Sami Ceran

Chest trauma in children

OBJECTIVES Chest trauma in childhood is uncommon in clinical practice. The management and treatment principles of children with thoracic trauma were discussed with the data reported in the literature. METHODS Of the chest injury diagnosed in 1653 patients, 225 were children in the last 17-year period. There were 199 boys (88.44%) and 26 girls (11.55%). The most common causes were blunt injuries in 135 cases (60%), stab wounds in 67 cases (29.77%) and gunshot wounds in 22 cases (9.77%). RESULTS Out of 225, 217 patients were treated conservatively and eight patients were treated surgically. There was no mortality and morbidity. CONCLUSIONS The prevalence of chest trauma in children due to blunt injuries is high in Turkey. Extremity injury is thought to be the most commonly associated extra-thoracic injury. However, thoracic trauma in children can be managed conservatively in most of the cases.

Tracheobronchial aspiration of foreign bodies and rigid bronchoscopy in children

Background:  A significant proportion of cases of tracheobronchial foreign body aspiration due to life‐threatening condition is observed during childhood. The aim of the present study was to describe our experience with the diagnosis and treatment of foreign body aspirations during childhood and review published literature.

Bilateral pneumothorax: a retrospective analysis of 40 patients.

PurposeTo retrospectively investigate the effectiveness of tube drainage in the treatment of bilateral pneumothorax.MethodsWe retrospectively examined 40 patients with bilateral pneumothorax treated at the Thoracic and Cardiovascular Surgery Departments of Selcuk University between January 1994 and December 2000. There were 37 male and 3 female patients, aged 5–80 years (mean age, 42 years). The definite diagnosis of pneumothorax was made by radiological evaluation. In total, 38 tube drainage, 2 thoracentesis, and observation procedures were done, and some patients also required thoracotomy or median sternotomy.ResultsThe types of pneumothorax were spontaneous in 9 patients, traumatic in 30, and iatrogenic in 1. We treated simultaneous bilateral pneumothorax in 34 patients and nonsimultaneous bilateral pneumothorax in 6 patients by tube drainage or additional surgical treatment. Two patients died.ConclusionsBilateral pneumothorax may require extended hospital stay and could result in death. We think that tube drainage is appropriate and effective for most cases of bilateral pneumothorax.

Respiratory Failure Caused by Giant Thymolipoma

The authors present the case of a 31-year-old woman with a massive anterior mediastinal tumor who presented with respiratory failure. A thoracic computed tomographic scan suggested a mediastinal lipomatous mass, and an operation was performed. Resection of the tumor resulted in immediate improvement in the patients pulmonary status, and the histopathologic examination revealed thymolipoma. Because thymolipoma can attain enormous dimensions and compress adjacent structures, it should be immediately resected.

Unusual location of arteriovenous malformation; posterior mediastinum

An arteriovenous malformation is an anomaly of capillary development that results in a direct connection between branches of an artery and veins, with no intervening capillary network. Vascular malformations of the mediastinum presenting as mediastinal masses are very rare. We report a histologically proven case of a posterior mediastinal arteriovenous malformation in a 42-year-old man that was incidentally detected by chest radiography during a routine health check. We discuss arteriovenous malformation and review the literature findings.

Cost-effective and time-saving surgical treatment of pulmonary hydatid cysts with multiple localization.

Abstract.Abstract.Purpose: The most frequent anatomic locations of hydatid cysts are the liver and lungs. Because there is no effective medical therapy against this parasitic disease, surgery is the treatment of choice. The aim of this retrospective study was to compare the cost and effect of a one-stage operation with those of two- or three-stage operations in the treatment of lung hydatid cysts with multiple localizations.Methods: We evaluated 364 patients who underwent surgical treatment for hydatid cysts, all of whom had multiple localizations. To avoid two- or three-staged operations, we performed median sternotomy, simultaneous bilateral thoracotomy and unilateral thoracotomy with a transdiaphragmatic approach.Results: For the treatment of 460 hydatid cyst localizations in 364 patients, a collective 381 operations were performed. The number of operations and periods of hospitalization were reduced.Conclusion: A one-stage surgical procedure for bilateral lung and liver hydatid cysts is superior to the traditional two- and three-stage operations because it reduces morbidity, hospital stay, and cost.

Congenital lobar emphysema: Is surgery routinely necessary?

Congenital lobar emphysema (CLE) is a rare congenital abnormality characterised by overinflation of a pulmonary lobe. Its aetiology is unknown. The management of CLE has traditionally been surgical. A newborn boy with a birthweight of 2.5 kg was delivered at full-term by caesarian section due to food delivery. There was no marked respiratory distress at birth, and little meconium stained liquor was seen on the skin. The initial diagnosis was meconium aspiration syndrome. After computed tomography of the thorax, CLE was diagnosed. The patient was observed throughout for a week and the CT of the thorax was repeated, which revealed that the emphysema had resolved. The nonoperative approach should be considered in asymptomatic patients with CLE.

Intrathoracic Extrapulmonary Hydatid Disease: Radiologic Manifestations

Hydatidosis is a parasitic disease caused by the larvae of Echinococcus granulosus and rarely by Echinococcus alveolaris. It is endemic to South America, North Africa, Asia, Australia, and the Middle East [1,2]. The definitive hosts are foxes and, less commonly, dogs and cats. Humans are infected by direct contact with an infected animal or by ingestion of contaminated food or fluids. Echinococcal embryos migrate through the intestinal mucosa, and, in 60%e70% of cases, reach the liver via the portal system [1]. They can then enter the systemic circulation via the porta caval anastomoses and be carried by the bloodstream to any organ or tissue in the body. Alternatively, the eggs can be inhaled and cause primary lung disease [2]. Intrathoracic extrapulmonary hydatid disease is very rare but can occur in the pleural space, extrapleural region, pleural fissure, chest wall, mediastinum, pericardium, myocardium, and diaphragm [1]. In this pictorial essay, we present the clinical manifestations and imaging features of patients with hydatid cysts (HC) in the extrapulmonary sites of the thorax.

A giant right atrial myxoma: Case report

Right atrial myxomas have rarely been reported. The authors describe a giant hourglass-shaped atrial myxoma consisting of three lobes; one of them had protruded into the right ventricle. Its size was 18×7×5 cm and weight was 170 g. The authors were not able to find another myxoma as big as this one in the literature, so they are reporting it. They review and discuss the literature involving the subject.

Bilateral aneurysms of the pulmonary artery with pectus excavatum: a case report

An eleven-year-old boy was operated on for a left-sided pulmonary artery aneurysm. The same patient had also been operated three years earlier because of a right sided aneurysm.