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Danielle Cristine Westphal - One of the best experts on this subject based on the ideXlab platform.
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expansion of a Lung Bulla caused by cystic adenomatoid malformation during air travel distensao de bolha pulmonar por malformacao adenomatoide cistica durante viagem aerea
2012Co-Authors: Fernando Luiz Westphal, Luis Carlos De Lima, Jose Correa, Lima Netto, Santos Da Silva, Danielle Cristine WestphalAbstract:Cases of gas embolism in divers who ascend too rapidly from great depths constitute the most common example of barotrauma, cases of barotrauma during air travel being rare. Therefore, we report the case of a 62-year-old male patient who experienced acute respiratory failure due to expansion of a Lung Bulla during air travel. The patient was admitted to an emergency room with intense chest pain and sudden-onset dyspnea during air travel. Immediately after admission, electrocardiography was performed and cardiac enzyme levels were determined. The electrocardiogram and cardiac enzyme levels were found to be normal. A chest X-ray revealed a round hypertransparent area located in the middle third of the left Lung and compressing the Lung parenchyma (Figure 1). An axial CT scan of the chest confirmed the presence of a hypertransparent area occupying the entire anterior segment of the left upper lobe and measuring 12.2 × 9.0 cm, as well as containing a fine liquid layer. No other changes were found. The patient underwent left thoracotomy with selective Lung intubation. We found a Lung Bulla located in the upper lobe and occupying the entire mediastinal surface of the Lung. The affected area was resected and stapled with a mechanical stapler, and abrasion pleurodesis was performed. No other macroscopic changes were observed during the surgical procedure. After the surgical procedure, the patient was transferred to the ICU, where he was woken and extubated. The postoperative evolution was favorable, the chest tube having been removed on postoperative day 5. A follow-up chest X-ray revealed re-expansion of the left Lung and hypotransparent areas in the middle third, which were attributed to the edema and the hematoma at the suture site. The histopathological features of the surgical specimen were found to be consistent with cystic adenomatoid malformation. Cystic adenomatoid malformation of the Lung is generally asymptomatic in adults, the diagnosis being incidental. (3) Changes in the atmospheric pressure can lead to rupture of
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distensao de bolha pulmonar por malformacao adenomatoide cistica durante viagem aerea expansion of a Lung Bulla caused by cystic adenomatoid malformation during air travel
2012Co-Authors: Fernando Luiz Westphal, Luis Carlos De Lima, Jose Correa, Lima Netto, Santos Da Silva, Danielle Cristine WestphalAbstract:O exemplo mais difundido de barotrauma e a embolia gasosa que ocorre em mergulhadores que retornam rapidamente a superficie apos mergulhos em grandes profundidades, sendo raros os casos de barotrauma durante viagens aereas. Por esse motivo, relatamos o caso de um paciente do sexo masculino, 62 anos de idade, que apresentou insuficiencia respiratoria aguda durante viagem aerea, devido a distensao de uma bolha pulmonar.O paciente foi admitido em um servico de pronto-atendimento com quadro de dor toracica de forte intensidade associada a dispneia de inicio subito durante uma viagem aerea. O eletrocardiograma e a dosagem de enzimas cardiacas realizadas imediatamente apos sua chegada foram normais. A radiografia de torax demonstrou uma area de hipertransparencia arredondada, em terco medio do pulmao esquerdo, comprimindo o parenquima pulmonar (Figura 1). A TC axial de torax confirmou a presenca da area de hipertransparencia ocupando todo o segmento anterior do lobo superior esquerdo, medindo 12,2 × 9,0 cm, contendo uma fina camada liquida em seu interior. Nao foram identificadas outras alteracoes. O paciente foi submetido a toracotomia esquerda, com intubacao seletiva do pulmao, sendo encontrada uma bolha pulmonar, localizada no lobo superior, ocupando toda a face mediastinal do pulmao. Foi realizada resseccao e sutura com grampeador mecânico de toda a area comprometida e pleurodese abrasiva. Nao foi observada nenhuma outra alteracao macroscopica durante o ato operatorio. Apos o termino da cirurgia, o paciente foi transferido para a UTI, acordado e extubado. Evoluiu bem no pos-operatorio, com a retirada do dreno pleural no quinto dia. A radiografia de torax de controle mostrou pulmao esquerdo reexpandido, com areas de hipotransparencia em seu terco medio, as quais foram atribuidas ao edema e ao hematoma no local da sutura. O exame histopatologico da peca cirurgica foi compativel com malformacao adenomatoide cistica.A malformacao adenomatoide cistica pulmonar geralmente e assintomatica em adultos, sendo diagnosticada incidentalmente.
