scholarly journals Clinical observation of fatal bilateral spontaneous pneumothorax in wegener granulomatosis, which simulated lung cancer

2018 ◽  
Vol 9 (2) ◽  
pp. 42-49
Author(s):  
N. B. Khaydukova ◽  
Yu. A. Khabarov ◽  
V. A. Stepanov ◽  
E. A. Zvyezdkhina ◽  
Yu. V. Ivanov
Keyword(s):  
Spontaneous Pneumothorax ◽  
Clinical Observation ◽  
Left Lung ◽  
Lower Lobe ◽  
Malignant Neoplasm ◽  
Chronic Obstructive ◽  
Bilateral Pneumothorax ◽  
Wegener Granulomatosis ◽  
Obstructive Pulmonary Disease ◽  
The Right

We present a clinical observation of a 77 year-old patient admitted to the hospital with a sharp deterioration in the course of chronic obstructive pulmonary disease. The results of computed tomography of the chest read in favor of a newly detected malignant neoplasm of the upper lobe of the right lung with invasion into the mediastinum and secondary disseminations in the lower lobe of the left lung and liver. The performed fiber-optic bronchoscopy with a transbronchial lung biopsy did not verify the cancer diagnosis. The patient developed a bilateral spontaneous pneumothorax with the formation of bilateral bronchial-pleural fistulae with a massive air discharge through the pleural drainage. The presence of bilateral large bronchopleural fistulae did not allow a surgical intervention which required a separate intubation of the main bronchi. Minimally invasive techniques were ineffective. The patient died on the third day from the moment of the bilateral pneumothorax development due to severe respiratory failure. The autopsy established the diagnosis of Wegener’s granulomatosis affecting the lungs and kidneys.

scholarly journals Swyer-James-MacLeod syndrome and pulmonary arteriovenous malformations: a rare combination

2020 ◽  
Vol 13 (1) ◽  
pp. e231972
Author(s):  
Paul Griffiths ◽  
Ayesha Kumar ◽  
Konstantinos Liatsikos
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Cigarette Smoking ◽  
Arteriovenous Malformations ◽  
Respiratory Symptoms ◽  
Lower Lobe ◽  
Chronic Obstructive ◽  
Pulmonary Arteriovenous Malformations ◽  
Obstructive Pulmonary Disease ◽  
Rare Combination ◽  
The Right

This case describes a female patient who presented with an acute on chronic deterioration in respiratory symptoms, on a background of chronic obstructive pulmonary disease and heavy cigarette smoking. Chest radiograph demonstrated long-standing hyperlucency of the right lower lobe, with further imaging later confirming the rare combination of Swyer-James-MacLeod syndrome and multiple pulmonary arteriovenous malformations within the affected lung.

Nonhomogeneous alveolar pressure swings in the presence of airway closure

1980 ◽  
Vol 49 (3) ◽  
pp. 398-402 ◽  
Author(s):  
R. Brown ◽  
S. Scharf ◽  
R. H. Ingram
Keyword(s):  
Lower Lobe ◽  
Chronic Obstructive ◽  
Airway Closure ◽  
Alveolar Pressure ◽  
Obstructive Pulmonary Disease ◽  
Thoracic Gas Volume ◽  
Airway Opening ◽  
The Right ◽  
Gas Volume

When thoracic gas volume (TGV) is determined plethysmographically, it is assumed that the alveolar pressure swings are homogeneous and are appropriately represented by pressure swings at the mouth. However, recent studies have demonstrated differences in total lung capacities derived from TGV measurements made at different levels in the vital capacity. These differences suggested that, in the presence of airway closure, alveolar pressure swings may be nonhomogeneous during a TGV determination. This possibility was tested in six dogs. Pressure at the airway opening (ao) was measured from an endotracheal catheter. A balloon-tipped catheter was passed into the right lower lobe (RLL) bronchus for measurement of RLL pressure. delta PRLL -- delta Pao was monitored during inspiratory efforts with the airway opening occluded. With the RLL balloon inflated, delta PRLL always exceeded delta Pao by an amount averaging 8.2%. Induction of a pneumothorax eliminated all differences between delta PRLL and delta Pao. Thus, during a TGV measurement, the chest wall may apply to the lungs nonhomogeneous forces that, in the presence of airway closure (e.g., chronic obstructive pulmonary disease and asthma) would result in nonhomogeneous alveolar pressure swings and potentially significant errors in the plethysmographic determination of TGV.

