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Query: UMLS:C0019079 (hemoptysis)
 6,129 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This retrospective study of elective pneumonectomy for complicated inflammatory lung disease was done to define modern-day mortality and morbidity. One hundred twenty-four patients received elective pneumonectomy. Patient ages ranged from 6 months to 71 years. Past, recurrent, or new pulmonary tuberculosis was present in 107 patients (86.3%). Clinical presentation involved recurrent infections or severe suppurative sequelae (abscess, empyema). Forty-seven patients had chronic hemoptysis and 25 patients had past or recent massive hemoptysis (> 600 ml of hemoptysis fluid within 24 hours). Nutritional deficiencies were common. One hundred six patients (85.5%) had end-stage destroyed lungs. Evaluative bronchoscopy showed inflammatory endobronchial changes in 106 patients (85.5%), bronchial strictures in 4, and indolent endobronchial tumor in 2. Lung separation was by double-lumen tube in 96 patients, single lung-single tube in 6, bronchus blocker in 6, and prone posture in 9. Extrapleural pneumonectomy was done in 83 patients (66.9%). Fifty-seven of these procedures were left sided and 26 were right sided. Standard transpleural pneumonectomy was done in 41 patients (33.1%): 30 left sided and 11 right sided. Nine pneumonectomies were conducted with the patient in the prone position. Four patients had completion pneumonectomy. Hospital mortality was three deaths (2.4%). Morbidity included postpneumonectomy empyema in 19 patients (15.3%). Seven postoperative bronchopleural fistulas occurred. Empyema in most patients was managed by open pleural drainage (thoracostoma) and later space closure. Pneumonectomy proved effective therapy with low mortality but postpneumonectomy empyema posed serious morbidity.
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PMID:Elective pneumonectomy for benign lung disease: modern-day mortality and morbidity. 747 40

A 66-year-old man was hospitalized because of hemoptysis. Four years earlier, he had undergone an operation involving the use of an omental pedicle flap that was supplied by the right gastroepiploic artery for the treatment of empyema. Arteriography revealed that the right gastroepiploic artery communicated with the periphery of the right pulmonary artery. The right gastroepiploic artery was divided surgically.
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PMID:Systemic artery-to-pulmonary artery shunt after using an omental pedicle flap. 769 30

From January 1986 through December 1993, we operated on 59 patients with documented Mycobacterium tuberculosis infection. Indications for operation were as follows: multidrug-resistant tuberculosis (MDRTB) in 19 patients; bronchopleural fistula secondary to Mycobacterium tuberculosis infection in 12; massive hemoptysis in 5; destroyed lung in 7; solitary nodule in 7; trapped lung in 3; complicated cavity in 4; and empyema in 2. Sixty-five operative procedures were performed: pneumonectomy with latissimus muscle flap in 15 patients; pneumonectomy in 3; lobectomy in 16; segmental or wedge resection in 11; decortication in 5; window thoracostomy in 3; thoracoplasty with myoplasty in 4; tube thoracostomy in 4; return to operating room for bleeding in 2; Clagett procedure in 1; and drainage of a cold abscess in 1. There were no operative deaths. Major postoperative complications occurred in 5 patients. The two late deaths were in patients with MDRTB: 1 with progressive disease and massive hemoptysis and the other with a relapse of MDRTB. Of the patients operated on as part of their therapeutic regimen for MDRTB, 17 (89%) of 19 have remained culture negative. We conclude that (1) surgery still plays an important role in the management of patients with Mycobacterium tuberculosis infection; (2) surgical intervention can be performed with acceptable mortality and morbidity; (3) a variety of procedures are needed to effect cure; and (4) encouraging results in patients with MDRTB support surgical therapy in this difficult group of patients.
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PMID:Current role of surgery in Mycobacterium tuberculosis. 777 18

