Cardiothoracic Surgery in Non Malignant Situations Flashcards
What is a lung abscess?
Collection of pus surrounded by granulation tissue
How does a lung abscess come about?
Aspiration of foreign body
Pneumonia
PTE
Lung cancer
Septic emboli
How does pneumonia lead to lung abscess?
Infection causes necrotion of tissue developing into an abscess
The lung try’s to discharge pus and it usually bursts into the pleural space causing empyema
- Sudden onset of severe pleuritic chest pain
- Swinging fever
How can lung abscesses be treated?
Via a drain inserted into the abscess cavity to drain pus/fluid
What is an empyema throacic?
Where pus spreads throughout the pleural cavity
How can an empyema thoracic be caused?
Post pneumonic
Post operative
Oesophageal
Upper abdominal related
Osteomyelitis
Post traumatic
How can oesophageal problems cause empyema?
Vomiting with relaxation of lower oesophageal sphincter and corresponding spasm of upper oesophageal sphincter.
- Leads to rupture of the oesophagus
- Discharges vomit into pleural cavity
- Gives rise to fatal empyema
- Vomiting then chest pain!
What is the aim of a pleurectomy and decortication?
Aim is to peel off parietal and visceral pleura from the accessible portions of the chest wall and lung surface to allow the lung to expand to its normal size (never full size but 80-90%).
What is a thymoma?
Malignant tumour, type a-c
What is a thymolipoma?
Combination of a thymoma and lipoma
What is a thymic carcinoma?
Most severe type of thymic tumour
Tends to invade surrounding structures
What is the prognosis for thymic carcinomas?
Often inoperable as invade into mediastinum and structures like vena cava, heart and aorta
What are the types of thymic tumours?
Thymoma
Thymolipoma
Thymic carcinoma
Carcinoid tumours of the thymus
Lymphoma
When would you perform tracheal surgery?
Repair of iatrogenic injury
Tracheal tumours
How do iatrogenic injuries occur?
If/when anaesthetist passes endotracheal tube through wall of the trachea
What are some tracheal tumours?
Salivary gland tumours
Squamous carcinoma
What are some benign lung tumours?
Hamartoma
Fibroma
Lipoma
Neural tumours
Papillomas
Chondroma
What is hamartoma?
Proliferation of cells usually found in that organ.
So in the lung proliferation of epithelial cells, cartilage and fat.