Surgical case reports
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Surgical case reports · Aug 2019
Single-trocar thoracoscopic pericardio-pleural fenestration under local anesthesia for malignant pleural effusion: a case report.
Pericardio-pleural fenestration by video-assisted thoracoscopic surgery is an efficient procedure for malignant pericardial effusion, but requires general anesthesia with single-lung ventilation. ⋯ Thoracoscopic pericardio-pleural fenestration under local anesthesia via a single trocar is feasible as an alternative approach in critically ill patients, allowing effective pericardial drainage, evaluation of the pleural cavity, and accurate biopsies of the pericardium and parietal pleura simultaneously.
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Surgical case reports · Aug 2019
Successful thoracoscopic evacuation of an extrapleural hematoma with delayed symptomatic pleural effusion: a case report.
Traumatic extrapleural hematoma is a rare condition and is usually managed conservatively until spontaneous resolution unless active bleeding or expansion is found. ⋯ Since posttraumatic extrapleural hematoma may result in delayed secondary intractable pleural effusion causing dyspnea, careful observation is necessary when considering indications of surgical intervention.
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Traumatic diaphragmatic injury is known to present with the spectrum of symptoms, and most patients would have some symptoms due to abdominal organ herniation. Majority of injuries tend to present on the left hemidiaphragm but right-sided injuries also occur mostly with subtle, delayed presentation due to the buffering effect of the liver. ⋯ Traumatic injuries of the diaphragm are rare, yet underestimated; therefore, they need a high index of suspicion for timely diagnosis and neglected diagnosis may present with a range of symptoms such as herniation months to years later.
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Surgical case reports · Apr 2018
A case of tension faecopneumothorax after delayed diagnosis of traumatic diaphragmatic hernia.
Traumatic diaphragmatic injuries from blunt or penetrating trauma are difficult to detect in the acute setting and, if missed, can result in significant morbidity and mortality in the future. We present a case demonstrating the natural progression of this resulting in faecopneumothorax, which is a rare but serious presentation. ⋯ A review of the literature demonstrates the rarity of traumatic diaphragmatic injuries resulting in faecopneumothorax with only a few case reports in the last 50 years. We present a case demonstrating a natural progression of the condition and highlight the importance of having a high index of suspicion of diaphragmatic injuries in the trauma setting.
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Surgical case reports · Jan 2018
Alfieri stitch for temporary severe functional mitral regurgitation after aortic valve replacement.
The outcome in functional mitral regurgitation after aortic valve replacement is unclear. A frail 82-year-old woman with severe aortic valve regurgitation and mild to moderate functional mitral valve regurgitation (NYHA functional class III) was referred to our clinic. ⋯ A central Alfieri edge-to-edge stitch was placed between the anatomical middle of the two leaflets of the mitral valve after reinstitution of cardiopulmonary bypass. This eliminated the mitral regurgitation, which enabled successful separation from cardiopulmonary bypass.