Two cases of pulmonary coccidioidomycosis are reported; both patients were treated with surgery because the pulmonary lesion did not respond to medical treatment, both live in endemic areas of coccidioidomycosis. Both patients had pulmonary cavities; one of them with secondary empyema, in the other the cavity enlarged progressivelly and the patient presented hemoptysis. The two patients were treated with ketoconazole before the surgery, neither of them responded to medical treatment. The empyema was treated with a pleural tube but the problem was not resolved; the surgical treatment was decided and a superior right anterior segmentectomy was performed in one patient and a superior left lobectomy plus decortication in the ohter. Both patients were treated with ketoconazole after the surgery, and actually there is not evidence of active infection.
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PMID:[Pulmonary coccidioidomycosis. Surgical treatment of 2 cases]. 806 76

We have performed percutaneous intracavitary treatment with anti-fungal reagents in 8 patients with pulmonary aspergilloma (6 males and 2 female) over the past decade. Ages ranged from 43 to 84 years old. All of the patients had underlying lung diseases, seven having old pulmonary tuberculosis and one pneumoconiosis. Five patients had a history of hemoptysis or hemosputum. Amphotericin B (AMPH) was injected daily in 5 patients, Fulconazol (FCZ) in 2 patients, and both in the remaining patient. For AMPH, maximal dose, total dose, and treatment duration were 20 to 50 mg, 285 to 1560 mg, and one to 7.5 months, respectively, and for FCZ, 20 to 30 mg, 450 to 1600 mg, 3 weeks to 4 months, respectively. At the end of treatment, fungus balls disappeared in 2 patients, decreased in size in 3 patients and were unchanged in 3 patients. After follow up periods of 7 months through 6.5 years, 5 of 6 patients remained in roentogenologically better condition than before treatment, and 3 of 5 patients with episodes of hemoptysis or hemosputum have not since had airway bleeding. The prognosis of the other two patients are unknown, since they died of other diseases before this survey. One patient had aspergillus empyema 7 months after treatment. There were no serious side effects or complications directly related to treatment. It was suggested that continuous percutaneous intracavitary treatment with anti-fungal reagents is safe and effective for inoperable patients with aspergilloma.
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PMID:[Percutaneous intracavitary treatment of pulmonary aspergilloma-clinical efficacy and prognosis]. 808 40

Between 6/87 and 3/92 22 out of 24 patients were treated (22 by surgery) for pulmonary and pleural Aspergillus disease. The most frequent lung disorder was tuberculosis (9 x), followed by bronchiectasis (5 x), congenital lung cysts (2 x), pneumonia with abscess formation (2 x), sarcoidosis (2 x), and bronchial cancer (4 x). More than half the patients had further severe secondary diseases. 4 patients with "simple aspergilloma" and 5 patients with "complex aspergilloma" underwent lobectomy or segmentectomy without complications or recurrence. Special surgical problems occurred in 13 patients with inflammation involving pleura and chest wall (pleuro-pulmonary aspergillosis, pleural aspergillosis) and invasive lung changes (invasive pulmonary aspergillosis). 7 patients developed an empyema after lung resection, on 4 occasions with bronchopleural fistula. In 4 cases myoplasty, in 2 cases thoracomyoplasty, on 2 occasions completion pneumonectomy with omentoplasty, in one case omentoplasty alone, and on 2 occasions decortication with pleurectomy and lung resection lead to a complete cure. 2 open window thoracostomies were constructed. In 15 cases a single operation was adequate. In 7 patients up to 3 further operations were necessary. 17 patients had haemoptysis, in 10 of these cases it was recurrent. On 7 occasions life-threatening haemorrhage took place, causing death in 2 cases. These were the only deaths resulting from the lung disease. Our results show that aggressive surgical action can be successful. Myoplasty, thoracomyoplasty, and omentoplasty are, in our view, the most suitable measures for healing pleura empyemas and bronchopleural fistulae coincident with pleuro-pulmonary aspergillosis.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Surgical treatment of pulmonary and pleuro-pulmonary Aspergillus disease. 836 59

We report 5 cases of oat head aspiration in children that resulted in serious complications due to the unidirectional migration of the oat head to the periphery of the lung. The complications included pneumothorax, pneumomediastinum, recurrent hemoptysis, chronic lung disease, bronchiectasis, lobectomy, bronchopleural and bronchocutaneous fistulae, pleural effusion, empyema cavity, and, one not described before, osteomylitis of the rib. Physicians should be aware of the dangers with this particular foreign body aspiration.
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PMID:Complications following oat head aspiration. 841 99

