Suppurative diseases of the lung and pleural space part I: Empyema thoracis and lung abscess

Roux, B. T. Le; Mohlala, M L; Odell, John A.; Whitton, I. D.

doi:10.1016/0011-3840(86)90031-6

Cited by 27 publications

(10 citation statements)

References 178 publications

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“…Lokal yayılım sebebi ile akciğer absesi ile ampiyem, sistemik yayılımda görülebilen beyin absesi, amiloidozis komplikasyonları çocukluk çağında %5 oranında izlenir (13).…”

Section: Patofi̇zyoloji̇unclassified

Bronchiectasis in Childhood

Yenigün¹,

Cangır²

2012

Toraks Cer Bult

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GİRİŞBronşektazi eski Yunanca'dan bronchos ve ektasis (dilatasyon-genişleme) kelimelerinden türemiştir. Havayolunda anormal kalıcı dilatasyonu belirtir. Geç-mişte tüberküloz ve süpüratif akciğer hastalıkları ile bunlarla ilişkili olan sekeller önemli morbidite ve mortaliteye neden olan sık görülen çocukluk çağı hastalıklarındandı. Günümüzde de klinik olarak bronşekta-zi hemoptizi, akciğer ve beyin abseleri, ampiyem ve solunum yetmezliğine neden olan şiddetli ve yaygın hastalıktır.Antibiyotik yelpazesinin ve etkinlik derecelerinin genişlemesi ile hasta bakımının modernize olmasıyla çocukluk döneminde alt solunum yolu enfeksiyonları şiddetinde azalma kaydedilmiştir. Son yıllarda batı dünyasında toplum kökenli pnömoni ve ampiyem hastalıklarında bildirilen artışa rağmen, bronşektazi sıklı-ğında göreceli olarak azalma vardır (1).Tekrarlayan alt solunum yolu enfeksiyonları, hem viral hem bakteriyel akut enfeksiyonlar, malnutrisyon, tüberküloz, HIV gibi kronik enfeksiyonlar bronşektazi etyolojisinde ön sıralarda yer alır. Günümüzde sağ-lık yönünden erişimi gelişmiş ülkelerde çocukluk çağı bronşektazisi etyolojisinde; tekrarlayan alt solunum yolu enfeksiyonları, genetik nedenler ve daha nadir olmasına rağmen kistik fibrozis patolojisi daha çok ön planda yer alır. Ancak sağlık hizmetleri yönünden geri kalmış veya gelişmekte olan ülkelerde yetersiz bağışık-lama programları ve uygun tedavi edilemeyen alt solunum yolları enfeksiyonu sonucunda bronşektazi yaygın olarak görülebilir. Bunun sonucunda da torasik cerrahi uygulamalarının önemli bir bölümünü plöropulmoner süpüratif hastalıklar oluşturur (2,3). ÖzetBronşektazi sıklıkla enfeksiyonlara ikincil gelişen, distal hava yollarında anormal kalıcı harabiyet ve genişlemeler izlenen nadir bir hastalıktır. Bronşektazi insidansında görülen artı-şın sebebi olarak alt solunum yolu enfeksiyonlarının sıklığı ve bağışıklık sistemi baskılanmış çocuk sayısındaki artış, antibiyotiğe dirençli organizmaların sıklığında, uyuşturucu bağımlılığı, tüberküloz ve HIV enfeksiyonlarının ortaya çık-masında görülen artışlar sorumlu tutulabilecek faktörlerdir. Bronşektazili çocukların aileleri özellikle hastalığın alevlenme dönemlerinde ciddi zorluklar yaşarlar. Bu grup hastalarda psikolojik morbiditeyi azaltmada erken teşhis, korunma, enfeksiyon alevlenmesinde uygun tedavi yöntemleri ile psikolojik morbiditeyi azaltmak mümkündür. Anahtar kelimeler: Bronşiektazi, çocuk yaş grubu AbstractBronchiectasis is an uncommon disease, most often secondary to an infectious process, that results in the abnormal and permanent distortion of one or more of the conducting bronchi or airways. An increase in the number of immunosuppressed children, emergence of antibiotic-resistant organisms, drug abuse, increasing incidence of tuberculosis, and HIV infections are all factors that may be responsible for an increased incidence of lower respiratory tract infections, which may in turn lead to bronchiectasis. There is a significant burden of disease, especially during exacerbation, on parents of children with bronchiectas...

