Cases reported "Pneumothorax"

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1/36. Button battery ingestion: hazards of esophageal impaction.

    Ingestion of button batteries has been seen with increasing frequency over the past decade. In a small number of reported cases, their impaction in the esophagus has led to serious, sometimes fatal, complications. The management of these cases has varied from expectant, supportive therapy to early surgical intervention. The authors report 2 pediatric patients in whom esophageal perforation developed after impaction of a disc battery. Both were treated conservatively with successful outcomes.
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2/36. pneumothorax and pneumoperitoneum during the apnea test: how safe is this procedure?

    apnea test is a crucial requirement for determining the diagnosis of brain death (BD). There are few reports considering clinical complications during this procedure. We describe a major complication during performing the apnea test. We also analyse their practical and legal implications, and review the complications of this procedure in the literature. A 54 year-old man was admitted for impaired consciousness due to a massive intracerebral hemorrhage. Six hours later, he had no motor response, and all brainstem reflexes were negative. The patient fulfilled American Academy of neurology (AAN) criteria for determining BD. During the apnea test, the patient developed pneumothorax, pneumoperitoneum, and finally cardiac arrest. apnea test is a necessary requirement for the diagnosis of brain death. However, it is not innocuous and caution must be take in particular clinical situations. Complications during the apnea test could be more frequent than reported and may have practical and legal implications. Further prospective studies are necessary to evaluate the frequency and nature of complications during this practice.
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3/36. Reexpansion pulmonary edema due to high-frequency jet ventilation: report of a case.

    barotrauma is well known to be a relatively common complication of high-frequency jet ventilation (HFJV); however, the occurrence of reexpansion pulmonary edema (REPE) is extremely rare. We report herein a case of REPE caused by difficulties encountered with anesthesia using HFJV during video-assisted thoracic surgery (VATS) for a spontaneous pneumothorax. We believe the rapid increase in pressure in the lung after degassing for VATS resulted in REPE as well as typical barotrauma.
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4/36. weaning to extubation directly from high-frequency oscillatory ventilation in an infant with cystic lung disease and persistent air leak: a strategy for lung protection.

    We report the successful weaning and extubation of an infant from a SensorMedics 3100A high-frequency oscillator without returning to conventional ventilation. A 7-week-old term infant with respiratory syncytial virus bronchiolitis complicated by cystic pulmonary lesions repeatedly failed attempts to return to conventional ventilation from high-frequency oscillatory ventilation (HFOV) for weaning, because of recurrent pneumothoraces. A computed tomography of the chest revealed multiple well defined cysts of various sizes involving both lungs. Therefore, weaning to extubation from HFOV was proposed as a way of preventing further air leak. The weaning strategy consisted of a technique we refer to as "sprinting." Using this method, the patient was successfully extubated directly from HFOV, with no complications. A follow-up computed tomography of the chest showed marked improvement in the size of the cystic lesions. The patient was discharged home with no need for home oxygen therapy.
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5/36. Current therapy of catamenial pneumothorax.

    Catamenial pneumothorax, or monthly recurring pneumothorax associated with menstruation, has been reported with increasing frequency in recent years. A representative case illustrates the clinical syndrome, particularly the intraoperative findings. Characteristic of this disorder are a peak incidence in the late twenties or early thirties, recurrent right-sided pneumothoraces occurring at the onset of menstruation, and an association with pelvic endometriosis. Pathologically, there is a consistent pattern of intrathoracic, especially diaphragmatic, foci of ectopic endometrial tissue. There is also a strong association with diaphragmatic fenestrations, though their significance is controversial. Traditional therapy has involved treatment with estrogens, danazol, or thoracotomy with mechanical pleurodesis. These methods have proven, through a large meta-analysis, to be associated with a relatively high rate of recurrence. Subsequent advances in hormonal therapy, along with the development of minimal access surgery, have led to an evolution in management. Despite uncertainty as to the etiology of catamenial pneumothorax, diagnosis of the condition is straightforward and modern treatment is successful in preventing recurrence.
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6/36. Management of tension pneumatocele with high-frequency oscillatory ventilation.

    We report the successful application of high-frequency oscillatory ventilation in a patient with tension pneumatocele (TP). The proposed check-valve mechanism for the development of pneumatoceles predicts that positive-pressure ventilation could lead to distension of these airspaces and formation of TPs. Therefore, high-frequency ventilation could be more applicable in conditions, such as massive air leak due to bronchopleural fistula, that are difficult to manage by conventional ventilator modes.
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7/36. tetralogy of fallot with absent pulmonary valve: a case complicated by bilateral relapsing pneumothorax.

    We report a case of a neonate with tetralogy of fallot with aneurysmal dilatation of the pulmonary artery, complicated by bilateral relapsing pneumothorax. The relapsing air leak made it necessary to place up to five chest drains and to switch from conventional ventilation to high frequency ventilation. In the course of 30 days, all drains were removed. Once other anatomical and functional malformations of the respiratory system had been appropriately excluded and reasonable haemodynamic stability had been achieved, the patient underwent successful radical corrective heart surgery in hypothermia and cardioplegia. We emphasize the advantage of resolving respiratory failure preoperatively to guarantee the success of corrective heart surgery and treatment of other surgically severe cases.
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keywords = high frequency, frequency
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8/36. Cathamenial pneumothorax.

    Cathamenial pneumothorax is a relatively low-frequency pathology (approximately 100 cases cited in the literature) characterized by recurrent pneumothorax episodes during the menstruation period. We report on a 34-year-old female patient who had recurrent pneumothorax that did not respond to chest drainage and whose presentation was directly related to the menstruation period. Our patient also had a significant clinical record for pelvic endometriosis. She underwent video-assisted thoracoscopic exploration (VATS) of the pleural cavity and dystrophic parenchymal blebs of the middle lobe were found. An atypical resection of the bollous tissue was performed and pleurodesis completed the intervention. During VATS no ectopic endometriosis foci or diaphragmatic fenestrations (widely considered as a possible cause of this clinical picture) were evidenced.
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9/36. Simultaneous fracture of every cervical vertebra: a case study.

    STUDY DESIGN: The case of a 14-year-old boy who sustained simultaneous fractures of every cervical vertebra in a high-energy snowmobile accident is reported. OBJECTIVE: To describe a case of multiple cervical spine fractures and their management. SUMMARY OF BACKGROUND DATA: Injuries from all-terrain vehicles and off-road vehicles, including snowmobiles, are increasing in severity and frequency. The reported case illustrates a result of high-impact loading in which the driver struck his head after being thrown from a snowmobile at high speed. methods: The 14-year-old boy in the reported case fractured C1-C7, but had no neurologic sequelae. RESULTS: The fractures were treated with a halo vest after traction and reduction of the displaced odontoid fracture. All the fractures healed with no residual cervical instability. CONCLUSIONS: This case report is the first to describe a patient of any age who sustained simultaneous fractures of every cervical vertebra. Treatment with a halo vest was successful in protecting the cervical spine until healing was complete.
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10/36. Management of pneumothorax during percutaneous radiofrequency ablation of a lung tumor: technical note.

    Percutaneous radiofrequency ablation (RFA) is a new procedure to treat lung cancer. pneumothorax (PTX) may occur intraprocedurally, especially with the large RFA probes, and complicate the completion of the treatment. The authors describe a case of PTX developing during RFA and its successful management.
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