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

During 8-year period 14 patients were treated for laryngotracheal trauma complex (8 of them with blunt injury and 6 with penetrating injury). The most common signs and symptoms were respiratory distress in 85.6%(12 patients), subcutaneous emphysema in 85.6% (12 patients) hoarseness or dysphonia in 64.3%(9 patients) and hemoptysis in 64.3% (9 patients). Tracheostomy was preferred for airway control and was required in 100% of the patients. Laryngotracheal plasty in 9 patients (6 patients within 6-48 hour after injury, 3 patients in 3-8 day after injury). Long-term airway quality was measured in 11 patients (for 2-4 year follow-up): A grade in 5 patients, B in 4 patients, and C in 2 patients.
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PMID:[Laryngotracheal trauma complex (report of 14 cases)]. 1118 26

In association with perforating or blunt trauma, isolated injuries of the trachea and the bronchi are rarely seen. More frequently, however, they occur when adjacent organs or structures are involved, thus creating very complex syndromes. Symptoms such as dyspnea, coughing attacks, hemoptysis, soft tissue emphysema, cyanosis, and pneumothorax should point to severe tracheobronchial injuries. Diagnosis is confirmed through an emergency tracheobronchoscopy; early surgical repair is mandatory. Iatrogenic injuries--most often due to intubation maneuvers--are infrequent but potentially life-threatening and demanding immediate repair except in cases with superficial tears. Leading symptoms of transmural lacerations are dyspnea, soft tissue emphysema, and pneumothorax. Tracheoesophageal fistulas result from decubital necrosis caused by long-term intubation. With spontaneous healing never occurring, surgical repair is carried out ideally by closing both openings in chronic fistulas, while simultaneous tracheal stenosis is treated by segmental resection. Tracheoarterial fistulas, mostly associated with tracheostomy, become fatal if not detected immediately. Definitive repair requires the resection of the vascular segment involved.
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PMID:[Tracheobronchial injuries and fistulas]. 1171 15

Transthoracic fine-needle biopsy (TFNB) is a valuable method of recognizing changes in lungs, especially suspected of cancer. Such operations are cheap, don't demand expensive instruments and are possible to perform in each pneumonology ward, especially if they are an ideal supplement for bronchofibroscoping examination. The possibility of quick and effective performance of transthoracic biopsy shortens the diagnostics considerably. From January 1997 to April 1999 there were performed 406 operations of TFNB. There were 334 people operated on (294 men--74.5%; 85 women--25.5%), average age for the whole group of patients--62.8 (+/- 10.4 years). The patients were divided into two groups considering hospitalization places: I--patients from (not transported for operation)--135 (40.4%), II--patients transported for operation from another hospitals--199 (59.6%) The examination was performed under control of rtg apparatus (7600 OEC Medical System with mobile x-ray tube on a C-arm and laser localizer). The usual complication was an pneumothorax--52 cases (12.8%); drained--16 cases (3.9%). An average depth of inserting in an early pneumothorax is 6.56 (+/- 0.73), in a late pneumothorax--8.6 cm (+/- 1.75), (p = 0.0015). An average depth of inserting in a drained pneumothorax was 8.9 cm (+/- 2.17), in a non-drained pneumothorax 7.7 cm (+/- 1.3) (p = 0.024). Patients that had to be transported for the operation had pneumothoraxes that needed to be drained considerably more often: 14 cases in 199 comparing to 2 in 135 among patients not demanding to be transported (p = 0.02). Pneumothoraxes appeared more often after indicating tumors of smaller size, from 3 cm--21.6%; 3.1-6 cm--13.3% (p = 0.036). From another complications one could notice: hemoptysis--4 cases; subcutaneous emphysema--1 case; fever and shivers--1 case; hypotonia--2 cases; cough--1 case. Those complications were treated symptomatically or vanished themselves.
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PMID:[Frequency of complications after transthoracic fine-needle biopsy of lung tumors]. 1177 Mar 9

