Non - Lung Cancer Thoracic Surgery In The Lung

Question 1

What are the causes of Lung Abscess?

Answer 1

Aspiration of foreign body

Pneumonia

Pulmonary thromboembolism

Lung Cancer

Septic emboli

Question 2

What eventually fills the space of a lung abscess?

Answer 2

Granulation tissue - collagen

Question 3

What is the cause of foul smelling pus?

Answer 3

Anaerobic bacteria

Question 4

How can pancreatitis cause pneumonia?

Answer 4

Causes compression of the lung

Question 5

What imaging technique is useful for finding pus in the body?

Answer 5

CT

Question 6

What are the causes of empyema thoracis? (1-5)

Answer 6

1. Post pneumonic
2. Complication of surgery
3. Blood clot causing pulmonary infarction
4. Bronchiectasis
5. Upper abdominal related

Question 7

What are the causes of empyema thoracis? (6-10)

Answer 7

6. Serious injury to chest (trauma)
7. Infection elsewhere, spread by blood (osteomyelitis)
8. Tuberculosis
9. Endoscopy (empyema rare complication)
10. infection caused by inhaled food

Question 8

What is pleurectomy?

Answer 8

part of pleura is removed

helps to prevent fluid from collecting in affected area

Question 9

What are examples of benign lung tumours?

Answer 9

Hamartoma

Fibroma

Lipoma

Papillomas

Chondroma

Carcinoid

Neural tumours

Question 10

What is meant by tension pneumothorax?

Answer 10

Progressive build-up of air within the pleural space

lung laceration allows air into pleural space but not return

Question 11

Define haemopneumothorax

Answer 11

combination of pneumothorax and hemothorax or blood in chest cavity

can occur if chest wall is punctured

Question 12

What are pulmonary blebs?

Answer 12

small sub-pleural thin walled air containing spaces

walls are less than 1 mm thick

If they rupture, they allow air to escape into pleural space resulting in a spontaneous pneumothorax

Question 13

What is the difference between a bleb and a bullae?

Answer 13

Bleb - less than 2cm

Bullae - bigger then 2cm

Question 14

What are the indications for surgery in pneumothorax?

Answer 14

Recurrence

Persistence

Sometimes after one episode

Question 15

What are the possible surgeries for pneumothorax?

Answer 15

• Pleurodesis
• Pleurectomy

Question 16

What is pleurodesis?

Answer 16

Reattachment of lung to chest wall

Can either be chemical or surgical

Chemical - Chemicals such as bleomycin, tetracyline or a slurry of talc can be introduced into the pleural space through a chest drain. The instilled chemicals cause irritation between the parietal and the visceral layers of the pleura which closes off the space between them and prevents further fluid from accumulating.

Surgical - Irritating the parietal pleura with a rough pad. Tunneled pleural catheters are also used to remove pleural fluid. Routine evacuation keeps the pleura together, resulting in physical agitation by the catheter, which slowly causes the pleura to scar together.

Question 17

When are lung transplants commonly seen?

Answer 17

Cystic fibrosis

Pulmonary fibrosis

Emphysema

Question 18

What is the mortality rate for lung transplantation?

Answer 18

• Single lung transplantation mortality 5-10%.
• Double lung transplantation mortality 10-20%.