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[PMID]:29132573
[Au] Autor:Schellenberg M; Inaba K
[Ad] Endereço:Division of Trauma and Surgical Critical Care, LAC+USC Medical Center, University of Southern California, 2051 Marengo Street, IPT C5L100, Los Angeles, CA 90033, USA.
[Ti] Título:Critical Decisions in the Management of Thoracic Trauma.
[So] Source:Emerg Med Clin North Am;36(1):135-147, 2018 Feb.
[Is] ISSN:1558-0539
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Traumatic injuries to the thorax are common after both blunt and penetrating trauma. Emergency medicine physicians must be able to manage the initial resuscitation and diagnostic workup of these patients. This involves familiarity with a range of radiologic investigations and invasive bedside procedures, including resuscitative thoracotomy. This knowledge is critical to allow for rapid decision making when life-threatening injuries are encountered. This article explores the initial resuscitation and assessment of patients after thoracic trauma, discusses available imaging modalities, reviews frequently performed procedures, and provides an overview of the indications for operative intervention, while emphasizing the critical decision making throughout.
[Mh] Termos MeSH primário: Traumatismos Torácicos/terapia
[Mh] Termos MeSH secundário: Serviço Hospitalar de Emergência
Parada Cardíaca/diagnóstico
Parada Cardíaca/terapia
Seres Humanos
Ressuscitação
Traumatismos Torácicos/diagnóstico
Traumatismos Torácicos/diagnóstico por imagem
Toracostomia
Toracotomia
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171128
[Lr] Data última revisão:
171128
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171115
[St] Status:MEDLINE


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[PMID]:28958357
[Au] Autor:Dennis BM; Bellister SA; Guillamondegui OD
[Ad] Endereço:Division of Trauma, Surgical Critical Care, and Emergency General Surgery, Department of Surgery, Vanderbilt University Medical Center, 1211 21st Avenue South, 404 Medical Arts Building, Nashville, TN 37212, USA. Electronic address: Bradley.m.dennis@vanderbilt.edu.
[Ti] Título:Thoracic Trauma.
[So] Source:Surg Clin North Am;97(5):1047-1064, 2017 Oct.
[Is] ISSN:1558-3171
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Management of chest trauma is integral to patient outcomes owing to the vital structures held within the thoracic cavity. Understanding traumatic chest injuries and appropriate management plays a pivotal role in the overall well-being of both blunt and penetrating trauma patients. Whether the injury includes rib fractures, associated pulmonary injuries, or tracheobronchial tree injuries, every facet of management may impact the short- and long-term outcomes, including mortality. This article elucidates the workup and management of the thoracic cage, pulmonary and tracheobronchial injuries.
[Mh] Termos MeSH primário: Pneumotórax/terapia
Traumatismos Torácicos/terapia
[Mh] Termos MeSH secundário: Seres Humanos
Pneumotórax/diagnóstico por imagem
Pneumotórax/etiologia
Fraturas das Costelas/diagnóstico por imagem
Fraturas das Costelas/terapia
Traumatismos Torácicos/complicações
Traumatismos Torácicos/diagnóstico por imagem
Toracostomia
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171004
[Lr] Data última revisão:
171004
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170930
[St] Status:MEDLINE


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[PMID]:28898380
[Au] Autor:Imran JB; Eastman AL
[Ti] Título:Pneumothorax.
[So] Source:JAMA;318(10):974, 2017 09 12.
[Is] ISSN:1538-3598
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Pneumotórax
[Mh] Termos MeSH secundário: Seres Humanos
Pneumotórax/diagnóstico
Pneumotórax/etiologia
Pneumotórax/terapia
Toracostomia
[Pt] Tipo de publicação:PATIENT EDUCATION HANDOUT
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170928
[Lr] Data última revisão:
170928
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170913
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2017.10476


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[PMID]:28391778
[Au] Autor:Lee J; Cho JS; I H; Kim YD
[Ad] Endereço:Department of Thoracic and Cardiovascular Surgery, Jeju National University Hospital, Jeju National University School of Medicine, Jeju, South Korea.
[Ti] Título:Delayed right chylothorax after left blunt chest trauma: a case report.
[So] Source:J Med Case Rep;11(1):98, 2017 Apr 10.
