Parenchymal Hemorrhage Case Study

PLAN: I have reviewed the chest x-rays available here and agree with the finding of bleb formation in the right and left upper lobes. Despite the fact that the patient has had a high INR, because of his history of tuberculosis and hemoptysis I believe obtaining sputum for TB is very, very important. We should rule out any other endobronchial lesions as the cause for his bleeding. I have discussed this matter with the patient and his wife. I have told them that there is the possibility of observing the condition by x-rays and repeated tests of his sputum. They understand that this is an option; however, they decided that because of concern regarding his repeated hemoptysis, they would consent to bronchoscopy. We will arrange for the patient to have a bronchoscopy done. He is off Coumadin.

Chest tubes are used to drain fluid or remove air from the patient’s chest area. My patient had a chest tube to drain his pleural effusion 26mL

Few days back, the patient had a CABG surgery and was send home under stable conditions. Family member noticed SOB and weakness from the patient and was directed to attend the ED. As they got to the ED, the emergency department nursing staff noticed SOB with pericardial hematoma and immediate drainage was necessary. A chest tube was placed as a treatment option.

Mr. S was driving when he experience a stabbing chest and back pain for the first time. The pain was so severe he immediately went to his local ER. Pulmonary ventilation and perfusion (VQ) scan and Computed tomography angiography (CTA) was done at his local ER. VQ scan was negative for pulmonary embolism (PE). CTA of the chest revealed

Pt received AP diameter X-ray to confirm tube placement and to see if there were any kind of infiltrates because of possible aspiration and to eliminate possible pneumothorax and pleural effusion. Findings included mild patchy infiltrates in the right upper to middle lobes. The left lower lobe also has some similar findings but less concerning. This may either be due to lung infection or pulmonary

At CTPA study performed at the time excluded any pulmonary emboli and the report made comment of a moderate sized right-sided pleural effusion with compressive atelectasis. There was no comment on the report of any parenchymal infiltrate and I have not cited the images myself. CRP was 113. He was given a presumptive diagnosis of pneumonia with parapneumonic effusion and commenced an Augmentin Duo Forte and doxycycline. In

A 50 years old male who has bilateral pneumonia, was found to have pneumothorax while on mechanical ventilation CPAP/PS mode. While placing the pigtail catheter, the patient

Some of the most expensive, physically painful and emotionally difficult treatments available are those which try to discover whether a patient has some form of cancer. Because of the emotional toll such a diagnosis can have for the individual, it is especially necessary to ensure comfort during the procedure. In the case of lung lesions, mediastinoscopy has long been the treatment of choice because it gives the physician a clear diagnostic picture of what is happening to the patient. However, there is an alternative that has been used in recent years that may prove more cost-effective and less troublesome to the patient. Endobronchial ultrasound-transbronchial needle aspiration (EBUS-TBNA) is a procedure in which the ultrasound serves as a guide for the more invasive procedure

Pt also has a history of deep vein thrombosis (DVT) with an inferior vena cava filter to capture any lose blood cells. The chest pain he is experiencing is no cardiac secondary to chest wall pain which is symptoms of his small cell carcinoma of the lung. Patient is required to use oxygen as needed for his SOB secondary to his lung cancer. No evidence of a compression fracture was found in the spine, patient has prior laminectomy postoperative changes in the lower lumbar secondary to previous falls.

J.M. is a 7-year-old girl that was involved in a high-speed MVA on 03/05/17. A semi-truck had rolled over the mini-van in which her, her parents, and her siblings where traveling in. When EMS arrived on the scene, all passengers had been extracted from the vehicle and J.M. had already been placed and was lying on a stretcher. Her father was found dead at the scene, her three other siblings were in critical condition, and her mother was transferred to CRMC. J.M. was then loaded onto an ambulance along with her other siblings and transported to VCH ED. Once J.M. arrived at VCH a head CT was performed and revealed a depressed comminuted frontal skull fracture. Six hours later a follow-up CT scan of the head was performed, which revealed a large intraparenchymal

There is no enlargement of the lymph nodes, pleural fluid or consolidation of a lung. There is no significance change in the appearance of the chest. The minimal subsegmental basal atelectasis is present. The compression fracture of a vertebra at the thoracolumbar junction, T12 or L1 is visualized. Radiographic images show atelectasis in lower part of the lung due to decrease amount of air in the alveoli resulting in volume loss and increase in density. The bilateral ribs are free of acute facture. There is no osseous expansile or destructive process. Pleural effusion or pneumothorax is rule out from this case

Pneumothorax can have a wide continuum of severity, ranging from simple asymptomatic pneumothorax caused by disruption

Hospital admission may be necessary for treatment procedures such as chest tube thoracostomy, pleurodesis, and surgery

A tension pneumothorax occurs when the lung is punctured, but there is no outside opening for air to escape. The pressure that builds is put on internal organs, which decreases cardiac output and the lungs’

And it has changed the situation for the pulmonologist and pathologist. The main operation indications of EBUS-TBNA are that: The stage of lymph node (LN), diagnosis of lung cancer, diagnosis of unexplained hilar and/or mediastinal lymph node (LN), diagnosis of mediastinal tumor, external pressure lesions of trachea and bronchus, diagnosis of submucosal lesions, tracking small cell tumor. The main operation contraindications of EBUS-TBNA includes: The seriously injured pulmonary function of patient and patients with bad tolerance to EBUS-TBNA who cannot cooperate well with the procedure, patients with heart dysfunction, severe hypertension and arrhythmia (tachyarrythmia and bradyarrythmia), the body and other organs have badly exhausted, patients with aortic aneurysms, asthmatic attack or massive hemoptysis, patients with narcotic allergy, patients with coagulopathy