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1.
Einstein (Sao Paulo) ; 18: eAO4409, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31618286

RESUMO

OBJECTIVE: To compare the chest tube drainage by the same thoracotomy intercostal space with the traditional approach in patients undergoing muscle-sparing thoracotomy. METHODS: We evaluated 40 patients aged ≥18 years who underwent elective muscle sparing thoracotomies. Patients were divided into two groups of 20 patients. One group underwent thoracic drainage by the same intercostal space of thoracotomy and the other by traditional chest drainage approach. RESULTS: The mean length of hospital stay for the intercostal drainage group in the intensive care unit was 1.5 day (1.0 to 2.0 days) and 2.0 days (25.1 to 3.0 days) for the traditional chest drainage group (p=0.060). The intercostal drainage group had mean length of hospital stay (p=0.527) and drainage (p=0.547) of 4 days, and the traditional chest drainage group and 2 and 5.5 days, respectively. Dipirona and tramadol doses did not differ between groups (p=0.201 and p=0.341). The mean pain scale values on first postoperative was 4.24 in the drainage by the same intercostal group and 3.95 in the traditional chest drainage (p=0.733). In third postoperative day, mean was 3.18 for the first group and 3.11 for the traditional group (p=0.937). In the 15th day after surgery, drainage by the incision was 1.53 and the traditional chest drainage was 2.11 (p=0.440), 30th days after drainage by incision was 0.71 and traditional chest drainage was 0.84 (p=0.787). Complications, for both groups were similar with 30% in proposed drainage and 25% in traditional approach (p=0.723). CONCLUSION: Drainage by the same thoracotomy intercostal space was feasible and results 30 days after surgery were not inferior to those of the traditional chest drainage approach.


Assuntos
Tubos Torácicos , Drenagem/métodos , Toracotomia/métodos , Analgesia Epidural , Analgésicos/uso terapêutico , Fibrilação Atrial/etiologia , Dipirona/uso terapêutico , Drenagem/estatística & dados numéricos , Dispneia/etiologia , Humanos , Tempo de Internação , Medição da Dor , Dor Pós-Operatória/tratamento farmacológico , Período Pós-Operatório , Estudos Prospectivos , Toracotomia/efeitos adversos , Tramadol/uso terapêutico
3.
Pan Afr Med J ; 33: 314, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31692848

RESUMO

Vulva haematomas are uncommon outside the obstetric population, with an incidence of 3.7% and represent only 0.8% of all gynaecological emergencies. The first case is a 24-year-old G2P1011 referred after the failure of conservative management of a progressively increasing right labia majora swelling. Vulva incision, exploration and relieve of hematoma were done under local anaesthesia. The second case is a 17-year-old G1P1001, a student who presented with spontaneous pain and swelling of the left labia majora. The swelling was rapidly increasing, tense and tender. It spontaneously ruptured, clots were drained and the wound was packed. Vulva hematomas are not very common hence necessitating careful assessment, right diagnosis and management. Management could be conservative (analgesics, local compression) as well as surgical in cases of hemodynamic instability, rapidly increasing size of hematoma and pain intensity. Prompt surgical management reduces the risk of infection and longer hospital stays, which is important in low resource settings like ours.


Assuntos
Drenagem/métodos , Hematoma/terapia , Doenças da Vulva/terapia , Adolescente , Feminino , Hematoma/patologia , Humanos , Doenças da Vulva/patologia , Adulto Jovem
4.
Pan Afr Med J ; 33: 276, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31692842

RESUMO

Cystic malformations of the bile ducts are rare congenital disorders, with an incidence of 1/2000000 live births. Complication including the angiocholitis, chronic pancreatitis, progressive biliary cirrhosis, portal hypertension or gallbladder lithiases can reveal severe disorder. Spontaneous perforation is one of the rare complications described for the first time in 1934 by Weber. We report the case of an 18-month old baby admitted with subocclusive syndrome with biliary peritonitis. Ultrasound was performed showing abdominal effusion with cystic formation communicating with the bile ducts associated with subcapsular effusion of the liver confirmed by a scanner. Treatment was based on peritoneal toilet with redon drain at the level of the perforation and subhepatic drain without cyst excision. The patient was re-admitted 6 months after this incident to be definitively treated.