[Is] ISSN:1752-1947
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Chylothorax is a disease that has various causes such as neoplasm, infection, post-surgery trauma, congenital, and venous thrombosis. In approximately 15% of cases of chylothorax, the exact cause is unknown. We report a case of delayed occurrence of right chylothorax in a patient who had multiple segmental ribs fracture on his left side. CASE PRESENTATION: A 70-year-old Asian man had a "rollover" accident in which the cultivator he was driving overturned. He presented to our hospital with the main complaint of severe dyspnea. On chest computed tomography, multiple ribs fracture from the first to the eighth rib of the left side of his chest and left-sided hemopneumothorax were presented, but there was no evidence of fracture in the right side of his chest. After closed thoracostomy, an emergency operation for open reduction of fractured ribs was performed. On the fifth postoperative day, tubal feeding was performed. On the next day, a plain chest X-ray image showed pleural effusion of the right side of his chest. After insertion of a small-bore chest tube, 3390 ml of fluid for 24 hours was drained. The body fluid analysis revealed triglycerides levels of 1000 mg/dL, which led to a diagnosis of chylothorax. Although non-oral feeding and total parenteral nutrition were sustained, drain amount was increased on the fifth day. Surgical treatment (thoracoscopic thoracic duct ligation and pleurectomy) was performed in the early phase. The right chest tube was removed on the 14th postoperative day after the effusion completely resolved and he was uneventfully discharged. CONCLUSIONS: In this case, as our patient was in old age and had multiple traumas, surgical treatment for chylothorax needed to be performed in the early phase.
[Mh] Termos MeSH primário: Quilotórax/diagnóstico
Derrame Pleural/diagnóstico
Fraturas das Costelas/diagnóstico por imagem
Traumatismos Torácicos/diagnóstico por imagem
Toracostomia
Ferimentos não Penetrantes/diagnóstico por imagem
[Mh] Termos MeSH secundário: Idoso
Tubos Torácicos
Quilotórax/cirurgia
Drenagem/instrumentação
Seres Humanos
Masculino
Derrame Pleural/terapia
Radiografia Torácica
Fraturas das Costelas/cirurgia
Ducto Torácico/cirurgia
Traumatismos Torácicos/complicações
Traumatismos Torácicos/cirurgia
Toracostomia/métodos
Tomografia Computadorizada por Raios X
Resultado do Tratamento
Ferimentos não Penetrantes/complicações
Ferimentos não Penetrantes/cirurgia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170911
[Lr] Data última revisão:
170911
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170411
[St] Status:MEDLINE
[do] DOI:10.1186/s13256-017-1250-2


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[PMID]:28383466
[Au] Autor:Leatherman ML; Held JM; Fluke LM; McEvoy CS; Inaba K; Grabo D; Martin MJ; Earley AS; Ricca RL; Polk TM
[Ad] Endereço:From the Department of Surgery (M.L.L., J.M.H., L.M.F., A.S.E., R.L.R., T.M.P.), Naval Medical Center Portsmouth, Portsmouth, Virginia (C.S.M.); Department of Surgery (K.I., D.G.), LAC+USC Medical Center, Los Angeles, CA; Navy Trauma Training Center (D.G.), Los Angeles, California; and Madigan Army Medical Center, Tacoma, Washington (M.J.M.).
[Ti] Título:Relative device stability of anterior versus axillary needle decompression for tension pneumothorax during casualty movement: Preliminary analysis of a human cadaver model.
[So] Source:J Trauma Acute Care Surg;83(1 Suppl 1):S136-S141, 2017 Jul.
