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

Two patients with closed rupture of the cervical trachea secondary to blunt trauma, one secondary to neck injury and the other secondary to thoracic injury, were analysed with those reported else where (58). Signs and symptoms included subcutaneous emphysema, respiratory distress, hoarseness/dysphonia, dysphagia, hemoptysis and so on. We conclude that: (1) the diagnosis of blunt trauma of the cervical trachea requires a high index of suspicion, since this injury can easily be overlooked; (2) tracheostomy is the best means of airway control; (3) good long-term airway quality is best obtained by immediate repair of injuries.
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PMID:[Closed rupture of the cervical trachea]. 130 96

Amongst the rare causes of haemoptysis rupture of the great vessels is always a possibility. An aorto-bronchial fistula is a rare complication of thoracic aneurysms of the aorta. A fistula starting from a false aneurysm is exceptionally rare. Our observation concerns a patient of 61 with previous vascular problems who was discovered to have a mediastinal tumour following dysphonia and haemoptysis. Aortography and surgical intervention revealed that this was a false aneurysm of the horizontal part of the aorta which had developed a fistula in the bronchus.
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PMID:[Aortobronchial fistula developing in a pseudoaneurysm of the horizontal aorta]. 272 72

Fifty head-injured patients who had tracheostomy were followed during rehabilitation by video fiberoptic laryngoscopy examination. Complications of aspiration (23/50), airway stenosis (13/50), and phonation dysfunction (16/24) were followed. Spontaneous resolution of aspiration may require a prolonged course. A majority of patients (37/50) had improvement and could be decannulated. Prognostic factors correlated to eventual decannulation included age, level on the Glasgow Coma Outcome Scale, and type of head injury. Those with poor neurologic improvement and glottic incompetence (13/50) are poor candidates for decannulation. Significant airway stenosis can involve both laryngeal and tracheal sites. Neurologic dysfunction may complicate the decannulation process after airway anatomy has been restored by surgery. Dysphonia resulting from intubation, peripheral laryngeal and nerve injury, or central laryngeal movement dysfunction are common. Preventive maintenance with ongoing evaluation can avoid airway crises such as aspiration pneumonia, hemoptysis, and innominate artery.
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PMID:Airway complications in the head injured. 274 96

The low incidence of blunt trauma to the cervical portion of the trachea limits management experience in most centers. Hence, we combined our patients with those in published reports containing essential information on injury, treatment, and results. Among 51 patients (93% male), ages ranged from 3 to 65 years. There were 32 complete transections, 15 partial transections, and four tears. There were associated injuries of the recurrent laryngeal nerve (49%), esophagus (21%), larynx (14%), and cervical spine (9%). Presenting signs and symptoms included subcutaneous emphysema in 84%, respiratory distress in 76%, hoarseness/dysphonia in 46%, and hemoptysis in 21%. Tracheostomy was the best means of airway control; 13 of 17 (76%) attempted oral/nasotracheal intubations failed, necessitating emergency tracheostomy. Five patients with no respiratory distress and minimal tissue injury were successfully managed without tracheal repair. Ten patients had tracheal repair without tracheostomy. The only poor result occurred in a patient with a treatment delay of several days. Tracheal repair with tracheostomy was used in 27 patients, with good results in 19. Two patients died of other injuries, and six patients (four with delayed repair) required subsequent tracheal reconstruction. Repair over a stent was used in seven patients, four of whom had satisfactory results. From this review we conclude that (1) the diagnosis of blunt trauma to the cervical trachea requires a high index of suspicion, since this injury can easily be overlooked; (2) tracheostomy (vs intubation or cricothyroidotomy) is the preferred means of airway control; (3) preoperative laryngoscopy/bronchoscopy should be done to assess vocal cord function, possible laryngeal damage, and level of tracheal injury; (4) good long-term results, measured by voice and airway quality, are best obtained by immediate repair of significant injuries.
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PMID:Blunt injuries of the cervical trachea: review of 51 patients. 305 18