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“…Lokal yayılım sebebi ile akciğer absesi ile ampiyem, sistemik yayılımda görülebilen beyin absesi, amiloidozis komplikasyonları çocukluk çağında %5 oranında izlenir (13).…”

Section: Patofi̇zyoloji̇unclassified

Bronchiectasis in Childhood

Yenigün¹,

Cangır²

2012

Toraks Cer Bult

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“…In some circumstances, however, it is possible to liberate and fully reexpand the lung after many years of entrapment and collapse. 45 In brief, treatment during the acute stage may be by multiple thoracenteses or preferably tube drainage. It is at this point that the best chance of avoiding a prolonged complicated course exists, by achieving early complete drainage.…”

Section: Stagesmentioning

confidence: 99%

Surgical Aspects of the Pleural Space

Thurer¹,

Palatianos

1987

Semin Respir Crit Care Med

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The pleura is the serous membrane that lines the inner surface of the hemithorax and covers the lung in continuity by folding back around the pulmonary hilum. The pleura envelops the pulmonary hilum and extends downward as a double layer from the inferior aspect of the mediastinal surface of the lung to the pericardium and ends in a free border inferiorly. This fold is referred to as the pulmonary ligament and contains lymphatic vessels from the pleura of the lower lobe that course toward the posterior mediastinal nodes.Covering the lung surface is the visceral pleura. The parietal pleura lines the inner surface of the hemithorax. Costal, diaphragmatic, mediastinal, and apical or cervical regions are noted according to their locations. The costal pleura is attached to the endothoracic fascia from which it is easily separated. The diaphragmatic pleura covers the superior surface of the diaphragm except for the area that abuts the pericardium. It is connected to and difficult to separate from the diaphragmatic musculature.The pleura descends to the level of the 12th rib posteriorly, to the level of the 6th costal cartilage anteriorly, and crosses the levels of the 7th to 11th ribs laterally where the costal and diaphragmatic pleural surfaces are in contact and form the costodiaphragmatic angle.Extending above the first rib and clavicle is the dome-shaped apical pleura, which is surrounded and supported by the suprapleural membrane (Sibson's fascia) and is in direct contact with the deep cervical fascia, the subclavian artery, and the subclavian vein. Because of this topographic relationship, the apical pleura may be easily entered during operations at the base of the neck, with resulting pneumothorax or hemopneumothorax.The mediastinal pleura extends from each side of the thoracic spine to the posterior surface of the sternum and is interrupted by the pulmonary hilum and the attachment of the pulmonary ligament. At these sites, the mediastinal pleura folds, covers the hilum, forms the pulmonary ligament, and continues as the visceral pleura.The right mediastinal pleura comes in contact with the superior vena cava, the innominate vein, the innominate artery, the azygos vein, the right side of the trachea, the right vagus and phrenic nerves, and the right side of the pericardium. The left mediastinal pleura covers part of the aortic arch, the left phrenic and vagus nerves, the left superior intercostal vein, left common carotid and left subclavian arteries, the esophagus, the thoracic duct, and the left side of the pericardium.Arterial blood supply to the parietal pleura consists of branches of the adjacent arteries. The intercostal, internal mammary, pericardial, and superior phrenic arteries contribute branches supplying the pleura. Arterial supply to the visceral pleura consists of radicles of the bronchial and pulmonary arteries. Venous drainage of the pleura corresponds to its arterial supply except for the bronchial arteries, which do not have corresponding veins, resulting in visceral pleural venous drainage v...

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“…Once a persistent air leak occurs, there is no standard procedure to manage it and the condition may cause postoperative space problems and serious infection leading to empyema. 5,6 Ideally, the problem should be addressed during the operation. We present our experience with a simple surgical technique for preventing air leaks from residual parenchymal raw surfaces after pulmonary resection.…”

Section: Introductionmentioning

confidence: 99%

Use of a Pericardial Fat Pad for Alveolar Air Leaks after Pulmonary Resections

Kawashima

Hirai²,

Kamiyoshihara³

et al. 1998

Asian Cardiovasc Thorac Ann

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To investigate the effectiveness of using a free pericardial fat pad to control air leaks from residual raw parenchymal surfaces after pulmonary resections, 30 consecutive patients were studied. There were 23 males and 7 females with a median age of 69 years. The indication for this technique was any alveolar air leak from a residual raw parenchymal surface which could not been controlled by suturing. There were 25 lobectomies with incomplete fissure and 5 cases of segmentectomy. None of the patients exhibited air leaks beyond 2 days, postoperative space problems, or infections. All patients had chest drains removed within 2 days after the operation. The application of a free pericardial fat pad is a promising new method of treating air leaks from residual raw parenchymal surfaces after pulmonary resections.

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Suppurative diseases of the lung and pleural space part I: Empyema thoracis and lung abscess

Cited by 27 publications

References 178 publications

Bronchiectasis in Childhood

Bronchiectasis in Childhood

Surgical Aspects of the Pleural Space

Use of a Pericardial Fat Pad for Alveolar Air Leaks after Pulmonary Resections

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