Mahmut Tokur

Giant Bronchogenic Cyst Mimicking Tension Pneumothorax

An 18-month-old girl presented with high fever and vomiting. Pneumothorax and a cystic formation in the right hemithorax were found on a chest radiograph. The cyst measuring 10 × 10 × 8 cm was resected by a simple wedge resection. Histology revealed a complicated bronchogenic cyst with abscess formation.

Pulmonary mucormycosis mimicking an endobronchial mass

Mucormycosis is an opportunistic fungal infection that can infect different regions of the body. This entity may present in rhinocerebral, pulmonary, cutaneous, and disseminated forms. Although pulmonary mucormycosis is usually seen as an invasive parenchymal consolidation or cavitation, it may rarely present as an endobronchial mass. We describe a case of endobronchial mucormycosis in which the fungal mass was completely removed via rigid bronchoscopy before medical therapy.

Spontan Şilotoraks (Bir Olgu Sunumu)

Şilotoraks, duktus torasikus ya da dallarinin bozulmasi ya da tikanikligina bagli olarak plevral araliga siloz sivinin sizmasidir. Oncesinde herhangi bir yakinmasi bulunmayan 3,5 yasinda erkek hasta, oksuruk ve hiriltili solunum sikayetleriyle basvurdu. Akciger grafisinde sol akcigerde konsolidasyon ile birlikte plevral efuzyon saptandi. Kapali sualti drenaja alinan hastanin efuzyon sivisinin gorunumu sut beyaz renkte, pH 7, dansite 1015, trigliserit 2101 mg/dl, glikoz 168 mg/dl, lokosit 590 mm3 bulundu. Plevral efuzyon sivisi kulturunde ureme olmadi. Bu bulgularla hastaya silotoraks tanisi konuldu. Yagdan fakir diyetle birlikte somatostatin 3 μgr/kg/saat baslandi. Somatostatin tedavisine 2 hafta devam edilen hasta 25. gunde toraks tupu cikarilarak taburcu edildi. Şilotoraksin cok nadiren de olsa spontan gerceklesebilecegi, tedavide somatostatin kullaniminin cerrahi mudahale ihtiyacini azaltabilecegi vurgulandi.A-19-year old male patient complained of shortness of breath. Aspiration of the pleural fluid revealed chylothorax. Right chest tube was inserted. His ABG showed hypoxaemia with relative hypercarbia. He underwent right thoracotomy and thoracic duct ligation under general anaesthesia and double lumen endobroncheal intubation. During surgery he lost 1.5 L of blood and 4 L chyle. He was transferred to the SICU intubated and on mechanical ventilation. On the subsequent days chyle leak was reduced to a minimum of 10 ml/hr. On the 9th postoperative day the patient was extubated. He was receiving TPN 2600 kcal/day. He was transferred to the normal floor on the 15th day. After 7 day he was readmitted, his chest showed severe lung fibrosis and consolidation. His ABG showed severe hypercarbia (PaCO2 = 126 mmHg). The patient was intubated. His condition deteriorated and he was considered for lung transplantation. No donor was available. Later he arrested and died. Anaesthesia and surgical management of spontaneous chylothorax is challenging. The mortality rate is high.

Pleural Mass Lesion Containing Calcium Sludge

A 30 year-old man was admitted with the symptoms of chest pain. Opacity with smooth margins in right lower zone at chest x-ray. Thoracic computed tomography showed in right-sided a calcified pleural mass (Figure 1). The patient operated with the diagnosis of chest wall mass. In the operation we seen pleural mass that was to lie down on from 4. costovertebral junction to costophrenic sinus. The mass settled between

Analysis of Surgical Treatment of 79 Lung Cancer Cases

Objective: The aim of this study is evaluation of operation timing in patients who suffered primary bronchial cancers with proper adjuvant therapies, indications for operation, selection of surgical method, postoperative complications and curative results of surgical attempts in the light of current literature. Methods: Seventy-nine patients (69 males-10 females) who were diagnosed and operated on with primary bronchial cancer, and followed between June 2002 and March 2005 at the Department of Thoracic surgery, Faculty of Medicine, Gazi University, were evaluated retrospectively. Results: Seventy-nine patients with primary bronchial cancer were operated on between June 2002 and March 2005 in our department. 87.3% of these cases were male (n=69), and 12.7% were female (n=10), median age of patients was 60.25±10.32 (38-82). 77 cases were diagnosed as non small lung cancer (NSLC) and 2 cases were diagnosed as small lung cancer (SLC). The patients were classified according to pathological stage as follows; 2.55% of the patients as carcinoma in situ (n=2), 39.2% of the patients as stage I (n=31), 19% of the patients as stage II (n=15), 32.9% of the patients as stage III (n=26), 3.8% of the patients as stage IV (n=3).