Tube thoracostomy in the treatment of tension from giant
نویسنده
چکیده
At the time of his hospital admission, he was noted to be tachypneic at rest hut felt subjectively he had been clinically improving. His leukemia was still in remission by laboratory analysis. Clinical examinatiomi identified decreased breath sounds over the right side of his chest. A CXR revealed a neai@complete lucency of the right hemithorax and a slight shift of the mediastimsum to the opposite side (Fig 1). A computed tomographic scan of the chest revealed an air-filled cavity in the right hemithorax with strands of fibrous septae spanning this cavity (Fig 2) and a marked shift of the mediastinal structures to the left. Because of inability to distinguish between ipx and tension from a giant hulla, the patient was taken to the operating suite where video-assisted thoracoscopy was performed under local anesthesia. This revealed complete collapse of the lung with adhesions to the parietal pleura. The patient was treated with tube thoracostomy for 7 days during which time his lung fully reexpanded and the air leak resolved. The hospital discharge CXR revealed the lung to he fully reexpanded with minimal hullous changes. At home, the patient noted mnarkedly improved exercise tolerance and was able to return to full—timeemployment.
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تاریخ انتشار 2006