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

Three patients were judged to be prohibitive operative risks despite the need for urgent drainage of cavitary pulmonary lesions. Cavernostomy was performed in each case, with a satisfactory long-term outcome in two patients. The third patient recovered from his pulmonary insult, but died much later, secondary to an unrelated illness. One patient had a purulent lung abscess due to aspiration, one had atypical tuberculosis resistant to all antibiotics, and the third patient experienced massive hemoptysis from a tuberculous cavity. Two-stage procedures were utilized in the first two patients, while urgent operation in the third patient was facilitated by adhesions from a previous thoracotomy and pleural infection. Care must be taken to minimize endobronchial and pleural contamination by meticulous attention to detail during the performance of percutaneous tube drainage. There are relatively few indications for percutaneous drainage of cavitary pulmonary lesions in this antibiotic era. However, certain clinical situations should prompt consideration for a pneumonotomy. These include a severely septic or debilitated patient who is unresponsive to medical management, the presence of resistant pathogens in a compromised host, and the presence of severe adhesive pleuritis which may prohibit an expeditious thoracotomy and resection for massive hemoptysis.
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PMID:Utility of pneumonotomy in the treatment of cavitary lung disease. 399 58

Gastroesophageal reflux (GER) is a functional entity which is defined as "the involuntary reflux of the gastric contents in the oesophagus, without vomiting and without the involvement of either the gastric, abdominal or diaphragmatic muscles". It is therefore a question of a syndrome which is independent of the anatomical abnormalities in the cardio-tuberositic region (i.e. hiatal hernia). It may also show itself through digestive symptoms, thoracic pains, ENT symptoms and breathing complications. The presence of the latter has been clearly established in certain circumstances: --in infants, GER can cause obstructive apneas, which are responsible for sudden inexplicable deaths (SID): GER and SID have very similar epidemiological characteristics; polygraphic recordings showed that a reflux may immediately precede the onset of obstructive apnea; the instillation of 0.1 N hydrochloric acid in the oesophagus of children with GER causes an apnea. Medical or surgical treatment of the reflux prevents the recurrence of these accidents; --in adults, and older children, GER is responsible for coughs, recurring bronchopneumopathies and asthma; long-term recordings of the oesophageal pH have proved that there is a time-relationship between the two events. Scintigraphic studies have shown the pulmonary contamination by a radioactive isotope placed in the stomach the previous evening. GER has been equally suspected for conditions such as lung abscess, bronchiectasis and hemoptysis, but here it is more difficult to prove. With certain pulmonary fibroses, histological lesions have been compared with those observed during inhalation bronchopneumopathies, but it is difficult to establish a link with a reflux; --functional respiratory studies have not produced a specific functional entity for patients with GER; --careful medical treatment or surgical correction of GER lead to the sedation of respiratory symptoms (RS) in the majority of cases; --the association frequency of a GER and of RS is difficult to establish because of the diversity of the means of diagnosis employed in the past and also because of the heterogeneity of the studied populations, but the frequency is nevertheless high, indeed significantly higher than the prevalence of GER in the general population. The mechanisms which link GER and RS are not well known: first of all, there is the failure of normal antireflux mechanisms and also certain hormonal, alimentary (coffee, alcohol, tobacco, etc.) and therapeutic (theophylline, betamimetics) factors, which facilitate the reflux.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[Gastroesophageal reflux and pulmonary disease]. 636 Feb 60

Case histories of 123 patients with massive hemoptysis were reviewed. The causes of hemorrhage were active pulmonary tuberculosis (47), bronchiectasis (37), chronic necrotizing pneumonia (11), lung abscess (six), lung cancer (six), bronchovascular fistula (five), primary pulmonary fungal infection (four), and miscellaneous (seven). Conservative management was used in 66 patients, with 21 deaths (31.8%). Surgical management was used in 34 patients, with six deaths (17.6%). Endobronchial iced saline lavage was used in 23 patients, with one death. All patients treated by lavage stopped bleeding, and further therapy, either surgical (five) or medical (18), was given as appropriate. The early control of tracheobronchial hemorrhage by endoscopic means is an effective though transitory holding procedure. The unpredictability of massive hemoptysis is underscored by eight deaths from sudden, engulfing hemorrhage in seemingly stable patients awaiting endoscopy or operation.
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PMID:Massive hemoptysis. Review of 123 cases. 684 80

Pulmonary tuberculosis in adults is typically localised in the apices of the lungs. Lower lung field tuberculosis, although uncommon, is a well recognised entity which still occurs in countries with low or high prevalence of tuberculosis. Six patients with lower lung field tuberculosis, seen at the University of Papua New Guinea hospital over a period of one year, are described in this report. All six were Melanesian with a mean age of 32 years. Five were female. Fever, productive cough, pleuritic chest pain and localised crepitant rales over the affected area of the lungs were the most common clinical findings. Duration of symptoms prior to hospitalisation ranged from two to 12 months (mean: eight months). Four patients had haemoptysis. Right lung was affected more often than the left. The diagnosis of tuberculosis was delayed in four patients owing to the atypical localisation of the pulmonary infiltrates and to the absence of acid fast bacilli in the first three sputum smears. Lower lung field tuberculosis occurs more commonly in young females, affects the right lung more often and is associated with haemoptysis, early cavitation and hilar lymphadenopathy. Atypical location of the infiltrate may result in mis-diagnosis as lobar pneumonia, lung abscess or carcinoma of the lung.
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PMID:Tuberculosis of the lower lung field. 693 31