Four cases of acute laryngeal fracture that demonstrate the history and clinical findings characteristic of blunt laryngotracheal trauma are presented. Symptoms in these patients included shortness of breath, neck pain, dysphasia, dysphonia, and hemoptysis. Physical examination findings suggesting acute laryngeal injury included pain on palpation of neck, swelling or edema of the neck, subcutaneous emphysema, and loss of landmarks in the neck. All four patients were admitted to the surgical intensive care unit and had the diagnosis of laryngeal fracture confirmed at laryngoscopy. Airway obstruction is a potential complication in all patients sustaining blunt laryngotracheal trauma. Early diagnosis and management may lead to a good outcome, as with these four patients.
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PMID:Blunt laryngotracheal trauma. 372 9

A few patients with traumatic aortic laceration remain undiagnosed and survive long enough to develop a chronic aneurysm. Such aneurysms are frequently asymptomatic; alternatively, they may manifest themselves in the form of chest pain, dysphonia, dysphagia, bronchial irritation, or sudden death. A case of aortobronchial fistula secondary to a chronic post-traumatic aneurysm of the aortic isthmus is presented. Hemoptysis was the main sign. The affected segment of the thoracic aorta was replaced with a Dacron graft and a left superior lobectomy was performed. Nevertheless, the patient died during the postoperative period due to adult respiratory distress syndrome. Pathogenesis, diagnosis, and management of aortobronchial fistulae are discussed.
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PMID:Aortobronchial fistula secondary to chronic post-traumatic thoracic aneurysm. 879 50

A 34-year-old man had development of an aortobronchial fistula 17 years after patch aortoplasty for correction of aortic coarctation and 5 years after blunt chest trauma, an unusual combination of predisposing factors. The clinical presentation, characterized by dysphonia and recurrent hemoptysis, and the surgical findings suggested the posttraumatic origin of the fistula, which was successfully managed by aortic resection and graft interposition under simple aortic cross-clamping, associated with partial pulmonary lobectomy. When hemoptysis occurs in a patient with a history of an aortic thoracic procedure, the presence of an aortobronchial fistula should be suspected. Early diagnosis offers the only possibility of recovery through a lifesaving surgical procedure.
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PMID:Aortobronchial fistula after coarctation repair and blunt chest trauma. 1073 36

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

The laryngeal amyloidosis is an uncommon disease accounting for 1% of all benign lesions of larynx. The commonest symptom is the dysphonia, sometimes accompanied by stridor, laryngeal globus sensation, dysphagia and, in rare occasions, cough, dyspnea and hemoptysis, specially when the tracheobronchial tree is also affected. This paper describes the case of a 30-year-old female patient, whose main symptoms were progressive dysphonia and dyspnea, admitted at allergy service to rule out asthma. The respiratory function tests showed obstruction in the medium and small caliber ways without reversibility with salbutamol. Biopsies of ventricular band, vocal cord and arytenoid stained with positive Congo red for amyloid tissue, established the laryngeal amyloidosis diagnosis. The complementary studies to rule out amyloid tissue in the remaining tracheobronchial tree were negative. Dyspnea had characteristics of laryngeal origin, caused by a pulmonary ventilation disorder provoked by the difficult arrival of air to alveoli, which caused the decreased partial pressure of oxygen and CO2.
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PMID:[Asthma or laryngeal amyloidosis? A report of a case and literature review]. 1663 59

Voice production is a complex process that involves more than one system, yet most causes of dysphonia are attributed to disturbances in the laryngeal structures and little attention is paid to extralaryngeal factors. Persistent dysphonia after general anesthesia is a challenge to both anesthesiologists and otolaryngologists. The etiology is often multivariable and necessitates a team approach for proper diagnosis. Laryngeal symptoms are subdivided into phonatory disturbances and airway related complaints. When they become persistent for more than 72 hours or are coupled with airway symptoms such as hemoptysis, stridor, dyspnea or aspiration, the anesthesiologist should suspect injury to the vocal folds or cricoarytenoid joints. Here-below, the laryngeal manifestations of endotracheal intubation and the pathophysiology of vocal fold scarring are discussed.
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PMID:Persistant dysphonia following endotracheal intubation. 1751 Nov 79


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