One of the most frequent anesthesiological manoeuvres is orotracheal intubation (OTI). Many complications can occur during OTI, one of these is the rupture of the trachea (TR) and/or of the bronchi. The aim of this study is to highlight the risk of TR during OTI. Over a period of three years of activity (1997-1999) in the Cardiothoracic Department of Pisa University nine patients we treated, eight of which were women ranging from 35 to 95 years of age. In the majority of the cases clinical signs like subcutaneous emphysema of the face and neck, hemoptysis and dyspnoea, variably combined were present. An X-ray of the thorax carried out on six patients did not permit the diagnosis. Bronchoscopy was the diagnostic examination in all nine patients. Seven cases were treated by senior anaesthesiologists, without stilet and OTI was easy. Predictive elements for difficult intubation were not observed in any case. Only one patient had a voluminous intrathoracic goitre dislocating the trachea. The nine patients were all treated surgically as they were all symptomatic and with important transmural lacerations that caused pneumothorax or pneumomediastinum. The survival percentage in the third month is 100%. Although rare TR must be suspected when clinical signs are present; bronchoscopy is the examination which permits diagnosis and a correct therapy.
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PMID:[Tracheal rupture a complication of orotracheal intubation]. 1224 94

Between 1988 and 2000 a total of 33 patients with traumatic tracheobronchial lesions were diagnosed and treated. The trauma was penetrating in 7 (stab and gun-shot), blunt in 10 (car accidents, compression and falling from heights) and iatrogenic in 16 of them (postintubational--15, after foreign body extraction--1). The main clinical and radiological features were subcutaneous emphysema, hemoptysis, respiratory insufficiency, pneumomediastinum and pneumothorax. The diagnosis was confirmed in all patients by early fiberoptic bronchoscopy. "Watch and see" tactics with massive antibiotics therapy was followed in 4 (12%) patients. A surgical treatment was carried out in 29 (88%) patients as follows: simple repair--19 (58%), left pneumonectomy--2 (6%), tracheal resection and anastomosis "end to end"--2 (6%), tracheostomy--1 (3%), thoracocenthesis and drainage--3 (9%) and cervical mediastinotomy--2 (6%). The operative mortality was 9%. The cause of death in these 3 patients were associated brain and spinal cord injuries. In the rest of patients the early and long-term postoperative results were considered very good.
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PMID:[Major respiratory tract traumas]. 1251 32

Lung volume reduction surgery has recently become an option for the management of patients with severe emphysema. The procedure consist of resecting non-functional lung in order to improve respiratory mechanics. Because postoperative prolonged air leakage is a serious complication of the operation, most surgeons now use staplers reinforced with bovine pericardial strips to seal the lung. We report a patient where the migration of an intact pericardium patch caused an obstructive pneumonia and recurrent hemoptysis over several years.
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PMID:Late complication of bovine pericardium patches used for lung volume reduction surgery. 1282 92

Computed tomography (CT) has not been considered useful for early diagnosis of traumatized patients who could hardly hold their breath, particularly patients with tracheal injuries. However, the recent development of spiral CT has made it possible to acquire contiguous patient data, which eliminates the respiratory misregistration. Air is easily differentiated from surrounding tissues by striking contrast, and the trachea can therefore be well displayed by three-dimensional (3D)-CT. We consider that it is possible to show tracheal injury by 3D-CT. The aim of this study is to clarify the usefulness of 3D-CT for detecting the injury site of blunt tracheal injuries. The study was carried out in hemodynamically stable patients who were suspected of having tracheal injury based on clinical manifestations such as hemoptysis, or cervical subcutaneous, deep cervical, or mediastinal emphysema. Repeated bronchoscopy confirmed tracheal injury. The virtual images of the 3D-CT (3D-tracheography) were compared with the direct images of bronchoscopic findings. Five cases were examined. In patients with tracheal injury, bronchoscopy revealed laceration of the tracheal lumen or disruption and dislocation of the tracheal cartilage, partially coated by mucus and clot, findings that confirmed the diagnosis of tracheal injury. The virtual images of the 3D-tracheography clearly showed the injury as a defect in the tracheal wall or a depression in the wall. The site and size of injury shown in the 3D-tracheography were comparable with those detected by bronchoscopy. We succeeded in detecting tracheal injuries by 3D-CT imaging, the virtual images of which were comparable with the bronchoscopic findings. 3D-tracheography is a useful method for diagnosing the site and form of tracheal injury in hemodynamically stable patients.
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PMID:Usefulness of the 3-dimensionally reconstructed computed tomography imaging for diagnosis of the site of tracheal injury (3D-tracheography). 1559 43

