Lung exclusion surgery for Hemoptysis
•
1 like•1,164 views
This is an Original Life Saving Surgical technique developed and published by me for treatment of Masiive or Recurrent Hemoptysis where standard lung resection is technically very difficult and or hazardous
Report
Share
Report
Share
Recommended
Airway stents
This document discusses airway stents, which are tube-shaped devices inserted bronchoscopically into airways to treat various large airway diseases. It describes indications for airway stenting including malignant and benign airway obstructions. The main types of stents are silicone, metal, and hybrid stents. The document reviews the techniques for inserting and monitoring airway stents as well as potential complications.
Pulmonary interstitium
The document discusses the pulmonary interstitium, which is the connective tissue within the lungs. It has three main functions: supporting the lung, fluid balance, and repair/remodeling. The interstitium is made up of a thin portion forming barriers between alveoli and capillaries, and a thick portion where fluid can accumulate. The thick portion contains extracellular matrix, macrophages, and fibroblasts. There are three zones of interstitial tissue: peripheral, axial, and parenchymal. Fluid balance in the interstitium is regulated by Starling forces and leakage can occur if pressures are too high. Remodeling of the matrix is also important for lung biology and chronic inflammation. The document then provides examples of
CTD ILDs.
This document discusses interstitial lung disease (ILD) associated with connective tissue diseases (CTDs). It begins by providing background on ILD and defining common presentations. It then discusses the classification of ILD and patterns associated with different CTDs. Common CTDs that can cause ILD are described such as systemic sclerosis, rheumatoid arthritis, and polymyositis/dermatomyositis. Risk factors, pathophysiology, epidemiology, clinical presentation, investigations including radiography and antibodies, and biomarkers for ILD associated with CTDs are summarized. Specific CT features that can help differentiate CTD-ILD from idiopathic pulmonary fibrosis are also outlined.
Pulmonary Hypertension Overview 2023
The document discusses updates to pulmonary hypertension in 2023. It summarizes the new ESC/ERS guidelines that define pulmonary hypertension as a mean PAP over 20 mmHg and pre-capillary pulmonary hypertension as a mean PAP over 20 mmHg, PAWP below 15 mmHg, and PVR over 2 wood units. It also discusses the prevalence of pulmonary hypertension, methods of diagnosis including echocardiogram, risk stratification, when treatment is warranted based on hemodynamics, and current treatment approaches and therapeutic targets.
Management of Hemoptysis
Hemoptysis is a serious medical problem requiring urgent or emergency management. This presentation discuss this in a lucid way
Lymphangioleiomyomatosis
This document discusses the case of a 26-year-old woman who presented with sudden right chest pain and dyspnea. Tests revealed a right pneumothorax and bilateral lung cysts. The most likely diagnosis is lymphangioleiomyomatosis (LAM), a rare lung disease that affects women and causes proliferation of smooth muscle cells in the lungs leading to cyst formation and spontaneous pneumothorax. LAM is characterized by recurrent pneumothorax, cough, dyspnea and chylous effusions. Diagnosis involves chest imaging and biopsy showing cystic changes. Treatment options include pleurodesis and lung transplantation for end-stage disease.
Pulmonaryembolism ....tanmay new
This document provides an overview of pulmonary embolism (PE). It discusses the historical context, pathophysiology, risk factors, clinical presentation, diagnostic testing and treatment of PE. Some key points include:
- PE is a common cause of preventable death, with over 600,000 cases annually in the US.
- Virchow's triad of hypercoagulability, stasis, and endothelial injury contributes to the development of PE.
- Clinical presentation is often nonspecific, and the classic triad of symptoms occurs in less than 20% of cases.
- Diagnostic testing includes D-dimer, chest CT, ventilation-perfusion scanning and pulmonary angiography. Early treatment with antico
Pavm
1. Pulmonary arteriovenous malformations (PAVMs) are rare vascular anomalies where abnormal dilated vessels provide a right-to-left shunt between the pulmonary artery and vein.
2. PAVMs are usually diagnosed through imaging like chest X-ray, CT, or MRI which show dilated vessels. Right-to-left shunting can be detected using echocardiography, oxygen studies, or pulmonary angiography.
3. Treatment involves embolization to occlude the abnormal vessels which successfully treats over 99% of PAVMs. Surgery is an alternative for cases that cannot be embolized or if embolization fails.
Recommended
Airway stents
This document discusses airway stents, which are tube-shaped devices inserted bronchoscopically into airways to treat various large airway diseases. It describes indications for airway stenting including malignant and benign airway obstructions. The main types of stents are silicone, metal, and hybrid stents. The document reviews the techniques for inserting and monitoring airway stents as well as potential complications.
Pulmonary interstitium
The document discusses the pulmonary interstitium, which is the connective tissue within the lungs. It has three main functions: supporting the lung, fluid balance, and repair/remodeling. The interstitium is made up of a thin portion forming barriers between alveoli and capillaries, and a thick portion where fluid can accumulate. The thick portion contains extracellular matrix, macrophages, and fibroblasts. There are three zones of interstitial tissue: peripheral, axial, and parenchymal. Fluid balance in the interstitium is regulated by Starling forces and leakage can occur if pressures are too high. Remodeling of the matrix is also important for lung biology and chronic inflammation. The document then provides examples of
CTD ILDs.
This document discusses interstitial lung disease (ILD) associated with connective tissue diseases (CTDs). It begins by providing background on ILD and defining common presentations. It then discusses the classification of ILD and patterns associated with different CTDs. Common CTDs that can cause ILD are described such as systemic sclerosis, rheumatoid arthritis, and polymyositis/dermatomyositis. Risk factors, pathophysiology, epidemiology, clinical presentation, investigations including radiography and antibodies, and biomarkers for ILD associated with CTDs are summarized. Specific CT features that can help differentiate CTD-ILD from idiopathic pulmonary fibrosis are also outlined.
Pulmonary Hypertension Overview 2023
The document discusses updates to pulmonary hypertension in 2023. It summarizes the new ESC/ERS guidelines that define pulmonary hypertension as a mean PAP over 20 mmHg and pre-capillary pulmonary hypertension as a mean PAP over 20 mmHg, PAWP below 15 mmHg, and PVR over 2 wood units. It also discusses the prevalence of pulmonary hypertension, methods of diagnosis including echocardiogram, risk stratification, when treatment is warranted based on hemodynamics, and current treatment approaches and therapeutic targets.
Management of Hemoptysis
Hemoptysis is a serious medical problem requiring urgent or emergency management. This presentation discuss this in a lucid way
Lymphangioleiomyomatosis
This document discusses the case of a 26-year-old woman who presented with sudden right chest pain and dyspnea. Tests revealed a right pneumothorax and bilateral lung cysts. The most likely diagnosis is lymphangioleiomyomatosis (LAM), a rare lung disease that affects women and causes proliferation of smooth muscle cells in the lungs leading to cyst formation and spontaneous pneumothorax. LAM is characterized by recurrent pneumothorax, cough, dyspnea and chylous effusions. Diagnosis involves chest imaging and biopsy showing cystic changes. Treatment options include pleurodesis and lung transplantation for end-stage disease.
Pulmonaryembolism ....tanmay new
This document provides an overview of pulmonary embolism (PE). It discusses the historical context, pathophysiology, risk factors, clinical presentation, diagnostic testing and treatment of PE. Some key points include:
- PE is a common cause of preventable death, with over 600,000 cases annually in the US.
- Virchow's triad of hypercoagulability, stasis, and endothelial injury contributes to the development of PE.
- Clinical presentation is often nonspecific, and the classic triad of symptoms occurs in less than 20% of cases.
- Diagnostic testing includes D-dimer, chest CT, ventilation-perfusion scanning and pulmonary angiography. Early treatment with antico
Pavm
1. Pulmonary arteriovenous malformations (PAVMs) are rare vascular anomalies where abnormal dilated vessels provide a right-to-left shunt between the pulmonary artery and vein.
