
- Department of Thoracic and Cardiovascular Surgery, Ulsan University Hospital, Ulsan, Korea
| | - Jae Cheol Hwang
- Department of Radiology, Ulsan University Hospital, Ulsan, Korea
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31
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Tantraworasin A, Saeteng S. Massive hemothorax due to intrathoracic extramedullary hematopoiesis in a patient with beta thalassemia hemoglobin E disease. J Med Assoc Thai 2013; 96:866-869. [PMID: 24319860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Case report of a 28-year-old man with beta thalassemia/hemoglobin E disease who developed a massive hemothorax due to bleeding from multiple large intrathoracic, paraspinal hematopoietic masses. Initially, a thoracotomy was required for the control of bleeding. Postoperatively, the patient received 2,000 ml of packed red cells but he continued bleeding after the blood chemistries and coagulopathy specimen were corrected. The decision was made to return to the operating room for a thoracotomy to control the bleeding. However, before re-operating, the patient underwent a collapse and failed resuscitation. This complication has never been previously reported in Thailand.
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Affiliation(s)
- Apichat Tantraworasin
- General Thoracic Surgery Unit, Department of Surgery, Faculty ofMedicine, Chiang Mai University Hospital, Chiang Mai, Thailand.
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Sevinç S, Unsal S, Oztürk T, Uysal A, Samancilar O, Kaya SO, Ermete S. Thoracic endometriosis syndrome with bloody pleural effusion in a 28 year old woman. J PAK MED ASSOC 2013; 63:114-116. [PMID: 23865146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Thoracic endometriosis, rarely encountered, is characterized with the localization of functional endometrium tissue in pleura, lung parenchyma or tracheobronchial system. A 28 years old female patient visited our clinic with complaints of cough and shortness of breath for the last two months. Right-sided massive pleural effusion was detected in the chest radiography and thorax computed tomography. Exudative fluid was aspirated with a haemorrhagic appearance on thoracentesis. Cytology was evaluated as suspicious. "Signet ring cells" were reported in pleural biopsy. Diagnostic biopsy was performed by video-assisted thoracic surgery (VATS) on the patient whose fiber-optic bronchoscopy was normal. The histopathological diagnosis was reported as "pleural endometriosis". Chemical pleurodesis was applied with asbestos-free chalk. The thorax HRCT (high resolution computed tomography) performed during menstruation was normal. Thoracentesis was needed 3 times for recurrent pleural effusion in the follow-ups and then parietal pleurectomy was performed. The patient is in postoperative 10th month follow-up and evaluated as normal clinically and as radiologically. Pleural endometriosis should be considered as a differential diagnosis in female patients with infertility with chest symptoms. Video-assisted thoracoscopic surgery can be useful in the diagnosis and treatment of these patients and chemical pleurodesis and parietal pleurectomy should be considered among the treatment options.
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Affiliation(s)
- Serpil Sevinç
- Department of Thoracic Surgery, Dr. Suat Seren Chest Disease and Thoracic Surgery Training and Research Hospital, Izmir, Turkey
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Schok T, Konsten JLM. [Hypovolaemic shock several days after rib fractures]. Ned Tijdschr Geneeskd 2013; 157:A4957. [PMID: 23302347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND A quarter of all patients with rib fractures develop a haemothorax. A haemothorax usually occurs immediately following trauma, but it can also occur with considerable delay. CASE DESCRIPTION We describe two patients, aged 58 and 51 years, who each had sustained thoracic trauma. After the initial assessment and additional diagnostic testing, the patients were admitted to hospital. On the 4th and 8th day after the trauma, respectively, they developed hypovolaemic shock resulting from a haemothorax. Both patients had multiple rib fractures. CONCLUSION A delayed haemothorax is rare but in cases of hypovolaemic shock, this dangerous complication of rib fractures should be ruled out.
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Affiliation(s)
- Thomas Schok
- VieCuri Medisch Centrum voor Noord-Limburg, afd. Chirurgie, Venlo, the Netherlands.
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35
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Boĭko VV, Zamiatin PN, Khashchina VA, Zamiatin DP. [The criteria of choice of the surgical treatment method in the injured persons with intrapleural post-traumatic hemorrhage in the closed thoracic trauma]. Klin Khir 2012:35-37. [PMID: 23610817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
The role of clinic-instrumental methods of investigation for establishment of criteria in the choice in the injured persons surgical treatment with intrapleural posttraumatic hemorrhage as a consequence of the closed thoracic trauma was studied up.