Percutaneous, nonsurgical interventions using angiographic catheter techniques and radiologic guidance were used in the management of seven cases of various lesions of the chest and lungs. Successful catheter therapy included the embolization of a large, acquired, postinflammatory vascular malformation causing massive hemoptysis and a cavernous hemangioma of the chest wall. Sixteen pulmonary arteriovenous fistulas (one patient), an iatrogenic internal mammary artery-to-innominate vein fistula, and a persistent, postbiopsy bronchopleural fistula were successfully closed. Percutaneous drainage of a pyogenic lung abscess and the nonoperative retrieval of an intravascular foreign body that had embolized to the left pulmonary artery were also successfully achieved. Performed under local anesthesia with minimal morbidity, stress, and risk, interventional catheter therapy is remarkably cost-effective. Primary chest physicians are encouraged to consider this mode of therapy whenever applicable.
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PMID:Percutaneous interventional catheter therapy for lesions of the chest and lungs. 703 84

A retrospective study of 1,150 consecutive patients with thoracic and cardiovascular diseases seen at the University College Hospital, Ibadan, Nigeria, over a five-year period (January, 1975, to December, 1979) showed that 42% (481 patients) were treated for suppurative diseases of the lung and pleura, notably empyema thoracis, lung abscess, and bronchiectasis. Of these, 336 or 70% were treated for empyema thoracis, most of whom were less than 2 years old. Seventy-five patients (16%) had lung abscess, 53 of whom were treated medically with 8 deaths, while 22 had emergency resection for massive hemoptysis with 9 deaths. Of the 70 patients with bronchiectasis, 37 were treated medically with 2 deaths, while 33 were treated surgically with 5 deaths. These data demonstrate that infectious diseases of the lung and pleura remain the greatest challenge to the thoracic surgeons in tropical, developing countries who are often handicapped by inadequate facilities, lack of drugs, illiteracy, poverty, superstitious beliefs, and poor environmental hygiene.
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PMID:Suppurative diseases of the lung and pleura: a continuing challenge in developing countries. 706 64

The rise in incidence of lung abscess due to opportunistic organisms has reemphasized the need for early recognition and treatment. Opportunistic organisms can cause lung abscess in immunocompromised hosts. Most lung abscesses are primary, occurring as a result of aspiration of oral contents into the dependent portions of the lung in persons with dysphagia or decreased consciousness. Symptoms of lung abscess include productive cough, fever, leukocytosis, weight loss, and putrid sputum. Among the complications are progression to a chronic stage, empyema, massive hemoptysis, metastatic brain abscess, and bronchopleural fistula. Treatment of lung abscess is primarily medical, consisting of an appropriate antibiotic regimen and chest physical therapy. Surgery is reserved for unresponsive patients or those with complications.
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PMID:Lung abscess: back for an encore? 708 45

This report reviews our experience with six patients with post-pneumonectomy empyema and bronchopleural fistula over a ten-year period (1969-1978) at the University College Hospital, Ibadan. The most common indications for pneumonectomy in this environment are TB-destroyed lung and suppurative diseases of the lung complicated by massive hemoptysis. Five of the six patients who developed these complications presented with life threatening hemoptysis due to lung abscess and pulmonary aspergillosis. The sixth patient presented with TB destroyed lung.This study shows that these complications are more common following emergency pulmonary resection for suppurative lung diseases and following the removal of the right lung. We have achieved the best results with initial closed chest tube drainage followed by continuous pleural irrigation and later by Clagett procedure or open tube drainage.
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PMID:Management of post-pneumonectomy empyema and bronchopleural fistula in Nigeria. 736 17

Three cases who presented with life threatening haemoptysis are reported, all of whom required surgery to control the bleeding. In all three patients chronic lung abscess was responsible for the haemoptysis. Even in the absence of typical clinical or radiographic features of an abscess this diagnosis should be considered in any patient presenting with life threatening haemoptysis.
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PMID:Lung abscess: a neglected cause of life threatening haemoptysis. 834 3

A 56-year-old man with bronchial asthma and diabetes was admitted with massive hemoptysis and thick-walled cavity in the right middle lung field on chest X-ray films. He had been treated with antibiotics for eight months under the diagnosis of lung abscess before his admission. After occlusion of the bronchial arteries with metallic coils, bronchofiberscopy was performed disclosing the obstruction of right B3b. Microscopic examination of bioptic material and bronchial brushing smear taken from right B3b yielded numerous broad, nonseparate hyphae. Right middle and lower lobectomy were performed under a diagnosis of chronic pulmonary mucormycosis. The patient was recovered and discharged on 55 th days after operation.
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PMID:[Chronic pulmonary mucormycosis diagnosed by bronchoscopy: a case report]. 837 21


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