2. PAVMs are usually diagnosed through imaging like chest X-ray, CT, or MRI which show dilated vessels. Right-to-left shunting can be detected using echocardiography, oxygen studies, or pulmonary angiography.
3. Treatment involves embolization to occlude the abnormal vessels which successfully treats over 99% of PAVMs. Surgery is an alternative for cases that cannot be embolized or if embolization fails.
Medastinal lymphadenopathy
1. The document describes the anatomical locations and classifications of mediastinal lymph nodes. It discusses 10 different lymph node stations located in the mediastinum, including the supraclavicular, upper and lower paratracheal, prevascular, subaortic, para-aortic, subcarinal, paraesophageal, pulmonary ligament, and hilar lymph nodes.
2. Conventional mediastinoscopy allows biopsy of stations 2L, 2R, 4L, 4R, and 7 while extended mediastinoscopy provides access to deeper stations 5 and 6. Endoscopic ultrasound with fine needle aspiration provides sampling of stations 7, 8, and 9.
3. Accurate lymph node
DLCO
1. The document discusses DLCO (diffusing capacity of the lungs for carbon monoxide), which measures the efficiency of the lungs in transporting oxygen across the alveolar capillary membrane.
2. It describes the single breath hold method for measuring DLCO, which involves inhaling a gas mixture containing carbon monoxide and exhaling into a collection device to measure gas concentrations.
3. DLCO can be lowered in conditions that decrease the surface area for diffusion like emphysema, or increase the thickness of the alveolar capillary membrane like interstitial lung diseases.
Chest radiology in intensive care
- Chest radiography is useful for assessing pulmonary edema, infiltrates, effusions, pneumothorax, and positioning of lines and tubes in intensive care patients. Common findings include air bronchograms, hilar enlargement, Kerley lines, and increased vascular pedicle width.
- Pneumomediastinum is suggested by findings like the continuous diaphragm sign, Naclerio's V sign, and double bronchial wall sign. A pneumothorax may be occult or demonstrated by a pleural line with absent lung markings.
- Proper positioning of central lines is important but can be challenging due to anatomical variability. The tip should lie in the SVC above the pericardial
NON RESOLVING PNEUMONIA
This document defines non-resolving pneumonia and discusses its causes and diagnostic evaluation. Non-resolving pneumonia is defined as persistence of clinical symptoms and radiographic abnormalities for longer than expected despite adequate antibiotic therapy. Common causes include inappropriate antibiotic therapy, complications of the initial infection, host factors, and presence of resistant or unusual pathogens. A thorough diagnostic evaluation includes assessing treatment response, looking for complications or superinfections, evaluating for unusual organisms, and examining host immune function. Radiological imaging, bronchoscopy with protected specimen brushing or biopsy, and CT-guided biopsies can help identify causative organisms or underlying conditions.
approach to interstitial lung disease
This document discusses the approach to interstitial lung diseases (ILD) and diffuse parenchymal lung diseases (DPLD). It begins by reviewing the spectrum of ILD and DPLD, identifying clues from clinical presentation to make a diagnosis, and reviewing common radiographic findings. Key points include that ILD involves the pulmonary interstitium located between the epithelial and endothelial basement membranes. Clinical presentation of DPLD/ILD often involves dyspnea, cough, and abnormal chest imaging. Diagnosis involves considering history, physical exam, pulmonary function tests, imaging like chest radiographs and CT, and tissue sampling. Management depends on the specific diagnosis but may include treatments like corticosteroids, immunosuppressants, anti
Non invasive ventilation in cardiogenic pulmonary edema
Cardiogenic pulmonary edema (CPE) is caused by increased hydrostatic pressure in the pulmonary capillaries due to elevated left atrial pressure. This imbalance in hydrostatic and oncotic pressures across the capillary membrane leads to fluid filtration into the lungs. CPE progresses through three stages as fluid accumulates first in the lung interstitium then alveoli, impairing gas exchange. Treatment aims to reduce preload and afterload on the heart along with diuresis. Noninvasive ventilation with CPAP or BiPAP improves oxygenation and reduces workload of breathing by increasing lung volume while also decreasing cardiac preload and afterload.
Ards 2018
This document discusses acute respiratory distress syndrome (ARDS). It begins with defining ARDS and reviewing its pathophysiology and risk factors. ARDS involves acute inflammation of the alveolar-capillary membrane causing pulmonary edema. Major risk factors include sepsis, trauma, burns, and pneumonia. The document then covers the clinical presentation of ARDS, including dyspnea, hypoxemia, and decreased lung compliance. It emphasizes the importance of identifying and treating the underlying cause, and discusses evidence-based management strategies like lung-protective ventilation with low tidal volumes, application of PEEP, conservative fluid management, and prone positioning.
Chest menifestation in hiv
This document discusses pulmonary manifestations in HIV patients. It begins with an introduction to HIV transmission and risk groups. It then discusses how HIV affects the lungs, causing direct infection and immune dysfunction. Common pulmonary conditions in HIV patients are described, including opportunistic infections like Pneumocystis pneumonia and tuberculosis, which present differently based on CD4 count. Imaging findings for various lung diseases seen in HIV are provided, with examples of abnormalities seen on chest x-ray and CT for conditions like Pneumocystis pneumonia and bacterial/mycobacterial infections. Risk factors, diagnosis and treatment approaches are also summarized.
Lung Ultrasound in Cardiac Care
1) Lung ultrasound is a useful technique for evaluating pulmonary conditions at the bedside with several advantages over other imaging modalities.
2) Normal lung ultrasound findings include lung sliding, the seashore sign, A-lines, and the lung pulse. Absence of lung sliding can indicate a pneumothorax.
3) B-lines appear as laser-like artifacts that arise from the pleural line and indicate excess fluid or interstitial syndrome. A higher number of B-lines correlates with decompensated heart failure.
Reexpansion pulmonary edema
Reexpansion pulmonary edema is a serious complication after sudden expansion of collapsed lung.Re-expansion pulmonary edema is an uncommon complication following drainage of a pneumothorax , pleural effusion or removal of any space occupying lesion.
The incidence referred is less than 1%, and mortality can reach up to 20%.
Ventilator Induced Lung Injury
This document discusses ventilator induced lung injury (VILI) from barotrauma to biotrauma. It explores how injurious ventilator strategies can increase cytokines and lead to inflammation in isolated rat lung models. High pulmonary vascular flow and pulmonary capillary pressure were shown to promote lung damage, edema, and hemorrhage independent of ventilator settings. A study on isolated perfused rabbit lungs found that high pulmonary vascular flow and low positive end-expiratory pressure (PEEP) led to increased lung weight gain and hemorrhage scores compared to low flow and high PEEP settings, particularly in a two-hit lung injury model using oleic acid pre-injury.
Approach to Bullous lung disease
This document discusses the approach to bullous lung disease. It defines a bulla as a large air-containing space within the lung larger than 1 cm in diameter. Bullae can occur with emphysema, pulmonary fibrosis, or in otherwise normal lungs. HRCT is useful for evaluating the size, number and relationships of bullae. Pulmonary function testing may show obstructive lung disease, hyperinflation and reduced diffusion capacity. For surgical candidates, bullectomy or lung volume reduction surgery may be considered to treat symptoms or complications like spontaneous pneumothorax.
Interpretation of chest CT
This document provides an overview of chest CT, including its advantages over standard x-rays, different types of CT scans, and a systematic approach to interpreting chest CT scans. It discusses interpreting various lung abnormalities visible on CT such as pneumonia, COPD, atelectasis, interstitial lung disease, pulmonary embolism, and nodules. Different windows and views used in chest CT are also outlined.