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36
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Singh V, Digra SK, Slathia SS, Kakkar T. Hemothorax following snakebite. Indian Pediatr 2012; 49:242-243. [PMID: 22484745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
We report a 12 year old girl with snakebite, who developed hemothorax 5 days after admission. One liter of blood was aspirated. The bite was presumed to be that of saw scaled viper (Echis carinatus) that resulted in DIC and direct endothelial injury leading to bleed. Selective bleed into the pleural cavity is a rarity.
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Affiliation(s)
- Virender Singh
- Department of Pediatrics, Government Medical College, Jammu, India
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Pantea MA, Maev RG, Malyarenko EV, Baylor AE. A physical approach to the automated classification of clinical percussion sounds. J Acoust Soc Am 2012; 131:608-619. [PMID: 22280623 DOI: 10.1121/1.3665985] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Chest percussion is a traditional technique used for the physical examination of pulmonary injuries and diseases. It is a method of tapping body parts with fingers or small instruments to evaluate the size, consistency, borders, and presence of fluid/air in the lungs and abdomen. Percussion has been successfully used for the diagnosis of such potentially lethal conditions as traumatic and tension pneumothorax. This technique, however, has certain shortcomings, including limitations of the human ear and the subjectivity of the administrator, that lead to overall low sensitivity. Automation of the method by using a standardized percussion source and computerized classification of digitized signals would remove the subjective factor and other limitations of the technique. It would also enable rapid on-site diagnostics of pulmonary traumas when thorough clinical examination is impossible. This paper lays the groundwork for an objective signal classification approach based on a general physical model of a damped harmonic oscillator. Using this concept, critical parameters that effectively subdivide percussion signals into three main groups, historically known as "tympanic," "resonant," and "dull," are identified, opening the possibility for automated diagnostics of air/liquid inclusions in the thorax and abdomen. The key role of damping in forming the character of the percussion signal is investigated using a 3D thorax phantom. The contribution of the abdominal component into the complex multimode spectrum of chest percussion signals is demonstrated.
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Affiliation(s)
- M A Pantea
- Institute for Diagnostics Imaging Research, University of Windsor, 401 Sunset Avenue, Windsor, Ontario N9B 3P4, Canada
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Krenke R, Klimiuk J, Korczynski P, Kupis W, Szolkowska M, Chazan R. Hemoptysis and Spontaneous Hemothorax in a Patient With Multifocal Nodular Lung Lesions. Chest 2011; 140:245-251. [PMID: 21729897 DOI: 10.1378/chest.10-1865] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Affiliation(s)
- Rafal Krenke
- Department of Internal Medicine, Pneumonology, and Allergology, Medical University of Warsaw, Poland.
| | - Joanna Klimiuk
- Department of Internal Medicine, Pneumonology, and Allergology, Medical University of Warsaw, Poland
| | - Piotr Korczynski
- Department of Internal Medicine, Pneumonology, and Allergology, Medical University of Warsaw, Poland
| | - Wlodzimierz Kupis
- Department of Surgery, National Research Institute of Tuberculosis and Lung Diseases, Warsaw, Poland
| | - Malgorzata Szolkowska
- Department of Pathology, National Research Institute of Tuberculosis and Lung Diseases, Warsaw, Poland
| | - Ryszarda Chazan
- Department of Internal Medicine, Pneumonology, and Allergology, Medical University of Warsaw, Poland
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Voskresenskiĭ OV, Beresneva ÉA, Sharifullin FA, Popova IE, Abakumov MM. [The preoperative thoracic X-ray for tactical decisions for the thoracic injuries treatment]. Khirurgiia (Mosk) 2011:15-21. [PMID: 22413154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Data of 379 patients with penetrating thoracic wounds were analyzed. The pathologic changes on X-ray of the thoracic cavity were registered 239 (63,1%) patients: the hemothorax was diagnosed in 44,3%, pneumothorax - in 26,8% and hemopneumothorax - in 28,9%. 154 patients had videothoracoscopic surgery and 225 patients were operated on using traditional open methods. Operative findings were compared with X-ray data. The sensitivity of plain chest radiography in diagnostics of hemothorax was 52,1%, the specificity - 92,1%. Mistakes of interpreting X-ray data in diagnosing of low-volume hemo- or pneumothorax were defined. The computed tomography of the thorax proved to be the most precise means of intrapleural injuries diagnostics. The optimal algorithm of preoperative thoracic X-ray was suggested.