scholarly journals A Patient with GOLD Stage 3 COPD « cured » by One-Way Endobronchial Valves

Medicina ◽  
2019 ◽  
Vol 55 (3) ◽  
pp. 65
Author(s):  
Eric Marchand ◽  
Jean-Paul d’Odemont ◽  
Michael V Dupont
Keyword(s):  
Lung Volume ◽  
Lower Lobe ◽  
Volume Reduction ◽  
Chronic Obstructive ◽  
Therapeutic Approaches ◽  
Lung Volume Reduction ◽  
Obstructive Pulmonary Disease ◽  
Gold Stage ◽  
Appropriate Therapy ◽  
The Right

Lung hyperinflation is a main determinant of dyspnoea in patients with chronic obstructive pulmonary disease (COPD). Surgical or bronchoscopic lung volume reduction are the most efficient therapeutic approaches for reducing hyperinflation in selected patients with emphysema. We here report the case of a 69-year old woman with COPD (GOLD stage 3-D) referred for lung volume reduction. She complained of persistent disabling dyspnoea despite appropriate therapy. Chest imaging showed marked emphysema heterogeneity as well as severe hyperinflation of the right lower lobe. She was deemed to be a good candidate for bronchoscopic treatment with one-way endobronchial valves. In the absence of interlobar collateral ventilation, 2 endobronchial valves were placed in the right lower lobe under general anaesthesia. The improvement observed 1 and 3 months after the procedure was such that the patient no longer met the pulmonary function criteria for COPD. The benefit persisted after 3 years.

scholarly journals Surgical treatment of a patient with placentoid transformation of the lower lobe of the right lung

2021 ◽  
Vol 180 (2) ◽  
pp. 69-72
Author(s):  
S. A. Eskov ◽  
V. V. Erokhov ◽  
A. M. Dziadzko ◽  
A. F. Minov ◽  
O. Iu. Gurova ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Surgical Treatment ◽  
Extracorporeal Membrane Oxygenation ◽  
Chorionic Villus ◽  
Lower Lobe ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
First Case ◽  
The Right ◽  
Dependent Patient

Placentoid transformation (in English publications – placental transmogrification) extremely rare lung disease, characterized by formation of villous structures, which look like chorionic villus with pulmonary emphysema. We report the first case of 28 y. o. patient with giant placentoid transformation and chronic obstructive pulmonary disease. We used extracorporeal membrane oxygenation support for surgical management and it let the oxygen-dependent patient to return to normal life.

THE ROLE OF PULMONARY REHABILITATION IN ACUTE EXACERBATIONS OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE

2020 ◽  
pp. 39-40
Author(s):  
RAHMAD ◽  
SHABRINA NARASATI ◽  
EKO NUGROHO ◽  
DJOKO WITJAKSONO ◽  
DWI INDRIANI LESTARI ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pulmonary Rehabilitation ◽  
Lower Lobe ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Chest Expansion ◽  
Postural Drainage ◽  
The Right ◽  
Incentive Spirometry

Objective: Chronic obstructive pulmonary disease (COPD) reduces lung function and generates systemic effects that decrease the quality of life. COPD is a major cause of chronic morbidity and mortality worldwide. Pulmonary rehabilitation can reduce symptoms of dyspnea and improve exercise capacity and quality of life in COPD patients. Methods: We report a case of a 60 y old male with an acute exacerbation (AE) of COPD and pneumonia. The inpatient pulmonary rehabilitation program was 5 consecutive days of 3 repetitions of cough control, 2 sets of 6 repetitions of pursed-lip breathing, 2 sets of 6 repetitions of deep breathing exercises, postural drainage, and manual clapping twice daily. Postural drainage in the lateral basal segment and manual clapping in the right lower lobe was chosen according to the chest x-ray (CXR). Results: At the initial visit, the following information was noted: inspiration capacity with incentive spirometry, 600 cc/s; chest expansion, 1.5 cm; and single-breath counting (SBC), 11. The activities of daily living (ADL) score according to the Barthel Index was 70, and CXR results showed COPD and pneumonia in the right lower lobe. After 5 d of pulmonary rehabilitation, there was a clear airway and improvement in shortness of breath (SOB), and the following was noted: incentive spirometry, 900 cc/s; chest expansion, 2 cm; SBC, 20; and Barthel Index score, 100. Conclusion: Early inpatient pulmonary rehabilitation in COPD AEs is clinically effective and safe, controls breathing and coughing, strengthens the respiratory muscles, and improves the clearing of the airway, which improves the patient’s pulmonary function capacity and quality of life.

