The paper presents a case where an implant for a part of the sternum (with costal cartilages) affected by cancer was created and implanted by using the specific reverse modeling method and solid free-form fabrication. The method provides surgeons with a fast and reliable tool for tissue engineering and implantation and therefore improves the quality of life for patients. Digital images of healthy sternum samples were used to develop a reverse modeling algorithm that semi-automatically generates a necessary and sufficient simplification of the tissue geometry to be fabricated in an inexpensive and applicable manner. In this particular case, the redesign of the missing part of the sternum in CAD software took three designer-hours. At the same time, the suitable simplification of the geometry affects the fabrication of simpler and less expensive casting molds. Furthermore, the core of the developed algorithm for the reverse modeling of sternum can be applied in the reverse modeling improvement of other tile (or plate-like) bones.
We report a case of successful sternum and ribs/cartilage resection and chest wall reconstruction with a methacrylate implant produced using a threedimensional model in a patient with a tuberculotic mass in this region. Clinical and radiologic follow-up 2 years after surgery showed excellent cosmetic and functional outcome.
Treatment of dumbbell schwannoma is surgical, dilemmas of the optimal surgical approach. When it is thoracally located the posterior approach with hemilaminectomy and costotransversectomy is safe and effective for its removal.
Introduction Chylothorax is an accumulation of chyle in the pleural cavity due to a disruption of the thoracic duct. Traumatic chylothoraces are usually a result of a penetrating trauma and disruption of the thoracic duct, but blunt traumatic chylothorax is a rare condition. The aim of this paper is to present a rare case of traumatic chylothorax after blunt thoracic trauma. Case Outline We present a case of traumatic chylothorax after blunt thoracic trauma in a patient injured in a motor vehicle accident. The patient had a right-sided fracture of rib XI, hydropneumothorax, lung contusion, and signs of pneumomediastinum. We performed thoracic drainage, but a few days later, according to the increase of amount of the fluid daily drained, and the confirmation of laboratory findings of the analyzed fluid, we made a diagnosis of chylothorax and the patient underwent a thoracotomy, where we sutured the thoracic duct. Conclusion Chylothorax should be considered in patients after chest trauma if they develop a milky pleural effusion. Analysis of pleural fluid and level of triglycerides is important for the diagnosis and treatment of chylothorax.
Cystic lesions of the mediastinum are uncommon, comprising 12% to 18% of all primary mediastinal tumors and unless they attain a large size and cause compressive symptoms, these tumors are generally asymptomatic and are discovered incidentally upon radiologic investigation of some other condition. We present in this paper a case of cystic lesions of the mediastinum in a 70-year-old male patient who underwent a surgery for mediastinal mass removal. Histopathology report had shown it was the case of mature cystic teratoma of anterior mediastinum. Based on a review of the literature, as well as our experience, we conclude that best treatment for cystic lesions of anterior mediastinum is complete surgical resection if possible.
Introduction. Management of a polytraumatized patient is a problem that requires a multidisciplinary approach, in order to optimise patient's outcome. The purpose of this study was to show the approach in the treatment of a patient with a severe life-threatening polytrauma, including a personalized healthcare approach with the positive outcome after the inadequate initial treatment. Case report. We presented a case of a young polytraumatized patient with trauma as a result of road traffic accident. The patient had chest, abdominal and right arm injuries. He was diagnosed of hepatic rupture with conquasation and retroperitoneal hematoma and the patient underwent liver tamponade. Chest trauma due to bilateral serial rib fracture with flail chest was treated by chest drainage. After the adequate multidisciplinary interventions for the patient, the patient was discharged. Conclusion. This case report is of great importance since it shows that severe polytraumatized patients with bad initial prognosis can successfully receive a lifesaving treatment.
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