Pulmonary sequestration ppt
Bronchopulmonary sequestration (BPS) is a rare congenital lung malformation where non-functioning lung tissue receives its blood supply from systemic arteries instead of the pulmonary circulation. It can be intralobar, located within a normal lung lobe, or extralobar, located outside the normal lung with its own pleura. Intralobar BPS presents most often in childhood or adulthood with recurrent pulmonary infections, while extralobar BPS usually presents in infancy with respiratory distress and has a higher association with other congenital anomalies. CT angiography is the preferred imaging method to evaluate BPS and delineate the anomalous systemic arterial supply.
Approach To Interstitial Lung Diseases
This document discusses interstitial lung diseases (ILD), also known as diffuse parenchymal lung diseases (DPLD). It provides the following key points:
1. ILD can be caused by over 200 diseases that result in damage to the lung interstitium. Common causes include occupational exposures, collagen vascular diseases, drugs, infections, and idiopathic interstitial pneumonias.
2. Accurately diagnosing ILD requires a multidisciplinary approach including clinical evaluation, radiology such as high-resolution CT, and pathology including surgical lung biopsy.
3. Idiopathic pulmonary fibrosis (IPF) is the most common idiopathic interstitial pneumonia and
Pulmonary aspergilloma
A 78-year-old male presented with cough, breathlessness, chest pain and haemoptysis. He had a history of pulmonary tuberculosis treated 2 years prior. Investigations revealed a cavitary lesion in his left lung containing a fungal mass. He was diagnosed with pulmonary aspergilloma developing in a pre-existing cavity from prior tuberculosis. Pulmonary aspergilloma occurs due to the fungus Aspergillus fumigatus infecting cavities left by healed tuberculosis. It was treated successfully with intravenous amphotericin B and oral itraconazole for 6 months. Relevant examinations and tests are needed to differentiate pulmonary aspergilloma from other conditions like lung cancer and properly
High altitude syndrome
This document discusses various medical problems that can occur at high altitudes. It begins by outlining different altitude ranges and their associated effects on the human body. It then covers the pathophysiology of altitude illness, including how the body acclimatizes to low oxygen levels over time. Various high altitude syndromes are defined such as acute mountain sickness (AMS), high altitude cerebral edema (HACE), and high altitude pulmonary edema (HAPE). Treatment strategies focus on descent, supplemental oxygen, medications, and prevention through gradual ascent.
An update on the management of Idiopathic Pulmonary Fibrosis (IPF)
This document provides a historical overview and update on the management of idiopathic pulmonary fibrosis (IPF). It discusses the evolution of IPF diagnosis and classification over time based on clinical and pathological criteria. Key risk factors for IPF like older age, family history, smoking and genetics are summarized. The document also reviews prognostic indicators, comorbidities, current pharmacological therapies including pirfenidone and nintedanib, and the multidisciplinary approach to diagnosis and management of IPF.
Update in evaluation of solitary pulmonary nodule
definition of solitary pulmonary nodule and subsolid nodule, various differences to distinguish between benign and malignant nodule, characteristics of subsolid nodule, treatment and followup of solid and subsolid pulmonary nodule.
Ards respiratory failure
This document discusses acute respiratory distress syndrome (ARDS) and respiratory failure. It provides details on:
- The diagnostic criteria for ARDS including hypoxemia, bilateral infiltrates on chest x-ray, and no left atrial hypertension.
- The clinical course of ARDS involving exudative, proliferative and fibrotic phases in the first few weeks.
- Treatment focuses on mechanical ventilation to prevent alveolar collapse while avoiding ventilator induced lung injury through strategies like PEEP and prone positioning.
- Respiratory failure is defined as inability to maintain adequate gas exchange and can be type 1 (hypoxemia without hypercapnia) or type 2 (hypoxemia with
10.07.08(a): Transplant Surgery and Immunology
Slideshow is from the University of Michigan Medical School’s M2 Renal sequence
View additional course materials on Open.Michigan:
openmi.ch/med-M2Renal
Acs0414 Pulmonary Resection
This document discusses techniques for pulmonary resection surgery. It covers:
- Patient positioning in the lateral decubitus position to allow access for posterior thoracotomy incisions.
- Isolating the lung to be resected using a double-lumen endotracheal tube for single lung ventilation during hilar dissection.
- Completing systematic inspection and palpation of the lung before dividing structures and removing the specimen to check for abnormalities.
More Related Content
What's hot
Medastinal lymphadenopathy
1. The document describes the anatomical locations and classifications of mediastinal lymph nodes. It discusses 10 different lymph node stations located in the mediastinum, including the supraclavicular, upper and lower paratracheal, prevascular, subaortic, para-aortic, subcarinal, paraesophageal, pulmonary ligament, and hilar lymph nodes.
2. Conventional mediastinoscopy allows biopsy of stations 2L, 2R, 4L, 4R, and 7 while extended mediastinoscopy provides access to deeper stations 5 and 6. Endoscopic ultrasound with fine needle aspiration provides sampling of stations 7, 8, and 9.
3. Accurate lymph node
DLCO
1. The document discusses DLCO (diffusing capacity of the lungs for carbon monoxide), which measures the efficiency of the lungs in transporting oxygen across the alveolar capillary membrane.
2. It describes the single breath hold method for measuring DLCO, which involves inhaling a gas mixture containing carbon monoxide and exhaling into a collection device to measure gas concentrations.
3. DLCO can be lowered in conditions that decrease the surface area for diffusion like emphysema, or increase the thickness of the alveolar capillary membrane like interstitial lung diseases.
Chest radiology in intensive care
- Chest radiography is useful for assessing pulmonary edema, infiltrates, effusions, pneumothorax, and positioning of lines and tubes in intensive care patients. Common findings include air bronchograms, hilar enlargement, Kerley lines, and increased vascular pedicle width.
- Pneumomediastinum is suggested by findings like the continuous diaphragm sign, Naclerio's V sign, and double bronchial wall sign. A pneumothorax may be occult or demonstrated by a pleural line with absent lung markings.
- Proper positioning of central lines is important but can be challenging due to anatomical variability. The tip should lie in the SVC above the pericardial
NON RESOLVING PNEUMONIA
This document defines non-resolving pneumonia and discusses its causes and diagnostic evaluation. Non-resolving pneumonia is defined as persistence of clinical symptoms and radiographic abnormalities for longer than expected despite adequate antibiotic therapy. Common causes include inappropriate antibiotic therapy, complications of the initial infection, host factors, and presence of resistant or unusual pathogens. A thorough diagnostic evaluation includes assessing treatment response, looking for complications or superinfections, evaluating for unusual organisms, and examining host immune function. Radiological imaging, bronchoscopy with protected specimen brushing or biopsy, and CT-guided biopsies can help identify causative organisms or underlying conditions.
approach to interstitial lung disease
This document discusses the approach to interstitial lung diseases (ILD) and diffuse parenchymal lung diseases (DPLD). It begins by reviewing the spectrum of ILD and DPLD, identifying clues from clinical presentation to make a diagnosis, and reviewing common radiographic findings. Key points include that ILD involves the pulmonary interstitium located between the epithelial and endothelial basement membranes. Clinical presentation of DPLD/ILD often involves dyspnea, cough, and abnormal chest imaging. Diagnosis involves considering history, physical exam, pulmonary function tests, imaging like chest radiographs and CT, and tissue sampling. Management depends on the specific diagnosis but may include treatments like corticosteroids, immunosuppressants, anti
Non invasive ventilation in cardiogenic pulmonary edema
Cardiogenic pulmonary edema (CPE) is caused by increased hydrostatic pressure in the pulmonary capillaries due to elevated left atrial pressure. This imbalance in hydrostatic and oncotic pressures across the capillary membrane leads to fluid filtration into the lungs. CPE progresses through three stages as fluid accumulates first in the lung interstitium then alveoli, impairing gas exchange. Treatment aims to reduce preload and afterload on the heart along with diuresis. Noninvasive ventilation with CPAP or BiPAP improves oxygenation and reduces workload of breathing by increasing lung volume while also decreasing cardiac preload and afterload.
