1/44. Pleural incarceration of the gastric graft after trans-hiatal esophagectomy.We report on a 73-year-old man who underwent a transhiatal esophagectomy for a T2N1M0 adenocarcinoma of the distal esophagus and developed an incarcerated herniation of the gastric graft through a defect in the right mediastinal pleura. The patient experienced delayed gastric emptying postoperatively, which was initially suggested by barium swallow. The gastric herniation was unidentified by early postoperative swallowing studies and endoscopies. After diagnosis by a later computed tomographic scan and barium study, the herniation was reduced by incising the mediastinal pleura from the diaphragm to the apex of the chest and by plication of the stomach longitudinally in order to reduce its intrathoracic diameter.- - - - - - - - - - ranking = 1keywords = gas (Clic here for more details about this article) |
2/44. Esophagopleural fistula originating from diverticulum after pneumonectomy. A case report and review of the literature.Esophagopleural fistula (EPF) is a very rare and fatal disease. A 56 year-old man developed a pyothorax resulting from an EPF with esophageal diverticulum after a right pneumonectomy. The patient was successfully treated with a three-stage operation and control of infection and nutritional status. First, fenestration was performed, then an ante-thoracic gastroplasty, and a radical thoracoplasty was performed. Surgical management, nutritional support, and control of infection were the cornerstones of the treatment of EPF.- - - - - - - - - - ranking = 0.14285714285714keywords = gas (Clic here for more details about this article) |
3/44. Gastropleural fistula as complication of postpneumonectomy empyema.A 54-year-old woman underwent a left pneumonectomy for monolateral congenital pulmonary cysts, complicated by a pleural empyema without bronchial fistula, in the late postoperative period. The pleural empyema was evacuated and managed by means of a small thoracic drainage. Three months after discharge the patient noticed the presence of ingesta in the pleural washing fluid. Diagnostic and operative procedures in this rare case of non malignant, non traumatic gastropleural fistula are described.- - - - - - - - - - ranking = 0.14285714285714keywords = gas (Clic here for more details about this article) |
4/44. Gastric seromuscular and omental pedicle flap for bronchopleural fistula after pneumonectomy.We report a case of postpneumonectomy bronchopleural fistula treated using a gastric seromuscular and omental pedicle flap and maintaining good postoperative respiratory function. A 76-year-old man underwent right pneumonectomy with regional lymph node dissection for squamous cell carcimoma of the lung. Five weeks later, a bronchopleural fistula occurred. empyema with the bronchopleural fistula was diagnosed and chest tube drainage implemented immediately. Despite the drainage, signs of inflammation persisted and the patient's nutrition did not improve leading to surgery, on August 18, 1997. The bronchopleural fistula was closed by horizontal suture proximal to the stapling sutured line. A gastric seromuscular and omental pedicle flap was sutured as a cover over the bronchial stump. Postoperative analysis of respiratory function and arterial blood gas showed good results.- - - - - - - - - - ranking = 0.42857142857143keywords = gas (Clic here for more details about this article) |
5/44. Subpleural lung involvement in Behcet's disease: first localization of a systemic entity.Behcet's disease (BD) is a chronic multisystem vasculitis, affecting many organs and the vascular system, of unknown aetiology. Eyes, skin, joints, the oral cavity, the central nervous system, and, less frequently, heart, lung, kidney, the genital system and the gastrointestinal tract can be involved. Intrathoracic manifestations of BD consist mainly of thromboembolism of the superior vena cava and/or other mediastinal veins; aneurysms of the aorta and pulmonary arteries; pulmonary infarct and haemorrhage; pleural effusion; and, rarely, myocardial and/or hilar lymphoid involvement. In the present case, the patient presented with BD with an asymptomatic subpleural lung mass and bilateral pulmonary artery enlargement. The patient was treated with a combination of surgical and medical therapy with complete resolution of the lung involvement and without any parenchymal relapses after an 8-month follow-up.- - - - - - - - - - ranking = 0.14285714285714keywords = gas (Clic here for more details about this article) |
