Reduction of persistent air leak with endoscopic valve implants.
The standard management of air leaks due to persistent bronchopleural fistula involves chest drainage and occasionally pleurodesis, with intractable cases requiring surgical decortication or surgical repair. However, some of these patients may be at high risk for surgery, particularly if they have already had thoracic surgery or have other medical problems; for this group there is a need for less invasive methods of stopping or reducing air leaks. Emphasys endobronchial valves (EBV) are occlusive devices designed primarily for endoscopic lung volume reduction in emphysema. Because the device is a one-way inspiratory airway blocker, it is possible that it could be used in controlling persistent air leaks while maintaining the drainage of secretions. Two cases are reported of persistent air leaks that were managed by endoscopic occlusion with EBV. In one case complete stoppage of the air leak was achieved with immediate clinical benefits. The second patient died 5 days after treatment from additional complications apparently not related to the procedure. Endobronchial blockage may be a useful salvage procedure for patients with persistent air leak for whom there is no other treatment available. (+info)
Pulmonary lymphangioleiomyomatosis in a male.
Pulmonary lymphangioleiomyomatosis has been observed almost exclusively in women, usually in their reproductive years. Exacerbations with pregnancy and after hormonal manipulation have been documented, and it has been suggested that its pathogenesis is due to the influence of hormonal(estrogenic) stimulus. The clinical, roentgenographic, and histopathologic features of this case of pulmonary lymphangioleiomyomatosis in a 22-year-old male are all characteristic of those described in prior reports, except for the patient's sex. With the following case of pulmonary lymphangioleiomyomatosis in a male, we suggest the possibility of the existence of an additional pathogenetic mechanism. (+info)
Pregnancy complicated by lymphangioleiomyomatosis.
Lymphangioleiomyomatosis, a multisystem disease characterized by cystic lung lesions can result in respiratory failure and is considered to be sex hormones related. No effective treatment for lymphangioleiomyomatosis is currently available. We report a 35-year-old patient in her second pregnancy. She also had experienced five episodes of spontaneous pneumothorax at the age of 30. Despite excessive estrogen production during pregnancy she had mild non-progressive exertional dyspnea without limitation of daily activities during pregnancy without deterioration of respiratory status. (+info)
Signal transducer and activator of transcription 3 is required for abnormal proliferation and survival of TSC2-deficient cells: relevance to pulmonary lymphangioleiomyomatosis.
Haemopericardium and cardiac tamponade complicating pulmonary lymphangioleiomyomatosis.
A case of pulmonary lymphangioleiomyomatosis complicated by haemopericardium and cardiac tamponade is reported. This was successfully managed by creating a subdiaphragmatic extraperitoneal window. (+info)
Atypical presentation of lymphangioleiomyomatosis as jugular vein thrombosis.