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At least 793 records · Page 44Linked to original sources
PubMed2000

Multilevel thoracic pedicle aplasia causing congenital thoracic kyphosis: case report.

OBJECTIVE AND IMPORTANCE: Congenital thoracic kyphosis is a rare cause of treatable myelopathy. Multilevel thoracic pedicle aplasia as a cause of this deformity has not been previously reported in the literature. We report a case and describe the surgical management and outcome. CLINICAL PRESENTATION: A 14-year-old boy presented to us with a 4-month history of back pain and slowly progressive spastic paraparesis. Radiographic studies revealed thoracic kyphosis and bilateral aplasia of the pedicles of T4-T8. INTERVENTION: The patient underwent surgical treatment via a posterior approach for decompression of T4-T8, followed by arthrodesis from T2 to T12, using a hook claw construct with multiple points of fixation and autologous bone grafting. CONCLUSION: Congenital vertebral anomalies may be clinically occult, and delayed presentation may occur in adolescence or adulthood. Aplasia of multiple thoracic pedicles can produce kyphotic deformities with neurological compromise. A posterior approach with multiple points of segmental instrumentation can be effective in treating kyphotic deformities that are flexible and of moderate severity (<75 degrees).

Adolescent↗
PubMed2000

A case of eosinophilic pleural effusion induced by pancreatothoracic fistula.

A 49-year-old man was admitted for evaluation of a left pleural effusion. Thoracenthesis yielded a hemorrhagic pleural effusion with a high percentage of eosinophils (15.9%). Although there were no significant abdominal signs, serological examinations demonstrated a marked increase of pancreatic enzyme activity. Moreover, abdominal CT demonstrated cystic changes between the tail of the pancreas and the spleen. Accordingly ERP was performed under pressure, and contrast medium draining from the pancreas was observed. Pancreatic pleural effusion in this patient consisted of pancreatic juice retained in the thoracic cavity, which resulted from intrapancreatic fistulation connecting to the thoracic cavity due to a pancreatic cyst caused by chronic pancreatitis. The present report indicates that we should investigate the retention of eosinophilic pleural effusion considering not only the possibility of thoracic disease, but also the possibility of a pleural effusion derived from abdominal diseases.

Eosinophilia↗
PubMedDate not supplied

Thoracic ectopic kidney in a child: a case report.

Congenital thoracic ectopic kidney is a very rare developmental anomaly and the rarest form of all ectopic kidneys. It is usually asymptomatic and discovered incidentally on a routine chest radiography. We report a thoracic ectopic kidney in a 19-month-old boy, which initially presented as a well demarcated mass at the base of the right lung on chest x-ray. Intravenous pyelography (IVP) and thoraco-abdominal computed tomography (CT) demonstrated a normal functioning transdiaphragmatic thoracic ectopic right kidney, but technetium-99m DTPA and DMSA scintigraphy demonstrated pelvic stasis. We hereby discuss the features of congenital thoracic ectopic kidney and review the literature. Although it is extremely rare, thoracic ectopic kidney should be considered in differential diagnosis of a mass with a well demarcated superior margin in the lower part of the thorax, and renal scintigraphy must be performed even if CT and IVP results are normal.

Diagnosis, Differential↗
PubMed2000

[300 videothoracoscopy procedures--personal experience].

Videothoracoscopy and video-assisted thoracic surgery are by now already standard therapeutic procedures in thoracic surgery. The authors submit their experience with the method after 300 thoracoscopic operation at the surgical clinic of the Faculty Hospital in Plzen from the end of 1993 to the beginning of 2000. The main indications for this mini-invasive procedure is the treatment of spontaneous pneumothorax, diagnostic biopsy in pulmonary dissemination of obscure etiology, diagnosis and treatment of pleural exudates and elimination of minor peripheral pulmonary lesions. The authors discuss different surgical procedures in the most frequent diagnoses, their advantages and risks, indication criteria, complications. Attention is also paid to the causes of 10% conversions. In case of treatment of a spontaneous pneumothorax the authors consider videothoracoscopy as the method of first choice, while in case of primary carcinoma of the lungs they recommend the classical procedure. Other possibilities for the wider application of thoracoscopy and its development in their own department include in particular traumatic thoracic surgery.

Humans↗
PubMedDate not supplied

Video-assisted thoracic surgery--state of the art.

Video-assisted thoracic surgery (VATS) is one of the main medical revolutions of the past decade. For its satisfactory performance, the following prerequisites are essential: (1) knowledge and experience in thoracic surgery; (2) team of experienced anesthesiologists; (3) preoperative assessment of respiratory function; (4) adequate postoperative care; and (5) instruments specially designed for thoracoscopic surgery. VATS is routinely performed under general anesthesia with double lumen endotracheal intubation for separate control of each lung. Insufflation of carbon dioxide must not exceed 1-3 mm Hg. Too high pressure may cause harmful reduction of venous return and mediastinal shift with impairment of ventilation. Presence of adhesions should be determined by finger exploration of the pleural cavity. Operative ports should be placed carefully, avoiding damage to the intercostal nerves and vessels. The video technique can be used with efficiency for the following indications: pneumothorax, resection of pulmonary nodules, biopsies of lung, pleura and mediastinal structures, resection of mediastinal tumors, management of empyema, and hemostasis and closure of lacerations after trauma. Indications for esophageal procedures include esophagomyotomy for achalasia and resections of benign lesions. Repair of perforated esophagus is a matter of controversy, but in early stages it can be done thoracoscopically. Although video-pericardioscopy has been performed by some surgeons, this procedure can be done easier and faster using the direct approach without the video equipment. There are differences of opinion with regard to major pulmonary and esophageal resections for cancer. The apparent advantage of diminished pain is offset by inadequate resection, spread of malignant cells and potential damage to the resected specimen with loss of important information concerning pathology. Complications of VATS are few, and include prolonged air leak, dysrhythmia, respiratory failure, bleeding and infection. Due to progress over the past several years, VATS has become an inseparable part of thoracic surgery and should be included in the basic training of every thoracic surgeon.

