11/164. Incarcerated postraumatic intercostal lung hernia. Case report and review of the literature.Traumatic lung hernia is a rare diagnosis. A 52-year-old female motorvehicle passenger was admitted as a trauma patient after a motorvehicle accident. She was found to have an incarcerated lung hernia. Size of the hernia, incarceration and respiratory insufficiency mandated immediate surgical intervention with reposition, drainage and stabilisation of the chest wall. The postoperative course was uneventful. The management of the patient is discussed and the available literature reviewed.- - - - - - - - - - ranking = 1keywords = chest (Clic here for more details about this article) |
12/164. Respiratory distress in a neonate with an enlarged thymus.Thymic hyperplasia, although not a rare condition in infancy, is usually asymptomatic. We describe an infant presenting in the perinatal period with marked tachypnoea. An enlarged thymus, demonstrated on chest radiograph and CT, was associated with small-volume, non-compliant lungs. Other causes of pulmonary malfunction and maldevelopment were excluded. CONCLUSION: Thymic enlargement is unusually associated with neonatal respiratory distress but should be considered in the differential diagnosis.- - - - - - - - - - ranking = 1keywords = chest (Clic here for more details about this article) |
13/164. Total arch replacement with an aortic arch aneurysm due to chronic interstitial pneumonia: report of a case.The case of a 66-year-old man who had rheumatoid arthritis, chronic interstitial pneumonia (IP) with honeycomb lung, and an aortic arch aneurysm is described. He complained of left chest pain in April 1998 and chest computed tomography revealed an enlargement of a thoracic aneurysm whose maximum diameter reached 7 cm. He was urgently transferred to our institution to undergo immediate surgery for an impending rupture of the aneurysm. His PaO2 with 80 Torr with oxygen therapy. The operation included a median sternotomy, extracorporeal circulation with selective cerebral perfusion, the use of cold blood cardioplegic solution, and open distal anastomosis. Although an acute exacerbation of IP occurred 2 months after the surgery, he successfully received intensive care including high-dose steroid therapy and artificial ventilation. He was successfully weaned from the ventilator and is now being followed up with medical treatment.- - - - - - - - - - ranking = 2.0560083955196keywords = chest, chest pain (Clic here for more details about this article) |
14/164. Negative pressure ventilation via chest cuirass to decrease ventilator-associated complications in infants with acute respiratory failure: a case series.Pulmonary and nonpulmonary complications of invasive positive pressure ventilation are well documented in the medical literature. Many of these complications may be minimized by the use of noninvasive ventilation. During various periods of medical history, negative pressure ventilation, a form of noninvasive ventilation, has been used successfully. We report the use of negative pressure ventilation with a chest cuirass to avoid or decrease the complications of invasive positive pressure ventilation in three critically ill infants at two institutions. In each of these cases, chest cuirass ventilation improved the patient's clinical condition and decreased the requirement for more invasive therapy. These cases illustrate the need for further clinical evaluation of the use of negative pressure ventilation utilizing a chest cuirass.- - - - - - - - - - ranking = 7keywords = chest (Clic here for more details about this article) |
15/164. Pulmonary sarcoidosis: presentation as bilateral spontaneous hydropneumothorax and pulmonary infiltrates.Pulmonary manifestations in sarcoidosis vary, ranging from asymptomatic chest radiographic abnormalities to progressive destruction of lung parenchyma with respiratory insufficiency. We describe a case of sarcoidosis in a patient with bilateral hydropneumothorax, parenchyma infiltrates, and respiratory insufficiency. hydropneumothorax is extremely rare, and to our knowledge only two cases have been reported.- - - - - - - - - - ranking = 1keywords = chest (Clic here for more details about this article) |
16/164. Respiratory failure during induction chemotherapy for acute myelomonocytic leukaemia (FAB M4Eo) with ara-C and all-trans retinoic acid.We report two cases of acute myeloid leukaemia FAB classification M4Eo with high white cell counts at presentation, who developed acute respiratory failure with pulmonary infiltrates on chest radiograph soon after commencing conventional cytotoxic chemotherapy plus all-trans retinoic acid (ATRA). We suggest that in patients with M4Eo ATRA should be used with caution, perhaps delaying its commencement until the white cell count is < 10 x 109/l.- - - - - - - - - - ranking = 1keywords = chest (Clic here for more details about this article) |
17/164. Femoral venoarterial extracorporeal membrane oxygenation for severe reimplantation response after lung transplantation.Severe pulmonary reimplantation response after lung transplantation is not very common, although the mortality can be high. We present a patient who developed an extremely severe reperfusion injury after bilateral lung transplantation. Because of severe hypoxia and hemodynamic instability, despite aggressive ventilator settings, venoarterial extracorporeal membrane oxygenation (ECMO) was instituted using the femoral approach at the bedside. During ECMO, the patient developed a thoracic wall hematoma that was treated with transfusion alone. After 50 h of ECMO, his chest radiograph had dramatically improved, his oxygen need had been reduced to 50%, and he was successfully weaned from ECMO. Two years later, he is doing extremely well. Therefore, institution of ECMO using the femoral approach can be performed safely at the bedside in the ICU, and can be lifesaving in the context of a very severe reimplantation response after lung transplantation.- - - - - - - - - - ranking = 1keywords = chest (Clic here for more details about this article) |
18/164. Negative extrathoracic pressure in infants with cystic fibrosis and respiratory failure.Respiratory support using negative extrathoracic pressure or high-frequency chest wall oscillation was used to treat 3 infants with cystic fibrosis and respiratory failure who had not responded to maximal medical therapy. Beneficial clinical effects were noted in all three cases. Pulmonary function testing was performed in 2 cases, and measures of compliance increased.- - - - - - - - - - ranking = 1keywords = chest (Clic here for more details about this article) |
19/164. Respiratory failure in postpneumonectomy syndrome complicated by thoracic lordoscoliosis: treatment with prosthetic implants, partial vertebrectomies, and spinal fusion.STUDY DESIGN: This study investigated the case of a 17-year-old girl with postpneumonectomy syndrome, complicated by a thoracic lordoscoliosis, who was successfully treated with prosthetic implants, partial vertebrectomies, and anteroposterior spinal fusion. OBJECTIVE: To report a unique case and describe the authors' method of treatment. SUMMARY OF BACKGROUND DATA: Postpneumonectomy syndrome is an uncommon complication of pneumonectomy. Many case reports describe successful treatment with insertion of prosthetic implants into the empty hemithorax to shift the mediastinum to its original position. Thoracic lordoscoliosis reportedly has contributed to pulmonary compromise, but no cases have shown its occurrence in the setting of postpneumonectomy syndrome. methods: The patient was observed at the National Children's Hospital in tokyo, referred to Children's Hospital in los angeles, california for surgical correction, and followed in tokyo for the next year. RESULTS: Two prosthetic implants with an injection port for further expansion were positioned in the right hemithorax to restore the mediastinum to its normal position. Anterior discectomies, partial vertebrectomies, and fusion of T5-T10 was performed concurrently. Then 5 days later, posterior spinal fusion of T1-T12 with instrumentation and bone graft were performed to correct the thoracic lordoscoliosis and increase the chest cavity space. At 1 month after the surgery, the patient was extubated after being ventilator dependent for 5 months. At the time of operation, the girl was ventilator dependent and nonambulatory, but 1 year later could participate in all activities of daily living without any oxygen supplementation. CONCLUSIONS: Postpneumonectomy syndrome can be treated successfully with prosthetic implants to restore the normal position of the mediastinum. Thoracic lordoscoliosis can complicate the syndrome and may be corrected to help restore normal pulmonary function.- - - - - - - - - - ranking = 1keywords = chest (Clic here for more details about this article) |
20/164. Respiratory weakness in neuralgic amyotrophy: report of two cases with phrenic nerve involvement.An isolated affection of the phrenic nerve is a rare feature in patients with neuralgic amyotrophy. We report 1 case each of bilateral and unilateral phrenic neuropathy. The first patient presented a sudden onset of severe respiratory failure without pain. The second patient developed intense pain in the neck and in the right shoulder followed by dyspnea on mild effort and orthopnea. Chest x-rays showed elevation of the diaphragm. Needle electromyography revealed denervation restricted to the diaphragm. The phrenic nerve conduction was within the normal range. The diagnosis of neuralgic amyotrophy may be particularly difficult when the palsy of the phrenic nerve appears without brachial plexus involvement or the typical shoulder pain of acute onset. In our patients, electrophysiological evaluation combined with radiographic studies, ventilatory parameters and biochemical analyses were helpful in establishing the diagnosis.- - - - - - - - - - ranking = 0.071566445224201keywords = plexus (Clic here for more details about this article) |
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