Surgically Treated Pneumothorax
| Autor: | Julia Flint, Nestor L. Müller, J. Stephen Kwong, Kirk G. Jordan |
|---|---|
| Rok vydání: | 1997 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty business.industry medicine.medical_treatment Respiratory disease Critical Care and Intensive Care Medicine medicine.disease Surgery Pleural disease Pneumothorax Effusion Fibrosis medicine Radiology Thoracotomy Mesothelioma Bulla (seal) Cardiology and Cardiovascular Medicine business |
| Zdroj: | Chest. 111:280-285 |
| ISSN: | 0012-3692 |
| DOI: | 10.1378/chest.111.2.280 |
| Popis: | Objective: Tocomparetheidentifiable pulmonary abnormalities on preoperative chest radio¬ graphs andCT scans withthehistologic findings inpatients requiring surgical intervention for recurrent orpersistent pneumothoraces. Materials andmethods: Chestradiographs were reviewed retrospectively in116consecutive patients (aged 16to81years) whohadundergone thoracotomy forrecurrent or persistent pneumothorax. CT scans were performed in21patients. Chestradiographs andCT scanswere reviewed bytwoobservers without knowledge ofthehistologic findings. Allspecimens were reviewed by asurgical pathologist. Results: Seventy-nine (68%) patients hadparenchymal abnormalities andfive(4%) hadpleural thickening evident on theradiograph. Themostcommon radiographic abnormalities included apical bullae (n=51), apical scarring (n=17), anddiffuse emphysema (n=9). Twenty of21(95%) CT scans demonstrated either a parenchymal or a pleural abnormality. CT demonstrated emphysema infourpatients withnormalradiographs, aswell asadditional findings insixpatients withabnormal radiographs. Histologically, 74patients hadfocal irregular emphysema, 26had distal acinaremphysema, sixhadmixedemphysema, fourhadisolated bullae or blebs, twohad mesothelioma, andone eachhadthefollowing: metastatic angiosarcoma, subpleural fibrosis, congenital cystic adenomatoid malformation, andtuberculous pleuritis withinactive interstitial fibrosis andhoneycombing. Conclusion: Mostpatients withsurgically treated pneumothorax haveemphysema or an isolated bulla. Although thesefindings maynotbeapparent on theradiograph andseen on CT,this probably does notaffect patient management. Inmostcases ofpneumothorax related toother causes,findings consistent withthediagnosis can beseen on theradiograph. (CHEST 1997; 111:280-85) |
| Databáze: | OpenAIRE |
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