Kyobu geka. The Japanese journal of thoracic surgery
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Case Reports
[Surgical treatment of PDA in the elderly patient accompanied with aneurysm of the main pulmonary artery].
A case of the elder PDA with aneurysm of the main pulmonary artery is reported. The patient was a 59-year-old female who had been suffering from severe heart failure. ⋯ The pathological finding of the aneurysm of the main pulmonary artery is a cystic mucoid degeneration like a finding of Marfan syndrome. The etiology of the aneurysm of the main pulmonary artery seems to be extended Ao-PA shunt besides somewhat congenital change of the pulmonary artery.
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Paraesophageal bronchogenic cyst is a rare disease. Only 24 cases have been previously reported in Japan. Recently, we experienced two successful cases of this disease. ⋯ Microscopic examination showed the typical findings of the bronchogenic cyst, as the inner wall of the cyst was covered with ciliated columnar epithelium and the wall consisted of cartilage, mucous glands and smooth muscle. Both postoperative courses were uneventful. Resection was recommended because of the symptoms due to the compression of the cyst and the possibility of malignancy.
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Post-thoracotomy wound pain in 11 patients who underwent thoracic operation was controlled by intercostal nerve block with alcohol and thoracic epidural anesthesia. The intercostal nerve block was performed just before the closure of the thoracotomy wound. ⋯ In late post operative periods after discharge, intercostal nerve block could maintain excellent analgesia in 9 of 11 patients, only 2 patients required analgesic drugs or re-block of the intercostal nerve. Thus, intercostal nerve block with alcohol is an effective and simple option to control recalcitrant post-thoracotomy wound pain in thoracic surgery.
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Three cases of catamenial pneumothorax were presented. A 42-year-old woman with intrapelvic endometriosis had recurrent right-sided pneumothorax with menstruation more than six times. At the operation only a bleb was noted at the apex of the right lung. ⋯ Though the operation was performed during her menstrual period, neither air leakage nor any lesions were found. In all cases each lesion was resected and did not prove endometriosis, and partial parietal pleurectomy was performed for pleurodesis. No pneumothorax has recurred.
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A 47-year-old female was admitted to the emergency room following an automobile accident. She was shocked complaining of respiratory difficulty and chest pain. A chest X-ray showed right hemothorax which drained 2.5 liters of blood on insertion of chest tube. ⋯ Second operation was performed and ruptured diaphragma was repaired. Her postoperative recovery was good. She was discharged from hospital at 7th week.