Clinical Scenarios in Thoracic Surgery by Robert Kalimi MD, L. Penfield Faber MD

By Robert Kalimi MD, L. Penfield Faber MD

This distinct case-based overview of thoracic surgical procedure bargains very good education for oral board examinations, which emphasize either normal wisdom and case administration. Written through well-known specialists, the ebook offers numerous instances masking the whole spectrum of thoracic surgical illnesses. every one case starts with the scientific presentation and proceeds to X-ray file, differential prognosis, CT experiment file, prognosis and suggestion, surgical strategy, end result, and dialogue. X-rays, CT scans, bronchoscopic images, and different proper illustrations accompany the textual content. a few situations comprise postoperative problems and dialogue of the motives, review, and administration of those complications.

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Example text

Spontaneous pneumothoraces can be categorized into primary or secondary types. A primary spontaneous pneumothorax occurs without any clinically apparent underlying lung disease known to promote a pneumothorax. The most common cause of primary spontaneous pneumothorax is an apical subpleural bleb. The typical patient is young, tall, and thin, and in late adolescence or early adulthood. The male-to-female ratio is 6:1. Clinical presentation may vary from asymptomatic (other than the initial chest pain episode) to tension pneumothorax with hemodynamic compromise or collapse.

The patient’s condition continues to deteriorate and progresses to severe distress, labored breathing, mild hypotension, and persistent desaturation. Recommendation Immediate orotracheal intubation and mechanical ventilation. Case Continued A supine chest x-ray is performed. Case 5 ■ Chest X-ray Figure 5-3 Chest X-ray Report Right-sided chest tubes are present. The right lung is expanded; however, there is a unilateral right pulmonary edema with sparing of the left lung. There is also subcutaneous emphysema, mostly on the patient’s right side.

Most failures occur within the first 3 years and usually occur as distant metastases affecting the brain, bone, liver, or contralateral lung. Followup should include a chest x-ray, which is performed every 3 to 4 months for the first year, every 6 months through the third year, and annually thereafter. 43 case 9 Presentation A 65-year-old man with no significant past medical history presents to your office with symptoms of dysphagia and regurgitation. He reports difficulty initiating swallowing both solids and liquids.

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