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Kim HJ, Seon HJ, Choi S, Jang NK. Ruptured Aneurysm of Intercostal Arteriovenous Malformation Associated With Neurofibromatosis Type 1: A Case Report. Cardiovasc Intervent Radiol 2010; 34 Suppl 2:S74-7. [PMID: 20711836 DOI: 10.1007/s00270-010-9965-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2010] [Accepted: 07/28/2010] [Indexed: 11/29/2022]
Affiliation(s)
- Hyung Jun Kim
- Department of Radiology, Chonnam National University Hospital, 671, Jebongno, Dong-gu, Gwangju 501-757, South Korea
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41
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Obitko-Pludowska A, Laguna P, Adamowicz-Salach A, Brzewski M, Del Campo KS. Haemothorax in children with congenital coagulopathy. Haemophilia 2010; 16:688-691. [PMID: 20398069 DOI: 10.1111/j.1365-2516.2010.02209.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
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Medford ARL, Entwisle JJ. "X marks the spot" is not a pleural guarantee. Postgrad Med J 2009; 85:572. [PMID: 19892891 DOI: 10.1136/pgmj.2009.088286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- A R L Medford
- Department of Respiratory Medicine, Glenfield Hospital, University Hospitals of Leicester NHS Trust, Leicester, Leicestershire, UK.
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Kara HV, Turna A, Günlüoglu MZ, Demir A, Metin M, Gurses A. Enigmatic contralateral hemothorax after left thoracotomy. Ann Thorac Cardiovasc Surg 2009; 15:336-338. [PMID: 19901890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
Abstract
Intrathoracic hemorrhage following surgical intervention that needs rethoracotomy has a low rate in the daily practice of thoracic surgery. Hemothorax in the contralateral site is definitely unexpected after thoracotomy. We present a case of contralateral hematoma after left posterolateral thoracotomy as a rare and enigmatic complication.
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Affiliation(s)
- H Volkan Kara
- Thoracic Surgery Department, Yedikule Teaching Hospital for Diseases of Chest and Thoracic Surgery, Istanbul, Turkey
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44
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El Ghazal R, Fabian T, Ahmed ZA, Moritz ED. Thoracic endometriosis: an unusual cause of hemothorax. Conn Med 2009; 73:453-456. [PMID: 19777977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
In this report we describe the clinical presentation, diagnosis, treatment and outcome of a 45-year-old woman with thoracic endometriosis. Four clinical presentations have been described. The majority have presented with catamenial pneumothorax, followed by hemothorax, hemoptysis and lung nodules. Our patient presented with right-sided hemothorax and lung nodules. Video-assisted thoracoscopic aurgery confirmed the presence of endometrial tissue embedded in the diaphragmatic pleura. Talc pleurodesis alongwith atotal abdominal hysterectomy and bilateral salpingo-oophorectomy led to a clinical and radiological resolution.
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Affiliation(s)
- Roland El Ghazal
- Department of Medicine, Hospital of Saint Raphael, New Haven, USA
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45
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Siller J, Havlícek K. [Haemothorax after blunt thoracic trauma]. Rozhl Chir 2009; 88:277-281. [PMID: 19642350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
BACKGROUND Haemothorax is frequent consequence of blunt and penetrating thoracic trauma and is usually associated with pneumothorax. The occurence of haemothorax in blunt thoracic trauma patients is estimated between 25-75%. The reason of bleeding is impairment of intercostal arteries or lung parenchyma after trauma of the ribs. Uncontrolled bleeding is the main cause of the death. The article is focused on the treatment of this injury. MATERIAL AND METHODS There were enrolled 238 patients with thoracic trauma, who were admitted into our department, into the study. The average age of the patients was 42.5 years. The ISS > or = 16 were in 101 patients. Forty two patients were artefitially ventilated. Conservative treatment prevails, almost in 65%. Special care was indicated in patients with haemothorax (fluidotoraxem). RESULTS Clinically and based on other screening methods the presence of the fluid in thoracic cavity was in 131 patients. Surgical treatment (punction, drainage, videothoracoscopy and thoracotomy) was necessary in 47 (35.0%). Thoracotomy for the bleeding was indicated in seven cases (5.3 %). CONCLUSION In diagnostics and in treatment of the bleeding in thoracic trauma patients the most important factor is clinical status of the patient. Indication for thoracotomy must be unambigous. Massive haemotorax leads to restrictive ventilation disorder with decreased preload and can be activator of the haemocolaguation disorders. This fact decreases chance for the survival of the patient.
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Affiliation(s)
- J Siller
- Chirurgická klinika, Pardubická krajská nemocnice.
