James W. Brooks

Blunt traumatic rupture of the diaphragm.

Blunt traumatic rupture of the diaphragm must be suspected in all patients with massive trauma and especially in those whose chest roentgenogram reveals an abnormal or obscured diaphragmatic shadow. Regular reevaluation is most important. A diagnostic pneumoperitoneum is the most accurate preoperative test available. Transthoracic approach is the operation of choice.

Extraction of Large Tracheal Foreign Bodies through a Tracheostoma under Bronchoscopic Control

Despite various technical manipulations through contemporary endoscopic equipment, large tracheal foreign bodies may be lost during bronchoscopic extraction, with a 1 to 2% in-hospital mortality. Recently, emergency tracheostomy was performed during bronchoscopy after a tracheal foreign body had become dislodged in the subglottic region causing blockage of the airway, and the results of this procedure provoked its deliberate application in a second patient. In 3 additional infants, aspirated tracheal T tubes (Montgomery tubes), which were producing acute respiratory distress, were brought from the carina to the performed tracheostoma under bronchoscopic manipulation and were withdrawn. Elective application of this simultaneous approach--tracheostomy with bronchoscopy--may decrease morbidity and mortality from large tracheal foreign bodies.

Pneumopericardium due to transdiaphragmatic perforation of a gastric ulcer

SummaryA 65-year-old man presented with cardiogenic shock and massive pneumopericardium. A gastropericardial fistula due to transdiaphragmatic penetration of a large fundal ulcer was documented radiographically and confirmed at autopsy. Previously recorded cases of pneumopericardium complicating gastric ulcers or other diseases of the digestive tract are briefly reviewed.

Sinus histiocytosis in non-diagnostic scalene lymph node biopsies

In view of the reported low incidence of sinus histiocytosis (SH) in benign diseases, an attempt was made to document whether the presence of SH in scalene lymph node biopsies was a reliable indicator of underlying cancer. Of 141 consecutive scalene node biopsies, 38 (27%) were diagnostic for various diseases and 3 were inadequate. The remaining 100 cases were analyzed for presence or absence of SH, and these findings were correlated with the presence or absence of clinically and pathologically documented cancer. SH was found not to be useful as an indicator of the presence of cancer, since only 26 of 41 SH‐positive cases were proven to have cancer. In lung cancer patients, the presence or absence of SH in scalene nodes did not provide useful prognostic information, since the rates of operability and of 1‐year survival were similar among SH‐positive and SH‐negative cases.

Benign mixed tumor of the trachea with seven-year follow-up

A case of a benign mixed tumor of the trachea in a 41‐year‐old man was successfully removed by wedge excision. This appears to be the only bona fide case in the American literature, although several isolated examples may be found in the Italian and German references. The patient has been followed for over 7½ years and reveals no evidence of recurrence.

Cricoid Split for Subglottic Stenosis in Infancy

Historically, tracheostomy has been used for infants with airway obstruction caused by congenital or acquired subglottic stenosis. Postoperative morbidity and mortality with this provisional operation led Cotton, in 1980, to substitute anterior cricoid split as the primary definitive procedure. Within the past three years, anterior cricoid split has been performed in 4 infants, aged 3 to 9 months, with acquired (3 patients) or congenital (1 patient) subglottic stenosis requiring ventilation through an endotracheal tube. Following cricoid split, the trachea is stented for 12 to 14 days by a nasotracheal tube, with extubation and rigid bronchoscopy in the operating room with the patient under anesthesia to confirm healing and patency. During an 18- to 24-month follow-up in these 4 patients, morbidity has been minimal, patency has persisted, and stridor has not recurred. Accordingly, a conclusive operation, cricoid split, rather than a temporizing tracheostomy may be employed for certain obstructive tracheal lesions early in life.

Chapter 50 – Tumors of the Chest

However, this era also allow you to get the book from many sources. The off line book store may be a common place to visit to get the book. But now, you can also find it in the on-line library. This site is one of the on-line library in which you can find your chosen one to read. Now, the presented tumors of the chest is a book that you can find here. This book tends to be the book that will give you new inspirations.

Bronchoplastic Techniques for Benign and Malignant Pulmonary Lesions

1. Daniel RA Jr: The regeneration of defects of the trachea and bronchi: an experimental study. J Thorac Surg 17335, 1948 2. Bucher RM, Bumett E, Rosemond GP: Experimental reconstruction of the tracheal and bronchial defects with stainless steel wire mesh. J Thorac Surg 21:572, 1951 3. Gebauer PW: Reconstructive surgery of the trachea and bronchi: late results with dermal grafts. J Thorac Surg 22:568, 1951 4. Davies OG, Edmiston JM, McCorkle HJ: The repair of experimental tracheal defects with fresh and preserved homologous tracheal grafts. J Thorac Surg 23:367, 1952 5. Paulson DL, Shaw RR: Bronchial anastomosis and bronchoplastic procedures in the interest of preservation of lung tissue. J Thorac Cardiovasc Surg 29238, 1955 6. Michelson E, Solomon R, Mann L, Romire J: Experiments in tracheal reconstruction. J Thorac Cardiovasc Surg 41:748, 1961 7. Ellis PR, Harrington OB, Beall AC, Jr, DeBakey ME: The use of heavy Marlex mesh for tracheal reconstruction following resection for malignancy. J Thorac Cardiovasc Surg 44:520, 1962 8. Kramish D, Marfit HM: The use of Teflon prosthesis to bridge complete sleeve defects in the human trachea. Am J Surg 106:704, 1963. 9. Thompson DT: Tracheal resection with left lung anastomosis following right pneumonectomy. Thorax 21:560, 1966 10. Montgomery WW: The surgical management of supraglottic and subglottic stenosis. Ann Otol Rhinol Laryngol 77534, 1968 11. Dedo HH, Fishman NH: Laryngeal release and sleeve resection for tracheal stenosis. Ann Otol Rhinol Laryngol 78:285, 1969 12. Geffin 8, Bland J, Grillo HC: Anesthetic management of tracheal resection and reconstruction. Anesth Analg 48:884, 1969 13. Paulson DL, Urschel HC, McNamara JJ, Shaw RR: Bronchoplastic procedures for bronchogenic carcinoma. J Thorac Cardiovasc Surg 59:38, 1970 14. Jensik RJ, Faber LP, Milloy FJ, Amato JJ: Sleeve lobectomy for carcinoma: a ten-year experience. J Thorac Cardiovasc Surg 64:400, 1972 15. Lee P, English ICW: Management of anesthesia during tracheal resection. Anaesthesia 29:305, 1974 16. Montgomery WW: Suprahyoid release for tracheal stenosis. Arch Otolaryngol 99:255, 1974 17. Pearson FG, Cooper JD, Nelems JM, VanNostrand AWP: Primary tracheal anastomosis after resection of cricoid