Humans↗
PubMed2001

[Coronary steal syndrome by systemic pulmonary hypervascularization fed by a mammary-left anterior descending artery bypass. Treatment by embolization].

We report a case of coronary-steal syndrome which occurred after coronary bypass surgery. It was related to systemic hypervascularization of the lung caused by a bronchopathy. The steal syndrome was fed by an ectopic bronchial artery arising from the internal mammary--left anterior descending artery bypass graft. The myocardial ischemia disappeared after hyperselective embolization of the ectopic bronchial artery. The authors outline the rarity of this syndrome and its pathophysiology. They insist on the necessity to perform broncho-systemic arteriography for candidates to coronary surgery, in patients with thoracic diseases which can induce systemic hypervascularization of the lung.

Bronchial Arteries↗
PubMed1998

[Clinical application of 2 mm micro-thoracoscopic surgery].

OBJECTIVE: To determine the clinical safety and efficacy of micro-thoracoscopic surgery. METHOD: From July 1996 to July 1997, video-assisted thoracoscopic surgery was performed in 47 patients by using 2 mm microthoracoscope. There were 36 males and 11 females. Their age ranged from 40 to 75 years with a mean age of 56.7 years. Surgical procedures included bullectomy (16 patients), wedge resection (3), lung cancer staging (4), lobectomy (2), exploration (15), and resection of mediastinal tumor (2), esophagectomy (1) and repair of pneumothorax (4). Local anesthesia was employed in 18 patients and general anesthesia with double lumen endotracheal tube in 29. RESULT: There were no operative mortality and postoperative complications. CONCLUSION: 2 mm micro-thoracoscopic surgery could be used in the management of a variety of thoracic conditions. It may be of significant value for diagnostic and therapeutic purposes, but the further study for this new technique is required to determine its safety and efficacy.

Adult↗
PubMedDate not supplied

[Measuring and decoding the capabilities of digital radiographic images].

The paper deals with the theory and practice of digital X-ray diagnosis. The adverse factors of formation of a digital X-ray film are considered. They included geometric and dynamic blurrinesses, blurriness of an image receiver, and the contrast and dynamic range of digital image. Analysis of a great deal of clinical data shows the capacities of digital X-ray study to diagnose different forms of pulmonary tuberculosis and other thoracic diseases.

Humans↗
PubMed2002

[Recurrent tuberculous abscess in the chest wall; report of a case].

A case of recurrent tuberculous abscess in the chest wall which was successfully treated by resection of the rib and transposition with a latissimus dorsi muscle flap is reported. A 70-year-old man was admitted to the hospital for the purpose of receiving tuberculostatic treatment after an operation for tuberculous abscess in the chest wall at another hospital. When he first visited the another hospital, he had complained of a left chest wall tumor and Mycobacterium tuberculosis was isolated from the pus. After admission to the hospital, tuberculous abscess recurrenced in the left chest wall 2 months after the operation. We performed resection of the abscess, 5th and 6th ribs, as well as transposition of the latissimus dorsi muscle flap. There have been no signs of recurrence and is followed in the clinic, as of 4 months after the operation. We think that resection of the abscess, ribs, and, transposition of the muscle flap are useful methods for tuberculous abscess in the chest wall.

Abscess↗
PubMed2002

[Video-assisted thoracoscopy (VATS) during the last ten years (1992-2001)].

We summarize and analyse the video-assisted thoracoscopies (VATS) performed in our department during the last ten years. In this period 296 patients underwent VATS for diagnosis or therapy. We describe indications, advantages and disadvantages, we also analyse the complications. Video-assisted thoracoscopy is less demanding to the patients than thoracotomy, it reduces the length and cost of inpatient treatment. We recommend extensive use of VATS in suitable patients.

Female↗
PubMed2002

[Diagnosis and treatment of post-traumatic coagulated hemothorax].

Analysis of 102 cases of coagulated hemothorax (CH) are presented: 32--after penetrating wounds and 70--after closed chest injury. In 57% patients with chest wounds and 72% patients with closed injury the cause of CH was to applying late for medical care. Diagnostic value of X-ray, ultrasonic methods, CT and pleural puncture was studied. Depending on the patients state severity, CH volume and stage of it formation conservative treatment, streptase administration, thoracoscopy and thoracotomy with pleurectomy and lung decortication were performed. Lethality was 2.9%.

Adolescent↗
PubMed2001

Menstruation in an unusual place: a case of thoracic endometriosis in Kampala, Uganda.

While pelvic endometriosis is relatively common, thoracic menstruation is rare. A report of what is believed to be the first case of thoracic endometriosis in Uganda is given. A 34-year-old female was complaining of on and off chest pain mainly on the right side. Clinically she had signs of pleural effusion and 500 mls of altered blood were tapped from her right pleural space. Worried about a possibility of a malignant process, an urgent chest CT scan was performed. A right posterior pleural mass and pleural effusion were found. A pleural biopsy was taken and confirmed at histology as endometrial tissue. She did well on surgical excision and hormonal therapy. This was a rare case of endometriosis which shows the usefulness of imaging in the patient work up.

Adult↗