Monaldi cavernostomy for lung aspergillosis: A case report
| Autor: | Mihai Dimitriu, Alina Croitoru, Alexandru Gibu, Alexandru Zariosu, Dragos Cretoiu, Nicolae Bacalbasa, Irina Balescu, Camelia Cristina Diaconu, Cornel Petreanu, Ovidiu Stiru, Cornel Savu |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Cancer Research
medicine.medical_specialty pulmonary suppuration medicine.disease_cause Immunology and Microbiology (miscellaneous) Parenchyma pulmonary aspergillosis medicine Bronchus Lung medicine.diagnostic_test business.industry respiratory failure Cancer Interventional radiology General Medicine Articles medicine.disease Surgery Pulmonary aspergillosis medicine.anatomical_structure cavernostomy Respiratory failure Superinfection business mycetoma |
| Zdroj: | Experimental and Therapeutic Medicine |
| ISSN: | 1792-1015 1792-0981 |
| Popis: | Pulmonary aspergillosis in patients with respiratory failure can severely affect the pulmonary functional status and may aggravate it through pulmonary suppuration, by recruitment of new parenchyma and hemoptysis, which can sometimes be massive, with lethal risk by flooding the bronchus. The treatment consists of a combination of medical therapy, surgery and interventional radiology. In small lesions, less than 2-3 cm, medical therapy methods may be sufficient; however, in invasive forms (larger than 3 cm) surgical resection is necessary. Surgical resection is the ideal treatment; nevertheless, when lung function does not allow it, action must be taken to eliminate the favorable conditions of the infection. In such cases, whenever the lung cavity is peripheral, a cavernostomy may be performed. Four cases of lung cavernous lesions colonized with aspergillus, in which the need for a therapeutic gesture was imposed by repeated small to medium hemoptysis and by the progression of respiratory failure, were evaluated, one of which is presented in the current study. Cavernostomy closure can be realized either surgically with muscle flap or spontaneously by scarring, after closure of the bronchial fistulas by epithelization and granulation. There were no recurrences of hemoptysis or suppurative phenomena. There was one death, a patient with severe respiratory failure caused by superinfection with nonspecific germs. However, in the case presented in this study, the patient recovered following cavernostomy, which seems to be an effective and safe method for cases in which lung resection is not feasible. |
| Databáze: | OpenAIRE |
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