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Presencia de fístula broncopleural en ni?os con patología pulmonar: Descripción de nueve casos clínicos
Navarro M.,Héctor; Caussade L.,Solange; Zú?iga R.,Sergio; Ronco M.,Ricardo; García B.,Cristián; Sánchez D.,Ignacio;
Revista chilena de pediatría , 2002, DOI: 10.4067/S0370-41062002000600006
Abstract: a bronchopulmonary fistula (bpf) is an abnormal communication between the bronchial tree and the pleural space. it′s development is associated with severe lung disease, pulmonary surgery and procedures that cause lung injury. we present a serie of 9 children, 7 girls, with bpf. the average age was 2 years, range 7 days to 7 years. bpf was associated with severe lung disease in 6 children (complicated pleuro-pneumonia in 4, severe bronchial obstruction in 1 and ards in 1). in 3 children bpf was a complication of lobectomy due to a congenital lung malformation and bronchiectasis. clinical presentation was recognized by the sudden onset of dyspnoea and the development of a tension pneumothorax in 4 cases and recurrent pneumothorax in 5. bpf was associated with mechanical ventilation in 5 cases and post-thoracocentesis in 2 children with pleuropneumonia. the management was pleural drainage and in patients on mechanical ventilation, adjusted pressure in order to decrease the air leak, in 2 cases high-frequency ventilation was indicated. the closure of bpf was surgical in 6 cases, 4 with severe lung disease and 2 with lobectomy. in conclusion, in our serie bpf developed in children with severe lung disease requiring mechanical ventilation or as a complication of pulmonary surgery
Fístula broncopleural  [cached]
Alex Victoria Barrera Palomar,Adriana Vargas Diaz,Augusto Buendia
Revista Colombiana de Anestesiología , 2008,
Abstract: A diario en nuestro medio se realizan procedimientos quirúrgicos que requieren aislamiento pulmonar y/o ventilación de un solo pulmón con excelentes resultados. Este caso clinico quiere dar a conocer como la elección del abordaje quirúrgico favorece el manejo de la ventilación de un solo pulmón. A su vez mostrar el resultado favorable con el uso del tratamiento recomendado para manejo pulmonar convencional (FiO2 100%, seguimiento de CO2 para mantener normocapnia, VC 8-10 ml/Kg). In Colombia many surgical procedures are made that require pulmonary isolation and/or one-lung ventilation with excellent results. Tis clinical case wants to present as the election of the surgical boarding favors the management of the ventilation of a single lung. To as well show the favorable result with the use of the treatment recommended for conventional pulmonary management.
Allergic bronchopulmonary aspergillosis.  [cached]
Oak J,Yavgal D,Chakore R
Journal of Postgraduate Medicine , 1996,
Abstract: A 38 year old male was diagnosed to have allergic bronchopulmonary aspergillosis which responded remarkably to prednisolone therapy.
Abordaje transesternal transpericárdico para el cierre de la fístula broncopleural tardía y manejo del empiema crónico asociado con tuberculosis Transternal transpericardial approach in the treatment of late bronchopleural fistula and the management of chronic tuberculous empyema
Antonio Luis Visbal,Rodrigo Sánchez
Revista Colombiana de Cirugía , 2006,
Abstract: El 33,33% de la población mundial padece de tuberculosis y aproximadamente dos millones de personas mueren al a o por esta enfermedad. En Colombia, su prevalencia es 23,4 por cada 100.000 habitantes. Algunas complicaciones requieren manejo quirúrgico. Sin embargo, la anatomía de los pacientes tuberculosos es compleja debido a fibrosis en el hilio pulmonar. Materiales y métodos: Una revisión de literatura encontró 140 pacientes con abordaje transmediastinal transpericárdico para el cierre de una fístula broncopleural tardía post-neumonectomía, descritos en diez series en los últimos 25 a os; diez pacientes presentaron tuberculosis. La mortalidad perioperatoria (14%) y recurrencia a cinco a os (10%), y la mayoría de los casos se presentaron en los primeros seis meses. Discusión: La fístula broncopleural es una complicación fatal posterior a una neumonectomía en pacientes tuberculosos; la de presentación tardía compromete gravemente la calidad de vida y se asocia con proceso inflamatorio