CONDITION OF HEMODYNAMICS IN THE PULMONARY CIRCULATION OF PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) CONCURRENT WITH METABOLIC SYNDROME WITH HYPERTROPHY AND ATROPHY OF THE MYOCARDIUM

2019 ◽  
Vol 72 (8) ◽  
pp. 1491-1493
Author(s):  
Viktor P. Boriak ◽  
Svitlana V. Shut’ ◽  
Tetiana A. Trybrat ◽  
Olena V. Filatova
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Metabolic Syndrome ◽  
Right Ventricular ◽  
Pulmonary Disease ◽  
Pulmonary Circulation ◽  
Contractile Function ◽  
Ventricular Myocardium ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
The Right

Introduction: In recent years, COPD is observed as not an isolated, but an associated pathology, in particular, concurrent with metabolic syndrome. The aim of the research is to identify the differences in changes of the rheopulmonography parameters (RPG) depending on the presence of hypertrophy or atrophy of the right ventricular myocardium in patients with COPD concurrent with metabolic syndrome.. Materials and methods: We studied changes in rheopulmonography (RPG) in 145 patients with chronic obstructive pulmonary disease (COPD) concurrent with metabolic syndrome. Results: We detected precapillary hypertension of the pulmonary circulation in patients with right ventricular myocardial hypertrophy: anacrotism serration; flattened peak of the systolic wave; decreased Vcp; high placement of incisura; horizontal course of catacrotism; decreased amplitude of the systolic wave (in this case, due to a greater increase in the resistance of the blood flow in the pulmonary vessels than the decreased impact volume of the right ventricle); prolonged Q-a (in this group of patients, it depends more on hypertension of the pulmonary circulation than on the reduction of contractile function of the myocardium). In atrophy of the right ventricular myocardium, the following changes in the RPG were revealed: decreased systolic wave at its dramatic rise; prolonged Q-a (in this case, due to the weakened heart contraction); Vmax reduction (it reflects the reduction of myocardial contractility); in hypertrophy of the myocardium, Vcp., unlike RPG, does not decrease, which is explained by the decrease in the pressure of the pulmonary circulation. Conclusions: We believe that these changes in RPG allow differentiating hypertrophy and right ventricular myocardial atrophy along with established diagnostic criteria, and can be used as markers for the diagnosis and treatment of COPD concurrent with metabolic syndrome.

scholarly journals Lower lobe lung volume reduction surgery: a case report

2020 ◽  
Vol 2020 (9) ◽  
Author(s):  
Mohammed J Al-Jaghbeer ◽  
Umur Hatipoglu ◽  
Sid Murthy ◽  
Yvonne Meli ◽  
Atul C Mehta
Keyword(s):  
Lung Volume ◽  
Lower Lobe ◽  
Supplemental Oxygen ◽  
Volume Reduction ◽  
Chronic Obstructive ◽  
Lung Volume Reduction Surgery ◽  
Lung Volume Reduction ◽  
Obstructive Pulmonary Disease ◽  
Heterogeneous Distribution ◽  
Optimal Medical Management

ABSTRACT Lung volume reduction surgery (LVRS) is an option for select patients with advanced chronic obstructive pulmonary disease (COPD). Current guidelines recommend LVRS for patients with appropriate physiology and heterogeneous distribution of emphysema predominately involving upper lobes. We present an unusual case of a 72-year-old male with an advanced COPD who suffered with recurrent exacerbations despite optimal medical management. He underwent a two-stage bilateral lower lobe LVRS for heterogeneous lower lobe emphysema via video-assisted thoracoscopic (VATS) approach. This resulted in a significant subjective as well as objective improvement in his pulmonary functions, 6-min walk distance and subsequent discontinuation of supplemental oxygen.