Ming Liu - One of the best experts on this subject based on the ideXlab platform.
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Bilateral bullectomy through uniportal video-assisted thoracoscopic surgery combined with contralateral access to the anterior mediastinum.
Jornal brasileiro de pneumologia : publicacao oficial da Sociedade Brasileira de Pneumologia e Tisilogia, 2013Co-Authors: Nan Song, Gening Jiang, Dong Xie, Peng Zhang, Ming LiuAbstract:OBJECTIVE: Video-assisted thoracoscopic surgery (VATS) has been a surgical intervention of choice for the treatment of spontaneous pneumothorax (SP) with Lung Bulla. Our objective was to introduce a uniportal VATS approach for simultaneous bilateral bullectomy and to evaluate its therapeutic efficacy. METHODS: Between May of 2011 and January of 2012, five patients underwent bilateral bullectomy conducted using this approach. All of the patients presented with bilateral SP. Preoperative HRCT revealed that all of the patients had bilateral apical Bullae. We reviewed the surgical indications, surgical procedures, and outcomes. RESULTS: All of the patients were successfully submitted to this approach for bilateral bullectomy, and there were no intraoperative complications. The median time to chest tube removal was 4.2 days, and the median length of the postoperative hospital stay was 5.2 days. The median postoperative follow-up period was 11.2 months. One patient experienced recurrence of left SP three weeks after the surgery and underwent pleural abrasion. CONCLUSIONS: Bilateral bullectomy through uniportal VATS combined with contralateral access to the anterior mediastinum is technically reliable and provides favorable surgical outcomes for patients with bilateral SP who develop bilateral apical Bullae. However, among other requirements, this surgical procedure demands that surgeons be experienced in VATS and that the appropriate thoracoscopic instruments are available.
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Bulectomia bilateral por cirurgia torácica vídeo-assistida uniportal combinada com acesso contralateral ao mediastino anterior Bilateral bullectomy through uniportal video-assisted thoracoscopic surgery combined with contralateral access to the anter
Sociedade Brasileira de Pneumologia e Tisiologia, 2013Co-Authors: Nan Song, Gening Jiang, Dong Xie, Peng Zhang, Ming LiuAbstract:OBJETIVO: A cirurgia torácica vídeo-assistida (CTVA) tem sido uma intervenção de escolha para o tratamento de pneumotórax espontâneo (PS) com bolha pulmonar. Nosso objetivo foi apresentar uma abordagem de CTVA uniportal unilateral para bulectomia bilateral e avaliar sua eficácia terapêutica. MÉTODOS: Entre maio de 2011 e janeiro de 2012, cinco pacientes foram submetidos a bulectomia bilateral por essa abordagem. Todos apresentavam PS bilateral. A TCAR pré-operatória mostrou que todos os pacientes tinham bolhas bilaterais no pulmão apical. As indicações cirúrgicas, os procedimentos de operação e os desfechos foram revisados. RESULTADOS: Todos os pacientes foram submetidos com sucesso a essa abordagem para bulectomia bilateral, sem complicações intraoperatórias. A mediana de tempo para a retirada do dreno torácico foi de 4,2 dias, e a mediana do tempo de hospitalização no pós-operatório foi de 5,2 dias. A mediana de seguimento pós-operatório foi de 11,2 meses. Um paciente teve recidiva de PE do lado esquerdo três semanas após a cirurgia e foi submetido a abrasão pleural. CONCLUSÕES: A bulectomia bilateral utilizando CTVA uniportal combinada com acesso contralateral ao mediastino anterior é tecnicamente confiável e promove desfechos favoráveis para pacientes com PS que desenvolvem bolhas bilaterais no pulmão apical. Entretanto, para a realização desse procedimento cirúrgico, são necessários cirurgiões com experiência em CTVA, instrumentos toracoscópicos longos, entre outras exigências.OBJECTIVE: Video-assisted thoracoscopic surgery (VATS) has been a surgical intervention of choice for the treatment of spontaneous pneumothorax (SP) with Lung Bulla. Our objective was to introduce a uniportal VATS approach for simultaneous bilateral bullectomy and to evaluate its therapeutic efficacy. METHODS: Between May of 2011 and January of 2012, five patients underwent bilateral bullectomy conducted using this approach. All