Assuntos
Cisto do Colédoco/diagnóstico , Peritonite/diagnóstico , Cisto do Colédoco/terapia , Drenagem/métodos , Humanos , Lactente , Masculino , Peritonite/etiologia , Ultrassonografia
5.
Pan Afr Med J ; 33: 287, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31692942

RESUMO

Catamenial pneumothorax is a rare condition that is often misdiagnosed. It is defined as spontaneous pneumothorax occurring within 72 hours before or after onset of menstruation. Etiology is unknown but could be linked to endometriosis. Pleural ablation via thoracoscopy and hormonal therapy are mainstay treatment options to avoid recurrence. We present a case of a young adult female who experienced gradual painless abdominal distention that resolved spontaneously after each menses twelve years post menarche. She was first seen at a peripheral facility where laparotomy undertaken was negative for suspected ectopic pregnancy. However, a bleeding omental mass was noticed and a biopsy taken. Histopathology reported it as an endometriotic tissue. The patient subsequently had recurrent cyclical chest pains and breathlessness leading to the diagnosis of catamenial pneumothorax. She had chemical pleurodesis done with sterile talc after chest tube drainage and has been well over two years now.


Assuntos
Endometriose/diagnóstico , Pleurodese/métodos , Pneumotórax/diagnóstico , Adulto , Dor no Peito/etiologia , Drenagem/métodos , Feminino , Gana , Humanos , Menstruação/fisiologia , Pneumotórax/terapia
7.
Zhonghua Shao Shang Za Zhi ; 35(10): 757-760, 2019 Oct 20.
Artigo em Chinês | MEDLINE | ID: mdl-31658548

RESUMO

Objective: To observe the clinical effects of sequential treatment with extensive lesion resection, vacuum sealing drainage (VSD) combined with irrigation of oxygen-loaded fluid, and tissue transplantation on hidradenitis suppurativa (HS) in buttocks which recurred after multiple surgeries. Methods: From January 2012 to March 2017, 15 male patients (aged 26-53 years) hospitalized in our burn ward with Hurley's stage Ⅲ HS in the buttocks recurred after 2-5 operations who met the inclusion criteria were enrolled in the prospective self pre- and post-control study. After extensive resection of the lesion, continuous VSD combined with intermittent irrigation of oxygen-loaded fluid was given, with negative pressure of -16.7 kPa and flow rate of pure oxygen of 1.0 L/min. After 7 days of treatment with VSD combined with irrigation of oxygen-loaded fluid, the negative pressure device was removed and autologous posterior thigh split-thickness skin grafts and/or local flaps were transplanted to repair the wounds. Six patients were performed with split-thickness skin grafting, 4 patients with local flap transplantation, and 5 patients with split-thickness skin grafting together with local flap transplantation. The donor sites of local flaps were sutured directly or transplanted with autologous posterior thigh split-thickness skin grafts, and the donor sites of split-thickness skin grafts with autologous thin split-thickness scalp. The wound tissue or wound granulation tissue was collected before lesion resection and 7 days after treatment with VSD combined with irrigation of oxygen-loaded fluid respectively for bacterial culture and detecting of the content of tumor necrosis factor-alpha (TNF-α) by enzyme-linked immunosorbent assay. Survival of skin grafts and flaps after operation was observed, hospitalization time was recorded, and recurrence and complications of HS were followed up. Data were processed with paired sample t test. Results: Bacterial culture result of wound tissue before lesion resection was positive in all patients, mainly Staphylococcus, Streptococcus, Proteus mirabilis, and anaerobic bacteria, etc., while that of wound granulation tissue after 7 days of treatment with VSD combined with irrigation of oxygen-loaded fluid was negative. The content of TNF-α in wound granulation tissue after 7 days of treatment with VSD combined with irrigation of oxygen-loaded fluid was (10.1±2.9) pg/L, significantly lower than (73.6±5.6) pg/L before lesion resection (t=33.47, P<0.01). The skin grafts and/or flaps of 15 patients survived post operation, and the wounds were healed. The patients were hospitalized for 17-31 days. During follow-up of 1 to 5 years, no recurrence of HS occurred in operative site of buttocks of 15 patients, but 1 patient had ulceration of healed perianal incision caused by high anal fistula and was healed after treatment. Conclusions: Sequential treatment with extensive resection, VSD combined with irrigation of oxygen-loaded fluid, and tissue transplantation can thoroughly remove HS lesions in the buttocks and improve the condition of wound bed for skin acceptance after debridement, which is conducive to the cure of HS in the buttocks which has undergone multiple operations but still recurs after operation.


