Kyobu geka. The Japanese journal of thoracic surgery
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Case Reports
[Experience of damage control as the primary surgery for thoraco-abdominal injury with hemorrhagic shock].
We experienced a traumatic victim with thoracic and abdominal injury with hemorrhagic shock, who was successfully treated with damage control. Thoracic drainage revealed more than 300 ml/hour of continuous hemorrhage in the left thoracic cavity with 60-80 mmHg of non-responding hypotention. ⋯ We decided re-thoracotomy and performed peri-pulmonary packing around the injured lung, by which we successfully controlled temporary intrathoracic hemorrhage and definitive left lower lobectomy. Peri-pulmonary packing was effective for intrathoracic hemostasis without lethal ventilatory and circulatory complication in this case.
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A 30-year-old man was admitted to our hospital due to infectious bulla. His chest X-ray and computed tomography (CT) showed bilateral multiple emphysematous bullae and a left bulla with effusion. ⋯ Further, Aspergillus was detected inside the wall in pathological diagnosis. Treatment with itraconazole 100 mg a day was started after surgery, and 6 months later the patient is well without recurrence.
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Case Reports
[Repeated catamenial pneumothorax with pleural and diaphragmatic endometriosis; report of a case].
A 31-year-old female with 2 episodes of right pneumothorax related to onset of menstruation was reported. Thoracoscopy revealed the presence of some cystic lesions in the diaphragm. Partial resection of the diaphragm including the lesions was performed. ⋯ Microscopic examination of the resected lung disclosed endometrial stroma in the macroscopically normal lung tissue. Since air leakage from chest tube continued after surgery, the hormonal therapy with a gonadotropin-releasing hormone analogue was started, and she was discharged from the hospital 3 weeks after hormonal therapy. Report of the demonstration of endmetriosis in the visceral pleura and diaphragm is very rare and the present case is very suggestive is considering the mechanism of the development of this disease.
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Outcome of the patients who underwent aortic root replacement with valve sparing procedure concomitant with cusp repair was evaluated. ⋯ Valve sparing aortic root replacement with concomitant cusp repair provided satisfactory midterm result.