Percutaneous transthoracic needle biopsy (PTNB) is an important procedure for diagnosis of pulmonary lesions. PTNB is minimally invasive procedure but sometimes complications can occur. The most common complications include pneumothorax, hemorrhage, and hemoptysis. Air embolism is very rare complication, but it can be a life-threatening if not managed appropriately. So knowledge of air embolism entity may minimize morbidity and mortality after PTNB.
Biopsy, Needle* ; Diagnosis ; Embolism, Air ; Hemoptysis ; Hemorrhage ; Image-Guided Biopsy ; Mortality ; Needles* ; Pneumothorax

Bronchopleural fistula is an uncommon but serious complication of lung resection, with a high mortality and morbidity. Problems associated with bronchopleural fistula and empyema are related to positive-pressure ventilation, which may result in infectious contamination of healthy lung tissue, loss of air, decreased alveolar ventilation leading to carbon dioxide retention, and the development of a tension pneumothorax. We experienced difficult intubation in patient who has large bronchopleural fistula and anatomic deviations of intact bronchus of the left lung, so we used a long single lumen tube made by attaching an another cuffed endotracheal tube under direct vision. The arterial oxygenation was effective, but carbon dioxide elimination was inadequate. After the operation, the ordinary cuffed endotracheal tube was intubated orally and the patient was transferred to the ward without problems 6 days after the operation.
Anesthesia* ; Bronchi ; Carbon Dioxide ; Empyema ; Fistula* ; Humans ; Intubation ; Lung ; Mortality ; Oxygen ; Pneumothorax ; Positive-Pressure Respiration ; Ventilation

BACKGROUND: To evaluate exudative pleural fluid, thoracentesis for microbiological and cytological examination and pleural biopsy by using a Cope needle are traditionally performed. Even after these studies, about 20% of patients remain undiagnosed. We evaluated the diagnostic accuracy and complications of 2-mm minithoracoscopy instead of blind biopsy in patients with undiagnosed exudative pleural effusion. METHOD: Fifteen patients with exudative pleural effusion underwent thoracoscopy between April 2002 and August 2003. The indication was undiagnosed pleural effusions after having performed sputum and pleural fluid examinations both microbiologically and cytologically. RESULT: The median age of the patients was 56 years (range 21-77). Pleural effusions were lymphocyte-dominant in 11 patients (73.3%) and neutrophil-dominant in 3 (20.0%). The remaining patient (6.7%) had pleural-fluid eosinophilia. Minithoracoscopic biopsy revealed accurate diagnosis in 14 patients (93.3%), consisting of tuberculous pleurisy in 8 (66.7%), malignant effusions in 4 (33.3%), and parapneumonic effusions in 2 (13.3%). One was diagnosed as having paragonimiasis from thoracoscopic findings and clinical considerations. There was no procedure-associated mortality. There were six cases of new onset fever (40%) and one of pneumothorax (6.7 %). CONCLUSION: Two-millimeter minithoracoscopy, which is less invasive than conventional thoracoscopy, was an accurate and safe method for undiagnosed exudative pleural effusion.
Biopsy* ; Diagnosis ; Eosinophilia ; Fever ; Humans ; Mortality ; Needles ; Paragonimiasis ; Pleural Effusion* ; Pneumothorax ; Sputum ; Thoracoscopy ; Tuberculosis, Pleural

Neonates with severe respiratory distress syndrome who require high levels of assisted ventilation have a high mortality and morbidity rate. Morbidity is mainly composed of bronchopulmonary dysplasia which is a result of air leak syndrome(ALS), oxygen toxicity. Even with unsolved controversy, there is a possibility that high-frequency oscillatory ventilation would decrease the development or progression of ALS in infants with severe respiratory distress syndrome. ALS is defined as pulmonary interstitial emphysema or gross air leak such as pneumothorax. We experienced HFOV to be effective in the treatment of newborn infant with pneumothorax.
Bronchopulmonary Dysplasia ; Emphysema ; High-Frequency Ventilation ; Humans ; Infant ; Infant, Newborn ; Mortality ; Oxygen ; Pneumothorax ; Ventilation*

Tension pneumothorax during one-lung ventilation is an insidious, life threatening emergency. Even though early diagnosis and rapid intervention are necessary to prevent mortality, treatment may be difficult because of the clinical diagnosis-mediastinal shift, hypoxemia, hypotension and increased airway pressure may be confusing in the operative setting. We present here the case of a patient who underwent right thoracotomy with one-lung ventilation and the patient developed left tension pneumothorax with resulting cardiac arrest.
Anoxia ; Early Diagnosis ; Emergencies ; Heart Arrest* ; Humans ; Hypotension ; Mortality ; One-Lung Ventilation ; Pneumothorax* ; Thoracotomy*

