1.Epiphrenic oesophageal diverticulum managed via laparoscopic transhiatal approach
Wai Tseung Soo ; Jackson Siew Wen Ling ; Jun Sen Chuah ; , Sze Li Siow
The Medical Journal of Malaysia 2019;74(3):243-245
Epiphrenic oesophageal diverticulum is a rare disorder
affecting the distal oesophagus. Surgical techniques for this
condition evolve over time from open transthoracic and
trans-abdominal approaches to minimally invasive surgery.
We report a case of an 82-year-old male who presented with
symptomatic epiphrenic oesophageal diverticulum over the
last 1 year. He underwent laparoscopic transhiatal
diverticulectomy, myotomy and anterior partial
fundoplication and was discharged well. He remains
asymptomatic after a follow-up of 6 months.
2.Emergency repair of blunt traumatic bronchus injury presenting with massive air leak.
Jun Sen CHUAH ; Zhun Ming RAYMOND LIM ; Ee Peng LEE ; Jih Huei TAN ; Yuzaidi MOHAMAD ; Rizal Imran ALWI
Chinese Journal of Traumatology 2022;25(6):392-394
Blunt traumatic tracheobronchial injury is rare, but can be potentially life-threatening. It accounts for only 0.5%-2% of all trauma cases. Patients may present with non-specific signs and symptoms, requiring a high index of suspicion with accurate diagnosis and prompt treatment. A 26-year-old female was brought into the emergency department after sustained a blunt trauma to the chest from a high impact motor vehicle accident. She presented with signs of respiratory distress and extensive subcutaneous emphysema from the chest up to the neck. Her airway was secured and chest drain was inserted for right sided pneumothorax. CT of the neck and thorax revealed a collapsed right middle lung lobe with a massive pneumothorax, raising the suspicion of a right middle lobe bronchus injury. Diagnosis was confirmed by bronchoscopy. In view of the difficulty in maintaining her ventilation and persistent pneumothorax with a massive air leak, immediate right thoracotomy via posterolateral approach was performed. The right middle lobar bronchus tear was repaired. There were no intra- or post-operative complications. She made an uneventful recovery. She was asymptomatic at her first month follow-up. A repeated chest X-ray showed expanded lungs. Details of the case including clinical presentation, imaging and management were discussed with an emphasis on the early uses of bronchoscopy in case of suspected blunt traumatic tracheobronchial injury. A review of the current literature of tracheobronchial injury management was presented.
Humans
;
Female
;
Adult
;
Pneumothorax/surgery*
;
Bronchi/injuries*
;
Wounds, Nonpenetrating/diagnosis*
;
Bronchoscopy
;
Trachea/injuries*