[Is] ISSN:2163-0763
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Tension pneumothorax (tPTX) remains a significant cause of potentially preventable death in military and civilian settings. The current prehospital standard of care for tPTX is immediate decompression with a 14-gauge 8-cm angiocatheter; however, failure rates may be as high as 17% to 60%. Alternative devices, such as 10-gauge angiocatheter, modified Veress needle, and laparoscopic trocar, have shown to be potentially more effective in animal models; however, little is known about the relative insertional safety or mechanical stability during casualty movement. METHODS: Seven soft-embalmed cadavers were intubated and mechanically ventilated. Chest wall thickness was measured at the second intercostal space at the midclavicular line (2MCL) and the fifth intercostal space along the anterior axillary line (5AAL). CO2 insufflation created a PTX, and needle decompression was then performed with a randomized device. Insertional depth was measured between hub and skin before and after simulated casualty transport. Thoracoscopy was used to evaluate for intrapleural placement and/or injury during insertion and after movement. Cadaver demographics, device displacement, device dislodgment, and injuries were recorded. Three decompressions were performed at each site (2MCL/5AAL), totaling 12 events per cadaver. RESULTS: Eighty-four decompressions were performed. Average cadaver age was 59 years, and body mass index was 24 kg/m. The CWT varied between cadavers because of subcutaneous emphysema, but the average was 39 mm at the 2MCL and 31 mm at the 5AAL. Following movement, the 2MCL site was more likely to become dislodged than the 5AAL (67% vs. 17%, p = 0.001). Median displacement also differed between 2MCL and 5AAL (23 vs. 2 mm, p = 0.001). No significant differences were noted in dislodgement or displacement between devices. Five minor lung injuries were noted at the 5AAL position. CONCLUSION: Preliminary results from this human cadaver study suggest the 5AAL position is a more stable and reliable location for thoracic decompression of tPTX during combat casualty transport. LEVEL OF EVIDENCE: Therapeutic study, level III.
[Mh] Termos MeSH primário: Descompressão Cirúrgica/instrumentação
Agulhas
Pneumotórax/cirurgia
Toracostomia/instrumentação
[Mh] Termos MeSH secundário: Axila
Cadáver
Feminino
Seres Humanos
Masculino
Meia-Idade
Transporte de Pacientes
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170830
[Lr] Data última revisão:
170830
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170407
[St] Status:MEDLINE
[do] DOI:10.1097/TA.0000000000001488


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[PMID]:28304084
[Au] Autor:Redden MD; Chin TY; van Driel ML
[Ad] Endereço:Ipswich Hospital, Ipswich, Queensland, Australia.
[Ti] Título:Surgical versus non-surgical management for pleural empyema.
[So] Source:Cochrane Database Syst Rev;3:CD010651, 2017 Mar 17.
[Is] ISSN:1469-493X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Empyema refers to pus in the pleural space, commonly due to adjacent pneumonia, chest wall injury, or a complication of thoracic surgery. A range of therapeutic options are available for its management, ranging from percutaneous aspiration and intercostal drainage to video-assisted thoracoscopic surgery (VATS) or thoracotomy drainage. Intrapleural fibrinolytics may also be administered following intercostal drain insertion to facilitate pleural drainage. There is currently a lack of consensus regarding optimal treatment. OBJECTIVES: To assess the effectiveness and safety of surgical versus non-surgical treatments for complicated parapneumonic effusion or pleural empyema. SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (2016, Issue 9), MEDLINE (Ebscohost) (1946 to July week 3 2013, July 2015 to October 2016) and MEDLINE (Ovid) (1 May 2013 to July week 1 2015), Embase (2010 to October 2016), CINAHL (1981 to October 2016) and LILACS (1982 to October 2016) on 20 October 2016. We searched ClinicalTrials.gov and WHO International Clinical Trials Registry Platform for ongoing studies (December 2016). SELECTION CRITERIA: Randomised controlled trials that compared a surgical with a non-surgical method of management for all age groups with pleural empyema. DATA COLLECTION AND ANALYSIS: Two review authors independently assessed trials for inclusion and risk of bias, extracted data, and checked the data for accuracy. We contacted trial authors for additional information. We assessed the quality of the evidence using the GRADE approach. MAIN RESULTS: We included eight randomised controlled trials with a total of 391 participants. Six trials focused on children and two on adults. Trials compared tube thoracostomy drainage (non-surgical), with or without intrapleural fibrinolytics, to either VATS or thoracotomy (surgical) for the management of pleural empyema. Assessment of risk of bias for the included studies was generally unclear for selection and blinding but low for attrition and reporting bias. Data analyses compared thoracotomy versus tube thoracostomy and VATS versus tube thoracostomy. We pooled data for meta-analysis where appropriate. We performed a subgroup analysis for children along with a sensitivity analysis for studies that used fibrinolysis in non-surgical treatment arms.The comparison of open thoracotomy versus thoracostomy drainage included only one study in