Posttraumatic pulmonary pseudocyst is a rare cavitary lesion lacking an epithelial lining, which develops within the pulmonary parenchyma after blunt chest trauma. Such pseudocysts develop most commonly in children and young adults. The clinical course is usually benign with spontaneous resolution of the radiologic manifestations within 2 to 4 months after trauma. A young male injured in a motor vehicle accident, sustaining a posttraumatic pulmonary pseudocyst, is presented here.
Secondary spontaneous pneumothorax almost always develops secondary to an underlying lung disease. A pneumothorax secondary to a malignancy is very rare, and is observed most frequently in soft tissue sarcomas. Pazopanib, a tyrosine kinase inhibitor, is used in metastatic soft tissue sarcomas treatment. The rate of pneumothorax that is caused by pazopanib is about 14% in the literature. The patient being presented in this article underwent surgery for soft tissue sarcoma, postoperatively received pazopanib (Votrient® 400 mg, oral, Glaxo Group Ltd, Brentford, UK) treatment due to widespread bilateral lung metastases, and developed synchronous spontaneous pneumothorax.
Pulmonary sequestration is an embryonic, cystic lung tissue that is supplied by systemic blood circulation. It is a nonfunctional lung parenchyma unconnected to normal tracheobronchial system. In cases of pulmonary sequestration, surgical interventions should be performed in order to prevent possible complications such as massive hemoptysis and infections. Preoperative imaging and treatment planning should be done carefully. We present an uncommon case of recurrent hemoptysis caused by intralobar pulmonary sequestration located in the left lower lobe.
The aim of this study was to investigate the effects of a postoperative respiratory physiotherapy program on pulmonary complications, length of hospital stay, and hospital cost after lobectomy for lung cancer.A total of 90 patients (75 males, 15 females; mean age 63.1±10.4 years; range, 30 to 82 years) who underwent elective lobectomy through thoracotomy due to lung cancer between June 2014 and December 2019 were retrospectively analyzed. The patients were divided into two groups as Group S who received standard postoperative care (n=50) and Group P who received postoperative respiratory physiotherapy in addition to standard care (n=40). Both groups were compared in terms of postoperative pulmonary complications, 30-day mortality, length of hospital stay, and hospital cost.The preoperative and surgical characteristics of the groups were similar. Group P had a lower incidence of postoperative pulmonary complications (10% vs. 38%, respectively; p=0.002) than Group S. The median length of stay in the hospital was six (range, 4 to 12) days in Group P and seven (range, 4 to 40) days in Group S (p=0.001). The drug cost (639.70 vs. 1,211.46 Turkish Liras, respectively; p=0.001) and the total hospital cost (2,031.10 vs. 3,778.68 Turkish Liras, respectively; p=0.001) of the patients in Group P were significantly lower. The multivariate logistic regression analysis showed that respiratory physiotherapy had a protective effect on the development of postoperative pulmonary complications (odds ratio =0.063, 95% confidence interval: 0.010-0.401, p=0.003).An intensive physiotherapy program focusing on respiratory exercises is a cost-effective practice which reduces the risk of development of postoperative pulmonary complications in patients undergoing lobectomy for lung cancer.
UNLABELLED To evaluate DeltaHb (daily changes of hemoglobin concentrations) in nonbleeding critically ill patients, and to investigate its relation with diagnostic blood loss (DBL) and fluid balance (FB). Hospital records of 34 nonseptic patients who stayed in respiratory intensive care unit (RICU) at least 72 hours with no evidence of acute bleeding, renal failure and bleeding diathesis, were evaluated retrospectively. Demographics, clinical features, acute physiology assessment and chronic health evaluation (APACHE) II scores, daily Hb levels, DBL and FB were recorded. Correlation statistics was performed between DeltaHb and DBL and FB. We compared the patients with DeltaHb > or =0.5 g/dL/day (group A) and the patients with DeltaHb < 0.5 g/dL/day (group B) in the first three days. The mean age was 55 +/- 14, Hb level was 13.2 +/- 1.7 g/dL at admission and 12.6 +/- 2.3 g/dL at discharge from RICU. DBL was 25.2 +/- 7.4 mL/d, and FB was 251 +/- 1783 mL/d for the first day in intensive care unit. DBL was lesser in subsequent days than in the first day but it wasn't significant. DeltaHb was -0.54 +/- 1.5 g/dL for the first three days, while it was -0.23 +/- 1.5 g/dL for subsequent four days (p= 0.9). DeltaHb in the first three days has no correlation with DBL and FB. Age, sex, APACHE II score, clinical features, DBL and FB were not differed between Group A and Group B. CONCLUSION No relation was found between DeltaHb and DBL, and also FB; but studies like this are important to indicate that Hb concentrations may decrease in critically ill patients without any reason such as bleeding.
Aim of this study was to determine the clinical characteristics, morbidity and mortality in patients with a sternum fracture (SF).From October 1998 to December 2008, 80 patients with sternal fractures were admitted to the Thoracic Surgery Department of the University Hospital. The records of all patients were reviewed retrospectively. Patients' age and gender, extent of sternal and thoracic injury, types of associated injuries, treatment and outcome, the length of hospital stay, morbidity and mortality were collected. We divided our patients into two groups: Group I with an isolated sternum fracture and Group II with a sternum fracture and additional injury.Patients' ages ranged from 18 to 83 years with an average age of 48.7 +/- 15.4 years. There were 67 male (84 %) and 13 female (16 %) patients. Thirty-five patients (44 %) sustained an isolated SF and the remaining 45 (56 %) had a SF in combination with associated injuries. The commonest etiology of the SF was a motor vehicle accident (77 %). Most of the fractures were located at the sternal body (76 %). The most common associated injuries were rib fractures (30 %), followed by extremity injuries (18 %). The great majority of patients (81 %) was treated with conservative measures such as bed rest, analgesia, etc. The remainder was treated either by tube thoracostomy (15 %), thoracotomy (1.25 %) or sternal fixation (2.5 %). There was no mortality and morbidity in Group I, but the morbidity and mortality rates of Group II were 15 % and 1 %, respectively. Mean length of hospital stay for all the patients was 5.7 days.Isolated SFs are benign entities that can be safely managed with rest and analgesia. Associated injuries in patients with SF determine the morbidity and length of hospital stay.