Cardiothoracic surgery and non-malignant lung situations Flashcards
What are the causes of a lung abscess?
Aspiration (incl. foreign bodies)
Inadequately treated pneumonia
Pulmonary thromboembolism
Lung cancer
Septic emboli
What does a lung abscess look like on a CXR?
Thin layer of granulation tissue forming the cavity
Liquid inside (often not filled entirely the way up)
Important to note the position the patient was in for the CXR as the pus inside the cavity will sit differently
What is the treatment for a lung abscess?
Surgical insertion of chest drain
Probably given a fuck ton of antibiotics as well
What would a burst lung abscess likely form?
Empyema
What is an empyema thoracis?
Collection of pus in the pleural cavity
Type of pleural effusion
What are the causes of an empyema?
Post-operative
Post-trauma
Post-pneumonic
Oesophageal
Upper abdominal related
Osteomyelitis
How is empyema treated?
Chest drain
Then pleurectomy & decortication procedures
What is a pleurectomy?
Operation to remove a thin layer of fibrous tissue from the surface of the lungs
What is a decortation?
Operation to remove a thin layer of fibrous tissue form the inner surface of the ribs
What is the purpose of the pleurectomy and decortation?
In the wise words of Jack pechey:
They do it to remove infected tissue if antibiotics and chest drain doesnt work
What and where is the thymus?
Thymus gland - part of the endocrine and the lymphatic system
Located in the mediastinum, deep to the sternum
What are some examples of thymic tumours?
Thymoma
Thymolipoma
Thymic carcinoma
Carcinoid tumours of the thymus
Lymphoma
Of the thymic tumours, which ones are/can be cancerous?
Thymoma - either benign or malignant
Thymic carcinoma
Carcinoid tumours of the thymus
Lymphoma
What are the types of surgeries of the trachea?
Repair of iatrogenic injury
Tracheal tumours:
- Salivary gland tumours
- Squamous carcinoma
What are the types of benign tumours of the lung?
Hamartoma Fibroma Lipoma Neural tumours Papillomas Chondroma (Carcinoid)
Why is carcinoid tumour not technically benign?
It is malignant, but is very slow growing so can be considered benign in some contexts
What is a neurofibroma?
Benign tumour of the cells and tissues covering nerves
Although benign, how might a intrathoracic neurofibroma cause problems?
Can grow to a large size and displace alveoli n stuff
What is a haemopneumothorax?
Blood and air in pleural cavity
What is Bullous lung disease?
What do they look like on a CXR?
Large bullae (blister things) in the lungs
Look like large black holes on a CXR
When would surgery be considered for a pneumothorax?
If the patient has recurrent, persistent pneumothorax’s
Sometimes after first episode if serious enough
(theres another lecture with more detail on this stuff)
What surgical procedures are carried out to treat a pneumothorax?
Pleurodesis
Pleurectomy
What are bronchogenic cysts?
Congenital growths of tissue containing fluid or mucous
Typically occur in the mediastinum
“Bronchogenic cysts belong to a group of cysts known collectively as __________”
foregut duplication cysts
What causes the development of symptoms for bronchogenic cysts?
pressing on the trachea or oesophagus
In serious cases of disease, lung transplants can be carried out
What non-cancer diseases may call for a lung transplant?
Cystic Fibrosis
Pulmonary fibrosis
Emphysema
What conditions must a patient meet to be fit for a lung transplant?
Basically they must be otherwise healthy
Age < 65 years Not overweight Not diabetic No renal failure No mental illness Good social support
What is the mortality rate for a single lung transplant?
5-10%
What is the mortality for a double lung transplant?
10-20%