Assuntos
Nádegas/microbiologia , Retalhos de Tecido Biológico/transplante , Hidradenite Supurativa/terapia , Tratamento de Ferimentos com Pressão Negativa/métodos , Lesões dos Tecidos Moles/cirurgia , Cicatrização/fisiologia , Adulto , Desbridamento , Drenagem , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Transplante de Pele , Resultado do Tratamento
8.
Medicine (Baltimore) ; 98(40): e17393, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31577747

RESUMO

RATIONALE: Bacteremia caused by polymicrobial infections are rare but dangerous. We report a case of hepatic abscess combined with polymicrobial bacteremia in a 49-year-old male patient after surgery and transcatheter arterial chemoembolization (TACE). PATIENT CONCERNS: The patient was admitted to hospital with metastatic liver cancer for periodic chemotherapy and developed a high fever and tenderness to the liver following surgery and TACE. DIAGNOSIS: Hepatic abscess combined with polymicrobial bacteremia. INTERVENTIONS: The clinician formulated a therapy in accordance with the drug susceptibility test and the empirical drug use for anaerobic bacteria. A comprehensive treatment plan was adopted, on the basis of the combination of nitrazole and imipenem as anti-infection drugs as well as continuous abscess drainage. OUTCOMES: After comprehensive therapy, the patient was ultimately discharged without any residual symptoms. LESSONS: Bloodstream infection caused by multiple bacteria increases the difficulty of anti-infection treatments, leading to poor treatment outcome and high mortality. Therefore, a fast and accurate diagnosis of polymicrobial bacteremia is key for initiation of an effective antimicrobial treatment. Additionally, pre-operative prophylactic antibiotics are advisable when patients have a history of abdominal surgery and are immune-compromised.


Assuntos
Bacteriemia/etiologia , Carcinoma Hepatocelular/terapia , Quimioembolização Terapêutica/efeitos adversos , Abscesso Hepático/etiologia , Neoplasias Hepáticas/terapia , Antibacterianos/uso terapêutico , Bacteriemia/tratamento farmacológico , Bacteriemia/microbiologia , Carcinoma Hepatocelular/cirurgia , Coinfecção , Drenagem , Humanos , Abscesso Hepático/tratamento farmacológico , Abscesso Hepático/microbiologia , Neoplasias Hepáticas/cirurgia , Masculino , Pessoa de Meia-Idade , Metástase Neoplásica
9.
Kyobu Geka ; 72(10): 744-748, 2019 Sep.
Artigo em Japonês | MEDLINE | ID: mdl-31582688

RESUMO

Peicardiocentesis and surgical pericardial drainage are essential treatment and diagnostic modality for pericardial effusion. Though it theoretically is a simple therapeutic method, accurate diagnosis, correct decision, and safe procedure are not always easy. Thoracic and cardiovascular surgeons are required to have high level of expertise in pericardial drainage as surgeons who specialize this anatomical part of the body. The presence of pericardial effusion does not always require drainage. Accurate diagnosis is essential to determine correct indication. Echocardiography and computed tomography are useful tools for accurate diagnosis. The percutaneous drainage has become much safer in these 2 decades with the aid of imaging technology, especially echocardiography and fluoroscopy. Surgical pericardial window still has its role and is considered one of the standard treatment methods with minimal chance to require repeat procedure compared to percutaneous drainage.


Assuntos
Tamponamento Cardíaco , Derrame Pericárdico , Pericardiocentese , Drenagem , Humanos , Paracentese , Estudos Retrospectivos
10.
Kyobu Geka ; 72(10): 834-839, 2019 Sep.
Artigo em Japonês | MEDLINE | ID: mdl-31582705

