Successfully treated pulmonary artery rupture complicated by aneurysm formation (original) (raw)
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Acute Development of Negative Pressure Pulmonary Hemorrhage Secondary to Endotracheal Tube
2016
Negative pressure pulmonary edema (NPPE) immediately after general anesthesia is a rare yet life threatening complication. It is caused by an increased fluid in the interstitial spaces and alveoli due to forced inspiratory efforts against tightly closed glottis and was described since 1977. The resulting pulmonary edema can appear within a few minutes after airway obstruction or in a deferred way after several hours, but rarely have frank pulmonary hemorrhage such as in this case. The clinical manifestations are potentially serious, but normally respond well to treatment with supplemental oxygen, positive pressure mechanical ventilation and diuretics. We report a clinical case with acute negative pressure pulmonary edema and exsanguinations of pulmonary bleeding after deep cervical lymph node biopsy under general anesthesia.
Vajira Medical Journal, 2014
Negative pressure pulmonary edema (NPPE) immediately after general anesthesia is a rare yet life threatening complication. It is caused by an increased fluid in the interstitial spaces and alveoli due to forced inspiratory efforts against tightly closed glottis and was described since 1977. The resulting pulmonary edema can appear within a few minutes after airway obstruction or in a deferred way after several hours, but rarely have frank pulmonary hemorrhage such as in this case. The clinical manifestations are potentially serious, but normally respond well to treatment with supplemental oxygen, positive pressure mechanical ventilation and diuretics. We report a clinical case with acute negative pressure pulmonary edema and exsanguinations of pulmonary bleeding after deep cervical lymph node biopsy under general anesthesia.
Journal of Medical Sciences and Health, 2021
A 75-year-old male patient referred from a medical college for emergency surgical removal of chest tube from the right pulmonary artery, inserted while treating a right-sided pneumothorax. The patient was a known case of COVID pneumonia treated successfully, 2 months back. The patient developed sudden breathlessness and chest pain with saturation of 70%. The patient had gone to nearest medical college for evaluation. Chest X-ray showed right-sided pneumothorax. Chest physician inserted intercostal chest tube. After insertion of chest tube, the patient drained 1500 ml of frank blood. Chest tube clamped and referred to a tertiary care center. Emergency computed tomography (CT) pulmonary angiogram is done. It showed chest tube tip in the right pulmonary artery. In view of post-COVID, severe interstitial lung disease, patient was not suitable for open heart surgery with the support of heart-lung machine. The patient was stable when we were received; saturation was 90% with 5 L oxygen. C...
Bronchial rupture with a left-sided polyvinylchloride double-lumen tube
Acta Anaesthesiologica Scandinavica, 2003
Bronchial rupture after intubation with a double-lumen endobronchial tube has been infrequently reported. Overinflation of the bronchial cuff was speculated to be a frequent cause of the bronchial damage. We report the case of a 78-year-old woman with non-small cell carcinoma of the right upper lobe. Her trachea and left main-stem bronchus were intubated with a left-sided polyvinylchloride (PVC) double-lumen endobronchial tube (Broncho-Cath 1 37 Fr, Mallinckrodth Medical, Athlone, Ireland). She underwent an uneventful right upper lobectomy. At the end of the resection, the surgeons noticed the herniating cuff from the ruptured left main-stem bronchus. Laceration was repaired. Subsequent course of the patient was uneventful: she developed neither bronchial leak nor med-iastinitis. Ten days later the patients was discharged home in a satisfactory condition. Factors that seem to increase the risk of injury by a double-lumen tube are discussed.
Pulmonary endarterectomy: experience and lessons learned in 1,500 cases
The Annals of Thoracic Surgery, 2003
Background. The incidence of pulmonary hypertension resulting from chronic thrombotic occlusion of the pulmonary arteries is significantly underestimated. Although medical therapy for the condition is supportive only, surgical therapy is curative. Our pulmonary endarterectomy program was begun in 1970, and 188 patients were operated on in the subsequent 20 years. With the increased recognition of the disease and the success of operative therapy, however, more than 1,400 operations have been done since 1990 at our center.
Lung volume reduction surgery as an emergency and life-saving procedure
European Respiratory Journal, 1997
Lung volume reduction surgery (LVRS) is emerging as a promising and unique therapeutic option for rigorously selected patients with severe debilitating emphysema. A 51 yr old man with generalized emphysema developed bilateral pneumothoraces during his first holiday abroad. Due to respiratory insufficiency, intubation and mechanical ventilation were necessary. In total, six chest tubes were inserted but massive air leak persisted and his respiratory condition deteriorated due to bronchopneumonia and sepsis. The patient was transferred to Belgium. As a last resort, bilateral LVRS was performed through a median sternotomy. The most diseased areas of the upper lobes containing the air leak were resected bilaterally and a pleurectomy was associated. Three months after operation, there was a remarkable improvement in spirometric values with an increase in forced expiratory volume in one second of almost 100%. The results were sustained after a follow-up of 18 months.
Spontaneous rupture of the right hemidiaphragm after video-assisted lung volume reduction operation
The Annals of Thoracic Surgery, 2002
terior chest wall by the trapezius, latissimus dorsi, and rhomboid muscle [6]. Posttraumatic pulmonary herniations are unlikely to resolve spontaneously, although small herniations have been managed successfully by thoracic strapping in the past [1, 7, 8]. Immediate surgical repair is mandatory for extrathoracic lung herniations, as reported here. The lung can usually be returned to the thoracic cavity, and only rarely is resection of incarcerated lung necessary before closing the chest wall defect. Entrapment of the lung on rib spicules at the site of rib fractures, as occurred in our patient, may require suturing of lacerated parenchyma to prevent air leaks and to shorten hospitalization. Depending on the site of lung herniation, the chest can be entered by means of either an anterior or a posterolateral thoracotomy. In the present case, a large wound in the left upper anterior chest, multiple anterior rib fractures, and left clavicle fracture-dislocation prompted us to perform an atypical transcostal vertical thoracotomy. This approach avoided multiple incisions and allowed treatment of all lesions in a single operative stage. In addition, we had some concern about placing the patient in a lateral decubitus position because of the necessity of exploring the subclavian vessels, phrenic nerve, and brachial plexus. This atypical approach allowed perfect control of lung reintegration into the thoracic cavity and limited damage to the parenchyma during this maneuver. Moreover, this approach allowed adequate exploration of the left thoracic viscera including heart, great vessels, and diaphragm.