Ards 2018
This document discusses acute respiratory distress syndrome (ARDS). It begins with defining ARDS and reviewing its pathophysiology and risk factors. ARDS involves acute inflammation of the alveolar-capillary membrane causing pulmonary edema. Major risk factors include sepsis, trauma, burns, and pneumonia. The document then covers the clinical presentation of ARDS, including dyspnea, hypoxemia, and decreased lung compliance. It emphasizes the importance of identifying and treating the underlying cause, and discusses evidence-based management strategies like lung-protective ventilation with low tidal volumes, application of PEEP, conservative fluid management, and prone positioning.
Chest menifestation in hiv
This document discusses pulmonary manifestations in HIV patients. It begins with an introduction to HIV transmission and risk groups. It then discusses how HIV affects the lungs, causing direct infection and immune dysfunction. Common pulmonary conditions in HIV patients are described, including opportunistic infections like Pneumocystis pneumonia and tuberculosis, which present differently based on CD4 count. Imaging findings for various lung diseases seen in HIV are provided, with examples of abnormalities seen on chest x-ray and CT for conditions like Pneumocystis pneumonia and bacterial/mycobacterial infections. Risk factors, diagnosis and treatment approaches are also summarized.
Lung Ultrasound in Cardiac Care
1) Lung ultrasound is a useful technique for evaluating pulmonary conditions at the bedside with several advantages over other imaging modalities.
2) Normal lung ultrasound findings include lung sliding, the seashore sign, A-lines, and the lung pulse. Absence of lung sliding can indicate a pneumothorax.
3) B-lines appear as laser-like artifacts that arise from the pleural line and indicate excess fluid or interstitial syndrome. A higher number of B-lines correlates with decompensated heart failure.
Reexpansion pulmonary edema
Reexpansion pulmonary edema is a serious complication after sudden expansion of collapsed lung.Re-expansion pulmonary edema is an uncommon complication following drainage of a pneumothorax , pleural effusion or removal of any space occupying lesion.
The incidence referred is less than 1%, and mortality can reach up to 20%.
Ventilator Induced Lung Injury
This document discusses ventilator induced lung injury (VILI) from barotrauma to biotrauma. It explores how injurious ventilator strategies can increase cytokines and lead to inflammation in isolated rat lung models. High pulmonary vascular flow and pulmonary capillary pressure were shown to promote lung damage, edema, and hemorrhage independent of ventilator settings. A study on isolated perfused rabbit lungs found that high pulmonary vascular flow and low positive end-expiratory pressure (PEEP) led to increased lung weight gain and hemorrhage scores compared to low flow and high PEEP settings, particularly in a two-hit lung injury model using oleic acid pre-injury.
Approach to Bullous lung disease
This document discusses the approach to bullous lung disease. It defines a bulla as a large air-containing space within the lung larger than 1 cm in diameter. Bullae can occur with emphysema, pulmonary fibrosis, or in otherwise normal lungs. HRCT is useful for evaluating the size, number and relationships of bullae. Pulmonary function testing may show obstructive lung disease, hyperinflation and reduced diffusion capacity. For surgical candidates, bullectomy or lung volume reduction surgery may be considered to treat symptoms or complications like spontaneous pneumothorax.
Interpretation of chest CT
This document provides an overview of chest CT, including its advantages over standard x-rays, different types of CT scans, and a systematic approach to interpreting chest CT scans. It discusses interpreting various lung abnormalities visible on CT such as pneumonia, COPD, atelectasis, interstitial lung disease, pulmonary embolism, and nodules. Different windows and views used in chest CT are also outlined.
Pulmonary sequestration ppt
Bronchopulmonary sequestration (BPS) is a rare congenital lung malformation where non-functioning lung tissue receives its blood supply from systemic arteries instead of the pulmonary circulation. It can be intralobar, located within a normal lung lobe, or extralobar, located outside the normal lung with its own pleura. Intralobar BPS presents most often in childhood or adulthood with recurrent pulmonary infections, while extralobar BPS usually presents in infancy with respiratory distress and has a higher association with other congenital anomalies. CT angiography is the preferred imaging method to evaluate BPS and delineate the anomalous systemic arterial supply.
Approach To Interstitial Lung Diseases
This document discusses interstitial lung diseases (ILD), also known as diffuse parenchymal lung diseases (DPLD). It provides the following key points:
1. ILD can be caused by over 200 diseases that result in damage to the lung interstitium. Common causes include occupational exposures, collagen vascular diseases, drugs, infections, and idiopathic interstitial pneumonias.
2. Accurately diagnosing ILD requires a multidisciplinary approach including clinical evaluation, radiology such as high-resolution CT, and pathology including surgical lung biopsy.
3. Idiopathic pulmonary fibrosis (IPF) is the most common idiopathic interstitial pneumonia and
Pulmonary aspergilloma
A 78-year-old male presented with cough, breathlessness, chest pain and haemoptysis. He had a history of pulmonary tuberculosis treated 2 years prior. Investigations revealed a cavitary lesion in his left lung containing a fungal mass. He was diagnosed with pulmonary aspergilloma developing in a pre-existing cavity from prior tuberculosis. Pulmonary aspergilloma occurs due to the fungus Aspergillus fumigatus infecting cavities left by healed tuberculosis. It was treated successfully with intravenous amphotericin B and oral itraconazole for 6 months. Relevant examinations and tests are needed to differentiate pulmonary aspergilloma from other conditions like lung cancer and properly
High altitude syndrome
This document discusses various medical problems that can occur at high altitudes. It begins by outlining different altitude ranges and their associated effects on the human body. It then covers the pathophysiology of altitude illness, including how the body acclimatizes to low oxygen levels over time. Various high altitude syndromes are defined such as acute mountain sickness (AMS), high altitude cerebral edema (HACE), and high altitude pulmonary edema (HAPE). Treatment strategies focus on descent, supplemental oxygen, medications, and prevention through gradual ascent.
An update on the management of Idiopathic Pulmonary Fibrosis (IPF)
This document provides a historical overview and update on the management of idiopathic pulmonary fibrosis (IPF). It discusses the evolution of IPF diagnosis and classification over time based on clinical and pathological criteria. Key risk factors for IPF like older age, family history, smoking and genetics are summarized. The document also reviews prognostic indicators, comorbidities, current pharmacological therapies including pirfenidone and nintedanib, and the multidisciplinary approach to diagnosis and management of IPF.
Update in evaluation of solitary pulmonary nodule
definition of solitary pulmonary nodule and subsolid nodule, various differences to distinguish between benign and malignant nodule, characteristics of subsolid nodule, treatment and followup of solid and subsolid pulmonary nodule.
Ards respiratory failure
This document discusses acute respiratory distress syndrome (ARDS) and respiratory failure. It provides details on:
- The diagnostic criteria for ARDS including hypoxemia, bilateral infiltrates on chest x-ray, and no left atrial hypertension.
- The clinical course of ARDS involving exudative, proliferative and fibrotic phases in the first few weeks.
- Treatment focuses on mechanical ventilation to prevent alveolar collapse while avoiding ventilator induced lung injury through strategies like PEEP and prone positioning.
- Respiratory failure is defined as inability to maintain adequate gas exchange and can be type 1 (hypoxemia without hypercapnia) or type 2 (hypoxemia with
What's hot (20)
Non invasive ventilation in cardiogenic pulmonary edema
Non invasive ventilation in cardiogenic pulmonary edema
An update on the management of Idiopathic Pulmonary Fibrosis (IPF)
An update on the management of Idiopathic Pulmonary Fibrosis (IPF)
Viewers also liked
10.07.08(a): Transplant Surgery and Immunology
Slideshow is from the University of Michigan Medical School’s M2 Renal sequence
View additional course materials on Open.Michigan:
openmi.ch/med-M2Renal
Acs0414 Pulmonary Resection
This document discusses techniques for pulmonary resection surgery. It covers:
- Patient positioning in the lateral decubitus position to allow access for posterior thoracotomy incisions.