of the patients presented with bilateral SP. Preoperative HRCT revealed that all of the patients had bilateral apical Bullae. We reviewed the surgical indications, surgical procedures, and outcomes. RESULTS: All of the patients were successfully submitted to this approach for bilateral bullectomy, and there were no intraoperative complications. The median time to chest tube removal was 4.2 days, and the median length of the postoperative hospital stay was 5.2 days. The median postoperative follow-up period was 11.2 months. One patient experienced recurrence of left SP three weeks after the surgery and underwent pleural abrasion. CONCLUSIONS: Bilateral bullectomy through uniportal VATS combined with contralateral access to the anterior mediastinum is technically reliable and provides favorable surgical outcomes for patients with bilateral SP who develop bilateral apical Bullae. However, among other requirements, this surgical procedure demands that surgeons be experienced in VATS and that the appropriate thoracoscopic instruments are available
Fernando Luiz Westphal - One of the best experts on this subject based on the ideXlab platform.
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expansion of a Lung Bulla caused by cystic adenomatoid malformation during air travel distensao de bolha pulmonar por malformacao adenomatoide cistica durante viagem aerea
2012Co-Authors: Fernando Luiz Westphal, Luis Carlos De Lima, Jose Correa, Lima Netto, Santos Da Silva, Danielle Cristine WestphalAbstract:Cases of gas embolism in divers who ascend too rapidly from great depths constitute the most common example of barotrauma, cases of barotrauma during air travel being rare. Therefore, we report the case of a 62-year-old male patient who experienced acute respiratory failure due to expansion of a Lung Bulla during air travel. The patient was admitted to an emergency room with intense chest pain and sudden-onset dyspnea during air travel. Immediately after admission, electrocardiography was performed and cardiac enzyme levels were determined. The electrocardiogram and cardiac enzyme levels were found to be normal. A chest X-ray revealed a round hypertransparent area located in the middle third of the left Lung and compressing the Lung parenchyma (Figure 1). An axial CT scan of the chest confirmed the presence of a hypertransparent area occupying the entire anterior segment of the left upper lobe and measuring 12.2 × 9.0 cm, as well as containing a fine liquid layer. No other changes were found. The patient underwent left thoracotomy with selective Lung intubation. We found a Lung Bulla located in the upper lobe and occupying the entire mediastinal surface of the Lung. The affected area was resected and stapled with a mechanical stapler, and abrasion pleurodesis was performed. No other macroscopic changes were observed during the surgical procedure. After the surgical procedure, the patient was transferred to the ICU, where he was woken and extubated. The postoperative evolution was favorable, the chest tube having been removed on postoperative day 5. A follow-up chest X-ray revealed re-expansion of the left Lung and hypotransparent areas in the middle third, which were attributed to the edema and the hematoma at the suture site. The histopathological features of the surgical specimen were found to be consistent with cystic adenomatoid malformation. Cystic adenomatoid malformation of the Lung is generally asymptomatic in adults, the diagnosis being incidental. (3) Changes in the atmospheric pressure can lead to rupture of
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distensao de bolha pulmonar por malformacao adenomatoide cistica durante viagem aerea expansion of a Lung Bulla caused by cystic adenomatoid malformation during air travel
