Not so simple: tension pneumothorax from caecal colonoscopic perforation

2017 ◽  
Vol 87 (4) ◽  
pp. 314-314
Author(s):  
Bhamini Vadhwana ◽  
Daniel J. Bell ◽  
Manojkumar S. Nair
Keyword(s):  
Tension Pneumothorax ◽  
Colonoscopic Perforation ◽  
Simple Tension

Survival case of acute and severe respiratory distress due to spontaneous tension gastrothorax

2020 ◽  
Vol 13 (9) ◽  
pp. e235281
Author(s):  
Sanjan Asanaru Kunju ◽  
Prithvishree Ravindra ◽  
Ramya Kumar Madabushi Vijay ◽  
Priya Pattath Sankaran
Keyword(s):  
Tension Pneumothorax ◽  
Emergency Laparotomy ◽  
Severe Respiratory Distress ◽  
Mediastinal Shift ◽  
Breath Sounds ◽  
Chest X Ray ◽  
The Right ◽  
Tension Gastrothorax ◽  
Obstructive Shock ◽  
Survival Case

A 20-year-old woman presented with abdominal pain and shortness of breath. She was in obstructive shock with absent breath sounds on the left haemithorax. Chest X-ray showed a large radiolucent shadow with absent lung markings and mediastinal shift to the right side with concerns for tension pneumothorax. Though tube thoracostomy was done on the left side of the chest, column movement was absent. To confirm the diagnosis CT with contrast was done that revealed a huge left side diaphragmatic defect with abdominal contents in the thorax and mediastinal structures are shifted to left. She underwent emergency laparotomy and postoperative period was uneventful.

scholarly journals Two cases of intraoperative hemodynamic instability during combined thoracoscopic-laparoscopic surgery for esophagogastric junction carcinoma

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Makiko Tani ◽  
Yoshikazu Matsuoka ◽  
Mayu Sugihara ◽  
Ayaka Fujii ◽  
Tomoyuki Kanazawa ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Esophagogastric Junction ◽  
Intraoperative Complications ◽  
Proximal Gastrectomy ◽  
Tension Pneumothorax ◽  
Hemodynamic Instability ◽  
Laparoscopic Proximal Gastrectomy ◽  
Surgical Field ◽  
Coronary Ischemia ◽  
Thoracic And Abdominal

Abstract Background Intraoperative complications during combined thoracoscopic-laparoscopic surgery for esophagogastric junction (EGJ) carcinoma have not been reported as compared to those during surgery for esophageal carcinoma. We present two cases which had surgery-related hemodynamic instability during laparoscopic proximal gastrectomy and intra-mediastinal valvuloplastic esophagogastrostomy (vEG) with thoracoscopic mediastinal lymphadenectomy for EGJ carcinoma. Case presentation In case 1, the patient fell into hypotension with hypoxemia during laparoscopic vEG due to pneumothorax caused by entry of intraabdominal carbon dioxide. In case 2, ventricular arrythmia and ST elevation occurred during laparoscopic vEG. Pericardium retraction to secure surgical field during reconstruction compressed the coronary artery, which caused coronary malperfusion. These two events were induced by the surgical procedure, characterized by the following: (1) connection of the thoracic and abdominal cavities and (2) cardiac displacement during vEG. Conclusion These cases indicated tension pneumothorax and coronary ischemia are possible intraoperative complications specific to combined thoracoscopic-laparoscopic surgery for EGJ carcinoma.

scholarly journals A comparison of the demographics, injury patterns and outcome data for patients injured in motor vehicle collisions who are trapped compared to those patients who are not trapped

2021 ◽  
Vol 29 (1) ◽  
Author(s):  
Tim Nutbeam ◽  
Rob Fenwick ◽  
Jason Smith ◽  
Omar Bouamra ◽  
Lee Wallis ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Blood Loss ◽  
Injury Severity ◽  
Spinal Cord Injuries ◽  
Motor Vehicle ◽  
Tension Pneumothorax ◽  
Research Network ◽  
Motor Vehicle Collisions ◽  
Vehicle Collisions ◽  
Time Critical

