Fatal Outcome ; Humans ; Infant, Newborn ; Kidney ; abnormalities ; Male ; Pneumothorax ; etiology ; Respiratory Distress Syndrome, Newborn ; etiology ; Syndrome

OBJECTIVETo assess the predisposing factors, frequency and mortality of pneumothorax (PTX) among the newborns hospitalized in a neonatal intensive care unit (NICU) in Isfahan, Iran.

METHODSThe data of 43 cases of PTX among the 738 neonates hospitalized in the NICU were analyzed retrospectively according to gestational age, birth weight, Apgar score, type of delivery, age of mother, parity, perinatal asphyxia, resuscitation at birth, side of PTX, mechanical ventilation, surfactant therapy, and underlying lung disorders.

RESULTSMean gestational age was 31 weeks and birth weight was 1 596 g in the PTX cases. The gestational age of 12 (28%) neonates was less than 28 weeks. Twenty-eight (65%) neonates were below 1,500 g. In total, PTX occurred in 43 (5.8%) neonates. Sixty-three episodes of PTX (97%) were unilateral and 2 (3%) were bilateral. Respiratory distress syndrome (RDS) (40/43, 93%) and mechanical ventilation (37/43, 86%) were common predisposing factors of PTX. Overall, 28 (65%) neonates with PTX died. Birth weight, gestational age and chest tube duration were significantly different between dead and surviving infants. The mortality rate was significantly higher in neonates who required surfactant therapy than that in those who did not require it.

CONCLUSIONSThe incidence and mortality of PTX in this study were higher than some other reports and this might be attributed to lower birth weight and gestational age. RDS and mechanical ventilation were the most common predisposing factors for the development of neonatal PTX, and mortality increased with lower birth weight, lower gestational age and more severe underlying primary lung disease.

Humans ; Incidence ; Infant, Newborn ; Intensive Care Units, Neonatal ; Iran ; epidemiology ; Pneumothorax ; epidemiology ; etiology ; mortality ; Retrospective Studies

Adult ; Female ; Humans ; Male ; Middle Aged ; Occupational Exposure ; analysis ; Pneumothorax ; complications ; etiology ; Silicon Dioxide ; analysis ; Silicosis ; complications ; etiology

Aged ; Anthracosis ; complications ; Catheterization ; Drainage ; methods ; Humans ; Male ; Middle Aged ; Pleural Effusion ; etiology ; therapy ; Pneumothorax ; etiology ; therapy ; Retrospective Studies

OBJECTIVE: To discuss the etiology, diagnosis, treatment, and prevention of pneumomediastinum or pneumothorax during the removal of bronchial foreign bodies in children. METHODS: We analyzed the clinical data of 10 cases of pneumomediastinum or pneumothorax during the removal of bronchial foreign bodies in children. RESULTS: Two patients died and the other 8 were cured. CONCLUSION Pneumomediastinum or pneumothorax is mainly caused by the intrapulmonary hyper-pressure and fracture of pulmonary bubbles. The prognosis of pneumomediastinum or pneumothorax is closely related to such factors as correct and punctual diagnosis and quick removal of the airway obstruction.
Bronchi ; Bronchoscopy ; adverse effects ; Child, Preschool ; Female ; Foreign Bodies ; surgery ; Humans ; Infant ; Male ; Mediastinal Emphysema ; etiology ; Pneumothorax ; etiology

