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

This paper presents a case of hoarseness caused by the pharyngolaryngeal localization of a leech. This pathological lesion is extremely rare in western European countries, but is more frequent in endemic areas. Possibly lethal dyspnoea, haemoptysis or haematemesis can be the revealing symptoms. When the diagnosis is suspected simple examination under anaesthesia and removal of the leech will effect a cure.
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PMID:Hoarseness due to leech ingestion. 1074 35

Progress in diagnostic radiology and pathology during the past decade has changed the approach to diagnosis of mediastinal masses. Diagnosis by CT-guided needle biopsy (CTNB) has replaced open biopsy and mediastinoscopy, CTNB of mediastinal masses is accurate, reliable and safe. It is done under local anesthesia, in ambulatory patients and is tolerated well. Between July 1987 and April 1997 we performed 67 biopsies in 63 patients aged 6-86 years; 33 were women (average age 40.8 years) and 30 men (average age 38.3 years). 57 of 67 biopsies were core biopsies for histologic examination and 10 were cytologic biopsies. In this report we concentrate on the 57 core biopsies. 41 of the biopsies were diagnostic; in 3 of them no evidence of malignancy was found. In 38 of the biopsies a tumor, malignant or benign, or an inflammatory process was diagnosed. In 24 of the biopsies the diagnosis was lymphoma. In 16 there was not enough material for diagnosis. We repeated the biopsy in 4 of the latter due to high suspicion of malignancy and reached a diagnosis in all 4 of them. In 6 the diagnosis was reached only on operation. The biopsies were from all compartments of the mediastinum. There were no complications such as pneumothorax or bleeding, except for 1 case of mild hemoptysis. In conclusion, CTNB of mediastinal lesions is accurate, safe and relatively cheap. In 72% a diagnosis was reached in the first attempt and a second attempt raised the diagnostic rate to 79%. We believe that CTNB should be the first step in tissue diagnosis of mediastinal masses, including those under high suspicion of lymphoma.
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PMID:[Fine needle aspiration biopsy of mediastinal masses guided by computed tomography--summary of 63 patients]. 1091 20

A rare case of primary pulmonary neoplasm is reported. The patient was a 38-year-old woman presenting with obstructive pneumonia. Fiberoptic bronchoscopy revealed an endobronchial mass obstructing the left main bronchus: a reddish polypoid mass which bled on contract that was suggestive of bronchial adenoma. The patient also had a long-standing history of bronchial asthma and hemoptysis and the delay in establishing the eventured diagnosis was caused by the minor symptoms mimicking those of asthma. A persistent restrictive lung and the presentation of obstructive pneumonia were important clues which warranted further investigation by computed tomography (CT) scan and bronchoscopy. The patient underwent rigid bronchoscopy with CO2-laser ablation under general anesthesia. Histopathology confirmed a bronchial adenoma. The clinical response was excellent. Bronchial adenoma should be considered in young patients presenting with asthma, hemoptysis and obstructive pneumonia. Bronchoscopic CO2-laser ablation is an effective treatment and provides an alternative to aggressive thoracotomy.
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PMID:Bronchial adenoma presenting with chronic asthma and obstructive pneumonia: a case report. 1211 46

Foreign body aspiration is a worldwide health problem which often results in life threatening complications. More than two thirds of foreign body aspirations occur among children younger than 3 years. Organic materials such as nuts, seeds, and bones are most commonly aspirated. There is a wide range of clinical presentation, and often there is not a reliable witness to supply the clinical history, especially in children. Maintaining a high index of suspicion is therefore necessary for the diagnosis. None of the imaging methods employed in such cases are diagnostic, and bronchoscopy is frequently necessary for the diagnosis as well as the treatment. In adults, removal of the foreign body can be attempted during diagnostic examination with a fibreoptic bronchoscope under local anaesthesia, which may help to avoid any further invasive procedures with more complications. When diagnosis is delayed, complications of a retained foreign body such as unresolving pneumonia, lung abscess, recurrent haemoptysis, and bronchiectasis may necessitate a surgical resection. However, some of the late complications may resolve completely after the retrieval of the foreign body, therefore, a preoperative flexible bronchoscopy should always be considered in suitable cases.
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PMID:Foreign body aspiration: clinical utility of flexible bronchoscopy. 1215 54

A 29-year-old woman at 37 weeks of gestation was brought to our hospital as an emergency patient complaining of severe cough, hemoptysis and dyspnea. On arrival, we suspected that she was suffering from bronchial asthma or pulmonary embolism, but were unable to improve her respiratory condition. The decision was made to terminate gestation immediately and an emergency cesarean section was performed under spinal anesthesia. Postoperatively diagnosis of tuberculosis was made. Fortunately, there was no intramural tuberculous infection. She was a nurse. Nurses are twice as likely as the general public to contract tuberculosis. Medical workers must keep in mind that they may be infected with tuberculosis and they could also become the source of infection of tuberculosis. It is important to rule out tuberculosis when a patient, particularly a medical worker, complains of severe cough, hemoptysis and dyspnea.
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PMID:[Tuberculosis detected after emergency cesarean section]. 1222 50

