Cases reported "Empyema"

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1/40. Developing bronchial fistulas as a late complication of extraperiosteal plombage.

    A 65-year-old male, who underwent extraperiosteal plombage for pulmonary tuberculosis 46 years ago, was referred to our hospital due to relapsing hemosputa and pneumonia. A chest computed tomography scan revealed a bronchial fistula and a fluid collection in one Lucite ball. On May 20, 1996, a right-anterior thoracotomy was performed in a supine position. Five Lucite balls were removed, and the empyema space was tightly filled with an omental pedicle flap. Although the bronchial fistulas were not sutured directly, the air leakage from the drainage tube ceased 12 days later. Two years postoperatively the patient has remained well. Our simple approach of combining an anterior thoracotomy and replacement of an empyema space with an omental pedicle flap in the same posture, without closing bronchial fistulas, would be an easy procedure, and therefore exploitable in patients who have a similar problem.
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ranking = 1
keywords = fistula
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2/40. The anaesthetic management of a deliberately created bronchoatmospheric fistula in bilateral pulmonary hydatids.

    Postoperative empyema and bronchopleural fistula are well known complications after surgery for pulmonary hydatid disease. The pneumonostomy technique of deliberately creating a bronchoatmospheric fistula after removal of the parasite has been used to prevent these complications. This technique, however, is an added anaesthetic challenge, especially if the child presents again for surgery before this fistula has healed. We describe the anaesthetic management of such a case where controlled increase of the resistance to the air leak via the fistula during intermittent positive pressure ventilation helped circumvent these problems.
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ranking = 1.1428571428571
keywords = fistula
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3/40. Refractory empyema caused by an intraoperative rib fracture sustained during esophagectomy: report of a case.

    A 57-year-old woman underwent esophagectomy with three-field lymphadenectomy for lower esophageal cancer, followed by gastric roll reconstruction through the posterior mediastinum. A laparotomy and right thoracotomy with partial resection of the right fifth rib were performed. A purulent discharge requiring drainage developed postoperatively and continued for 3 months despite anastomotic integrity and the absence of a bronchopleural fistula. An empyema developed 3 months after drain removal, and a thoracostomy tube was reinserted. A displaced fragment of the right fifth rib was identified within the abscess cavity. drainage and irrigation were not curative, and removal of the bone fragment was performed 18 months after the initial procedure. The patient has been symptom-free during 1 year of follow-up. We believe that the rib fragment functioned as a foreign body, which complicated treatment of the patient's postoperative infection.
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ranking = 0.14285714285714
keywords = fistula
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4/40. Infected esophageal duplication cyst simulating empyema.

    Duplications of the esophagus are the second most common duplication of the gastrointestinal tract. The children with esophageal duplication cyst usually present with respiratory distress or as asymptomatic thoracic mass found on incidental chest x-ray. We report a case of infected esophageal duplication cyst initially confused with empyema in a two years old boy.
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ranking = 0.00065594307984724
keywords = dental
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5/40. carcinoma arising in the pleural cavity following pneumonectomy for hydatid disease.

    We report a case of carcinoma following 42 years of chronic empyema in a patient who underwent surgery for a hydatid cyst at the age of 3. At the time of diagnosis, an esophageal fistula was observed and treated with cyanoacrylate. We hypothesize that chronic inflammation of the pleura, caused by decades of empyema, associated with the presence of heterotopic squamous epithelium due to a long-standing esophago-pleural fistula, led to neoplastic transformation.
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ranking = 0.28571428571429
keywords = fistula
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6/40. A novel procedure using a tissue expander for management of persistent alveolar fistula after lobectomy.

    We treated a patient with postlobectomy persistent alveolar fistula using a tissue expander, which is a prosthesis widely used in plastic surgery. The patient had thoracic empyema develop after right bilobectomy for lung cancer, and consequently underwent drainage of empyema followed by muscle flap closure for alveolar fistula. A residual space remained, and air leak persisted. However, implanting and expanding a tissue expander enabled us to tightly fix the flap on the raw pulmonary surface, which eventually solved the air leak. The tissue expander greatly contributed to muscle flap closure for a persistent alveolar-pleural fistula with a large remaining thoracic space.
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ranking = 1
keywords = fistula
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7/40. Intraorbital abscess: a rare complication after maxillary molar extraction.

    BACKGROUND: The orbit is prone to being affected by an odontogenous infection, owing to its anatomical proximity to the maxillary sinus. A possible reason for an ophthalmic manifestation of a dental abscess is extraction of an acutely inflamed tooth. CASE DESCRIPTION: The authors describe the treatment of a man who had painful swelling and redness in the area of his right eye after having a maxillary molar extracted a few days previous. A general dentist referred the patient to the clinic after he began to experience a progressive deterioration of vision of his right eye. Emergency surgical intervention prevented impending loss of vision, and subsequent healing was uneventful. CLINICAL IMPLICATIONS: To avoid serious complications, clinicians should not perform a tooth extraction when the patient is in the acute stage of a maxillary sinus infection. Appropriate diagnostic imaging and profound evaluation of the clinical state play major roles in managing the treatment of patients with inflammatory processes that involve the oral and paraoral regions.
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ranking = 0.00065594307984724
keywords = dental
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8/40. Closure of a large bronchial fistula with a latissimus dorsi myocutaneous flap.

    We describe a case of a large bronchial fistula and empyema after right upper lobectomy that was treated successfully with open window thoracostomy followed by a latissimus dorsi myocutaneous flap and limited thoracoplasty. A latissimus dorsi myocutaneous flap can provide immediate airtight closure of a large bronchial fistula, allowing lavage and curettage of the empyema cavity to reduce the chance of postoperative infection. An important aspect of this technique is that the deepithelialized skin side rather than muscle is sutured to an opening of the bronchus. As compared with other techniques, a latissimus dorsi myocutaneous flap is superior in that it requires a single incision and does not require an intraoperative change of position. In addition, the technique causes little dysfunction of the chest and shoulder and preserves the vascular supply to ensure the viability of the flap even if it was divided in a previous operation.
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ranking = 0.85714285714286
keywords = fistula
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9/40. Management of empyema cavity with the vacuum-assisted closure device.

    Management of empyema after pulmonary resection remains a challenging problem. Along with mandatory drainage of the thoracic cavity and investigations to rule out bronchopleural fistula, a reliable method of thoracic cavity closure is needed. The open thoracic window and Eloesser flap techniques rarely represent definitive therapy. Muscle flap and thoracoplasty procedures may provide well-vascularized tissue to close bronchopleural fistula and obliterate the empyema cavity, but they are quite complex and involve significant patient morbidity. We report a case of empyema without bronchopleural fistula after lobectomy in which the vacuum-assisted closure device was used to achieve complete wound healing after open drainage.
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ranking = 0.42857142857143
keywords = fistula
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10/40. Group F streptococcal empyema from aspiration of a grass inflorescence.

    A previously healthy 15-year-old boy was seen with a loculated right lower lobe empyema. Group F beta-hemolytic streptococci were cultured from the pleural fluid. Surgical intervention was required. An unsuspected aspirated grass inflorescence and a bronchopleural fistula were discovered during a decortication procedure.
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ranking = 0.14285714285714
keywords = fistula
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