Congenital lung malformations are often discovered incidentally on routine prenatal sonography or postnatal imaging. Lesions such as congenital cystic adenomatoid malformations (CCAM), sequestrations, bronchogenic cysts and congenital lobar emphysema may be asymptomatic at birth or at the time of discovery later in life. Some authors advocate simple observation because of the lack of data on the incidence of long-term complications. However, there are very few described cases where CCAM and intralobar sequestration have remained asymptomatic throughout life; complications eventually develop in virtually all patients. The most common complication is pneumonia, which may respond poorly to medical treatment. Other complications include the development of malignancies (carcinomas and pleuropulmonary blastomas), pneumothorax and hemoptysis or hemothorax. Since lung resection will be required sooner or later for CCAM, intralobar sequestration and intrapulmonary bronchogenic cysts it is best not to wait for complications to occur. For patients diagnosed prenatally, we recommend surgery at 3 to 6 months of life at the latest, so that compensatory lung growth can occur. At this age the postoperative course is usually smooth and long-term follow-up has shown normal respiratory function. Mediastinal bronchogenic cysts also tend to become symptomatic and elective resection is recommended. On the other hand, asymptomatic congenital lobar emphysema may regress spontaneously and observation is warranted. The management of small noncommunicating extralobar sequestrations is more controversial; it is known that these lesions can remain asymptomatic throughout life but complications may develop and they are sometimes difficult to differentiate from neuroblastoma.
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PMID:Asymptomatic congenital lung malformations. 1577 May 85

Traumatic tracheobronchial rupture is a rare and serious complication of blunt chest trauma. Authors report the case of a 9 years old girl who was hit by a car. She presented to the admission, a respiratory distress with subcutaneous emphysema, hemoptysis, bilateral pneumothorax and pneumomediastinum. Apparently persistent pneumothorax in spite of clinic improvement after oxygenoterapy and pleural drainage, had made consider tracheobronchial rupture. The bronchoscopy achieved in emergency, had shown a low lesion of the trachea and a desinsertion of the left main bronchus. A right thoracotomy had permitted to repair the lesions. Post-operative outcome was good and authors insist in interest of early management.
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PMID:[Traumatic tracheobronchial rupture: importance of early respiratory resuscitation and bronchoscopy]. 1577 86

Pulmonary bullae are a common late complication in patients with emphysema. Non-communicating emphysematous bullae may expand during air travel when the ambient pressure is reduced, resulting in various forms of barotrauma including pneumothorax and air embolism. We report a 62-yr-old man with emphysema who developed hemoptysis during international commercial air travel. CT scan of the chest obtained after the travel showed air-fluid level in an enlarged bulla. He underwent resection of the bulla and had a full recovery. This is a unique presentation of stretch injury of a bulla as a form of pulmonary barotrauma occurring during commercial air travel. With the most recent ruling by the Federal Aviation Administration to allow patients with advanced chronic obstructive lung disease to travel by air with their own supplemental oxygen devices, physicians need to be aware of this type of pulmonary barotrauma and properly advise such patients who are planning to travel by air.
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PMID:Hemorrhage from an enlarged emphysematous bulla during commercial air travel. 1718 25


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