The state of the cardiovascular system in occupational bronchitis and chronic obstructive pulmonary disease, not associated with the impact of harmful industrial factors

2021 ◽  
pp. 55-68
Author(s):  
Vyacheslav S. Lotkov ◽  
Anton Vladimirovich Glazistov ◽  
Antonina G. Baykova ◽  
Marina Yuryevna Vostroknutova ◽  
Natalia E. Lavrentieva
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Cardiovascular System ◽  
Pulmonary Disease ◽  
Lung Diseases ◽  
Chronic Obstructive ◽  
External Respiration ◽  
Obstructive Pulmonary Disease ◽  
Occupational Lung Diseases ◽  
The Right ◽  
The Impact

The formation and progression of chronic dust bronchitis and chronic bronchitis of toxic-chemical etiology, chronic obstructive pulmonary disease is accompanied by an increase in the degree of ventilation disorders, echocardiographic signs of hypertrophy and dilatation of the right ventricle are formed, typical for chronic pulmonary heart disease. The progression of disturbances in the function of external respiration in dusty lung diseases leads to a decrease in myocardial contractility. The detection of hemodynamic disturbances at the early stages of the development of occupational lung diseases indicates the need for individual monitoring of the functional state of the cardiovascular system in the process of contact with industrial aerosols, especially in groups of workers with long-term exposure.

scholarly journals Chronic Obstructive Lung Disease in young: Alpha 1 anti trypsin deficiency

2015 ◽  
Vol 3 (2) ◽  
pp. 65-67
Author(s):  
S.S. Dhakal ◽  
K.K. Agrawaal ◽  
N.K. Bhatta
Keyword(s):  
Bronchial Asthma ◽  
Clinical Manifestations ◽  
Lower Lobe ◽  
Chronic Obstructive Lung Disease ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Severe Deficiency ◽  
History Of ◽  
Pulmonary Arterial ◽  
Alpha 1 Antitrypsin

Alpha-1 antitrypsin (AAT) deficiency is a clinically under recognized inherited disorder. The main clinical manifestations relate to three separate organs: the lung, the liver, and the skin. In the lung, severe deficiency of AAT predisposes to chronic obstructive pulmonary disease. We present a case of 34 years male with a history of recurrent chest infections in past and treated in the line of bronchial asthma but not relieved. He was admitted on 22nd May 2011 at BPKIHS. He presented with type 2 respiratory failure and had features of severe pulmonary arterial hypertension and left lower lobe pneumonia. The patient got improved with the treatment and is doing well on follow up. The diagnosis should be strongly suspected in patients with history suggestive of bronchial asthma and with obstructive features.Journal of Advances in Internal Medicine 2014;3(2):65-67

scholarly journals Frequency and Pattern of Bronchiectasis in Patients with Chronic Obstructive Pulmonary Disease Presenting in a Tertiary Care Hospital

2021 ◽  
Vol 35 (3) ◽  
pp. 54-57
Author(s):  
Asifa Karamat
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Tertiary Care ◽  
Lower Lobe ◽  
The United States ◽  
Diagnostic Tools ◽  
Chronic Obstructive ◽  
High Morbidity ◽  
Care Hospital ◽  
Obstructive Pulmonary Disease

Introduction: Chronic Obstructive Pulmonary Disease (COPD) is a high burden respiratory issue all over the world. It has high morbidity and mortality in the United States. Bronchiectasis is associated with chronic obstructive pulmonary disease (COPD) and is under diagnosed as diagnostic tools like HRCT though easily available but an expensive test in developing countries like Pakistan. We aim to establish the frequency and patterns of bronchiectasis in patients of COPD. Aims and Objectives: To establish the frequency and pattern of bronchiectasis in COPD in our population so that we can improve patient care and quality of life of these patients. Place and duration of study: We did a cross sectional survey in Department of Pulmonology, Gulab Devi Hospital, Lahore. Study was completed from 1st September 2017 to 28th February 2018. Material & Methods: After taking an informed consent 150 already diagnosed COPD patients were included. Bronchiectasis was seen on high resolution CT scan (HRCT). Data was collected on a structured proforma and analyzed on SPSS version 20. Results: Bronchiectasis was observed in 76 (50.6%) patients of COPD while 74 patients had no bronchiectasis. Out of 76, cylindrical bronchiectasis was seen in 82%. Lower lobe and bilateral involvement was more common. Means of age, gender, exacerbations of COPD, and history of pulmonary tuberculosis were not related to bronchiectasis while pack years of smoking, duration of illness and Modified Medical Research Council (MMRC) Dyspnea Scale were significantly related to bronchiectasis. Conclusion: This is observed that bronchiectasisis quite common (50.6%) in patients of COPD in our population.

Sign in / Sign up

Export Citation Format

Share Document