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

We reviewed the results of 146 aspiration lung biopsies (ALB) performed on 140 patients over a five-year period. A negative fiberoptic bronchoscopy in patients with a pulmonary mass lesion or infiltrate was the major indication for ALB in this group. Seventy-two patients had various malignant chest lesions, 63 had benign or inflammatory pulmonary disease. A definite diagnosis was not obtained in the remaining five patients. The diagnostic accuracy of ALB was 73.6 percent in malignant disease and 17.5 percent in benign disease with no false positive results. Of 50 patients ultimately proven to have unresectable cancer, 46 (92.6 percent) were spared the necessity of exploratory thoracotomy for diagnosis by prior ALB. Complications included pneumothorax in 30 percent necessitating chest tube drainage in 14.3 percent. Minor hemoptysis occurred in 3.4 percent, hemothorax in 0.68 percent and subcutaneous emphysema in 1.36 percent. There were no deaths directly attributable to the procedure. We conclude that ALB is a valuable procedure in the diagnosis of malignant chest lesions, sparing exploratory thoracotomy for histologic diagnosis in many patients.
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PMID:Aspiration biopsy in the diagnosis of pulmonary disease. 727 79

The objectives of this study were to determine the risk for coughing as an adverse reaction to angiotensin converting enzyme (ACE) inhibitors under everyday circumstances in a large population and to study whether this adverse effect is more common in women. A population-based case-control study was used. The study was set in the practices of 161 Dutch general practitioners (GPs), in which all consultations, morbidity, mortality, medical interventions and prescriptions were registered during 4 consecutive 3-month periods in 4 consecutive groups of 40-41 GPs. The subjects were 2436 patients with incident coughing and up to 3 controls per case were obtained (total group: 7348 controls), matched for GP and a contemporary consultation in the same 3 months. All cases and controls were 20 years or older and had no notification of respiratory infections, influenza, tuberculosis, asthma, chronic bronchitis, emphysema, congestive heart failure, sinusitis, laryngitis, haemoptysis or respiratory neoplasms during the 3-month period. The results showed that cases were 3.6 times as likely as controls to have been exposed to ACE inhibitors (95% CI: 2.4-5.5) but after adjustment for potential confounders the odds ratio was 2.5 (95% CI: 1.6-3.9). The crude odds ratio for males was 2.7 (95% CI: 1.4-5.1) and for females 4.2 (95% CI: 2.4-7.5). The adjusted odds ratio for males was 1.8 (95% CI: 0.9-3.5) and for females 2.7 (95% CI: 1.5-4.8).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Angiotensin converting enzyme inhibitor associated cough: a population-based case-control study. 776 16

Pulmonary complications of alpha 1-antitrypsin deficiency are most commonly manifested by panlobular emphysema. This report describes histologically proven bronchiectasis in a 21 year old man with massive haemoptysis and homozygous deficiency of alpha 1-antitrypsin. Neither panlobular emphysema nor cirrhosis of the liver were present. Bronchiectasis must be considered part of the spectrum of the pulmonary pathology that may be encountered in individuals with alpha 1-antitrypsin deficiency.
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PMID:Bronchiectasis and homozygous (P1ZZ) alpha 1-antitrypsin deficiency in a young man. 871 67

Lymphangioleiomyomatosis (LAM) is a rare disease, which only affects women of childbearing age. A case of LAM in a 36-year-old woman is presented. Patho-anatomical findings are smooth muscle hyperplasia leading to obstruction of lymphatics (possibly resulting in chylothorax), blood vessels (possibly resulting in haemoptysis) and bronchi (possibly resulting in emphysema and pneumothorax). High resolution computed tomography (HRCT) of the chest can show the typical multiple small cysts and bullous emphysema distributed diffusely throughout both lungs together with interstitial fibrosis. Treatment of the disease aims at an inhibition of the presumed growth-promoting effect of oestrogen on the smooth muscle cells. However, progression is often seen in spite of treatment.
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PMID:[Lymphangioleiomyomatosis]. 784 79

Pulmonary barotrauma (PB) is caused by expansion of gases in the respiratory system. We describe 22 cases in divers that constituted 10.2% of the accidents treated at the Spanish navy's hyperbaric center (1969-1990). Hemoptysis (27.2%), subcutaneous emphysema (22.7%) and chest pain (9.1%) were the most frequent thoracic-pulmonary signs. Changes in consciousness (54.5%) and motility (22.7%) were the main neurological symptoms. The highest indices of PB were recorded during training exercises in diving courses, with 91% of the trauma patients recuperating with no aftereffects thanks to prompt deep (50 m) recompression. Protocols for applying therapeutic tables are described, and the advantages of using tables for oxygen as opposed to air are discussed. Finally, we justify the need to have a hyperbaric chamber nearby for treating this type of accident.
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PMID:[The lung overexpansion syndrome as a diving accident. A review of 22 cases]. 774 71

Six cases with bronchial disruption due to blunt chest trauma are reported. Clinical symptoms were dyspnea in 5 patients, hemopneumothorax in 3 cases, and hemoptysis and subcutaneous emphysema in 4 cases each. Pneumothorax was not found on immediate radiological examination in 3 patients. Bronchial disruption was defined by exploratory thoracotomy in one case three days after trauma. In the remaining 5 cases, the diagnosis was demonstrated by lipiodol bronchography and fibrobronchoscopy 70 days to 6 years later. End-to-end anastomosis of the bronchus was performed in 5 patients, whereas right middle and lower lobectomy was done in one case. Five patients with bronchial repair suffered transient atelectasis of the lung, which reexpanded in 4 to 10 days.
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PMID:[Bronchial disruption due to blunt chest trauma--a report of 6 cases]. 822 10

The paper provides the results of treating 118 patients aged 16 to 78 years who had complicate bullous emphysema. The most frequent complication was spontaneous pneumothorax (n = 107). Chronic respiratory failure was observed in 8 patients with bullous formations occupying 1/3-2/3 of the hemithorax volume. Two patients had recurrent hemoptysis. Eighty patients with spontaneous pneumothorax underwent thoracic operations: endoscopic bullectomy, endoscopic pleurodesis with MK-7 and MK-8 medical glues, endoscopic electro- and laser coagulation of pulmonary bullae through infrared gallium arsenide and argon lasers. Thoracotomy with marginal resection of the lung, bullectomy, parietal pleurectomy was performed in 29 (25%) patients. The paper shows indications and contraindications for endoscopic and surgical operations, methods for applying IGA laser for marginal resection of the lung, bullectomy, pleurectomy, endoscopic coagulation of the bullae, complications of endoscopic and surgical treatments.
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PMID:[Surgical treatment of complicated bullous pulmonary emphysema]. 829 98

Airway disruptions after blunt chest trauma are rather infrequent with an incidence of about 1%. Even in large centers with many such casualties they are episodical. The clinical picture is not an uniform one, and typical clinical signs occur often without an airway lesion. Therefore, the correct diagnosis may be delayed. Two case reports, one with a tracheal rupture, the other with complete disruption of the main right bronchus are presented. Both patients showed significant soft tissue emphysema, increasing dyspnea and hypoxia respectively within a few hours after their accident. The diagnosis was established bronchoscopically after time intervals of 8 and 32 hours respectively, followed by immediate surgical correction. Both patients experienced a smooth recovery with good longterm results. In blunt chest trauma presenting with subcutaneous emphysema, pneumomediastinum, pneumothorax, hemoptysis and respiratory distress, tracheobronchial disruption should be considered. In this case, expert bronchoscopy, preferably by a surgeon with large thoracic experience, is mandatory.
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PMID:[Tracheal and bronchial rupture after blunt thoracic trauma]. 845 88

A 76-year-old man was admitted for recurrent hemoptysis of 3 weeks' duration. Chest X-ray revealed lung emphysema, but no findings of thoracic aortic aneurysm. The patient's physician attributed to bronchoectasia, and he underwent angiography for the purpose of embolization of bronchial arteries. Angiography showed a small saccular thoracic descending aortic aneurysm and an aortopulmonary fistula. So aneurysmectomy and patch angioplasty was done under partial cardiopulmonary bypass. Lobectomy or wedge pulmonary resection was not necessary. His postoperative course was uneventful. In case of the patients with hemoptysis, the possibility of aortopulmonary fistula should be considered, and computed tomography or aortography should be done to rule out other pulmonary diseases.
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PMID:[Hemoptysis due to aortopulmonary fistula: a case report of successful surgical treatment]. 853 9

Traumatic bronchial rupture is a rarity. Its incidence is about 1.5% to 3% in most series of blunt chest trauma. We report a patient who presented after a road traffic accident with an apparently persistent pneumothorax which failed to respond to emergency treatment. This was later discovered to be due to a traumatic bronchial rupture. It is difficult to diagnose traumatic bronchial rupture, the main reason being that it is often not considered by doctors caring for the patient with blunt chest trauma in the Accident and Emergency Department. Failure to recognise this condition contributes to its high mortality. The authors would like to recommend that emergency bronchoscopy be carried out in patients with blunt chest trauma to exclude this potentially treatable condition. This is especially so if there are suggestive clinical features, such as the presence of extensive and spreading subcutaneous emphysema, pneumomediastinum, pneumothorax, haemoptysis, fractures of the first two ribs and respiratory distress. A history of massive blunt force to the chest wall as a mechanism of injury should also prompt the trauma team to consider the need for emergency bronchoscopy.
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PMID:Traumatic bronchial rupture--a case report. 883 2


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