1/6. Late mediastinal shift after repeated aspiration of postpneumonectomy seroma.Development of a postoperative seroma is a frequent complication after muscle-sparing thoracotomy. We describe an unusual case of late mediastinal shift in a patient in whom our original plan to perform a limited muscle-sparing thoracotomy was abandoned. The procedure was converted to a standard posterolateral incision to perform a pneumonectomy for a large central carcinoid tumor with extrabronchial extension. Fluid that accumulated in her pneumonectomy space presumably shifted into the dissected tissues of her chest wall, and was then drained repeatedly by her local physician in the time interval between 2 weeks and 3 months after surgery.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/6. Aortobronchial fistula: a rare etiology for hemoptysis.Aortobronchial fistula is an extremely rare cause of hemoptysis. Aortobronchial fistula occurs in patients who have a history of thoracic vascular surgery. Because its symptoms are nonspecific, a high index of suspicion is critical if the physician is to detect it. The results of imaging studies (e.g., plain films, computed tomography, and angiography) and bronchoscopy are sometimes, but not always, diagnostic--another reason the diagnosis is difficult. Left untreated, mortality in patients with aortobronchial fistula is 100%. patients can be salvaged by a variety of techniques, including the placement of an endovascular stent. We describe the case of a 52-year-old man who came to us with hoarseness and hemoptysis, which proved to be underlying symptoms of aortobronchial fistula. He was treated successfully.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
3/6. Unresponsive wheezing to asthma therapy in a 32-year-old female.Repeat failure of any patient to respond to asthma therapy, particularly corticosteroids, should alert physicians to carry out further pulmonary evaluation. This will prevent unnecessary side effects of asthma therapy and provide prompt treatment for other diseases that may require urgent attention.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
4/6. Tracheobronchial ruptures due to cuffed Carlens tubes.At our institution in the past 22 years, more than 3,000 patients have undergone chest procedures, and 2,700 of them were intubated with a cuffed Carlens endotracheal tube. In this paper we report on 5 patients with tracheobronchial ruptures caused by intubation with these tubes. We believe this hazard should be brought to the attention of physicians.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
5/6. Intrabronchial metastases from renal carcinoma with recurrent tumour expectoration.Three patients are described who presented to their doctors with a history of coughing up pieces of tissue. These took the form of large bronchial casts and consisted of intrabronchial deposits of clear cell carcinoma. In one patient the pulmonary symptoms preceded the finding of a primary renal carcinoma by four years. The other two patients had undergone nephrectomy for renal carcinoma 13 and four years previously. Expectoration of intrabronchial tumour should alert the physician to the possibility of metastasis from clear cell carcinoma of the kidney.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
6/6. somatostatin-receptor scintigraphy of subcutaneous and thyroid metastases from bronchial carcinoid.We present a case of bronchial carcinoid tumor with multiple metastases in the retina, subcutaneous tissues and thyroid gland. These metastatic lesions were detected by 111In-pentetreotide scintigraphy 15 yr after removal of the primary tumor. The extensive metastatic involvement documented on scintigraphy spared the patient unnecessary total thyroidectomy and directed the attention of the primary physician to previously unknown and potentially more important foci of metastatic disease.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |