1/15. Chest wall arteriovenous fistula: an unusual complication after chest tube placement.Posttraumatic arteriovenous fistulas can form between vessels of the thorax that have sustained loss of integrity to the vessel wall. Although most are caused by injuries as a consequence of missile penetration or stab wounds, iatrogenic damage is a potential cause. Herein we present a case of a systemic arteriovenous fistula involving an intercostal artery and subcutaneous vein after chest tube placement.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
2/15. Catamenial pneumothorax caused by diaphragmatic stromal endometriosis.A case of catamenial pneumothorax caused by stromal endometriosis of the diaphragm is described. A 40-year-old woman suffered two episodes of right-sided pneumothorax which occurred after onset of menstruation. thoracoscopy revealed brownish spots in the right diaphragm and partial excision of the diaphragm was performed. Histological examination showed that the lesion was characterized by sheets of cells resembling endometrial stromal cells, small thin-walled blood vessels and extravasated erythrocytes in varying proportions. Some clusters of these cells were transmural. No endometrial-type glands were found. Immunohistochemically, the nuclei of the endometrial stromal cells were strongly positive for both estrogen and progesterone receptors. Therapy with a gonadotropin-releasing hormone analogue was started and the patient has since been asymptomatic for 6 months. Pathologists should not overlook diaphragmatic stromal endometriosis as a possible cause of pneumothorax.- - - - - - - - - - ranking = 0.5keywords = vessel (Clic here for more details about this article) |
3/15. Macleod's syndrome presenting with spontaneous pneumothorax.A 19-year-old woman with a recent history of recurrent bronchitis presented with a spontaneous left pneumothorax. review of the chest radiographs revealed features of Macleod's syndrome on the same side, with unilateral lucency and hypoplastic hilar vessels. To our knowledge this is the first report of Macleod's syndrome presenting with spontaneous pneumothorax.- - - - - - - - - - ranking = 0.5keywords = vessel (Clic here for more details about this article) |
4/15. Massive intrathoracic haemorrhage after CT-guided lung biopsy.CT-guided lung biopsy is now widely performed for tumorous lesions in the lung, and both its usefulness in this context and the associated complications have been well described in the literature. Although severe complications are rare, we describe a case in which massive intrathoracic haemorrhage developed after lung biopsy and necessitated emergency operation for control. Intraoperative findings suggested that the source of the haemorrhage was a fibrous, cord-like substance present at the site of adhesion associated with old tuberculosis. We attributed this haemorrhage to a pneumothorax, which developed after lung biopsy and caused the new vessels penetrating the centre of the fibrous, cord-like substance to stretch and rupture. Numerous cases have been reported of spontaneous haemopneumothorax precipitated by spontaneous pneumothorax and resulting from the rupture of such vessels.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
5/15. How can we approach a left-sided stab wound in the neck, with isolated tracheal laceration?Any penetrating trauma to the mediastinum may cause great vessel damage resulting in massive bleeding or even shock. Associated tracheal injury increases morbidity and mortality. We report a case of a penetrating mediastinal injury with isolated tracheal laceration. The stab entered in the left supraclavicular fossa. The patient presented with right-sided pneumothorax, pneumomediastinum and respiratory collapse. bronchoscopy revealed two injuries in the trachea that were repaired by right thoracotomy and left cervicotomy. The patient was discharged on postoperative day 6. Isolated thoracic tracheal injury is very rare in mediastinal stab wounds and operative strategy may change according to bronchoscopic findings.- - - - - - - - - - ranking = 0.5keywords = vessel (Clic here for more details about this article) |