Although uncommon and rarely reported, tracheo-esophageal perforation during traumatic intubation is life threatening and associated with a high mortality rate. It may result in severe airway complications such as a pneumothorax, pneumomediastium, pneumonia, and mediastinitis. The mortality rate of esophageal perforation has been reported to range from 6 to 34%, and up to 56% if the diagnosis is delayed by more than 12 hours after the event. In our case, the patient had been intubated for 3 weeks with an esophago-tracheal perforation. The perforation was not found by the physician because he had no signs of esophageal perforation, the tip of endotracheal tube was well in the trachea and balloon of the tube was sufficient to prevent air leakage. After the failure of extubation for three times, the diagnosis was carried out by gastrofibroscopy, bronchoscopy and chest 3-dimensional computed tomography. His tracheal and esophageal walls were injured with severe inflammation. Therefore, primary repair could not be done and only a tracheostomy was performed.
Airway Management* ; Bronchoscopy ; Diagnosis ; Esophageal Perforation ; Humans ; Inflammation ; Intubation ; Mediastinitis ; Mortality ; Pneumonia ; Pneumothorax ; Thorax ; Trachea ; Tracheostomy

The morbidity and mortality rates are believed to be much higher if the staghorn calculus is left unoperated, since complications resulting from infection and/or obstruction may become life-threating. So, surgical removal is essential element in the successful management of the majority of patients with staghorn calculous disease. To understand better the optimal management, we did a retrospective analysis of 41 patients treated during 12 year periods. Surgical managements were performed in 36 patients (41 kidneys) and no operation in 5. Methods of surgical managements were extended pyelolithotomy in 11 cases, extended pyelolithotomy and pyeloplasty in 1, extended pyelolithotomy with parenchymal extension in 4, ex- tended pyelolithotomy with parenchymal extension and partial nephrectomy in 1, anatrophic nephrolithotomy in 7, antrophic nephrolithotomy with partial nephrectomy in 3, partial nephrectomy in 3, partial nephrectomy in 3 and nephrectomy in 9. Complete removals of calculi were done in 32 kidneys(69.6%). Clinical complications occurred in 14 kidneys(30.4%) ; 5 were remnant stones(10.8%), massive bleeding in 2, renal artery injury in 1, urine leakage in 3, pneumothorax in 2 and hematuria and sepsis in 1. The managements of complications were reoperation in 8 cases, conservative treatment in 5 and no follow up in 1.
Calculi* ; Follow-Up Studies ; Hematuria ; Hemorrhage ; Humans ; Mortality ; Nephrectomy ; Pneumothorax ; Renal Artery ; Reoperation ; Retrospective Studies ; Sepsis

Fifty three percutaneous nephrolithotomy were performed in 52 patients from August `86 to July `87 in Pusan National University Hospital. We discussed our first experience in regard of failure and complications. Success rate was 81.1 per cent, increased along with learning curve from 58.3 per cent to 93.3 per cent. There was no mortality and the incidence of complications related with percutaneous nephrolithotomy was, 28.8 per cent including 6 patients with remnant stone and one patient with extrarenal lost of stone. The major complications were extravasation into peritoneal cavity in one patient and hydrothorax and pneumothorax in one patient. The most common causes of failure was inability to make proper nephrostomy tract especially in the very beginning of our experience.
Busan ; Humans ; Hydrothorax ; Incidence ; Learning Curve ; Mortality ; Nephrostomy, Percutaneous* ; Peritoneal Cavity ; Pneumothorax

The authors investigated mortality rate of hospitalized CWP(coal workers' pneumoconiosis) patients. Date, which was composed of age, date of hospitalization, date of death, and radiological findings(profusion of small opacity, type of large opacity, tuberculosis, emphysema, pneumothorax, and cardiac abnormality), was gathered from medical charts and chest x-ray films at the time of hospitalization of CWP patients. Among 738 CWP patients, that were entered survey differently and have followed different period, 160 CWP patients were died during different observational period. Mean value of observational period was 203 weeks, and mean age at hospitalization was 51 years. Because of short observational period, mean survival time could not found. There was statistically significant difference of mortality rate between group of small opacity and that of large opacity. In group of small opacity 5 year survival rate was 0.80 and in group of large opacity that was 0.73. And 80 percentile survival time was 57 months in group of small opacity and that was 40 months in group of large opacity.
Coal* ; Emphysema ; Hospitalization* ; Humans ; Mortality ; Pneumoconiosis* ; Pneumothorax ; Survival Rate* ; Thorax ; Tuberculosis ; X-Ray Film

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