Achieving sterilization of the postpneumonectomy space and bronchial healing may be difficult when active granulomatous infection of the pleural space and lung parenchyma is present at the time of operation. Three patients with chronic bronchopleural fistula, fungal empyema, and fungal cavities of the remaining ipsilateral lobe were managed with one-stage completion pneumonectomy and modified eight-rib thoracoplasty. Two patients had infection with Aspergillus fumigatis and 1 patient had Coccidioides immitis. Two patients had received mediastinal radiation after prior upper lobectomy for carcinoma of the lung. Two patients were having massive hemoptysis at the time of pneumonectomy. Eight-rib thoracoplasty with suturing of the intercostal muscles to the bronchial stump was performed on all patients. In 2 patients a mass closure of hilar vessels and bronchus was used because of inability to individually close the vessels and bronchus due to ligneous scarring of the hilum. Antibiotic and antifungal irrigations into the operative area were used postoperatively. Chest tubes were left in place 6 to 8 weeks. All wounds healed primarily. Patients were alive without recurrent local infection or tumor at follow-up 3 to 13 years postoperatively.
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PMID:Completion pneumonectomy and thoracoplasty for bronchopleural fistula and fungal empyema. 845 29

Bronchiectasis is pathologically defined as an abnormal and permanent dilatation of one or several bronchi. There are localized and generalized types of bronchiectasis. A vicious circle hypothesis, including an initial insult to the lower airways, impaired mucociliary clearance, microbial colonization/infection, bronchial obstruction and a local inflammatory response, has been proposed to explain the damage to the bronchial tree and the adjacent lung parenchyma. The clinical picture is variable and affected individuals might be asymptomatic or suffer from severe respiratory failure. Daily sputum production is the most common, though unspecific symptom of bronchiectasis. Other common symptoms are hemoptysis and recurrent episodes of sputum purulence, fever and pleurisy. Occasionally, major, life-threatening hemoptysis from a ruptured bronchial artery occurs. Infectious complications, e.g. lung abscess, empyema, brain abscess, and secondary amyloidosis are rarely seen today. The chest radiograph reveals changes suggestive of bronchiectasis in the majority of patients with clinically important disease. High resolution computed tomography of the lung has almost completely replaced bronchography for diagnosis, the latter rarely being of value if surgery is contemplated. No etiology is identified in about one- to two-thirds of the patients, although there are many diseases eventually associated with bronchiectasis. Prevention and therapy of underlying diseases are most important. Traditionally, the therapy of symptomatic bronchiectasis is based on antibiotics, antibronchoobstructive medication, and chest physical therapy. Surgical resection is the treatment of choice for localized symptomatic disease. Bilateral lung transplantation should be considered in younger patients with severe, generalized bronchiectasis and respiratory failure. Prospective, randomized, largescale trials supporting any of the different treatment strategies are not available, but antibiotics and surgery probably have improved the long-term outcome of many patients with bronchiectasis. In this review, some recent findings regarding the classification, pathogenesis, pathology, etiology, diagnosis, treatment, and prognosis of bronchiectasis are discussed.
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PMID:[Bronchiectasis--current aspects of an old disease]. 915 28

A 59-year-old woman was admitted to the hospital with a one-month history of hemoptysis, generalized fatigue, and a high fever. A chest X-ray film obtained on admission showed a massive right-sided pleural effusion. Examination of an aspirate showed a high level of amylase, and bacteria that were the same as oral bacteria. Closed drainage yielded ichorous pus and food residues, which led us to the diagnosis of empyema caused by esophageal perforation. Esophagography and fiberoptic esophagoscopy revealed that an esophagobronchial fistula related to an advanced esophageal carcinoma had caused the empyema. Surgical resection was done, and the patient was alive at the time of this writing, 7 months after she was first treated. Esophageal carcinoma is sometimes accompanied by esophagobronchial fistula. Patients with this condition usually have severe respiratory symptoms; those presenting with empyema are rare. Esophageal carcinoma must be carefully ruled out as the cause of empyema.
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PMID:[Esophagobronchial fistula and empyema resulting from esophageal carcinoma]. 923 40


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