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Pneumothorax-I01:26

Pneumothorax-I

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A pneumothorax is a condition where air builds up in the space between the lung and the chest wall, causing the lung to collapse. This condition arises when air enters the space between the parietal and visceral pleura, disrupting the negative pressure essential for lung inflation. This can lead to a partial or complete collapse of the lung.
Pneumothorax can be even further classified as spontaneous, traumatic, and tension pneumothorax.
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Pneumothorax-II01:27

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Pneumothorax is a medical condition defined by the buildup of air in the pleural space between the lungs and the chest wall. This accumulation of air can lead to partial or complete lung collapse, resulting in a range of clinical manifestations. Understanding the clinical presentation and effective management strategies is crucial for healthcare professionals in providing timely and appropriate care to individuals with pneumothorax.
Clinical Manifestations:
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Endoscopic Studies II: Thoracocentesis01:26

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Thoracentesis(Thoracocentesis), commonly known as pleural tap, is a medical procedure where a 22 gauge needle is inserted into the pleural space, the area between the lung and chest wall. This procedure is commonly performed to diagnose or treat various respiratory disorders.
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Excess pleural fluid or air may accumulate in some respiratory disorders in the thoracic cavity. To treat pleural effusion, a physician conducts thoracentesis by carefully piercing the chest wall and entering...
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Flail Chest-II01:26

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Managing flail chest, a condition characterized by a segment of the chest wall moving independently from the rest of the thoracic cage, requires a comprehensive approach. It includes a thorough assessment of the patient's condition, a diagnostic evaluation to determine the extent of the injury, and the implementation of appropriate medical interventions tailored to the individual's needs.
Assessment:
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Pulmonary Cycle: Exhalation01:17

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In terms of human respiration, the act of expelling air, known as exhalation (or expiration), operates on the principle of pressure gradients. During expiration, the pressure within the lungs exceeds that of the surrounding atmosphere. Under normal conditions, quiet breathing involves passive exhalation and is free of muscular contractions. This is because the exhalation process is driven by the natural elastic recoil of the lungs and chest wall, both of which have an inherent tendency to...
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Esophageal Perforation-II: Clinical Manifestations and Management01:28

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Esophageal perforations manifest in various clinical forms, influenced by factors such as the perforation's cause and location (cervical, intrathoracic, or intra-abdominal), the extent of contamination, and potential injury to adjacent mediastinal structures. The timing between the perforation occurrence and treatment initiation also affects the clinical presentation.
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Normothermic Negative Pressure Ventilation Ex Situ Lung Perfusion: Evaluation of Lung Function and Metabolism
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Diaphragm disease in emergency surgery.

Diwakar R Sarma1, Pratik Bhattacharya2

  • 1Department of General Surgery, University Hospital Coventry and Warwickshire, Coventry, UK.

British Journal of Hospital Medicine (London, England : 2005)
|April 3, 2020
PubMed
Summary

Diaphragm disease, a severe non-steroidal anti-inflammatory drug enteropathy, causes small bowel obstruction. Long-term NSAID use and female gender are key risk factors for this rare condition.

Keywords:
Diaphragm diseaseEmergency surgeryNon-steroidal anti-inflammatory drug-induced enteropathySmall bowel obstruction

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Area of Science:

  • Gastroenterology
  • Surgical Pathology
  • Pharmacology

Background:

  • Diaphragm disease of the small bowel is a rare, severe manifestation of non-steroidal anti-inflammatory drug (NSAID)-induced enteropathy.
  • It characteristically presents with multiple circumferential stenoses within the small intestine.
  • This condition often leads to acute small bowel obstruction, necessitating emergency surgical intervention.

Purpose of the Study:

  • To conduct a systematic review of histologically-proven diaphragm disease of the small intestine.
  • To identify risk factors associated with its development.
  • To evaluate patient outcomes in those undergoing emergency surgery for small bowel obstruction.

Main Methods:

  • A comprehensive literature search was conducted from January 1975 to March 2019 using relevant Medical Subject Headings (MeSH) terms.
  • Studies were selected based on predefined inclusion criteria, focusing on diaphragm disease defined by macroscopic thin, diaphragm-like mucosal folds.
  • Data extracted included patient demographics, NSAID usage, surgical procedures, complications, and diagnostic presentations.

Main Results:

  • Twenty-one studies comprising 17 case reports, one case series, and three retrospective comparative studies were analyzed, involving 29 patients.
  • All patients had a history of non-steroidal anti-inflammatory drug (NSAID) use, averaging 3-5 years.
  • Female patients and those with over 7 years of NSAID use were more prevalent in comparative studies, with all patients presenting with acute small bowel obstruction requiring laparotomy.

Conclusions:

  • Diaphragm disease is a rare and challenging diagnosis, often confirmed intraoperatively by the characteristic circumferential bowel stenosis.
  • Long-term NSAID use and female gender are identified as significant risk factors.
  • Early diagnosis is crucial due to the high risk of acute small bowel obstruction in affected patients.