6/44. Late esophagopleural fistula after left pneumonectomy: report on one case.Esophagopleural fistula is an uncommon complication of pneumonectomy. Late nonmalignant esophagopleural fistula after left pneumonectomy for lung cancer is exceedingly uncommon. We report on one patient who developed such a fistula 33 months after the operation. signs and symptoms were first attributed to infection of the thoracotomy incision and diagnosis was made only after detection of some food coming from the pleural space. thoracostomy, enteral feeding by a percutaneously placed gastrostomy tube and myoplasty allowed both closure of the fistula and obliteration of the pleural space.- - - - - - - - - - ranking = 0.14285714285714keywords = gas (Clic here for more details about this article) |
7/44. Pleural gas gangrene secondary to esophageal injury by an ingested fish bone.We report a 73-year-old woman with right pleural gas gangrene, treated successfully by thoracoscopic debridement. The clinical course and chest computed radiography and thoracoscopy findings suggested that her condition resulted from a relatively rare esophageal injury after she accidentally ingested a fish bone. Video-assisted thoracoscopic intervention has proved useful in cases involving pleural gas gangrene.- - - - - - - - - - ranking = 0.85714285714286keywords = gas (Clic here for more details about this article) |
8/44. Spontaneous biliopneumothorax (thoracobilia) following gastropleural fistula due to stomach perforation by nasogastric tube.Gastropleural fistula may occur after pulmonary resection, perforated paraesophageal hernia, perforated malignant gastric ulcer at the fundus, or gastric bypass surgery for morbid obesity. We describe a case of gastropleural fistula after stomach perforation by a nasogastric tube in a patient who underwent Billroth II gastric resection for adenocarcinoma. Left biliopneumothorax occurred and was treated by thoracic drainage with -20 cm H2O aspiration. As gastropleural fistula persisted, laparotomy was repeated and gastric and diaphragmatic perforations were sutured. Gastropleural fistula is rare and, to our knowledge, this is the first reported case of gastropleural fistula and biliopneumothorax caused by gastric and diaphragmatic perforation by a nasogastric tube.- - - - - - - - - - ranking = 2.5714285714286keywords = gas (Clic here for more details about this article) |
9/44. Pleuro-biliary fistula--a delayed complication following open cholecystectomy.A 24-year-old lady presented with bilious expectoration and history suggestive of obstructive jaundice, 16 months following open cholecystectomy. Pleurocentesis was done, followed by intercostal drainage, which drained about 300 mL bilious fluid per day for a month. Her symptoms of obstructive jaundice were relieved. A pleuro-biliary fistula was demonstrated by percutaneous transhepatic cholangiogram, HIDA scan and ERCP, which showed complete cut-off at the lower end. The patient underwent bilio-enteric bypass with gastric access loop, with complete healing of the pleuro-biliary fistula.- - - - - - - - - - ranking = 0.14285714285714keywords = gas (Clic here for more details about this article) |
10/44. Malignant oesophago-pleuro-pericardial fistula in a patient with oesophageal carcinoma.Pericardial and cardiac fistulae secondary to oesophageal or gastric tumours are a rare complication. We report about a 50-year-old male patient with a 10-month history of distal oesophageal carcinoma with lung and liver metastases who was referred to our hospital after 6 cycles of palliative chemotherapy at the beginning of March 2004. The patient presented with dysphagia, dyspnea, tachycardia, and hypotension. Purulent pericardial and bilateral pleural effusion was diagnosed, and the patient was treated with antibiotics, repeated pleurocentesis and pericardial drainage with daily polihexanide lavage. Oesophagogastroduodenoscopy, Peritrast swallow and computed tomographic scans of chest revealed a malignant oesophago-pleuro-pericardial fistula. A total of three coated, expandable metal stents were inserted into the oesophagus, which sealed successfully the fistula. Unfortunately, the patient succumbed to his carcinoma three months later.- - - - - - - - - - ranking = 0.28571428571429keywords = gas (Clic here for more details about this article) |
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