Cases reported "Emphysema"

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1/6. Percutaneous drainage of emphysematous cholecystitis associated with pneumoperitoneum.

    emphysematous cholecystitis, a relatively rare variant of acute cholecystitis, is associated with high morbidity and mortality rates. In the presence of a concomitant pneumoperitoneum, these rates may be considered even higher, approaching those of perforation of the gallbladder. The first choice of treatment in cases presenting with pneumoperitoneum is emergency laparotomy. We performed a staged procedure as a second best alternative. In a 65 year-old female patient, initial percutaneous cholecystostomy with a strict intravenous antibiotics regimen, and subsequent cholecystectomy 6 months, later was carried out with successful outcome. A review of the literature revealed 13 other cases of this combination. Treatment modalities and outcome of these patients are discussed.
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2/6. Complications of a retrograde intubation in a trauma patient.

    The authors report the case of an elder woman involved in a motor vehicle collision (MVC) requiring emergent intubation using the technique of retrograde intubation (RI). Since RI is a blind technique, potential complications arising from its use are numerous and may result in increased morbidity and mortality. Such was the case of this RI that involved incorrect placement of the endotracheal tube (ETT), resulting in suboptimal ventilation and increased morbidity. Additionally, this case illustrates how the failure to detect this error in multiple settings (ambulance, helicopter, emergency department) led to unnecessary and potentially deleterious procedures and significant delay in providing the basics of trauma care, oxygenation and ventilation. Although theoretical complications of RI have been addressed in the past, there have been very few published reports of actual complications. The emergency physician must be aware of difficult airways, options available to establish alternative airways, and methods to confirm appropriate placement of the ETT. The authors also discuss the indications, procedures, and complications involved in performing an RI.
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3/6. Primary lung cancer: treatment with radio-frequency thermal ablation.

    Primary lung cancer is the most frequently diagnosed malignancy in the world and the leading cause of death from cancer [1]. When the initial diagnosis is made, most cases are inoperable or the patients' condition does not permit surgical interventions [2]. For patients with inoperable lung cancer, percutaneous radio-frequency thermal ablation (RFA) under CT guidance represents an alternative and minimally invasive treatment. It can also be applied in combination with radiation therapy and chemotherapy. We report three cases treated by percutaneous CT-guided RF ablation, from which two had post-operative recurrent tumor and one was inoperable.
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4/6. Percutaneous drainage in emphysematous pyelonephritis--an alternative to major surgery.

    Emphysematous pyelonephritis is a rare, life-threatening infection of the kidney associated with the production of gas, usually found in diabetic patients. Experience of this condition reported in the literature suggests that vigorous medical treatment and early nephrectomy are advisable. We report a case in which percutaneous renal drainage combined with medical therapy produced not only complete recovery of the patient, but also preservation of renal function on the affected side.
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5/6. Emphysematous pyelonephritis in a solitary kidney.

    A middle-aged female diabetic presented with ureteral obstruction, renal failure and emphysematous pyelonephritis in a solitary kidney. She was treated non-operatively with intensive antimicrobial therapy, prolonged ureteral catheter drainage and dialysis. Good recovery of renal architecture and function was eventually obtained. Although the usual indications for surgical extirpation or drainage of the kidney with emphysematous pyelonephritis seem to be well established circumstances may occasionally dictate an alternative course of action.
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6/6. lung-volume reduction in parallel with coronary heart surgery: a case report.

    For patients with severe disabling emphysema, lung-volume reduction surgery has recently been introduced as an alternative to transplantation. Performing parenchyma resection from appropriate areas can improve pulmonary functions in selected patients having severe emphysema with a flattened diaphragm. We report the case of a patient, who urgently needed coronary revascularization and was otherwise inoperable because of severe chronic obstructive pulmonary disease (COPD). We carried out lung-volume reduction surgery at the same time as the coronary bypass.
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