6/15. Chronic necrotizing pulmonary aspergillosis complicated by pneumothorax.A 61-year-old man presented with left-sided pneumothorax. On the chest computed tomograghy (CT), severe bilateral emphysema and left-sided pleural thickening were seen. His pneumothorax was drained with a chest tube. Because of a persistent air leakage, video-thoracoscopic wedge-resection of the suspected fistula and muscle-sparing minithoracotomy with extensive wedge resections of the left upper lobe were performed. biopsy specimens showed micronodular mycetomas with septate hyphae highly suggestive of aspergillus. The fungus destructed the lung tissue without vessel invasion. The patient had not been taking immunosuppressant drugs and had no prior opportunistic infections. itraconazole was begun, the lung was expanded and the patient recovered. We propose that extensive resection of affected lung tissue in combination with long-term antifungal therapy with itraconazole is a valuable therapeutic option in patients with a complicated course of chronic necrotizing pulmonary aspergillosis (CNPA).- - - - - - - - - - ranking = 0.5keywords = vessel (Clic here for more details about this article) |
7/15. Spontaneous haemopneumothorax: a rare clinical entity.A 39 yr old man presented with a spontaneous pneumothorax. On initial pleural drainage 120 ml of haemorrhagic fluid were collected. Twenty four hours, after re-expansion of the lung, shock developed and 1,200 ml of haemorrhagic fluid were spontaneously collected. The diagnosis haemopneumothorax was considered and at operation a bleeding vessel, which originated from the parietal pleura, was located and coagulated. The occurrence of an air fluid line at radiological examination, the development of a haemorrhagic pleural effusion and shock should alert the physician of this entity. This case stresses the importance of early recognition and surgical intervention because of the possible lethal evolution.- - - - - - - - - - ranking = 0.5keywords = vessel (Clic here for more details about this article) |
8/15. Micronodular hyperplasia of type II pneumocytes--a new lung lesion associated with tuberous sclerosis.Open lung biopsy in a 38-year-old female with Pringle-Bourneville syndrome and recurrent pneumothorax revealed a micronodular pneumocyte II hyperplasia, a new entity probably associated with the tuberous sclerosis syndrome. The lesion caused an obstruction of the alveolar lymphatic vessels and alveolar ducts, resulting in an emphysema-like picture. This cystic dilation of alveoli and draining lymphatics followed by rupture caused the recurrent pneumothorax. The epithelial pneumocytic nature of the lesion was confirmed by immunohistochemistry and electronmicroscopy.- - - - - - - - - - ranking = 0.5keywords = vessel (Clic here for more details about this article) |
9/15. Extracardiac intrathoracic abnormalities demonstrated by Tc-99m RBC gated blood pool imaging.In addition to intrathoracic great vessel abnormality, pericardial effusion, and splenomegaly, extracardiac intrathoracic abnormalities were found in 12 of 210 patients' 99mTc red blood cell (RBC) gated cardiac blood pool imagings. These abnormalities, including five cases of absent pulmonary perfusion due to tumor mass, four of pleural effusion, two of pneumothorax, and one of left lung mass attenuation, were confirmed with concurrent or subsequent chest radiography, chest CTs, or biopsy. Pulmonary blood pool activity is normally seen on both sides in both anterior and left anterior oblique views; decreased or absent perfusion on either side or in part of the lung may indicate chest/pulmonary pathologies. Although pulmonary and thoracic wall lesions are not frequently seen, such incidental findings during gated cardiac blood pool imagings can lead to further study for these clinically unsuspected lesions and may benefit the patient.- - - - - - - - - - ranking = 0.5keywords = vessel (Clic here for more details about this article) |
10/15. Pulmonary lymphangiomyomatosis.Pulmonary lymphangiomyomatosis is a rare but distinct clinical and pathological entity. It is characterized by hamartomatous proliferation of smooth muscle around the lymphatic vessels of the lung, mediastinum, and retroperitoneum. It occurs only in menstruating women and girls and is manifested by spontaneous pneumothorax and chylous pleural or abdominal effusion. As it progresses, the lungs become increasingly involved with subsequent pulmonary insufficiency and recurrent infection. Eventually death results. This entity has not been reported previously in the surgical literature even though the thoracic surgeon is called on to both establish the diagnosis and aid in palliation. The hypothesis that the disease is estrogen dependent is reviewed and the desirability of estrogen ablation in patients with positive estrogen receptors is suggested.- - - - - - - - - - ranking = 0.5keywords = vessel (Clic here for more details about this article) |
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