Pneumothorax Case Studies

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.

The patient may have a hard time breathing because she is in pain after having surgery. Since they patient doesn’t want to breath due to the pain it can cause atelectasis and later sepsis if not treated in time. It would be important to teach the patient about splinting and to use an incentive spirometry in order to help her be able to breath. Another risk factor for the patient not being able to oxygenate would be hypovolemia since there is less blood volume which can also lead to less oxygen being able to travel in the blood or able to perfuse throughout the body.

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

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

82 developed an index defined as GAP (gender, age, physiology), in order to predict mortality in IPF. US and Italian patients included in this study were divided in three groups: 228 patients, 44.3% of which with biopsy proven IPF, were included in the derivation cohort and 555, 54.7% of which with biopsy, in two validation cohorts of 330 and 325 patients. Mean follow-up was 1.7 and 2.4 in the derivation and the validation cohorts, respectively. The primary endpoint of the study was time to death or lung transplantation. Overall mortality was 49% in the derivation cohort and 62% in the validation cohorts. A competing-risk regression model was used to screen potential predictors of mortality in the derivation cohort including age, sex, body mass index (BMI), smoking status, supplemental oxygen use, FVC, FEV1, TLC and DLCO. Age, sex, FVC% predicted and DLCO% predicted were identified as independent predictors and were used to develop the GAP individual risk calculator towards mortality and staging system. Three stages (stages I, II, and III) were identified based on the GAP index with 1-year mortality of 6%,16%, and 39%,

A chest x-ray is the primary way to diagnose a pneumothorax. Generally two chest x-rays will be taken, one on inspiration and one on expiration. This allows to better visualize the collapsed lung. An additional CT scan may be required. Ultrasound may also be used.

We review air embolism in the context of interventional radiology, although air embolism can also occur with barotrauma, lung biopsies and during surgical procedures, most notably neurosurgery and cardiothoracic surgery. In the former, patients may be operated on in the upright position,

For many years now, the fusion of a PET/CT scanner has proven to show its benefits in staging lung carcinoma, especially NSCLC. Lung cancer staging is done with the TMN staging system. The T refers to the size of the primary tumor and whether it has invaded local tissue. A few studies have shown that PET alone or CT with contrast, is not as accurate as combined PET/CT for the T staging of NSCLC (B, M, N). Pawaroo et al. showed that the PET aspect of PET/CT is useful for outlining the primary tumor volume, especially if there is atelectasis or invasion into the mediastinum. However, PET/CT is less accurate if the subtype is a bronchoalveolar adenocarcinoma (Pawaroo).

One day post op Ms Smith had clinical indications of a large flank hematoma and pelvic swelling. An abdominal ultrasound was ordered to check for possible internal bleeding. The ultrasound probe was placed on Ms. Smith and her entire abdomen appeared as nothing but dark shadow no matter what probe, frequency, or pressure was applied. To a new sonographer or someone who hasn’t seen this before it could be quite puzzling. Apparently during Ms. Smiths extended surgery the air that was put into her abdomen to for better visualization had not been completely removed. It is a rare complication of surgery, and is called subcutaneous emphysema. It additionally can be caused by a collapsed lung, blunt force trauma, and scuba diving. The air usually

Pneumonectomy is defined as a surgical procedure to remove a lung. There are two types of pneumonectomy: simple or traditional pneumonectomy and Extrapleural pneumonectomy. Simple pneumonectomy is defined as removal of just the affected lung because of cancer and extrapleural pneumonectomy defined as removal of the affected lung, plus the part of the diaphragm, the parietal pleura and pericardium on the side, this is primarily used for treatment of malignant mesothelioma. In the journal of thoracic and cardiovascular, it is stated that, “Chest wall resection is a safe and effective therapeutic option in the management of localized chest wall recurrence of malignant pleural mesothelioma.”

Rationale: This client has sustained a blunt or a closed chest injury. Basic symptoms of a closed pneumothorax are shortness of breath and chest pain. A larger pneumothorax may cause tachypnea, cyanosis, diminished breath sounds, and subcutaneous emphysema. Hyperresonance also may occur on the affected side. A sucking sound at the site of injury would be noted with an open chest injury.

|Specific Purpose: |To inform readers on the causes, effects and treatments of lung cancer. |

Imagine waking up in the morning to the discomfort of not being able to take a proper ventilation. Horrible, right? This is what people who have pleural effusions feel. I chose to do my paper on pleural effusions. Pleural effusions are a collection of fluid in the pleural space, the cavity surrounding the lungs. Typically, there is 10 mL of fluid in this space to lubricate the pleura, however when disrupted by diseases such as pneumonia, pulmonary embolisms, congestive heart failure, or cancer, fluid begins to third space and collect in abnormal amounts. The biggest challenge then becomes dyspnea and tachypnea. This is because the extra fluid decreases pressure making it difficult for the lung to fully expand. Pleural effusions

This procedure is done to remove excess fluid, known as a pleural effusion, from the pleural space to help you breathe easier. It may be done to determine the cause of your pleural effusion. Some conditions such as heart failure, lung infections, and tumors can cause pleural effusions.” So, after my sister okayed the procedure, my mom flat out said “no, they’re not going to do that procedure on my husband,” which hindered his healing

Even in primary malignant disease of the pleura partial thickness resection over the diaphragm ???????????????? as there is a potential plane between the parietal pleura and the diaphragmatic muscle fibres.