Long Case One
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A patient presented with dyspnea following an upper GI endoscopy. Imaging found pneumomediastinum, subcutaneous emphysema, a right pleural effusion, and free intraperitoneal air. This was diagnosed as an iatrogenic esophageal perforation during the endoscopy, with defects in the upper third of the esophagus wall allowing air to dissect into the mediastinum and peritoneum. A non-ionic contrast would be used instead of barium for follow-up exams due to risk of mediastinal fibrosis from the perforation.
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Pneumothorax refers to the presence of air in the pleural space and can occur spontaneously due to ruptured blebs or as a result of trauma or medical procedures. It presents clinically as reduced breath sounds, hyperresonance to percussion, and mediastinal shift. Chest x-ray or CT scan are used for diagnosis and show hypertranslucency. Treatment involves supplemental oxygen, aspiration, or chest tube placement. Physiotherapy focuses on improving ventilation and exercise tolerance. Recurrence can be prevented through procedures like pleurodesis or thoracotomy along with smoking cessation.
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This document discusses lung abscess, including its definition, causes, microbiology, risk factors, clinical presentation, diagnosis and treatment. A lung abscess is a localized infection and necrosis of lung tissue, often caused by aspiration of oral or gastric contents, that produces a cavity within the lung. It commonly presents with cough, sputum production and fever. Diagnosis is made through chest imaging showing a lung cavity. Treatment involves prolonged use of antibiotics active against the typical bacterial causes, such as clindamycin and metronidazole, for 4-6 weeks.
Upper Airway Obstruction Dr Juhina Clinical Serise
This document summarizes upper airway obstruction in children. It discusses the anatomy of the pediatric airway and causes of stridor. Common causes of acute upper airway obstruction like croup, epiglottitis, and retropharyngeal abscess are described. Evaluation, management, and treatment of these conditions are outlined, including securing the airway if needed and administering antibiotics. Diagnostic tools like lateral neck x-rays are discussed.
unilateral hyperlucent lung in children
presentation includes causes and detailed evaluation of unilateral hyperlucent lung fields in children
Meconium aspiration syndrome_
Meconium aspiration syndrome (MAS) is a respiratory distress in infants born through meconium stained amniotic fluid. It occurs in 5% of infants delivered through meconium stained fluid and is caused by mechanical obstruction and chemical pneumonitis from inhaled meconium. Clinical features include respiratory distress, cyanosis, and chest retractions. Diagnosis is confirmed by chest x-ray showing infiltrates and management involves ventilatory support, surfactant therapy, inhaled nitric oxide, and potentially extracorporeal membrane oxygenation. With aggressive treatment, mortality from MAS has decreased to less than 5%.
ADENOIDS&ADENOIDECTOMY BY ROOHIA
This document discusses rigid endoscopic evaluation of conventional curettage adenoidectomy. It begins with an introduction stating that adenoidectomy is a common procedure in children and conventional curettage is commonly used. It then provides details on the anatomy and physiology of the adenoids, clinical presentation of adenoid hypertrophy, diagnosis, grading systems used, different surgical techniques including conventional curettage and various types of endoscopic adenoidectomy, post-operative care, and potential complications.
Surgery of Pulmonary Infections
Property of Prof Dr. Ahmed Deebis, Head of Cardiothoracic Surgery Department, Faculty of Medicine. University of Zagazig
Pneumothorax
This document discusses pneumothorax, which is the accumulation of air in the pleural space causing lung collapse. It defines pneumothorax as air in the pleural space that can occur spontaneously or from trauma. The types are described as spontaneous, open, or tension pneumothorax. Clinical manifestations include shortness of breath, chest pain, and decreased breath sounds on the affected side. Diagnosis involves history, exam, chest x-ray and blood gas analysis. Management depends on the type but may include observation, needle aspiration, chest tube placement, or surgery to repair the lung. Nursing care focuses on dressing wounds, positioning, monitoring chest tube drainage, and watching for complications like respiratory failure.