- Isolating the lung to be resected using a double-lumen endotracheal tube for single lung ventilation during hilar dissection.
- Completing systematic inspection and palpation of the lung before dividing structures and removing the specimen to check for abnormalities.
Lesions simulating tuberculosis of the chest
Basra Journal of Surgery, September 2002
Abstract:
Pulmonary tuberculosis (PTB) is endemic in Iraq with its incidence progressively increasing under the influence of the sanction since 1990. Nevertheless, the diagnosis of PTB should not be made easily without the appropriate investigations. Otherwise, the correct diagnosis of important thoracic disorder (sometimes a serious one like malignancy) may be missed. In this study, six patients with different benign and malignant thoracic lesions chosen among many others are presented. All of them were misdiagnosed and five were treated as tuberculosis. The study reminds the clinician in TB endemic areas that TB can be simulated by many thoracic lesions.
Pulmonary resection in basrah: personal experience
Basra Journal of Surgery, March 2004
Abstract:
Pulmonary resection is the operation that defines the thoracic surgeon. It represents the appropriate surgical treatment for many pulmonary lesions. This is the first study on pulmonary resection in Basrah, south of Iraq. The study is conducted in the Section of Thoracic and Cardiovascular Surgery in Basrah Teaching Hospital over a 5-year period (August 1996 to July 2001). The aim of the study is to present the personal experience of the author in lung resection, analyze the indications, surgical and anaesthetic management and outcome including morbidity and mortality in view of the literature. Thirty patients (17 males and 13 females) underwent pulmonary resection for different indications were retrospectively analyzed. The results of this study indicate that despite the small number of patients and the difficulties in anaesthetic management, pulmonary resection is practiced safely in Basrah, south of Iraq.
14. pulmonary-function-tests
Pulmonary function tests (PFTs) objectively assess lung function using tests such as spirometry, lung volume measurements, and diffusing capacity measurements. PFTs can predict, diagnose, and monitor pulmonary dysfunction. They can distinguish between obstructive and restrictive lung diseases and determine disease severity and treatment responses. PFTs also assess surgical risk and postoperative pulmonary complications. Simple bedside tests include breath counts, cough strength tests, and peak flow measurements. Laboratory PFTs precisely measure volumes, flows, gas exchange, and generate flow-volume loops. Proper interpretation of PFTs involves comparing values to predicted normals.
Partial liquid ventilation
This document discusses partial liquid ventilation, a technique where the lungs are filled with an oxygenated perfluorochemical liquid at the functional residual capacity during mechanical ventilation. Two key types are discussed: total liquid ventilation where the entire lung is filled with liquid, and partial liquid ventilation where only the FRC is filled. While theoretical advantages include improved oxygenation and recruitment of collapsed alveoli, clinical trials have shown no clear benefits over conventional ventilation and some increased risks. As a result, liquid ventilation is not currently recommended for routine clinical use.
Lung volume reduction surgery
LVRS involves surgically removing portions of emphysematous lung to allow the remaining lung tissue to expand. The NETT trial found LVRS benefits patients with upper lobe-predominant emphysema and low exercise capacity by improving lung function, exercise ability, and quality of life. Candidates for LVRS have severe emphysema, poor exercise capacity, marked lung hyperinflation, and meet criteria for pulmonary function tests, exercise testing, and cardiac/pulmonary evaluations. The procedure aims to improve ventilation/perfusion matching, reduce airway resistance, and allow the chest wall and diaphragm to resume a more normal position.
Empyema narthananan
This document discusses empyema, a type of pleural infection. It begins by outlining the aims and introduction. It then covers the pathogenesis and types of paraneumonic pleural effusions. Diagnosis involves thoracentesis and pleural fluid analysis. Common causative bacteria include streptococcus, staphylococcus aureus, and anaerobes. Treatment requires accurate diagnosis, appropriate antibiotic therapy guided by cultures, drainage of infected material via chest tube, and potential intrapleural therapies. Complications can arise if not properly treated.
Pulmonary resection
lecture about pulmonary resection for undergraduate medical students with audio lecture notes in Arabic.
Pulmonary resection
The technique of pulmonary resection had dramatically changed from mass ligation of pulmonary hilum to individual ligation of hilar structures and recently to video-assisted thoracoscopic pulmonary resection. However, the safe performance of lung resection requires a perfect knowledge of hilar anatomy and a technique with which the surgeon is familiar.
Surgery of Pulmonary Infections
Property of Prof Dr. Ahmed Deebis, Head of Cardiothoracic Surgery Department, Faculty of Medicine. University of Zagazig
Pleuro-Pulmonary Tuberculosis - Surgical Principles
Presented at 2nd Annual Conference of College of Gynaecology and Obstetrics of Rwanda, Kigali, Rwanda, Africa, on 5th – 6th May 1999. Pictured in Hotel Mille Collins, rendered famous in the movie "Hotel Rwanda", which depicted the genocide in Rwanda in 1994. "Hotel Rwanda" is Hotel Mille Collins ('Thousand Hills).
Approach to the Solitary Pulmonary Nodule - New Staging System for NSCLC - Ly...
Approach to the Solitary Pulmonary Nodule - New Staging System for NSCLC - Ly...Bassel Ericsoussi, MD
1. The document discusses the evaluation and management of solitary pulmonary nodules (SPNs). It outlines the clinical factors that influence the pre-test probability of malignancy for SPNs and diagnostic tools used in evaluation.
2. Management options for SPNs depend on the assessed risk of cancer, ranging from serial CT imaging for low-risk nodules to surgical resection for high-risk nodules to biopsy or PET scan for indeterminate risk. The key is determining the individual patient's risk through clinical and radiological factors.
3. The document also summarizes changes to the TNM staging system for lung cancer implemented in 2010, including revisions to T, N, and M descriptors and stage groupingsSequelae & Complications of Pneumonectomy
Pneumonectomy, or surgical removal of an entire lung, carries several potential sequelae and complications. Post-pneumonectomy pulmonary edema, which occurs within 72 hours of surgery and has a mortality rate over 50%, may be due to high oxygen levels or reperfusion injury. Over months, the remaining lung expands and the mediastinum shifts to fill the space, potentially leading to post-pneumonectomy syndrome through tracheal compression years later. Pulmonary function generally declines less than 50% with FEV1 and FVC decreasing the least. Mortality risk depends on preoperative lung function tests and cardiopulmonary exercise capacity.
Causes of Haemoptysis
Hemoptysis is the expectoration of blood from the respiratory tract. It is classified as mild if a small amount of blood is coughed up, while massive hemoptysis involves coughing up more than 200-240 mL of blood in 24 hours and is considered a medical emergency. The blood in hemoptysis can originate from the pulmonary arteries or bronchial arteries. Common causes of hemoptysis include infections like tuberculosis, lung tumors, vascular diseases, cardiac issues, immunological disorders, trauma, chronic airway inflammation, bleeding disorders, and iatrogenic causes stemming from medical procedures.
Anesthesia for toracic surgery
Thoracic anesthesia presents unique physiological challenges. Careful preoperative evaluation is needed to identify high-risk patients. The lateral position, open pneumothorax, and one-lung ventilation can cause hypoxemia and require attention. Pulmonary function tests help assess risk. During surgery, techniques like double-lumen tubes and lung isolation are used to optimize ventilation while limiting complications. Close monitoring and postoperative care are important.
Hemoptysis
Haemoptysis, or coughing up blood from the lungs or respiratory tract, can have various causes including infections like tuberculosis, lung cancer, or other chronic lung conditions. The document describes 4 cases of haemoptysis, including a 23-year-old male with a history of TB, a 70-year-old male smoker evaluated for sudden hemoptysis, a 21-year-old male with massive hemoptysis and HIV, and an 80-year-old male referred for dental bleeding workup. Causes, risk factors, presentations, signs, and mechanisms of massive haemoptysis are also outlined.