severo en el hilio pulmonar. Su manejo requiere una vía alternativa 'virgen' para lograr una disección precisa y segura del hilio pulmonar. La mortalidad perioperatoria (14%) y recurrencia (10%) son comparables a los resultados obtenidos con transposición intratorácica de colgajos músculo-cutáneo y de epiplón en la fístula broncopleural temprana. Conclusión: El abordaje transmediastinal transpericárdico se puede hacer de una manera segura y usar en el manejo de la fístula broncopleural tardía posterior a neumonectomía por tuberculosis. One third of the world population is affected by tuberculosis, and approximately 2 million people die of it. The Colombian prevalence is 23.4 per 100,000 people. Some tuberculosis complications require surgical management. However, these patients' anatomy is complex due to the presence of hiliar pulmonary fibrotic tissue. Material and methods: Literature review of 140 patients in 10 series published during the past 25 years that underwent transmediastinal transpericardial approach for closure of late bronchopleural fistula, including two patients from the Santa Clara Hospital. Results: 10 patients presented tuberculosis. The operative mortality was 14% and the recurrence rate was 10% at five years, with the majority of cases appearing within the first six months of follow-up. Discussion: Postneumonectomy broncopleural fistula is a deadly complication. Late presentation of broncopleural fistula severely compromise the life quality of the patient, and it is associated with a severe fibrosis of the pulmonary hilium. Thus, its management require
The Patency Rate of Arteriovenous Fistulas
A?k?n Ender Topal,Derya Topal
Dicle Medical Journal , 2004,
Abstract: The purpose of this investigation is to determine the patency of thearteriovenous (A-V) fistulas, created in patients with chronic renal failure, inthe early and late periods according to sex.The A-V fistulas created for hemodialisis were investigated retrospectively.Of 238 patients, there were 130 male.269 operations were made to 238 patients. Of these, 198 (73.6 %) wereradiochephalic, 56 (20.8 %) were brachiochephalic, 8 (3 %) were brachiobasilicA-V fistulas. In 3 (1.1 %) patients loop graft between brachial artery and vein,in 1 (0.37 %) patient graft between radial artery and brachial vein, in 1 patientgraft between brachial artery and basilic vein, in 1 patient graft betweensuperficial femoral artery and saphenous vein were placed. Of 198radiochephalic A-V fistulas 24 (12.1 %) in early period and 3 (1.5 %) in lateperiod became inactive. Of 56 brachiochephalic A-V fistulas 4 (7.1 %) and of 8brachiobasilic A-V fistulas 2 (25 %) became unsuccessful in early period. 1 of 6A-V fistulas with prosthetic graft failed in late period because of thrombosis. Inradial level patency rate of A-V fistulas in females were lower than in males(82.3 %-89.8 %).The patency rate of A-V fistulas in radial and brachial levels were similar,but in radial level rate of successful of A-V fistulas decreased in femalesaccording to males. Use of graft in A-V fistula didn’t give superiority to A-Vfistulas without graft.
Bronchopulmonary allergic aspergillosis Aspergilosis broncopulmonar alérgica
Ana María Cock Rada,Alvaro Fortich,Rodrigo Ramírez
Iatreia , 1990,
Abstract: A series of well defined entitles associated with colonization or invasion by fungi of the genus Aspergillus are grouped under the term Aspergillosis; there are various modalities of pulmonary involvement, namely, extrinsec asthma, extrinsec allergic alveolitis, allergic bronchopulmonary aspergillosis, aspergilloma and an invasive form in debilitated terminal patients; besldes there exists a form of food poisoning. We report on the case of a 45 year-old asthmatic woman suffering from allerglc bronchopulmonary aspergillosis and sum. maryze the clinical and laboratory features of the different pulmonary forms of aspergillosis. El término Aspergllosis reúne una serle de entidades bien definidas, causadas por hongos del género Aspergillus. En este artículo se presenta el caso de una mujer de 45 a os con aspergllosis broncopulmonar alérgica, atendida en el Hospital Universitario San Vicente de Paúl, de Medellín y se hace una somera revisión clínico-patológica de las diferentes formas de aspergllosis pulmonar.
