Para-oesophageal hiatal hernia in infants mimicking 'lung abscess'.
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Biomedical subjects
Publications and source records attributed to B J Henderson.
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In the 10 year period from May, 1973, to May, 1983, a total of 251 pneumonectomies were undertaken. Total unilateral bronchiectasis, the consequence of previous tuberculosis, occurred in 67.3% of cases and was the major indication for pneumonectomy. Of the 251 pneumonectomies, 14.7% were done through an empyema. The management of patients undergoing this procedure is discussed. There were two operative deaths among the 37 patients. Postpneumonectomy empyema developed in 16 patients (45.7%), and five of these patients required thoracoplasty, five left the hospital with an open drain or sinus, and in six the empyema was sterilized.
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One hundred and eighty-one patients with carcinoma of the upper thoracic oesophagus were intubated perorally using a Procter-Livingstone tube. The mortality was 16-6 per cent but, in the patients who survived, the palliation achieved, as judged by improved swallowing, was considered satisfactory. Factors influencing the success of intubation are also considered.
Malignant esophago-respiratory fistula is an incurable condition calsing severe distress to those patients suffering from it. Sixty two successive patients with esophago-respiratory fistulae, secondary to squamous cell carcinomas of the esophagus, were intubated for palliation. The first 14 were intubated by a traction technique using the Celestin tube, and the remaining 48 were intubated by the Procter-Livingstone tube inserted by a pulsion method. Celestin intubation had a mortality of 64.3% but 75% of those intubated by the Procter-Livingstone tube were discharged from hospital, swallowing satisfactorily and relieved of their respiratory distress. In our experience the insertion of the Proctor-Livingstone tube by a pulsion technique, can be performed in a few minutes, with little morbidity and allows the patient to be discharged from hospital within 3-4 days of the procedure. It is a successful and acceptable method of treating malignant esophago-respiratory fistulae.
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