Aspergilosis canina
Este documento describe Aspergillus sp., un hongo oportunista que puede causar infecciones en humanos e animales inmunodeprimidos. Se detallan las características del hongo, los tipos de infecciones que puede causar como aspergilosis nasal y sistémica, los síntomas, el diagnóstico y las lesiones encontradas. En particular, señala que Aspergillus fumigatus es el agente más común de aspergilosis nasal en humanos y de aspergilosis sistémica en pastores alemanes.
Congenital cystic diseases of the lung
This document discusses several congenital cystic lung diseases that can cause respiratory distress in infants:
1) Pulmonary sequestration is a segment of lung with its own blood supply not connected to the tracheobronchial tree.
2) Bronchogenic cysts originate from lung bud abnormalities and are usually located near the mainstem bronchus or carina.
3) Congenital cystic adenomatoid malformation is caused by arrested alveolar development, presenting as cystic lung lesions.
4) Congenital lobar emphysema is due to deficient bronchus cartilage leading to lobar overinflation. Surgical resection is often needed to treat respiratory symptoms from these congen
Pulmonary surgery
Pulmonary surgeryShrimad Rajchandra College of Physiotherapy,Shree Swaminarayan Physiotherapy College
This document discusses pulmonary surgery procedures including lobectomy, pneumonectomy, and segmental resection. It describes the indications, risks, and postoperative physiotherapy treatment for lung surgery. Key points covered are clearing lung secretions, expanding the lungs, preventing complications like infection and blood clots, regaining movement, and conditioning exercises to aid recovery.Viewers also liked (20)
Pulmonary resection in basrah: personal experience
Pulmonary resection in basrah: personal experience
Pleuro-Pulmonary Tuberculosis - Surgical Principles
Pleuro-Pulmonary Tuberculosis - Surgical Principles
Approach to the Solitary Pulmonary Nodule - New Staging System for NSCLC - Ly...
Approach to the Solitary Pulmonary Nodule - New Staging System for NSCLC - Ly...
Similar to Lung exclusion surgery for Hemoptysis
Acute respiratory distress syndrome
This document provides an overview of Acute Respiratory Distress Syndrome (ARDS). It discusses the epidemiology, causes, clinical course and features, diagnostic criteria, investigations and management of ARDS. The key points are: ARDS affects approximately 10% of ICU patients annually and has a mortality rate of around 30%; it is caused by direct or indirect lung injury and progresses through exudative, proliferative and fibrotic phases; diagnosis is based on acute onset hypoxemia, bilateral opacities on chest imaging and low oxygen levels; management focuses on treating the underlying cause, lung protective ventilation with low tidal volumes, PEEP and prone positioning if severe. With treatment, most ARDS survivors recover lung function within 6-
Management of Parapneumonic Effusion and Empyema
This document provides information on the management of parapneumonic effusion and empyema. It defines parapneumonic effusion as any pleural effusion associated with bacterial pneumonia, lung abscess, or bronchiectasis. Empyema is defined as pus in the pleural space. The pathogenesis, bacteriology, clinical presentation, diagnosis, and management of parapneumonic effusion and empyema are discussed in detail over multiple sections. Key recommendations include chest tube drainage for frank pus or pH <7.2, antibiotics targeted to likely pathogens, consideration of intrapleural fibrinolytics or surgery for persistent collections, and a minimum 4-6 week antibiotic course.
Thoracoscopy vs laparoscopy technical feasibility and complications in cong...
Thoracoscopy and laparoscopy are minimally invasive surgical techniques that can be used to repair congenital diaphragmatic hernias. Thoracoscopy is typically used to repair Bochdalek hernias while laparoscopy is used for Morgagni and paraesophageal hernias. Both techniques have advantages over open surgery such as reduced pain, faster recovery, and less postoperative ventilation. However, thoracoscopy carries risks of abdominal organ injury during suturing while laparoscopy makes reduction of herniated organs more difficult. The author's experience found thoracoscopy had a higher success rate and fewer complications compared to laparoscopy for CDH repair in selected neonatal patients. Selection criteria and
LAPROSCOPIC 11.pptx
Laparoscopy is a minimally invasive surgical technique that uses small incisions and an endoscope to visualize the inside of the abdomen. Maintaining an optimal intra-abdominal pressure of 10-13 mmHg during laparoscopy is important for surgical conditions but can increase venous pooling and affect the cardiovascular and respiratory systems. Anesthesia aims to minimize these physiological effects through fluid loading, head positioning, and use of carbon dioxide for insufflation due to its rapid absorption. Complications related to increased intra-abdominal pressure include subcutaneous emphysema, pneumothorax, gas embolism, and well-leg compartment syndrome. Careful patient positioning and monitoring are important aspects of anesthesia for lapar
Management of parapneumonic effusion and empyema
Any pleural effusion associated with bacterial pneumonia,lung abscess or bronchiectasis is defined as parapneumonic effusion.Presence of pus in pleural space is called empyema. Pathogenesis,bacteriology,clinical presentation,diagnosis,management has been described in this powerpoint presentation.
Anaesthesia for laparoscopic surgery from ceaccp journal
Laparoscopic surgery has several benefits over open surgery such as reduced postoperative pain, quicker recovery times, and fewer wound complications. However, the pneumoperitoneum required for laparoscopy can cause physiological changes that require careful management to avoid risks. Specific patient factors, surgical risks, positioning risks, and effects of the elevated abdominal pressure from the pneumoperitoneum like decreased cardiac output and impaired lung function must be addressed with appropriate anesthesia techniques and postoperative monitoring. Close attention is needed for patients at higher risk of complications during and after laparoscopic procedures.
Respiratory emergencies
The document discusses the stepwise management of hemoptysis. It defines hemoptysis and massive hemoptysis. The most common causes in Egypt are discussed. Steps in diagnosis include history, exams, labs, imaging like CXR, CT, bronchoscopy. Treatment depends on localization and cause but may include bronchoscopic interventions, bronchial artery embolization, or surgery. Disease-specific approaches are also outlined. Three case studies are presented to demonstrate tailored management of hemoptysis.
Empyema as a complication of lung abscess drainage
This document describes the case of a 66-year-old male admitted for management of a cavitary lung lesion. He underwent CT-guided drainage of a lung abscess, but subsequently developed an empyema, likely due to contamination during drainage. He required a VATS procedure with debridement and decortication. Key learning points included that lung abscesses usually resolve with antibiotics, but drainage or resection may be needed for complicated cases, and percutaneous drainage carries risks of empyema or fistula formation from contamination.
trauma (1).pptx
1) Rib fractures are common injuries from chest trauma and can lead to high morbidity and mortality, especially in elderly patients. Surgical fixation of rib fractures is increasingly being used to manage injuries.
2) For flail chest segments, early surgical stabilization is recommended to reduce respiratory compromise and pain. For multiple simple rib fractures, surgical fixation may decrease pain and recovery time compared to conservative treatment.
3) Early rib fixation within 72 hours of injury may lead to shorter hospital stays and fewer complications like pneumonia compared to later fixation. Surgical stabilization should generally be considered early for displaced or anterior chest wall fractures.
Pulmonary surgeries
Pulmonary surgeries are performed to remove part or all of the lung, repair lung tissues, or drain fluid from the chest cavity. Common reasons for lung surgery include suspected abnormal growths, infections, trauma, lung replacement, and conditions such as cancer, blebs, or collapsed lungs. The main types of pulmonary surgeries are pneumonectomy (removal of an entire lung), lobectomy (removal of one or more lung lobes), wedge resection, segmentectomy, and sleeve resection. Surgeries are performed by cardiothoracic surgeons through various incisions and can treat conditions like bronchiectasis, tuberculosis, and emphysema. Complications may include nerve damage or deformity.
