Clinical Scenarios in Thoracic Surgery - download pdf or read online

By Robert Kalimi MD, L. Penfield Faber MD

ISBN-10: 078174797X

ISBN-13: 9780781747974

This specified case-based assessment of thoracic surgical procedure bargains very good coaching for oral board examinations, which emphasize either normal wisdom and case administration. Written by means of well-known specialists, the ebook offers a number of circumstances protecting the complete spectrum of thoracic surgical illnesses. each one case starts off with the medical presentation and proceeds to X-ray record, differential analysis, CT experiment record, prognosis and advice, surgical strategy, final result, and dialogue. X-rays, CT scans, bronchoscopic images, and different suitable illustrations accompany the textual content. a few situations comprise postoperative issues and dialogue of the motives, review, and administration of those complications.

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Example text

The pleural fluid represents a sympathetic effusion based on chemistries. Thoracostomy tube insertion is sufficient management as long as the effusion is adequately drained. At the time of neck exploration through the original incision, a small amount of cloudy fluid is evident, but the tissues are otherwise healthy, and there is no obvious defect in the mucosa. 47 48 Clinical Scenarios in Thoracic Surgery An appropriate amount of concern is necessary in managing suspected leaks. In this patient, even though no obvious leak is identified, reinforcement of the region of suspected leakage with healthy tissue and proper drainage is appropriate.

Followup should include a chest x-ray, which is performed every 3 to 4 months for the first year, every 6 months through the third year, and annually thereafter. 43 case 9 Presentation A 65-year-old man with no significant past medical history presents to your office with symptoms of dysphagia and regurgitation. He reports difficulty initiating swallowing both solids and liquids. He also experiences occasional spontaneous regurgitation of undigested food into the back of his throat. There is no history of cough or pneumonia.

Case 5 ■ Chest X-ray Figure 5-3 Chest X-ray Report Right-sided chest tubes are present. The right lung is expanded; however, there is a unilateral right pulmonary edema with sparing of the left lung. There is also subcutaneous emphysema, mostly on the patient’s right side. An endotracheal tube is identified above the level of the carina. There is significant gastric distention. ■ Discussion Reexpansion pulmonary edema (REPE) is a rare condition. It is most often reported after reexpansion of the lung following a sudden decompression of pneumothorax of several days’ duration.

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Clinical Scenarios in Thoracic Surgery by Robert Kalimi MD, L. Penfield Faber MD


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