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46
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De Zoysa N, Vasani S, Prasad V, Stearns M. Radiology quiz case 1. Massive cervicothoracic hematoma due to extracapsular rupture of a parathyroid adenoma. Arch Otolaryngol Head Neck Surg 2009; 135:316-319. [PMID: 19289714 DOI: 10.1001/archoto.2008.551-a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
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Carrillo EH, Barkoe DJ, Sanchez R, Lee SK, Rosenthal A, Pepe A, Nardiello D. Open thoracic window: a useful alternative for retained infected pleural collections in critically ill trauma patients. Am Surg 2009; 75:152-156. [PMID: 19280809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Historically, tube thoracostomy, image-guided drainage, or an open thoracotomy has been indicated as the standard procedure for the management of patients with retained infected pleural collections (RIPC). These infections can be a debilitating and potentially lethal complication in already critically ill trauma patients. The purpose of this review was to evaluate the usefulness of an open thoracic window (OTW) as definitive therapy for the management of RIPC refractory to conventional therapies. The medical records of patients who underwent an OTW for RIPC were reviewed for the following: demographic data, primary diagnosis, clinical findings that explained the failure of the conventional management, bacteriology of the retained collection, and final outcome. Over a 3-year period, eight critically ill trauma patients who had sustained multiple system trauma and developed a RIPC were identified (six males and two females; average age, 47 years). Of the eight patients identified, six collections were in the right and two in the left pleural cavity. Staphylococcus aureus and Acinetobacter were the two most common bacterial isolates from these collections. All patients had undergone multiple and unsuccessful drainage attempts by thoracostomy tubes. Additionally, two of the patients also underwent image-guided drainage procedures, which proved to be unsuccessful. After creation of the OTW, all patients had complete resolution of the RIPC, and all were discharged alive from the hospital. During outpatient follow up, the OTW was found to have completely healed and required no further surgical intervention. The creation of long-term pleural drainage, with an OTW, facilitates and expedites the resolution of persistent infected pleural collections by providing more efficient surgical drainage and mechanical débridement. Our experience also shows this uncommon operation to be an effective alternative when conventional measures have failed.
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Affiliation(s)
- Eddy H Carrillo
- Division of Trauma Services, Memorial Regional Hospital, 3501 Johnson Street, Hollywood, FL 33021, USA.
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48
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Grabczak EM, Krenke R, Jeleńska M, Komarow I, Ambroziak U, Fangrat A, Chazan R. [Hemorrhagic parapneumonic effusion in a 64 year-old patient as the first symptom of hemophilia B]. Pneumonol Alergol Pol 2009; 77:320-326. [PMID: 19591107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
Abstract
Hemophilia B is an inherited, X chromosome-linked disease. It is usually diagnosed in childhood, sometimes in adolescence. The commonest symptoms include spontaneous or post-traumatic bleeding into the joints and/or muscles, as well as mucosal bleeding. Respiratory symptoms are rarely reported. We present the case of a 64 year-old man in whom bloody parapneumonic effusion (hemothorax) was the first symptom of hemophilia B. The reason for prolonged activated partial thromboplastin time (APTT) found on admission has not been elucidated. Since antibiotic therapy and pleural tube thoracostomy with intrapleural streptokinase were found to be ineffective, video-assisted thoracic surgery was performed with the right lung decortication. Post-operative treatment was complicated by massive pleural bleeding requiring two subsequent thoracotomies. Additional blood tests revealed factor IX deficiency and resulted in hemophilia B being diagnosed. The presented case proves that hereditary bleeding disorders may be diagnosed even in late adulthood. Intrapleural bleeding related to pneumonia and pleural inflammation might be the first presenting symptom. Hemophilia should be considered as a potential cause of APTT prolongation, even in an elderly patient with atypical presentation. Explaining the reason for APTT prolongation before the surgical procedure could have allowed to avoid severe bleeding in the described patient.
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Affiliation(s)
- Elzbieta M Grabczak
- Katedra i Klinika Chorób Wewnetrznych, Pneumonologii i Alergologii Warszawskiego Uniwersytetu Medycznego.
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Durai R, Hoque H, Kerwat R. QUIZ HQ 48. Oesophageal hiatus hernia and complications of fundoplication. J Gastrointestin Liver Dis 2008; 17:451-452. [PMID: 19104708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Affiliation(s)
- Rajaraman Durai
- Department of Surgery, Queen Mary's Sidcup NHS Trust, Sidcup, Kent, UK
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50
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Backus C, Folio L. Radiology corner. Answer to last month's radiology case (#26) and image: Lung laceration with loculated blood, active bleeding, contusion and hemothorax. Mil Med 2008; 173:xv-xvi. [PMID: 18751605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023] Open
Abstract
The following case demonstrates the importance of emergent imaging in victims of gunshot wound to the chest. The AP chest in our case highlights findings that correlate well with support of follow up CT Angiogram of the chest. This case also exemplifies description of complex planes now available with modern CT imaging capabilities described here as para-axial, para-coronal and para-sagittal reconstructions.
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