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

We present the case of a 69-year-old male bearing a Swan-Ganz catheter while undergoing aortic and mitral valve replacement. Massive hemorrhage through the endotracheal tube began after closure of the sternotomy. Selective endobronchial intubation was performed and the thorax immediately reopened to reveal a tear in the right pulmonary artery at the level of the middle lobar branch. The tear was sutured, and throughout the early postoperative hours the patient presented signs of active bleeding through thoracic drains, with persistent slight hemoptysis in the right branch of the endotracheal tube. Ventilation was controlled artificially with two synchronized respirators and positive end-expiratory pressure (PEEP) up to 10 cm H2O in the right lung. The double-lumen tube was removed after 15 days with no complications and the patient was released two months after surgery. Massive endobronchial hemorrhage resulting from perforation of the pulmonary artery or its tributaries caused by Swan-Ganz catheters requires early diagnosis and treatment based on airway protection and immediate location and control of the point of hemorrhage. Selective endobronchial intubation with double-lumen tubes, direct arterial surgery and use of PEEP may constitute a valid alternative for management of these patients, making resection unnecessary.
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PMID:[Massive endobronchial hemorrhage due to pulmonary artery rupture caused by a Swan-Ganz catheter]. 837 63

Bilateral, concurrent massive hemoptysis with respiratory failure is rare and difficult to manage. We encountered two patients with this condition. One was a 51-year-old woman and one was a 63-year-old woman. Both had inactive pulmonary tuberculosis and episodes of hemoptysis. Home oxygen therapy was prescribed to the former patient and bronchial artery embolization was done in the latter. The sites of initial bleeding were in the left basal segment and in the lingular segment. Bleeding was well controlled by endobronchial tamponade with a Fogarty balloon catheter in the left main bronchus, contralateral intubation, and systemic artery embolization. Use of water instead of air in the balloon was more effective in over the long term. Concurrent bleeding from the contralateral upper lobe bronchus was controlled by compression with a tracheal tube cuff at the bronchial orifice. Afterward, an infiltrative shadow was seen on the chest X-ray film and hemoptysis occurred in case 2 occurred in case 2. Treatment with erythromycin and antituberculosis drugs brought about improvement of chest X-ray findings and disappearance of the hemoptysis.
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PMID:[Two cases of recurrent, massive hemoptysis with contralateral, concurrent hemoptysis]. 881 Jul 60

A syndrome of acute pulmonary edema has been previously reported among scuba divers in cold, European waters. Because of the temperatures involved, the name "cold-induced pulmonary edema" was coined in the original 1989 description. We report six individuals who developed the identical syndrome, five while diving in Puget Sound and one in the Gulf of Mexico. The four women and two men ranged in age from 24 to 60 yr. They experienced one to six episodes apiece, each with the development severe dyspnea at depth without excessive exertion. Associated symptoms included cough, weakness, expectoration of froth, chest discomfort, orthopnea, wheezing, hemoptysis, and dizziness. Emergency medical evaluation of four divers revealed rales on examination and pulmonary edema on chest radiograph. In one diver with pulmonary edema on chest radiograph, pulmonary capillary wedge pressure was normal when measured acutely. Symptoms resolved either spontaneously over 1-2 days or with standard medial treatment for pulmonary edema. Prior history of cardiovascular disease was negative except for hypertension and mitral valve prolapse in one diver. Cardiac evaluations following recovery from the acute episodes were normal. Episodes in the cold waters of Puget Sound sometimes occurred despite the use of dry suits. Furthermore, one diver developed recurrent episodes in 27 degrees C water off Cozumel, Mexico. Development of pulmonary edema while scuba diving constitutes a distinct clinical entity which may occur in either "cold" or "warm" water. It is not associated with a decompression mechanism. Personnel caring for divers should be aware of the syndrome in order to provide optimal medical management.
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PMID:Pulmonary edema of scuba divers. 906 53

Chemical burns are associated with significant morbidity, especially anhydrous ammonia burns. Anhydrous ammonia is a colorless, pungent gas that is stored and transported under pressure in liquid form. A 28 year-old patient suffered 45% total body surface area of second and third degree burns as well as inhalational injury from an anhydrous ammonia explosion. Along with fluid resuscitation, the patient's body was scrubbed every 6 h with sterile water for the first 48 h to decrease the skin pH from 10 to 6-8. He subsequently underwent a total of seven wound debridements; initially with allograft and then autograft. On post burn day 45, he was discharged. The injuries associated with anhydrous ammonia burns are specific to the effects of ammonium hydroxide. Severity of symptoms and tissue damage produced is directly related to the concentration of hydroxyl ions. Liquefactive necrosis results in superficial to full-thickness tissue loss. The affinity of anhydrous ammonia and its byproducts for mucous membranes can result in hemoptysis, pharyngitis, pulmonary edema, and bronchiectasis. Ocular sequelae include iritis, glaucoma, cataracts, and retinal atrophy. The desirability of treating anhydrous ammonia burns immediately cannot be overemphasized. Clothing must be removed quickly, and irrigation with water initiated at the scene and continued for the first 24 h. Resuscitative measures should be started as well as early debridement of nonviable skin. Patients with significant facial or pharyngeal burns should be intubated, and the eyes irrigated until a conjunctivae sac pH below 8.5 is achieved. Although health care professionals need to be prepared to treat chemical burns, educating the public, especially those workers in the agricultural and industrial setting, should be the first line of prevention.
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PMID:Anhydrous ammonia burns case report and review of the literature. 1081 76