children, which reported no deaths in either treatment arm. However, the trial showed a statistically significant reduction in mean hospital stay of 5.90 days for those treated with primary thoracotomy. It also showed a statistically significant reduction in procedural complications for those treated with thoracotomy compared to thoracostomy drainage. We downgraded the quality of the evidence for length of hospital stay and procedural complications outcomes to moderate due to the small sample size.The comparison of VATS versus thoracostomy drainage included seven studies, which we pooled in a meta-analysis. There was no statistically significant difference in mortality or procedural complications between groups. This was true for both adults and children with or without fibrinolysis. However, mortality data were limited: one study reported one death in each treatment arm, and seven studies reported no deaths. There was a statistically significant reduction in mean length of hospital stay for those treated with VATS. The subgroup analysis showed the same result in adults, but there was insufficient evidence to estimate an effect for children. We could not perform a separate analysis for fibrinolysis for this outcome because all included studies used fibrinolysis in the non-surgical arms. We downgraded the quality of the evidence to low for mortality (due to wide confidence intervals and indirectness), and moderate for other outcomes in this comparison due to either high heterogeneity or wide confidence intervals. AUTHORS' CONCLUSIONS: Our findings suggest there is no statistically significant difference in mortality between primary surgical and non-surgical management of pleural empyema for all age groups. Video-assisted thoracoscopic surgery may reduce length of hospital stay compared to thoracostomy drainage alone.There was insufficient evidence to assess the impact of fibrinolytic therapy.A number of common outcomes were reported in the included studies that were not directly examined in our primary and secondary outcomes. These included duration of chest tube drainage, duration of fever, analgesia requirement, and total cost of treatment. Future studies focusing on patient-centred outcomes, such as patient functional scores, and other clinically relevant outcomes, such as radiographic improvement, treatment failure rates, and amount of fluid drainage, are needed to inform clinical decisions.
[Mh] Termos MeSH primário: Empiema Pleural/terapia
Cirurgia Torácica Vídeoassistida
Toracostomia
[Mh] Termos MeSH secundário: Adulto
Criança
Drenagem/efeitos adversos
Drenagem/métodos
Drenagem/mortalidade
Empiema Pleural/mortalidade
Empiema Pleural/cirurgia
Seres Humanos
Tempo de Internação
Ensaios Clínicos Controlados Aleatórios como Assunto
Viés de Seleção
Cirurgia Torácica Vídeoassistida/efeitos adversos
Cirurgia Torácica Vídeoassistida/mortalidade
Toracostomia/efeitos adversos
Toracostomia/mortalidade
Terapia Trombolítica
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170718
[Lr] Data última revisão:
170718
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170318
[St] Status:MEDLINE
[do] DOI:10.1002/14651858.CD010651.pub2


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[PMID]:28253440
[Au] Autor:Fetzer TJ; Walker JM; Bach JF
[Ad] Endereço:Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI, 53706.
[Ti] Título:Comparison of the efficacy of small and large-bore thoracostomy tubes for pleural space evacuation in canine cadavers.
[So] Source:J Vet Emerg Crit Care (San Antonio);27(3):301-306, 2017 May.
[Is] ISSN:1476-4431
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To determine if there is a difference in the amounts of air (A), low-viscosity fluid (LV), or high-viscosity fluid (HV) that can be aspirated from the pleural cavity of canine cadavers using small-bore (SB) or large-bore (LB) thoracostomy tubes. DESIGN: Prospective experimental ex vivo study. SETTING: University teaching hospital. ANIMALS: Thirty-six canine cadavers. INTERVENTIONS: Each cadaver was randomly assigned to 1 of 6 groups (SB-A, LB-A, SB-LV, LB-LV, SB-HV, LB-HV). In each cadaver bilateral thoracostomy tubes (either SB or LB) were placed and 20 mL/kg of air, LV fluid, or HV fluid was instilled via 1 thoracostomy tube. Both tubes were aspirated and the volume aspirated was recorded and analyzed as a percentage of instilled air or fluid volume. The procedure was repeated on the contralateral hemithorax. MEASUREMENTS AND MAIN RESULTS: There was no significant difference in air or fluid recovery when SB and LB groups were compared. Median (range) air recovery volumes in the SB-A and LB-A groups were 101.5% (94.4-115.8%) and 102.8% (94.1-107.8%), respectively (P = 0.898). Recovery of LV fluid was 93.5% (79.2-99.0%) for SB-LV and 85.8% (77.1-101.8%) for LB-LV cadavers (P = 0.305) and recovery percentages of HV fluid were 92.6% (86.1-96.2%) and 91.4% (74.2-96.4%) for SB-HV and LB-HV groups, respectively (P > 0.999). There was no significant difference between SB and LB groups when all substances were combined (94.1% [79.2-115.8%] and 93.5% [74.2-107.8%], respectively, P = 0.557). CONCLUSIONS: SB and LB thoracostomy tubes demonstrated similar efficacy in removing known amounts of air, LV fluid, and HV fluid from the pleural space of canine cadavers. Further study is necessary to determine if SB and LB thoracostomy tubes demonstrate similar efficacy in clinical veterinary patients.