We report a case of tension pneumothorax after an endoscopic sphincterotomy. A 78-yr-old woman presented with progressing dyspnea. She had undergone an endoscopic retrograde cholangiopancreatogram three days before due to acute cholecystitis. She underwent endoscopic sphincterotomy for stone extraction, but the procedure failed. On arrival to our hospital, she complained about severe dyspnea and she had subcutaneous emphysema. A computed tomogram scan revealed severe subcutaneous emphysema, right-side tension pneumothorax, and pneumoretroperitoneum. Contrast media injected through a transnasal biliary drainage catheter spilled from the second portion of the duodenum. A second abdominal computed tomogram showed multiple air densities in the retroperitoneum and peritoneal cavity, which were consistent with panperitonitis. We recommended an emergent laparotomic exploration, but the patient's guardians refused. She died eventually due to septic shock. Endoscopic retrograde cholangiopancreatogram is a popular procedure for biliary and pancreatic diseases, but it can cause severe complications such as intestinal perforation. Besides perforations, air can spread through the abdominal cavity, retroperitoneum, mediastinum, and the neck soft tissue, eventually causing pneumothorax. Early recognition and appropriate management is crucial to an optimal output of gastrointestinal perforation and pneumothorax.
Acute Disease ; Aged ; Cholangiopancreatography, Endoscopic Retrograde/*adverse effects ; Cholecystitis/diagnosis ; Female ; Humans ; Intestinal Perforation/etiology ; Pneumothorax/*diagnosis/etiology ; Retropneumoperitoneum/*diagnosis/etiology ; Sphincterotomy, Endoscopic ; Tomography, X-Ray Computed

Absorbable Implants ; Adult ; Aged ; Humans ; Male ; Middle Aged ; Pneumothorax ; etiology ; surgery ; Polyglycolic Acid ; Silicosis ; complications ; surgery ; Surgical Sponges

Acute Coronary Syndrome ; diagnosis ; Aged ; Diagnosis, Differential ; Echocardiography ; Electrocardiography ; Humans ; Male ; Pneumothorax ; complications ; diagnosis ; Takotsubo Cardiomyopathy ; diagnosis ; etiology

OBJECTIVETo investigate the occurrence of complications in US-guided percutaneous biopsy using core (>19G) gauge cutting needle.

METHODSA retrospective analysis of 5366 US-guided thick needle biopsies was conducted to analyze the incidence of complications after biopsy at different positions.

RESULTSThe total incidence of complications was 1.08%, including most frequent hemorrhage, pneumothorax, hemotysis and infection.

CONCLUSIONUltrasound-guided automatic biopsy is easy to operate and safe, and strict execution of the procedures can lower the incidence of the complications.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Biopsy, Needle ; adverse effects ; methods ; Child ; Child, Preschool ; Female ; Hemorrhage ; etiology ; prevention & control ; Humans ; Male ; Middle Aged ; Pneumothorax ; etiology ; prevention & control ; Retrospective Studies ; Ultrasonography, Interventional ; Young Adult

PURPOSE: Several risk factors for development of reexpansion pulmonary edema (REPE) after drainage of pneumothoraces have been reported, but the association between the method of thoracostomy and the development of REPE is unknown. The aim of this study was to compare the frequency of REPE after treatment of spontaneous pneumothorax with trocar or hemostat assisted closed thoracostomy. MATERIALS AND METHODS: We performed a prospective, observational study including 173 patients with spontaneous pneumothorax who visited the emergency department from January 2007 to December 2008. In 2007, patients were treated with hemostat-assisted drainage, whereas patients in 2008 were treated with trocar-assisted drainage. The main outcome was the development of REPE, determined by computed tomography of the chest 8 hours after closed thoracostomy. Outcomes in both groups were compared using univariate and multivariate analyses. RESULTS: Ninety-two patients were included, 48 (42 males) of which underwent hemostat-assisted drainage and 44 (41 males) underwent trocar-assisted drainage. The groups were similar in mean age (24+/-10 vs. 26+/-14 respectively). The frequencies of REPE after hemostat- and trocar-assisted drainage were 63% (30 patients) and 86% (38 patients) respectively (p=0.009). In multivariate analysis, trocar-assisted drainage was the major contributing factor for developing REPE (odds ratio=5.7, 95% confidence interval, 1.5-21). Age, gender, size of pneumothorax, symptom duration and laboratory results were similar between the groups. CONCLUSION: Closed thoracostomy using a trocar is associated with an increased risk of REPE compared with hemostat-assisted drainage in patients with spontaneous pneumothorax.
Adult ; Female ; Hemostatic Techniques ; Humans ; Male ; Multivariate Analysis ; Pneumothorax/*complications/*surgery ; Prospective Studies ; Pulmonary Edema/*diagnosis/etiology/*surgery ; Risk Factors ; Surgical Instruments ; Thoracostomy/*adverse effects/*methods ; Tomography, X-Ray Computed ; Treatment Outcome ; Young Adult