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Related Concept Videos

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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The thorax muscles are central to the body's respiration and provide essential support and movement for the upper body. They are intricately designed to facilitate the complex breathing process while also contributing to the structural integrity and mobility of the chest and upper limbs.
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Flail Chest-I01:24

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Overview of Flail Chest
Flail chest is a severe and potentially life-threatening condition characterized by the fracture of three or more adjacent ribs in multiple places. It is most commonly caused by direct impacts and trauma, such as motor vehicle accidents or injuries from a steering wheel impact. It can also occur due to falls in elderly individuals with osteoporosis, or assaults involving sharp objects.
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Esophageal Perforation-I: Introduction01:22

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Esophageal perforation is a severe medical condition characterized by a breach in the integrity of the esophageal wall. This breach can occur due to various factors such as trauma, medical procedures, or underlying diseases. When the esophageal wall is compromised, it allows food, fluids, and digestive juices into the chest cavity or adjacent structures, leading to potential complications and health risks.
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Pulmonary ventilation is a vital process that ensures the exchange of oxygen and carbon dioxide in the lungs. It refers to the movement of air into and out of the lungs, enabling the body to obtain oxygen and remove waste carbon dioxide. In this article, we will explore the intricacies of pulmonary ventilation, including its underlying principles, mechanisms, and the interplay of pressures within the respiratory system.
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Continuous Telemetric In Utero Tracheal Pressure Measurements in Fetal Lambs
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Transdiaphragmatic Chest Wall Herniation.

Anna G Meader1, David L Ciraulo1, Joseph F Rappold1

  • 192602 Department of Surgery, Maine Medical Center, Portland, ME, USA.

The American Surgeon
|December 18, 2020
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Summary

Traumatic transdiaphragmatic intercostal hernias (TDIH) are rare injuries, often caused by severe cough or heavy lifting. This study highlights a high recurrence rate, suggesting mesh repair may be more beneficial for these complex chest wall defects.

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Area of Science:

  • Trauma Surgery
  • Thoracic Surgery
  • Surgical Innovation

Background:

  • Traumatic transdiaphragmatic intercostal hernia (TDIH) is a rare injury, with fewer than 50 cases reported since 1946.
  • Established risk factors and optimal management strategies for TDIH are not well-defined due to its rarity.

Purpose of the Study:

  • To present the largest single-center case series of traumatic TDIH to date.
  • To discuss the challenges associated with the diagnosis and surgical repair of TDIH.
  • To evaluate outcomes and recurrence rates following different surgical interventions.

Main Methods:

  • A retrospective review of adult patients diagnosed with traumatic TDIH between July 2014 and January 2019.
  • Data abstraction from electronic medical records, including patient demographics, injury mechanisms, symptoms, and treatment approaches.

Main Results:

  • Seven cases of traumatic TDIH were identified, with 6 cases resulting from severe cough and 1 from heavy lifting.
  • All patients were overweight or obese; common symptoms included pain and a "popping sensation".
  • Three patients experienced recurrence of the intercostal hernia component following primary repair and mesh augmentation.

Conclusions:

  • Right-sided injuries were more common in this series, contrary to previous assumptions.
  • Computed tomography (CT) is recommended for diagnosis and surgical planning.
  • High recurrence rates suggest mesh repair should be more frequently considered, especially for delayed reconstructions or when primary closure is not feasible.