[Mh] Termos MeSH primário: Tubos Torácicos/veterinária
Doenças do Cão/cirurgia
Derrame Pleural Maligno/veterinária
Toracostomia/veterinária
[Mh] Termos MeSH secundário: Animais
Cadáver
Cães
Desenho de Equipamento
Feminino
Masculino
Derrame Pleural Maligno/cirurgia
Estudos Prospectivos
Toracostomia/instrumentação
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170828
[Lr] Data última revisão:
170828
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170303
[St] Status:MEDLINE
[do] DOI:10.1111/vec.12593


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[PMID]:28166998
[Au] Autor:Tröbs RB; Finke W; Bahr M; Roll C; Nissen M; Vahdad MR; Cernaianu G
[Ad] Endereço:Department of Pediatric Surgery, St. Mary's Hospital, St. Elisabeth Group, Ruhr-University of Bochum, D-44627, Herne, Widumer Str. 8, Germany. Electronic address: ralf-bodo.troebs@elisabethgruppe.de.
[Ti] Título:Isolated tracheoesophageal fistula versus esophageal atresia - Early morbidity and short-term outcome. A single institution series.
[So] Source:Int J Pediatr Otorhinolaryngol;94:104-111, 2017 Mar.
[Is] ISSN:1872-8464
[Cp] País de publicação:Ireland
[La] Idioma:eng
[Ab] Resumo:PURPOSE: We compared the postnatal course, morbidity and early results after repair for cases of isolated or "pure" TEF with those for cases of esophageal atresia (EA) with distal tracheoesophageal fistula (TEF). METHODS: Twenty-four consecutive infants were divided into two groups: isolated TEF [TEF group] (n = 5) and EA with distal TEF [EA group] (n = 19). RESULTS: A high rate of prematurity (29%) and major cardiac and other surgically-relevant malformations (0.8 vs. 0.7 per infant) was found in both groups. The median age at surgery was 8 days for the TEF group vs. 1 day for the EA group (p < 0.01). Most infants of both cohorts had stable acid-base and respiratory parameters at admission. Generally, tracheoscopy provided valuable information regarding the position of the TEF. Surgery for isolated TEF was performed via right cervicotomy in 4 cases and via thoracotomy in one. Postoperative thoracostomy tubes were inserted in 3 cases and one emergency gastrostomy was created for acute gastric overextension (exclusively in patients with EA). The duration of postoperative mechanical ventilation (49 vs. 113 h, p = 0.045) and the median length of stay in the pediatric surgery unit (10 vs. 20.5 days, p = 0.003) were shorter for the isolated TEF group. Four EA patients experienced severe events. Total mortality was 8% (0 out of 5 with TEF vs. 2 out of 19 with EA). CONCLUSION: Developmental delay and a high rate of morbidity were found in both groups. More complex surgery increased perioperative morbidity in cases of EA. With early recognition of isolated TEF, a less complicated course can be expected in comparison with esophageal atresia.
[Mh] Termos MeSH primário: Atresia Esofágica/cirurgia
Fístula Traqueoesofágica/cirurgia
[Mh] Termos MeSH secundário: Endoscopia
Atresia Esofágica/complicações
Feminino
Gastrostomia
Seres Humanos
Lactente
Recém-Nascido
Recém-Nascido Prematuro
Masculino
Morbidade
Complicações Pós-Operatórias/epidemiologia
Complicações Pós-Operatórias/terapia
Toracostomia
Toracotomia
Fístula Traqueoesofágica/complicações
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170208
[St] Status:MEDLINE


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[PMID]:28131104
[Au] Autor:Rabiou S; Younssa H; Didier J; Ibrahim M; Harissou A; Adakal O; Sani R
[Ad] Endereço:Department of Thoracic Surgery, CHU Hassan II, Fes, Morocco.