Pneumonia
Pneumonia is an inflammatory process in the lungs caused by infectious agents. It can be bacterial, viral, fungal or chemical. Symptoms include shaking chills, chest pain, cough with sputum, and shortness of breath. Diagnosis involves physical exam, chest x-ray, and sputum culture. Treatment is with antibiotics, oxygen therapy, and chest physiotherapy. Nursing care focuses on airway maintenance, sputum collection, chest physiotherapy, diet, infection control, and monitoring for complications like respiratory failure. With treatment, most patients improve within 2 weeks but elderly or very sick patients may need longer treatment.
Pneumonia
This document provides an overview of pneumonia, including its definition, classification, causes, transmission, risk factors, symptoms, diagnostic tests, treatment, nursing care, prevention, prognosis, and complications. Pneumonia is defined as an inflammatory condition of the lungs caused by infectious agents. It can be classified according to its causes such as bacterial, viral, fungal, or chemical, and the area of lung involvement. Common symptoms include fever, cough, chest pain, and shortness of breath. Diagnosis involves medical history, physical exam, chest x-ray, and sputum/blood tests. Treatment consists of antibiotics, oxygen therapy, and chest physiotherapy. Nursing care focuses on airway maintenance, infection control, respiratory support,
Introduction to thoracic surgery
This introductory lecture in thoracic surgery covers the following topics:
Development of the lung.
Developmental Anomalies.
Anatomy of the lungs and the bronchial tree.
Diagnostic procedures in thoracic surgery.
Closed tube thoracostomy.
Aspirated tracheobronchial foreign bodies.
Pulmonary hydatid cysts.
Bacterial destruction of the lungs
Bacterial destruction of the lungs can lead to serious complications like lung abscesses and pleural effusions. Lung abscesses form when bacteria destroy lung tissue, causing necrosis and pus-filled cavities. Left untreated, the abscess can drain into the pleural cavity, causing a pleural effusion. Pleural effusions are accumulations of fluid in the pleural space that can become infected (pyothorax) or allow air to enter (pyopneumothorax), requiring drainage to prevent respiratory distress. Proper treatment involves identifying the underlying infection through testing of pleural fluid, administering antibiotics, and draining excess fluid or air in the pleural cavity through chest tubes or thoracentesis.
Congenital anomalies of the larynx
The document discusses various congenital anomalies of the larynx including cartilaginous anomalies like laryngomalacia and epiglottic anomalies, soft tissue anomalies like cysts and fistulas, and neurological anomalies like vocal cord palsy. Specific conditions like laryngomalacia, bifid epiglottis, laryngeal atresia, cleft and subglottic stenosis are explained in detail covering their classification, clinical features, investigations and treatment. Other anomalies discussed include laryngeal cysts, tracheoesophageal fistula, congenital vocal cord palsy and laryngeal webs and hemangioma.
Ludwig's angina
Ludwig's angina is an acute, potentially life-threatening infection of the submandibular space that causes severe swelling and difficulty opening the mouth or swallowing. It usually stems from dental infections. Clinical features include bilateral swelling of the submandibular region, elevated tongue, and difficulty speaking or swallowing. Management involves securing the airway through tracheostomy or intubation, administering IV antibiotics, and incising and draining any abscesses through bilateral submandibular and submental incisions. Early diagnosis, antibiotic treatment, and surgical drainage are crucial for successful treatment.
Updates in Parapneumonic Effusion and Empyema
The document discusses parapneumonic effusion and empyema. It classifies pneumonias and defines related terms like pleurisy, parapneumonic effusion, and empyema. It describes the pathophysiology of effusions in stages from pleuritis sicca to organization. Clinical presentation and differential diagnosis are also covered. Laboratory studies and imaging studies like chest radiography are important for diagnosing complicated parapneumonic effusions or empyemas to allow for optimal management.
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