Anaesthesia for laparoscopic surgeries
This document provides an overview of anesthesia considerations for laparoscopic surgeries. It discusses the history of laparoscopy, physiological effects of pneumoperitoneum including on the cardiovascular, respiratory, central nervous and renal systems. It also outlines respiratory complications like subcutaneous emphysema, pneumothorax, gas embolism and their treatment. The effects of patient positioning and conduct of anesthesia are summarized.
Airway management
This document discusses airway management and provides details on basic and advanced techniques. It begins with an introduction on basic airway management focusing on treatment and prevention techniques like removing foreign objects and positioning. It then describes advanced methods which rely on medical equipment and include supraglottic techniques using airways, infraglottic intubation, and surgical procedures like cricothyrotomy and tracheostomy. Complications of some techniques like cardiopulmonary resuscitation are also mentioned.
ANAESTHESIA FOR THORACOSCOPY AND VATS
The document discusses anesthesia considerations for thoracoscopy and VATS procedures. It covers preoperative assessment and optimization, intraoperative anesthetic management including lung isolation techniques, ventilation strategies, positioning, and management of issues like hypoxemia. Protective lung ventilation principles with low tidal volumes, PEEP, and recruitment maneuvers are emphasized for lung protection during one-lung ventilation.
Pulmonary interventional radiology techniques
This document discusses pulmonary interventional radiology procedures. It covers percutaneous lung biopsy techniques and indications. Minimally invasive image-guided procedures are described for draining fluid collections in the lungs and chest. Percutaneous transcatheter embolization is discussed as the standard treatment for pulmonary arteriovenous malformations to reduce risks. Various embolic agents, advantages, and recanalization risks are summarized.
Anaesthetic Implications Of Lung Resection (3).ppt
This document provides information on preoperative assessment for lung resection surgery. It discusses evaluating patients' risks, exercise tolerance, predicted postoperative lung function, and discontinuing smoking. For high-risk patients, it recommends measuring diffusing capacity and conducting ventilation/perfusion scans. The aim is to identify at-risk patients and determine how much lung tissue can be removed safely. A thorough history, exam, tests including spirometry, ECG, and labs are outlined. The document also covers intraoperative management including techniques for one lung ventilation.
Video-assisted thoracic surgery (VATS).pptx
Presentation about video-assisted thoracic surgery (VATS), which is minimally invasive thoracic surgery that does not use a formal thoracotomy incision, it is principally employed in the management of (pulmonary, mediastinal, and pleural pathology.
Anesthesia for laparacopic surgery 2022.
- Laparoscopic surgery utilizes carbon dioxide insufflation to create space in the abdomen for visualization, but this causes various physiological effects.
- General anesthesia with endotracheal intubation is the standard to allow ventilatory control and protect the airway during positioning.
- Potential complications include hemodynamic issues, pulmonary complications from gas absorption or positioning, and injuries related to surgical instrumentation or patient positioning. Close communication with the surgeon is important if complications occur to potentially reduce intra-abdominal pressure or convert to an open procedure.
Thoracic surgery anesthesia
1) Thoracic anesthesia presents unique physiologic challenges including lung mechanics changes with lateral positioning, open pneumothorax risks, and one lung ventilation complications like hypoxic pulmonary vasoconstriction inhibition.
2) Careful patient evaluation and optimization is important preoperatively, including pulmonary function tests and cardiac evaluation. Intraoperatively, techniques like double lumen tubes, lung isolation, and thoracic epidural analgesia are utilized.
3) Postoperative complications can include pulmonary issues like edema, hemorrhage, or respiratory failure. Prolonged air leaks or bleeding may require chest tube insertion.
SESSION 14. Lung abscess Bronchiectasis.pptx
The document discusses lung abscess and bronchiectasis. It defines lung abscess as a suppurative lesion caused by infected lung tissue necrosis that forms cavities containing pus or fluid. Bronchiectasis is an abnormal, permanent dilation of the bronchi often caused by infection. The document outlines the epidemiology, pathogenesis, clinical features, investigations, management, and prevention of lung abscess and bronchiectasis. It describes the most common causes and pathogens, as well as signs and symptoms, management with antibiotics and drainage, and importance of preventing aspiration to control the conditions.
Anaesthesia for laproscopic procedures (18 jan)
Laparoscopy involves visualizing the abdominal cavity through an endoscope inserted through small incisions. Carbon dioxide is used to insufflate the abdomen and provide working space. Anesthesia aims to minimize physiological effects of pneumoperitoneum on the cardiovascular, respiratory, and central nervous systems through fluid loading, controlled ventilation with PEEP, and limiting increases in intra-abdominal pressure. Complications include subcutaneous emphysema, gas embolism, and respiratory issues related to diaphragm movement. Postoperative management focuses on analgesia and preventing postoperative nausea and vomiting.
Similar to Lung exclusion surgery for Hemoptysis (20)
Thoracoscopy vs laparoscopy technical feasibility and complications in cong...
Thoracoscopy vs laparoscopy technical feasibility and complications in cong...
Anaesthesia for laparoscopic surgery from ceaccp journal
Anaesthesia for laparoscopic surgery from ceaccp journal
Empyema as a complication of lung abscess drainage
Empyema as a complication of lung abscess drainage
Anaesthetic Implications Of Lung Resection (3).ppt
Anaesthetic Implications Of Lung Resection (3).ppt
More from Dr Rajinder Dhaliwal
Anatomy of thorax (2)
In this pppt I have described surgical anatomy of chest wall, lungs and mediastinum. This will be useful to medical students, surgical residents and surgons
Chest trauma pg
Chest injuries ranks 3rd after head injuries and extremity injuries in a case of multisystem trauma.It is of two types blunt chest trauma and peneterating chest trauma.The main cause of blunt chest trauma is road side accidents due to vehicles. Peneterating chest trauma is more dangerous and is common in war injuries and civilian terroism.In this ppp I have discussed some useful uncommon and important aspects of chest injuries
Amputations - A procedure no body wants or likes
Amputation involves surgically removing a body part, such as a limb or extremity. It is used to treat conditions like gangrene, tumors, severe trauma, or infection in order to save the patient's life. Lower limb amputations are more common than upper limb amputations, usually due to issues like vascular disease, diabetes, or trauma. The appropriate type of amputation depends on factors like the location and condition of the affected body part. After amputation, rehabilitation focuses on wound healing, physiotherapy, fitting an appropriate prosthesis, and relearning daily activities.
Lymphoedema - Clinical features and Management
Lymphoedema is an abnormal swelling of limb due to the collection of excessive amount of high protein fluid secondary to defective lymphatic drainage in the presence of normal capillary filteration.It is very disabiling condition to the patient. In this ppp I have discussed its clinical picture and management in a simple way
Carcinoma oesophagus
Carcinoma esophagus is a lethal disease and carries poor prognosis.The diagnosis is usually delayed and over all 5yrs survival is less than 15% In this presentation I have discussed carcinoma esophagus - its pathology, clinical features, investigations and treatment in nutshell
Innovative th surg techniques
In this ppp I have described three new original thoracic surgical operations which I have devised myself, used for many years and published in reputed international journals.These are very useful and simple operatins for complex chest problems and will benefit every thoracic surgon for treating his patients
Thoracic Surgery in India -Past,Present & Future
This is prestigious Godrej S Karai Oration I delivered in the annual conference of IACVTS -Indian Association of Cardiovascular & Thoracic Surgons few years back.Thoracic Surgery is neglected cousin of Cardiac Surgery in India but it is equally important for patients and students.I hope this ppp will stimulate the minds of younger CVT Surgons .
Surgical treatment of Valvular Heart diseases
Valular heart disease is very common in most of Afro Asian counteries mainly due to Rheumatic heart disease..Definitive treatment is surgery.which may be valve replacement or reapir. In this ppp I have discussed this subject in a simple way
Foregion Body Esophagus
This document discusses foreign bodies in the esophagus. It notes that coins and food items are commonly ingested, especially by children and elderly patients. Symptoms depend on the patient's age but may include irritability, coughing, and difficulty swallowing. Radiography is the main diagnostic tool, where radio-opaque objects like coins can be seen. Treatment depends on the object's size, shape and location. Flexible endoscopy under local anesthesia is generally preferred but surgery may be needed for sharp or impacted objects or if perforation is suspected. Complications of removal procedures include esophageal trauma and infections.