[Ti] Título:A Simplified Technique for Drainage of Chronic Calcified Pleural Empyema.
[So] Source:Thorac Cardiovasc Surg;65(7):586-588, 2017 Oct.
[Is] ISSN:1439-1902
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:Chronic pleural pocket has well-known diagnosis and treatment principles since first described by Hippocrates 2,400 years ago. However, its treatment remains constant even though its causes, severity during management, and terrain vary considerably. In well-structured health care systems, posttuberculous empyema has become rare; its well-codified medical treatment relies on early diagnosis and adapted antibiotherapy, punctures/drainage, and appropriate intrapleural antifibrinolytics. In developing countries, a poor health organizational system increases the incidence of pleural pocket, which can progress until surgery is indicated. In such a context, the general principles of treatment include pleural decortication along with pulmonary resection. This technique remains difficult, risky, and, sometimes, impossible due to the chronicity of the lesion. In patients debilitated by several months of septic evolution, a simplified thoracostomy technique permits complete resection of the pocket.
[Mh] Termos MeSH primário: Calcinose/cirurgia
Drenagem/métodos
Empiema Pleural/cirurgia
Toracostomia
[Mh] Termos MeSH secundário: Calcinose/diagnóstico
Doença Crônica
Empiema Pleural/diagnóstico
Seres Humanos
Posicionamento do Paciente
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171030
[Lr] Data última revisão:
171030
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170129
[St] Status:MEDLINE
[do] DOI:10.1055/s-0036-1597592


  10 / 1293 MEDLINE  
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[PMID]:28118795
[Au] Autor:Turkyilmaz A; Karapolat S; Kilic M; Tekinbas C
[Ad] Endereço:1 Department of Thoracic Surgery, Karadeniz Technical University Medical School, Trabzon, Turkey.
[Ti] Título:The Perforation of the Superior Vena Cava Secondary to the Left Subclavian Dialysis Catheter.
[So] Source:Vasc Endovascular Surg;51(2):95-97, 2017 Feb.
[Is] ISSN:1938-9116
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: The perforation of the superior vena cava during the placement of dialysis catheter and consequent hemothorax is a rare serious complication. CASE REPORT: Dialysis catheter was placed in the left subclavian vein in a 69-year-old male patient with chronic renal insufficiency who was hospitalized for intracerebral hematoma. During hemodialysis a day after the procedure, the patient was noted having right-sided hemothorax, causing lethargy, dyspnea, hypotension, and bradycardia. Right tube thoracostomy was performed and 1500 cc of hemorrhagic fluid was drained. Under general anesthesia, the right posterolateral thoracotomy was performed and the tip of the dialysis catheter was found in the pleural space, penetrating the anteromedial side of the superior vena cava. The perforation area was repaired by suturing with 3-0 prolene, and the dialysis catheter was removed externally. Postoperative period was uneventful, and tube thoracostomy was terminated on day 4. CONCLUSION: Establishing the diagnosis early and accurately and performing appropriate surgery would be lifesaving in superior vena cava perforation due to dialysis catheter.
[Mh] Termos MeSH primário: Cateterismo Venoso Central/efeitos adversos
Cateteres de Demora/efeitos adversos
Cateteres Venosos Centrais/efeitos adversos
Diálise Renal/efeitos adversos
Insuficiência Renal Crônica/terapia
Artéria Subclávia
Lesões do Sistema Vascular/etiologia
Veia Cava Superior/lesões
[Mh] Termos MeSH secundário: Idoso
Cateterismo Venoso Central/instrumentação
Tubos Torácicos
Remoção de Dispositivo
Hemotórax/etiologia
Seres Humanos
Masculino
Diálise Renal/instrumentação
Insuficiência Renal Crônica/diagnóstico
Artéria Subclávia/diagnóstico por imagem
Técnicas de Sutura
Toracentese/métodos
Toracostomia/instrumentação
Toracotomia
Resultado do Tratamento
Lesões do Sistema Vascular/diagnóstico por imagem
Lesões do Sistema Vascular/terapia
Veia Cava Superior/diagnóstico por imagem
Veia Cava Superior/cirurgia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170313
[Lr] Data última revisão:
170313
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170126
[St] Status:MEDLINE
[do] DOI:10.1177/1538574416689427



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