RESUMO

The proper management of chest tubes for patients undergoing lung resection is very important to prevent postoperative complications. Although it is desired to have evidence-based consensus for the management of chest tubes, currently the protocols vary among institutions. This article reviewed some recent literatures and our opinions regarding postoperative management of chest tubes. The use of 1 chest tube has been recently preferred compared to 2 chest tubes. However, the use of 2 chest tubes are required when postoperative air leakage, massive fluid discharge, or hemorrhage is concerned after peeling the firm and broad range of pleural adhesions. The chest tube is inserted through the skin incision through an access port and upper edge of the rib at an intercostal space from the skin incision, and then, commonly attached to the chest drainage unit employing a 3-bottle system. Although continuous suction with water sealing is usually utilized, a randomized controlled trial revealed that continuous suction was not better than water sealing without suction in terms of duration of air leakage, chest drainage, and hospital stay. Chest tubes can be safely removed with both no air leakage during coughing as well as daily drainage volume of up to 200 ml. According to a systematic review and meta-analysis, recently developed digital chest drainage system, with which the pleural pressure can be constantly maintained and air leakage can be evaluated objectively, proved to reduce the risk of prolonged air leakage and to shorten the duration of chest drainage and hospital stay after lung resection when compared with the traditional analog drainage system. Prolonged postoperative air leakage is usually treated with chemical pleurodesis using autologous blood, minocycline, or OK -432. Some studies demonstrated that pleurodesis with 50% glucose solution was a safe and effective treatment option.


Assuntos
Tubos Torácicos , Pneumonectomia , Drenagem , Humanos , Complicações Pós-Operatórias , Sucção
11.
Kyobu Geka ; 72(10): 854-858, 2019 Sep.
Artigo em Japonês | MEDLINE | ID: mdl-31582709

RESUMO

We sometimes encounter patients with chronic empyema of their thoracic cavity with or without air leakage. These patients suffer from mental and physical problems because of restrictions in daily life and long-term treatment. Pyothorax is divided into acute or chronic empyema. The former is treated by thoracic drainage or debridement under video-assisted thoracic surgery, while the latter is treated by managing the infection and reducing the dead space of the thoracic cavity. In this section, we describe the procedures for some treatment methods and technical skills to manage pyothorax, including fenestration, pedicle muscle flap plombage, omental plombage. The thoracic surgeon should consider the advantages and disadvantages of each method and choose an appropriate technique or possibly a combination of techniques to obtain an optimal outcome in the treatment of pyothorax. The techniques and knowledge described in this section would be useful for many thoracic surgeons' clinical work. Although the treatment methods differ between institutions, this guideline for thoracic empyema is needed to standardize treatment of this entity in the future.


Assuntos
Empiema Pleural , Desbridamento , Drenagem , Humanos , Omento , Retalhos Cirúrgicos
12.
Kyobu Geka ; 72(11): 893-896, 2019 Oct.
Artigo em Japonês | MEDLINE | ID: mdl-31588103

RESUMO

A 77-year-old man vomited after alcohol drinking and was sent to our hospital by an ambulance due to sustained chest pain. Chest computed tomography (CT) showed pneumothorax and pleural effusion, and thoracic drainage was performed. Since food residue was found from chest drainage and esophagoscopy and esophagography showed injured potion on the left wall of the lower thoracic esophagus perforating to the left thoracic cavity, a spontaneous esophageal rupture was diagnosed. Establishment of fenestration for open drainage and gastrostomy were performed. After 49 days, the fistula was successfully closed by cleaning of the left thoracic cavity, with application of basic fibroblast growth factor and enteral nutrition through gastrostomy. The fenestration was closed after 53 days and the patient was discharged after 78 days.


Assuntos
Empiema , Perfuração Esofágica , Doenças do Mediastino , Idoso , Drenagem , Fator 2 de Crescimento de Fibroblastos , Humanos , Masculino , Ruptura Espontânea
13.
Kyobu Geka ; 72(11): 897-900, 2019 Oct.
Artigo em Japonês | MEDLINE | ID: mdl-31588104

RESUMO

For safe and effective drainage in patients with pleural effusion after cardiac surgery, ultrasound-guided thoracocentesis was carried out under standing with assistance of a tilt table. Thoracocentesis was performed in 5( 11%) of the 44 patients who were treated under passive orthostatism using a tilt table. Four cases were under intubated-ventilator assist, and 2 cases were under intraaortic balloon pumping( IABP). No adverse events occurred. Thoracocentesis under standing with assistance of a tilt table can be safely performed.