Hemoptysis is a frightening symptom for patients and often is a manifestation of significant underlying disease. The chest radiograph, history and examination findings, comorbid illnesses, and demographic factors guide evaluation of patients with minor hemoptysis. Massive hemoptysis occurs in less than 5% of patients with hemoptysis and is almost always due to serious pulmonary or systemic illness. Massive hemoptysis is a life-threatening event that requires ICU admission and urgent bronchoscopic evaluation for lateralization or localization of the bleeding site. Management should be individualized and requires prompt consultation with appropriate cardiothoracic surgery, pulmonary medicine, anesthesia, and interventional radiology staff. The availability of endobronchial techniques and bronchial arterial embolization has enhanced our ability to control massive bleeding short-term and decreased the need for emergency surgical treatment. Massive hemoptysis may recur without warning. Prompt workup and treatment are required for all patients.
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PMID:Manifestations of hemoptysis. How to manage minor, moderate, and massive bleeding. 1240 Jan 52

Anesthetic management of a parturient with respiratory failure associated with hemoptysis, dyspnea, and orthopnea is difficult. An anesthesiologist should realize that the patient's major problem is not solved during the surgery. This circumstance is similar to a patient with associated cardiac disease scheduled for non-cardiac surgery. General anesthesia with endotracheal intubation can provide safe oxygenation for both the parturient and the fetus, but with possible unexpected massive hemoptysis and tumor seeding. Prolonged intubation may delay the patient's pulmonary treatment course. Laryngeal mask anesthesia can provide an airway, but must not be secured due to the risk of aspiration. The need of high doses of inhalation drugs may hinder uterine contractions. The addition of a muscle relaxant will change the patient's respiratory patterns and physiology. Regional anesthesia alone might not be tolerated. A decrease in cough strength, as well as dyspnea, orthopnea, and hyperventilation may be harmful to both the parturient and the fetus. However, we successfully managed this case using epidural anesthesia combined with assisted mask ventilation instead of spontaneous breathing usually provided by a simple mask in almost all American Society of Anesthesiology (ASA) class I-II parturients during cesarean section. The anesthetic level was maintained at T8 with 18 ml of 2% Xylocaine mixed with 2 ml of 7% sodium bicarbonate with 1:200,000 epinephrine epidurally and with the patient in a supine position with the head up at 30 degrees to prevent cephalic spreading and to ensure better pulmonary ventilation.
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PMID:Anesthetic management of a parturient undergoing cesarean section with a tracheal tumor and hemoptysis. 1265 13

This article presents a case of hoarseness, dysphagia, and hemoptysis caused by the laryngeal localization of a leech. This pathological condition is extremely rare in urban areas but is frequent in endemic rural areas. Laryngoscopic evaluation of our patient has shown a leech lodged on the left arytenoid region hanging down to larynx. We present a patient living in an urban area with laryngeal leech that was removed under general induction anesthesia of sevoflurane via a face mask without endotracheal intubation.
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PMID:Removal of a laryngeal leech: A safe and effective method. 1313 Apr 48

The bronchiectasis process is irreversible, and only resection of the involved bronchiectatic segments offers the possibility of potential cure. We present our experience in video-assisted thoracoscopic lobectomy for localized right middle lobe bronchiectasis in 16 patients. From July 1994 to June 2002, we enrolled 16 patients with right middle lobe bronchiectasis. There were nine women and seven men, with a mean age of 39.7 years (range, 21-67 years). The mean duration of symptoms such as hemoptysis and chronic purulent productive cough was 7.3 years (range, 2-19 years). Surgical indications included repeat pulmonary infection with often abundant purulent, sometimes fetid, expectoration in eight patients (50%), frequent massive hemoptysis in four patients (25%), and both repeat pulmonary infection and hemoptysis in four patients (25%). During operation, all patients were placed in left lateral position under double-lumen intubated anesthesia. Three incisions were needed. One 1-cm incision for the camera port was created at the seventh intercostal space along the anterior axillary line and the other 1- and 4-cm incisions were created at the seventh and fifth intercostal spaces along the midclavicular line. Right middle lobectomy could be completed by use of either traditional or endoscopic instruments. The mean total operative time was 87 minutes (range, 60-110 minutes). The mean hospital stay was 6 days (range, 4-11 days). One patient suffered from a mild hemothorax complication that needed 10 days of pleural drainage. There was no surgical mortality in this study. The mean follow-up period was 45 months (range, 10-94 months). Overall, 14 (87.5%) patients were asymptomatic, and the other 2 (12.5%) obtained apparent symptomatic improvement after operation. Video-assisted thoracoscopic lobectomy for right middle lobe bronchiectasis is technically feasible using our approach and is potential safe in treating patients with localized right middle lobe bronchiectasis.
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PMID:Video-assisted thoracoscopic lobectomy for right middle lobe bronchiectasis. 1552 Dec 49

Tracheoinnominate artery fistula is an uncommon but life-threatening complication usually requiring emergency ligation of the artery. The recent introduction of stent-grafts offers a new therapeutic option for emergency management of hemorrhage. Stent-grafts can be used for definitive treatment or as a bridge to surgery. The purpose of this report is to describe a case of hemoptysis due to a tracheoinnominate artery fistula that occurred after a single orotracheal intubation for general anesthesia and was treated by placement of a covered stent followed 12 hours later by surgical revascularization of the innominate artery using a cryopreserved arterial allograft.
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PMID:Tracheoinnominate artery fistula: combined endovascular and surgical management by emergency stent-graft placement followed by cryopreserved arterial allograft repair. 1683 Feb 8


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