Surgery for pulmonary tuberculosis
Pulmonary tuberculosis is a very common disease in developing counteries and a big health hazard. Drug therapy is main treatment.Surgery is required mainly for its complications.In this ppp I have described this topic in a simple way
Tracheostomy
Tracheostomy is a life saving operation.Every doctor and para medical person should know about it, This pppt describes this procedure in a simpe way
Organ transplantation heart & lung transplant
Power point presentation about general principles of organ transplantation and pioneer surgons and investigators, Specific discussion about Heart, Heart lung and Lung transplantation is given
More from Dr Rajinder Dhaliwal (12)
Recently uploaded
NVBDCP.pptx Nation vector borne disease control program
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Basavarajeeyam - Ayurvedic heritage book of Andhra pradesh
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
A Classical Text Review on Basavarajeeyam
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
Top 10 Best Ayurvedic Kidney Stone Syrups in India
we have mentioned the best 10 ayurvedic Kidney Stone Syrups. You can check all these products and choose the best one for yourself.
Top Effective Soaps for Fungal Skin Infections in India
Swisschem Dermacare has mentioned the List of The Best Antifungal Soap In India 2022. All of these soaps are trusted by various Dermatology Experts.
Adhd Medication Shortage Uk - trinexpharmacy.com
The UK is currently facing a Adhd Medication Shortage Uk, which has left many patients and their families grappling with uncertainty and frustration. ADHD, or Attention Deficit Hyperactivity Disorder, is a chronic condition that requires consistent medication to manage effectively. This shortage has highlighted the critical role these medications play in the daily lives of those affected by ADHD. Contact : +1 (747) 209 – 3649 E-mail : sales@trinexpharmacy.com
Phone Us ❤8107221448❤ #ℂall #gIRLS In Dehradun By Dehradun @ℂall @Girls Hotel...
Phone Us ❤8107221448❤ #ℂall #gIRLS In Dehradun By Dehradun @ℂall @Girls Hotel...chandankumarsmartiso
Phone Us ❤8107221448❤ #ℂall #gIRLS In Dehradun By Dehradun @ℂall @Girls Hotel With 100% Satisfaction
Efficacy of Avartana Sneha in Ayurveda
Avartana Sneha is a unique method of Preparation of Sneha Kalpana in Ayurveda, mainly it is indicated for the Vataja rogas.
Best Ayurvedic medicine for Gas and Indigestion
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
Light House Retreats: Plant Medicine Retreat Europe
Our aim is to organise conscious gatherings and retreats for open and inquisitive minds and souls, with and without the assistance of sacred plants.
Role of Mukta Pishti in the Management of Hyperthyroidism
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
Identification and nursing management of congenital malformations .pptx
Identification and nursing management of congenital malformations .pptxMGM SCHOOL/COLLEGE OF NURSING
Identification and nursing management of congenital malformations Recently uploaded (20)
NVBDCP.pptx Nation vector borne disease control program
NVBDCP.pptx Nation vector borne disease control program
Basavarajeeyam - Ayurvedic heritage book of Andhra pradesh
Basavarajeeyam - Ayurvedic heritage book of Andhra pradesh
Top 10 Best Ayurvedic Kidney Stone Syrups in India
Top 10 Best Ayurvedic Kidney Stone Syrups in India
Vestibulocochlear Nerve by Dr. Rabia Inam Gandapore.pptx
Vestibulocochlear Nerve by Dr. Rabia Inam Gandapore.pptx
Top Effective Soaps for Fungal Skin Infections in India
Top Effective Soaps for Fungal Skin Infections in India
Phone Us ❤8107221448❤ #ℂall #gIRLS In Dehradun By Dehradun @ℂall @Girls Hotel...
Phone Us ❤8107221448❤ #ℂall #gIRLS In Dehradun By Dehradun @ℂall @Girls Hotel...
Thyroid Gland- Gross Anatomy by Dr. Rabia Inam Gandapore.pptx
Thyroid Gland- Gross Anatomy by Dr. Rabia Inam Gandapore.pptx
Tests for analysis of different pharmaceutical.pptx
Tests for analysis of different pharmaceutical.pptx
Light House Retreats: Plant Medicine Retreat Europe
Light House Retreats: Plant Medicine Retreat Europe
Role of Mukta Pishti in the Management of Hyperthyroidism
Role of Mukta Pishti in the Management of Hyperthyroidism
Identification and nursing management of congenital malformations .pptx
Identification and nursing management of congenital malformations .pptx
Lung exclusion surgery for Hemoptysis
- 1. Lung Exclusion Surgery for Hemoptysis Dr.R S Dhaliwal M.B.B.S,M.S.DNB(Surg),M.Ch,DNB(CTV Surg) FACS,FCCP,FNCCP,FICA,FIACS Former Prof.&HOD,CTV Surgery,PGIMER, Chandigarh,India
- 2. INTRODUCTION • MASSIVE HEMOPTYSIS-EXPECTORATION OF >600 ml BLOOD IN 24 hrs . ETIOLOGY - Pulmonary Tuberculosis Bronchiectasis Lung Abcess Bronchogenic Carcinoma Aspergilloma , Mitral Stenosis AV Malformations
- 3. INTRODUCTION • Medical Treatment . Embolism Therapy • LUNG RESECTION IS TREATMENT OF CHOICE • Resection may be hazardous or not possible due to - Dense Fibrosis, Vascular Adhesions & Calcification * ALTERNATIVE LIFE SAVING PROCEDURE IS PHYSIOLOGICAL LUNG EXCLUSION
- 4. Physiological Lung Exclusion • Life saving Alternative/Adjunct to a difficult or hazardous lung resection due to dense vascular adhesions between chest wall and lung • PHYSIOLOGICAL BASIS INVOLVED PART OF LUNG ISOLATED BY DIVISION OF * PULMONARY ARTERY * BRONCHUS & BRONCHIAL ARTERIES * VIABILITY OF ISOLATED LUNG MAINTAINED BY * VASCULAR ADHESIONS WITH CHEST WALL * INTACT PULMONARY VEINS FOR DRAINAGE
- 5. Pulm TB RUL Pulm TB LUL
- 7. SURGICAL TECHNIQUE • Antero Lateral Thoracotomy • J Sternotomy • Minimum Lung Mobilisation near Hilum • PULMONARY ARTERY LIGATION EXTRA OR INTRAPERICARDIALLY * INVOLVED BRONCHUS DIVIDED AND CLOSED * PULMONARY VEINS PRESERVED
- 16. J STERNOTOMY
- 20. RESULTS • Hospital Mortality Nil • Post Operative Empyema Nil • Residual Space Nil • Recurrance of Hemoptysis 1 (FOB - Oother side Bleeding) • Follow Up Up to 18 Yrs No Problem NO BPF OR EMPYEMA
- 21. CONCLUSIONS PHYSIOLOGICAL LUNG EXCLUSION IS AN EFFECTIVE ALTERNATIVE OPERATION FOR CONTROL OF MASSIVE OR RECURRENT HEMOPTYSIS WHERE LUNG RESECTION IS DIFFICULT/HAZARDOUS DUE TO DENSE FIBROSIS, VASCULAR ADHESIONS & CALCIFICATION
- 23. Remarks • This is an original surgical technique developed and published by me for treatment of Hemoptysis ( Massive or Recurrent) where a standard lung resection is hazardous or dangerous due to dense vascular lung adhesions,severe fibrosis or calcification in the pleural cavity • Every thoracic surgeon should know this technique , it will save his patient from death due to bleeding during difficult lung resection and spare him from a very embarassing situation R S Dhaliwal