Cases of childhood hemoptysis are rare and usually result from foreign body aspiration or congenital heart or lung diseases. However, human hirudiniasis due to the leech still exists, and could involve the upper airways after drinking infested water from quiet streams and pools. We report the case of a 6-year-old child who presented suffocating at the emergency room after having been misdiagnosed and treated for asthma over a 1-month period. His mother reported he had had recurrent hemoptysis, as well. The child inadvertently drank leech-infested water in a rural area of northern Syria. Surgical removal of the leech resulted in prompt resolution of the symptoms. Although laryngeal hirudiniasis is rare in the developed world, it remains a possible cause of childhood airway obstruction, hemoptysis, and anemia which needs to be considered in patients with a suggestive history.
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PMID:Laryngeal hirudiniasis: an unusual cause of airway obstruction and hemoptysis. 1183 3

Pulmonary edema of water immersion, which is not associated with aspiration or a closed glottis, is infrequently described in the literature. Swimming-induced pulmonary edema is a syndrome whose pathophysiologic characteristics have not been fully elucidated. Immersion alone has marked effects on central vascular volume, redistribution of pulmonary blood flow, and lung volumes. These changes are more prominent in cold water. These changes, coupled with an elevated cardiac output, may expose regions of the capillary bed to high pressures that favor the extravasation of fluid by hydrostatic forces and potential stress failure of the capillaries. Patients with swimming-induced pulmonary edema present with dyspnea, cough, hypoxemia, and occasionally hemoptysis. Physical examination and chest radiographs usually reveal evidence of pulmonary edema. Treatment is symptomatic and conservative. Improvement and resolution of symptoms are usually rapid, with radiographic normalization in 24 to 48 hours. We describe here 3 cases of swimming-induced pulmonary edema.
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PMID:Swimming-induced pulmonary edema. 1254 77

In the Chaibasa region of the West Singhbhum district of Jharkhand, India, an abandoned chrysotile asbestos mine is a health scourge for villagers and former mine workers. A massive pile of asbestos waste mixed with chromite has lain atop the hilltops of Roro village for two decades, gradually seeping into the land, water, homes, and bodies of the tribal communities living at the foothills of Roro. To investigate the status of the asbestos waste and its impact on the community and the environment, a fact-finding team made a preliminary assessment. Its findings suggest that the careless closure of the mines and the unscientific disposal of toxic asbestos and chromite waste by the mining company pose a serious threat to the health of the local community and the environment. The preliminary health survey of 14 villages around the Roro hills, with 45% of the respondents being former workers of the Roro asbestos mines, indicates a highly probable link between the asbestos exposures and several adverse health effects such as low back pain, dyspnea, hemoptysis, and blindness.
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PMID:The blighted hills of Roro, Jharkhand, India: a tale of corporate greed and abandonment. 1296 62

Acute pulmonary edema may be induced by diving and strenuous swimming. We report the case of a diver using closed-circuit, scuba equipment who developed acute dyspnea, hemoptysis, and hypoxemia following a dive in 18 degreesC (64.4 degrees F) water and physical exertion during the swim back to shore. With the growing popularity of recreational scuba diving, emergency physicians are liable to be faced with increasing numbers of diving-related medical problems. Diving-induced pulmonary edema should be included in the differential diagnosis of acute hypoxemia, sometimes accompanied by acid-base abnormalities, when this is seen in a diver.
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PMID:Pulmonary edema following closed-circuit oxygen diving and strenuous swimming. 1462 Apr 79

Severe leptospirosis rarely presents with primary pulmonary manifestations, without any associated jaundice or renal dysfunction. The authors report a nine-year-old boy who presented with complaints of abrupt onset of high fever; with myalgia, headache, and pain in right chest region, productive cough with hemoptysis and vomiting developing over the past 72 hours. Chest radiograph showed consolidation in the right upper lobe with air bronchogram. A history of contact with sewage water and presence of conjunctival suffusion in a child with pneumonia made us suspect leptospirosis. Following prompt initiation of parenteral penicillin therapy the child's complaints resolved over the next five days. Dri-Dot test to detect anti-Leptospira antibodies was positive. The diagnosis of leptospirosis was confirmed by a positive microagglutination test to Leptospira interrogans serovar Australis by a fourfold rise in antibody titer in paired sera collected during convalescence. Leptospirosis presenting with pulmonary hemorrhage has been associated with significant mortality but it can be successfully treated with early clinical suspicion of alveolar hemorrhage and prompt therapy.
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PMID:Leptospiral pneumonia. 1568 65

Acute pulmonary oedema has been described in individuals participating in three aquatic activities: (i) scuba diving; (ii) breath-hold diving; and (iii) endurance swimming. In this review, 60 published cases have been compiled for comparison. Variables considered included: age; past medical history; activity; water depth, type (salt or fresh) and temperature; clinical presentation; investigations; management; and outcome. From these data, we conclude that a similar phenomenon is occurring among scuba, breath-hold divers and swimmers. The pathophysiology is likely a pulmonary overperfusion mechanism. High pulmonary capillary pressures lead to extravasation of fluid into the interstitium. This overperfusion is caused by the increase in ambient pressure, peripheral vasoconstriction from ambient cold, and increased pulmonary blood flow resulting from exercise. Affected individuals are typically healthy males and females. Older individuals may be at higher risk. The most common symptoms are cough and dyspnoea, with haemoptysis also a frequent occurrence. Chest pain has never been reported. Radiography is the investigation of choice, demonstrating typical findings for pulmonary oedema. Management is supportive, with oxygen the mainstay of treatment. Cases usually resolve within 24 hours. In some cases, diuretics have been used, but there are no data as to their efficacy. Nifedipine has been used to prevent recurrence, but there is only anecdotal evidence to support its use.
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PMID:Pulmonary oedema of immersion. 1573 Mar 35


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