Biomedical subjects

Nikolitsa Kalantzi

Publications and source records attributed to Nikolitsa Kalantzi.

4 recordsLinked to original sources

PubMed2003

Spontaneous pneumomediastinum: a rare benign entity.

OBJECTIVE: Spontaneous pneumomediastinum usually occurs in young people without an apparent precipitating factor or disease. Thoracic surgeons are involved in the diagnosis and management of this entity because of the potentially life-threatening conditions that either must be treated as an emergency or excluded, such as esophageal perforation or necrotizing mediastinitis. We present our modest experience in treating spontaneous pneumomediastinum. MATERIALS: Between 1988 and 1998 we treated 22 cases of spontaneous pneumomediastinum in 18 male patients and 4 female patients, ranging in age between 12 and 32 years. All traumatic cases were excluded. Retrosternal chest pain was the main symptom the patients presented. In only 11 cases was subcutaneous emphysema present. Chest radiography was diagnostic in all our cases. Computed tomographic scan, when performed, confirmed the diagnosis. An esophagogram was essential to exclude an esophageal rupture. Last, a cardiologic examination especially focusing on pericarditis excluded cardiac disease. RESULTS: Conservative treatment consisted of bed rest, oxygen therapy, and analgesics, which led to rapid resolution of the spontaneous pneumomediastinum. The mean hospital stay ranged between 3 and 10 days. In a follow-up of 3 to 12 years only 1 recurrence was observed. CONCLUSION: Spontaneous pneumomediastinum is usually an undiagnosed benign entity that responds very well to conservative treatment. It should be considered in the differential diagnosis of chest pain, especially in healthy adolescents and young adults.

Adolescent↗

PubMed2003

Primary traumatic pulmonary pseudocysts: a rare entity.

OBJECTIVE: Pulmonary contusion is the usual manifestation of lung parenchymal injury after blunt chest trauma. With deceleration these parenchymal lacerations can result in cavities known as primary traumatic pulmonary pseudocysts (TPPC). We present our experience in treating this rare entity. MATERIAL: From 1989 trough 1999, 14 young patients, 11 male and three female ranging in age between 13 and 24 years were treated for primary TPPC in our department. Blunt chest injuries resulting from traffic accidents were the causes in all our cases. The main symptoms were pain, hemoptysis and dyspnea not associated with severe hypoxemia. The cavitary lesion was apparent in chest radiographs, but the imaging modality of choice was the computed tomography. RESULTS: Multisystem injury was present in 7 of them. Two of our patients required ICU facilities but none needed mechanical ventilation. Hemopneumothorax was present in two cases, whereas pneumothorax in four drained by tube thoracostomy. The hospital stay ranged between 9 and 23 days. Contraction and complete radiological resolution of the PPC needed a follow up of 6-11 weeks. CONCLUSIONS: (1) Primary traumatic pulmonary pseudocysts are benign lesions secondary to blunt chest trauma needing only conservative treatment unless complications arise, such as hemo- or pneumothorax or infection of the cavitary lesion. (2) Computed tomography is a really sensitive method for early detection of the lesion while plain roentgenograms are sufficient for the follow up.

Adolescent↗

PubMed2002

Management of esophageal foreign bodies: a retrospective review of 400 cases.

OBJECTIVE: A retrospective study was conducted in 400 patients with esophageal foreign bodies (EFB) to assess characteristics of EFB and methods of treatment. METHODS: From 1962 through 1998, 400 patients with EFB were treated in our department on an emergency basis. There were 202 men (50%) and 198 women (49.6%) ranging in age from 1.5 to 95 years. The main symptoms patients complained of were difficulty in swallowing and pain. Detailed anamnesis, oropharynx and hypopharynx examination and finally radiological examination were the diagnostic tools. The location of the FB was in the cervical esophagus in 57% of cases, in the thoracic one in 26% and at the cardioesophageal junction in 17%. The most common objects found were bones, morsels, coins and needles. RESULTS: The treatment consisted of rigid esophagoscopy under general anesthesia in 343 (85.7%) of our cases. In 57 cases (14.3%) other means such as flexible esophagoscopy, Fogarty or Foley catheters and bougienage turned to be very useful. Only 12 patients (3%) were led to surgery because either extraction was impossible or perforation was present. No major complications occurred in the surgical group, whereas in the group of rigid esophagoscopy, there was one iatrogenous esophageal perforation that presented with empyema thoracis successfully treated. Finally, there was a case of an aortoesophageal fistula with mortal outcome perioperatively. CONCLUSIONS: (1) Esophagoscopy is a reliable method in the treatment of EFB impaction. (2) Alternative methods such as bougienage, etc., can be used only in selected cases with smooth foreign bodies. (3) Surgical treatment is unavoidable in cases of irretrievable EFB or esophageal perforation.

Adolescent↗

PubMed2002

Bronchobiliary fistulae due to echinococcosis.

OBJECTIVE: A bronchobiliary fistula (BBF) is a rare complication of echinococcosis due to rupture of hydatid cysts located at the upper surface of the liver to the bronchial tree. We present our experience in treating this uncommon and dangerous entity. MATERIAL: During the last 20 years, 21 patients, ten men and 11 women ranging in age from 26 to 83 years with a BBF were treated in our department. They presented dyspnea, biloptysis, cough or fever. Diagnostic imaging studies have been very helpful in identifying the communication and in delineating its location. The disease was limited to the liver in 11 cases, whereas in the rest ten cases, both liver and lung were involved. RESULTS: Right thoracotomy was the approach of choice. Our strategy consisted of adequate evacuation of the intrahepatic cysts, obliteration of the cyst space, freeing the adherent lung, dissection and closure of the BBF. Two deaths occurred due to anaphylactic shock and cardiac insufficiency. Follow up at 7-12 years did not reveal any recurrence. CONCLUSION: Although the incidence of echinococcosis has been decreased, the BBF still remains a serious complication with a high morbidity and mortality. Early diagnosis and management of septic associated complications are essential.

Adult↗