2012Co-Authors: Fernando Luiz Westphal, Luis Carlos De Lima, Jose Correa, Lima Netto, Santos Da Silva, Danielle Cristine WestphalAbstract:O exemplo mais difundido de barotrauma e a embolia gasosa que ocorre em mergulhadores que retornam rapidamente a superficie apos mergulhos em grandes profundidades, sendo raros os casos de barotrauma durante viagens aereas. Por esse motivo, relatamos o caso de um paciente do sexo masculino, 62 anos de idade, que apresentou insuficiencia respiratoria aguda durante viagem aerea, devido a distensao de uma bolha pulmonar.O paciente foi admitido em um servico de pronto-atendimento com quadro de dor toracica de forte intensidade associada a dispneia de inicio subito durante uma viagem aerea. O eletrocardiograma e a dosagem de enzimas cardiacas realizadas imediatamente apos sua chegada foram normais. A radiografia de torax demonstrou uma area de hipertransparencia arredondada, em terco medio do pulmao esquerdo, comprimindo o parenquima pulmonar (Figura 1). A TC axial de torax confirmou a presenca da area de hipertransparencia ocupando todo o segmento anterior do lobo superior esquerdo, medindo 12,2 × 9,0 cm, contendo uma fina camada liquida em seu interior. Nao foram identificadas outras alteracoes. O paciente foi submetido a toracotomia esquerda, com intubacao seletiva do pulmao, sendo encontrada uma bolha pulmonar, localizada no lobo superior, ocupando toda a face mediastinal do pulmao. Foi realizada resseccao e sutura com grampeador mecânico de toda a area comprometida e pleurodese abrasiva. Nao foi observada nenhuma outra alteracao macroscopica durante o ato operatorio. Apos o termino da cirurgia, o paciente foi transferido para a UTI, acordado e extubado. Evoluiu bem no pos-operatorio, com a retirada do dreno pleural no quinto dia. A radiografia de torax de controle mostrou pulmao esquerdo reexpandido, com areas de hipotransparencia em seu terco medio, as quais foram atribuidas ao edema e ao hematoma no local da sutura. O exame histopatologico da peca cirurgica foi compativel com malformacao adenomatoide cistica.A malformacao adenomatoide cistica pulmonar geralmente e assintomatica em adultos, sendo diagnosticada incidentalmente.
D. E. Amundson - One of the best experts on this subject based on the ideXlab platform.
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Spontaneous regression of a giant pulmonary Bulla.
Thorax, 1996Co-Authors: D. A. Bradshaw, K. M. Murray, D. E. AmundsonAbstract:Gradual expansion of a Lung Bulla is common and may be associated with debilitating pulmonary symptoms. The aetiology of Bulla expansion is unclear. Spontaneous regression, on the other hand, is rarely observed. The case is presented of a man in whom near complete spontaneous resolution of a giant pulmonary Bulla occurred. This event was associated with dramatic improvement in the radiographic picture and pulmonary function.
Nan Song - One of the best experts on this subject based on the ideXlab platform.
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Bilateral bullectomy through uniportal video-assisted thoracoscopic surgery combined with contralateral access to the anterior mediastinum.
Jornal brasileiro de pneumologia : publicacao oficial da Sociedade Brasileira de Pneumologia e Tisilogia, 2013Co-Authors: Nan Song, Gening Jiang, Dong Xie, Peng Zhang, Ming LiuAbstract:OBJECTIVE: Video-assisted thoracoscopic surgery (VATS) has been a surgical intervention of choice for the treatment of spontaneous pneumothorax (SP) with Lung Bulla. Our objective was to introduce a uniportal VATS approach for simultaneous bilateral bullectomy and to evaluate its therapeutic efficacy. METHODS: Between May of 2011 and January of 2012, five patients underwent bilateral bullectomy conducted using this approach. All of the patients presented with bilateral SP. Preoperative HRCT revealed that all of the patients had bilateral apical Bullae. We reviewed the surgical indications, surgical procedures, and outcomes. RESULTS: All of the patients were successfully submitted to this approach for bilateral bullectomy, and there were no intraoperative complications. The median time to chest tube removal was 4.2 days, and the median length of the postoperative hospital stay was 5.2 days. The median postoperative follow-up period was 11.2 months. One patient experienced recurrence of left SP three weeks after the surgery and underwent pleural abrasion. CONCLUSIONS: Bilateral bullectomy through uniportal VATS combined with contralateral access to the anterior mediastinum is technically reliable and provides favorable surgical outcomes for patients with bilateral SP who develop bilateral apical Bullae. However, among other requirements, this surgical procedure demands that surgeons be experienced in VATS and that the appropriate thoracoscopic instruments are available.