Assuntos
Derrame Pleural , Toracentese , Drenagem , Humanos , Balão Intra-Aórtico , Ultrassonografia
14.
Acta Gastroenterol Belg ; 82(3): 389-395, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31566326

RESUMO

BACKGROUND AND AIM: Preoperative biliary drainage (PBD) in patients with pancreatic cancer remains debatable. The aim of this study was to analyse the indications for PBD in patients performing pancreaticoduodenectomy (PD) and to evaluate the impact of this procedure on postoperative outcome. METHODS: Observational retrospective cohort study of patients undergoing PD for pancreatic cancer. Clinical data and postoperative outcome, namely complications and 90-day mortality, were prospectively collected and compared between patients performing PBD or direct surgery (DS). RESULTS: Eighty-two patients were included: 40 underwent PBD and 42 performed DS. Major complications (27.5% vs 33.3%, P=0.156) and 90-day mortality (10% vs 16.7%, P=0.376) were similar between the two groups. There was a trend for higher mean total bilirubin in patients with PBD (P=0.073). The indication for PBD was suspicion of cholangitis/choledocholithiasis or need to perform neoadjuvant chemotherapy in 24 (60%) patients. In the remaining, elevated bilirubin was probably the only reason to perform PBD. Length of hospital stay was longer in PBD group (P=0.003). On multiple logistic regression, 90-day mortality was not related with preoperative bilirubin levels, biliary drainage or its indication, but solely with age (OR 1.15, 95%CI 1.05-1.31, P=0.008). CONCLUSIONS: PBD is often performed in patients undergoing PD without a formal indication, mainly due to high bilirubin levels. No increased morbidity/mortality was observed but length of hospital stay was prolonged in patients performing PBD.


Assuntos
Drenagem/efeitos adversos , Pancreaticoduodenectomia/métodos , Complicações Pós-Operatórias/prevenção & controle , Cuidados Pré-Operatórios/métodos , Bilirrubina/sangue , Drenagem/métodos , Humanos , Pancreaticoduodenectomia/efeitos adversos , Estudos Retrospectivos , Resultado do Tratamento
16.
Zhonghua Yi Xue Za Zhi ; 99(38): 3005-3007, 2019 Oct 15.
Artigo em Chinês | MEDLINE | ID: mdl-31607033

RESUMO

Objective: To investigate the therapeutic effects of first phase renal puncture and drainage guided by B ultrasound and second phase percutaneous nephrolithotomy(PCNL) in the treatment of urinary calculi complicated with pyonephrosis. Methods: From January 2014 to April 2018, 28 patients with upper ureteral segment and kidney calculi complicated with pyonephrosis were collected. All patients received the pyonephrosis puncture under B ultrasound. After the inflammation was controlled and the clinical situation improved, the second phase was treated by PCNL. During the operation, routine in dwelling ureteral stent drainage and renal fistula wereperformed. The outcomes of the operation were observed. Results: A total of 28 cases were successfully punctured, the obstruction was relieved and the inflammation was controlled. Additionally, the second phase of PCNL surgery was successful, and there were no significant stone residues after PCNL. There were no complications such as severe systemic inflammatory response syndrome and severe hemorrhage. After 3 to 12 months of follow-up, renal function was restored to varying degrees, and there were no renal failure patients who needednephrectomy. Conclusions: Early diagnosis of urinary calculi complicated with pyonephrosis is the key to successful treatment. Active and effective B ultrasound-guided renal puncture and drainage, drainage of pus, and removal of urinary obstruction can improve the safety of the second phase of PCNL, and thus it attaches great importance to the treatment of pyonephrosis.


Assuntos
Cálculos Renais , Nefrolitotomia Percutânea , Nefrostomia Percutânea , Pionefrose , Drenagem , Humanos , Paracentese , Punções , Resultado do Tratamento
17.
Wiad Lek ; 72(9 cz 2): 1736-1739, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31622257