Secuestro pulmonar en un lactante Bronchopulmonary sequestration in an infant
FERNANDO BRACHO M,GUSTAVO PIZARRO T,JOSé A SEPúLVEDA C
Revista chilena de pediatría , 2007,
Abstract: Introducción: El secuestro pulmonar es una malformación congénita poco frecuente, caracterizada por un segmento anormal de tejido broncopulmonar irrigado por una arteria anómala de origen sistémico. Objetivo: Presentar el caso de un lactante menor con un secuestro pulmonar intralobar y revisar los aspectos más relevantes de este tipo de malformación congénita. Caso Clínico: Lactante menor de 6 meses de edad, tratada por una neumonia del lóbulo inferior izquierdo, con persistencia de la imagen de condensación por más de 6 semanas. Por este motivo se le realizó una Tomografía axial computada (TAC) que mostró una imagen sugerente de secuestro pulmonar, por lo que fue sometida a cirugía, corroborándose la variedad intralobar de esta malformación, la cual fue resecada sin inconvenientes. Conclusiones: El secuestro pulmonar es una malformación congénita poco frecuente, pero que se debe considerar ante la presencia de neumonías recurrentes o imágenes de condensación persistentes Background: Bronchopulmonary sequestration is a rare congenital lung malformation, charactarized by an abnormal segment of bronchopulmonary tisue, irrigated by an anomalous systemic artery. Objective: To report the clinical course of an infant with an intralobar bronchopulmonary sequestration and review the most relevant aspects of this lung malformation. Case-report: A six months-old infant, treated for a pneumonia involving the right lower lobe, with persistence of the consolidation image for more than six weeks. Because of a computed tomography (CT) that showed an image suggesting a bronchopulmonay sequestration, the infant was scheduled for surgery, confirming the presence of the intralobar type of the malformation, which was removed without incidents. Conclusion: Bronchopulmonary sequestration is a rare congenital lung malformation, but it has to be considered in the presence of recurrent pneumonia or persisting consolidation images
Coronary arterial fistulas
Shakeel A Qureshi
Orphanet Journal of Rare Diseases , 2006, DOI: 10.1186/1750-1172-1-51
Abstract: Coronary arterial fistulasCoronary arterial fistulas or malformationsA coronary arterial fistula (also known as coronary arteriovenous malformation) is a connection between one or more of the coronary arteries and a cardiac chamber or great vessel, having bypassed the myocardial capillary bed.This is a rare abnormality and usually occurs in isolation [1]. Its exact incidence is unknown. The majority of the fistulas have a congenital origin, but may occasionally be detected after cardiac surgery, such as valve replacement, coronary artery bypass grafting and after repeated myocardial biopsies in cardiac transplantation [2,3].The feeding artery of the fistula may drain from a main coronary artery or one of its branches and is usually a dilated and tortuous artery terminating in one of the cardiac chambers or a vessel. The more proximal the feeding artery originates from the main coronary artery, the more dilated it tends to be. If the fistula drains to the right atrium with a proximally arising feeding artery, it tends to be considerably dilated but less tortuous (Figure 1a, b and Figure 2a, b). If there is a more distal origin of the feeding artery, and in particular when the fistulas originate from the left coronary artery and drain to the left ventricle, they may be very tortuous, presenting a challenge for catheter closure (Figure 3a, b). However, in the less frequently encountered right coronary artery to coronary sinus drainage, the fistula vessel may be large and very tortuous. It is important to note that there may be multiple feeding arteries to a single coronary arterial fistula drainage point or there may be multiple drainage sites [2]. The fistulas originate from the right coronary artery in about 52% of cases, the left anterior descending coronary artery being the next most frequently involved in approximately 30% of cases and the circumflex coronary artery in about 18% of cases [4]. Over 90% of the fistulas from either coronary artery drain to the right
The Rate of Aneurysm and Infection in Arteriovenous Fistulas
A.Ender Topal,Derya Topal
Dicle Medical Journal , 2004,
Abstract: The purpose of this investigation is to determine the rate of aneurysm andinfection in the arteriovenous (A-V) fistulas created in patients with chronic renalfailure, according to sex. 244 patients with A-V fistulas created for hemodialysiswere investigated retrospectively. Of 244 patients, there were 134 male. Aneurysmoccured in 11 (5.3 %) of 208 radiochephalic A-V fistulas, end to end anastomosis ofradial arteries were performed in all cases. Aneruysm occured in 10 (15.1 %) of 66brachiochephalic A-V fistulas, in 8 cases end to end anastomosis of brachialarteries were performed, in 2 cases saphenous graft were used. Aneurysm occuredin 1 (5.9 %) of 17 brachiobasilic A-V fistulas, in this case end to end anastomosis ofbrachial artery was perfomed. In 11 (13.2 %) of total 83 A-V fistulas at brachiallevel aneurysm occured. 2 of radiochephalic A-V fistulas were infected, aneurysmalso occured in these cases. There was no difference between sexs for aneurysmformation. Aneurysm formations were seen more in brachial level than forearmA-V fistulas. Because uf aneurysm formation risk ; if available vascular structuresare found, forearm can be preferred for A-V fistula.
Fistulas secondary to gynecological and obstetrical operations  [PDF]
Jakovljevi? Branislava N.,Dra?a Tatjana P.,Dra?a Petar D.
Zbornik Matice Srpske za Prirodne Nauke , 2003, DOI: 10.2298/zmspn0304099j
Abstract: The authors present urogenital and rectogenital fistulas treated at the Department of Obstetrics and Gynecology in Novi Sad in the period from 1976 to 1999. The study comprised 28 cases of fistula out of which 17 were vesicovaginal, 3 ureterovaginal, 1 vesicorecto vaginal and 7 recto vaginal. During the investigated period there were 182 Wertheim operations, 3864 total abdominal hysterectomies, 1160 vaginal hysterectomies and 7111 cesarean sections. The vesicovaginal fistulas were most frequent with the incidence of 0.33%, whereas the tocogenic fistulas did not occur. Urogenital fistulas secondary to radical hysterectomy are extremely rare thanks to the administered measures of prevention during the surgical procedure.
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