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Bulectomia bilateral por cirurgia torácica vídeo-assistida uniportal combinada com acesso contralateral ao mediastino anterior Bilateral bullectomy through uniportal video-assisted thoracoscopic surgery combined with contralateral access to the anter
Sociedade Brasileira de Pneumologia e Tisiologia, 2013Co-Authors: Nan Song, Gening Jiang, Dong Xie, Peng Zhang, Ming LiuAbstract:OBJETIVO: A cirurgia torácica vídeo-assistida (CTVA) tem sido uma intervenção de escolha para o tratamento de pneumotórax espontâneo (PS) com bolha pulmonar. Nosso objetivo foi apresentar uma abordagem de CTVA uniportal unilateral para bulectomia bilateral e avaliar sua eficácia terapêutica. MÉTODOS: Entre maio de 2011 e janeiro de 2012, cinco pacientes foram submetidos a bulectomia bilateral por essa abordagem. Todos apresentavam PS bilateral. A TCAR pré-operatória mostrou que todos os pacientes tinham bolhas bilaterais no pulmão apical. As indicações cirúrgicas, os procedimentos de operação e os desfechos foram revisados. RESULTADOS: Todos os pacientes foram submetidos com sucesso a essa abordagem para bulectomia bilateral, sem complicações intraoperatórias. A mediana de tempo para a retirada do dreno torácico foi de 4,2 dias, e a mediana do tempo de hospitalização no pós-operatório foi de 5,2 dias. A mediana de seguimento pós-operatório foi de 11,2 meses. Um paciente teve recidiva de PE do lado esquerdo três semanas após a cirurgia e foi submetido a abrasão pleural. CONCLUSÕES: A bulectomia bilateral utilizando CTVA uniportal combinada com acesso contralateral ao mediastino anterior é tecnicamente confiável e promove desfechos favoráveis para pacientes com PS que desenvolvem bolhas bilaterais no pulmão apical. Entretanto, para a realização desse procedimento cirúrgico, são necessários cirurgiões com experiência em CTVA, instrumentos toracoscópicos longos, entre outras exigências.OBJECTIVE: Video-assisted thoracoscopic surgery (VATS) has been a surgical intervention of choice for the treatment of spontaneous pneumothorax (SP) with Lung Bulla. Our objective was to introduce a uniportal VATS approach for simultaneous bilateral bullectomy and to evaluate its therapeutic efficacy. METHODS: Between May of 2011 and January of 2012, five patients underwent bilateral bullectomy conducted using this approach. All of the patients presented with bilateral SP. Preoperative HRCT revealed that all of the patients had bilateral apical Bullae. We reviewed the surgical indications, surgical procedures, and outcomes. RESULTS: All of the patients were successfully submitted to this approach for bilateral bullectomy, and there were no intraoperative complications. The median time to chest tube removal was 4.2 days, and the median length of the postoperative hospital stay was 5.2 days. The median postoperative follow-up period was 11.2 months. One patient experienced recurrence of left SP three weeks after the surgery and underwent pleural abrasion. CONCLUSIONS: Bilateral bullectomy through uniportal VATS combined with contralateral access to the anterior mediastinum is technically reliable and provides favorable surgical outcomes for patients with bilateral SP who develop bilateral apical Bullae. However, among other requirements, this surgical procedure demands that surgeons be experienced in VATS and that the appropriate thoracoscopic instruments are available