RESUMO

OBJECTIVE: Introduction: The issue of surgical treatment of acute pancreatitis, in particular the choice of operative technique, is becoming increasingly relevant. The aim: To work out surgical approach in patients with acute complicated pancreatitis (ACP) using minimally invasive and traditional operative techniques. PATIENTS AND METHODS: Materials and methods: 170 patients underwent surgery for ACP. The main group (109 subjects) had minimally invasive techniques (MIT) dominated, the comparative group (61 subjects) - traditional operations. RESULTS: Results: MIT performed "as final" in 62 (69%), "stage"- in 16 (18%) and "stabilizing patient condition" - in 12 (13%) of observations. The number of combined interventions predominated in the main group - 26% and 12% (χ2=4.002; р=0.04), traditional in comparative groups - 67% and 17% cases (χ2=40.291; р<0.0001). Primary laparotomy operations were used in 41 (67%) patients from comparative and 19 (17%) patients from the main group (χ2=40.291; р<0.0001). The extent of traditional operations in the maingroup consisted predominantly of necrosequestrectomy with Beger closed drainage - in 26 (55%) and 15 (31%) observations, respectively (χ2=5.018; р=0.02). Necrosequestrectomy with subsequent stage lavage performed in common purulent-necrotic lesions were comparable in both groups - in 11 (23%) and 13 (26%) observations (χ2=0.0013; р>0.05). CONCLUSION: Conclusions: The worked out surgical treatment approach in ACP with individual and combined use of MIT and traditional operations resulted in decreased rates of postoperative complications from 13.1% to 8.3% and mortality from 14.8% to 9.2%.


Assuntos
Procedimentos Cirúrgicos Minimamente Invasivos , Pancreatite Necrosante Aguda/cirurgia , Doença Aguda , Drenagem , Humanos , Laparotomia
18.
Medicine (Baltimore) ; 98(39): e17365, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31574884

RESUMO

RATIONALE: Periorbital cellulitis or an orbital abscess caused by acute sinusitis is a serious acute infectious disease. If not treated in time, serious complications may occur. PATIENT CONCERNS: A 16-year-old girl with a history of right-sided proptosis, periorbital swelling, chemosis, hypophasis, restricted ocular movement in the upward direction, and diminution of vision was referred to our institution. The clinic, computed tomography (CT) and magnetic resonance imaging (MRI) examination indicate right orbital abscess in the upper quadrant and sinusitis. DIAGNOSES: She was diagnosed with orbital abscess, acute sinusitis. INTERVENTIONS: She underwent medical management, transnasal endoscopic surgery and then ultrasound-guided fine needle aspiration (FNA) and catheter drainage. OUTCOMES: She was completely cured without any complications or sequelae. LESSONS: Performance of surgical drainage in a timely manner and administration of effective antibiotic treatment according to bacterial culture can reduce the complications of orbital abscesses. Ultrasound-guided FNA and catheter drainage is a safe, simple, and effective method for the treatment of orbital abscess.


Assuntos
Abscesso/cirurgia , Drenagem/métodos , Aspiração por Agulha Fina Guiada por Ultrassom Endoscópico/métodos , Doenças Orbitárias/cirurgia , Sinusite/cirurgia , Abscesso/microbiologia , Doença Aguda , Adolescente , Cateteres , Drenagem/instrumentação , Feminino , Humanos , Doenças Orbitárias/microbiologia , Sinusite/microbiologia
20.
Medicine (Baltimore) ; 98(41): e17555, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31593139

RESUMO

RATIONALE: Endobronchial ultrasound has revolutionized the field of bronchoscopy and has become one of the most important tools for the diagnosis of intrathoracic lymphadenopathy and para-bronchial structures. The reach of this technique has not been limited to these structures and pleural lesions have been at times accessible. To our knowledge, pleural fluid collections have not been accessed with endobronchial ultrasound (EBUS). PATIENT CONCERNS: 52-year-old women with dyspnea, fever and a new loculated pleural effusion that was suspected to be the source of the fever but was not accessible through traditional thoracentesis. DIAGNOSIS: Malignant pleural effusion. INTERVENTIONS: Sampling and drainage of the loculated pleural fluid collection using EBUS scope introduced via the esophagus. OUTCOMES: Infection excluded. Resolution of fever and improved dyspnea after drainage of effusion. LESSONS: The convex curvilinear ultrasound bronchoscope allows unprecedented access to thoracic structures. The reach is not limited to mediastinal lymph nodes and parenchymal masses adjacent to the airways, and pleural space and pleural fluid are at times accessible, particularly when one considers the esophageal approach.


Assuntos
Derrame Pleural Maligno/diagnóstico por imagem , Derrame Pleural Maligno/cirurgia , Toracentese/métodos , Broncoscópios , Drenagem/métodos , Aspiração por Agulha Fina Guiada por Ultrassom Endoscópico/métodos , Feminino , Humanos , Pessoa de Meia-Idade , Derrame Pleural Maligno/patologia , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento
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