Extra-pleural haematoma secondary to blunt chest trauma. An unusual presentation.

The case history is described of a young man who presented with an apparent splenic rupture following thoracic compression during a rugby tackle. The actual diagnosis was that of an extra-pleural haematoma following transection of the internal mammary artery. This case is discussed within the context of the rarity of such a presentation--both in the site of the haematoma and the cause of the transection; and the problems posed in making the initial diagnosis.

Modification of minitracheostomy technique to limit bleeding complications.

Minitracheostomy is a commonly performed procedure usually carried out by junior medical staff. Though there are few problems associated with the technique of minitracheostomy, bleeding is often encountered. We now present a brief case report demonstrating the problems associated with bleeding. We also outline an alteration in insertion technique with the 'Minitrach' designed to diminish the risks of serious bleeding, and report on our results with this technical modification.

Castleman's disease arising from the intercostal space.

A 27-year-old woman was investigated for a tumour of the posterior chest wall. This was excised surgically and histologically it proved to be a hyaline vascular type of angiofollicular lymphoid hyperplasia or Castleman's disease. This is the third case from the literature of such a tumour arising from the intercostal space. Surgical excision has been proved curative until now with no recurrence.

Pleurectomy through the triangle of auscultation for treatment of recurrent pneumothorax in younger patients. Evaluation of 60 consecutive cases.

Sixty patients, aged 14 to 35 years, with recurrent pneumothorax were treated with pleurectomy through the triangle of auscultation, with no chest wall muscle transection. The advantages of this approach over a full thoracotomy are that with no muscle transection, a shorter postoperative recovery is expected and, subsequently, early return to normal activity is achieved. The scar may also be more cosmetically acceptable. There was no postoperative mortality, and only one patient required reoperation because of bleeding. The technique is simple, and exposure is adequate. If necessary, this limited thoracotomy can be converted to a full thoracotomy with no difficulty.

Acute left anterior descending coronary artery occlusion following blunt chest injury.

A case of acute coronary artery occlusion following blunt chest injury is reported. The incidence, cause and management of this injury are reviewed.

Ruptured bronchus following endobronchial intubation. A case report.

A case of a ruptured bronchus, following endobronchial intubation with a double-lumen tube, is reported. Possible contributing factors and causes of this bronchial rupture are discussed and careful monitoring of cuff pressures is advocated.

Deep vein thrombosis in a Queensland hospital.

Investigation in the postoperative period of 75 patients by means of the radioiodinated fibrinogen uptake method, by the use of the Doppler ultrasonic flow detector, and by clinical assessment revealed an incidence of deep vein thrombosis of only 12%. This is distinctly lower than has been reported by other investigators using the same techniques both in Australia and elsewhere. It appears from this study and associated work that the Doppler ultrasonic technique is sufficiently accurate to be of value in the clinical diagnosis of significant deep vein thrombosis.