Abstract Background Motor vehicle collisions (MVCs) are a common cause of major trauma and death. Following an MVC, up to 40% of patients will be trapped in their vehicle. Extrication methods are focused on the prevention of secondary spinal injury through movement minimisation and mitigation. This approach is time consuming and patients may have time-critical injuries. The purpose of this study is to describe the outcomes and injuries of those trapped following an MVC: this will help guide meaningful patient-focused interventions and future extrication strategies. Methods We undertook a retrospective database study using the Trauma Audit and Research Network database. Patients were included if they were admitted to an English hospital following an MVC from 2012 to 2018. Patients were excluded when their outcomes were not known or if they were secondary transfers. Results This analysis identified 426,135 cases of which 63,625 patients were included: 6983 trapped and 56,642 not trapped. Trapped patients had a higher mortality (8.9% vs 5.0%, p < 0.001). Spinal cord injuries were rare (0.71% of all extrications) but frequently (50.1%) associated with other severe injuries. Spinal cord injuries were more common in patients who were trapped (p < 0.001). Injury Severity Score (ISS) was higher in the trapped group 18 (IQR 10–29) vs 13 (IQR 9–22). Trapped patients had more deranged physiology with lower blood pressures, lower oxygen saturations and lower Glasgow Coma Scale, GCS (all p < 0.001). Trapped patients had more significant injuries of the head chest, abdomen and spine (all p < 0.001) and an increased rate of pelvic injures with significant blood loss, blood loss from other areas or tension pneumothorax (all p < 0.001). Conclusion Trapped patients are more likely to die than those who are not trapped. The frequency of spinal cord injuries is low, accounting for < 0.7% of all patients extricated. Patients who are trapped are more likely to have time-critical injuries requiring intervention. Extrication takes time and when considering the frequency, type and severity of injuries reported here, the benefit of movement minimisation may be outweighed by the additional time taken. Improved extrication strategies should be developed which are evidence-based and allow for the expedient management of other life-threatening injuries.

Fitting Weibull Strength Data and Applying It to Stochastic Mechanical Design

1992 ◽  
Vol 114 (1) ◽  
pp. 35-41 ◽  
Author(s):  
C. R. Mischke
Keyword(s):  
Mechanical Design ◽  
Least Square ◽  
Stochastic Methods ◽  
Coordinate Transformations ◽  
Strength Data ◽  
The Third ◽  
Tension Tests ◽  
Property Data ◽  
Simple Tension ◽  
Best Fit

This is the second paper in a series relating to stochastic methods in mechanical design. The first is entitled, “Some Property Data and Corresponding Weibull Parameters for Stochastic Mechanical Design,” and the third, “Some Stochastic Mechanical Design Applications.” When data are sparse, many investigators prefer employing coordinate transformations to rectify the data string, and a least-square regression to seek the best fit. Such an approach introduces some bias, which the method presented here is intended to reduce. With mass-produced products, extensive testing can be carried out and prototypes built and evaluated. When production is small, material testing may be limited to simple tension tests or perhaps none at all. How should a designer proceed in order to achieve a reliability goal or to assess a design to see if the goal has been realized? The purpose of this paper is to show how sparse strength data can be reduced to distributional parameters with less bias and how such information can be used when designing to a reliability goal.

Relief of tension pneumothorax

Anaesthesia ◽  
1976 ◽  
Vol 31 (6) ◽  
pp. 801-802 ◽  
Author(s):  
A. J. Asbury
Keyword(s):  
Tension Pneumothorax

Intraoperative bilateral tension pneumothorax in a patient undergoing breast augmentation surgery with general anesthesia

2014 ◽  
Vol 67 (6) ◽  
pp. e165-e166 ◽  
Author(s):  
Renato Vera-Merchancano ◽  
Joaquín Hernández-Palazón ◽  
Diego Fuentes-García ◽  
Luis Enrique Fernández-Rodríguez
Keyword(s):  
General Anesthesia ◽  
Breast Augmentation ◽  
Tension Pneumothorax
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