WordNet

not tractable; difficult to manage or mold; "an intractable disposition"; "intractable pain"; "the most intractable issue of our era"; "intractable metal"
a collection of pus in a body cavity (especially in the lung cavity)

PrepTutorEJDIC

(人・人の性質が)手に負えない,強情な / (物事が)処理しにくい,取り扱いにくい
胸の,胸部の

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1. 成人における肺炎随伴性胸水および膿胸 parapneumonic effusion and empyema in adults
2. 小児における肺炎随伴胸水および膿胸の疫学、臨床症状および評価 epidemiology clinical presentation and evaluation of parapneumonic effusion and empyema in children
3. カンジダ感染症の概要 overview of candida infections
4. 小児における肺炎随伴胸水および膿胸のマネージメントおよび予後 management and prognosis of parapneumonic effusion and empyema in children
5. 肺全摘後の後遺症および合併症 sequelae and complications of pneumonectomy

English Journal

Intractable pneumothorax with empyema in a patient with interstitial pneumonia.

Miyoshi S1, Tamura M, Araki O, Ikeda Y, Chida M.Author information 1Department of General Thoracic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan, smiyoshi@md.okayama-u.ac.jp.AbstractSecondary pneumothorax occurring in interstitial lung disease cases is a refractory and life-threatening condition, because of compromised lung function. A 70-year-old woman with interstitial pneumonia was referred to our hospital after treatment failure for pneumothorax associated with empyema. An open window thoracostomy was created, and mechanical irrigation and dressing changes of the pleural cavity were performed. Then, the lung was widely covered with the latissimus dorsi and serratus anterior muscles because there were multiple fistulae on the lung surface. After the covering muscles were completely adhered to the lung surface and stopped air leaking, the chest was successfully closed. The wide covering technique of the lung with chest wall muscles is effective for intractable pneumothorax with multiple fistulae.
General thoracic and cardiovascular surgery.Gen Thorac Cardiovasc Surg.2013 Oct;61(10):574-7. doi: 10.1007/s11748-012-0162-8. Epub 2012 Oct 11.
Secondary pneumothorax occurring in interstitial lung disease cases is a refractory and life-threatening condition, because of compromised lung function. A 70-year-old woman with interstitial pneumonia was referred to our hospital after treatment failure for pneumothorax associated with empyema. An
PMID 23054619

Bronchial fistula after lobar size reduction for bilateral lung transplantation in Kartagener's syndrome: a surgical challenge.

Brioude G1, D'journo XB, Reynaud-Gaubert M, Thomas PA.Author information 1Aix-Marseille University, Marseille, France.AbstractBilateral lung transplantation was performed in a 52-year old man with end-stage Kartagener's syndrome. A postimplantation right lower lobectomy was required for volume reduction and dextrocardia. A bronchial fistula developed with an intractable colonized residual pleural cavity. Closure was obtained successfully with multiple-stage procedures including decortication, muscle flap and an open-window thoracostomy without modification of the immunosuppressive protocol.
Interactive cardiovascular and thoracic surgery.Interact Cardiovasc Thorac Surg.2013 Jul;17(1):184-6.
Bilateral lung transplantation was performed in a 52-year old man with end-stage Kartagener's syndrome. A postimplantation right lower lobectomy was required for volume reduction and dextrocardia. A bronchial fistula developed with an intractable colonized residual pleural cavity. Closure was obtain
PMID 23575755

[Surgical intervention for residual space empyema and bronchopleural fistula after major pulmonary resection].

Otani S1, Yamamoto S, Endo S.Author information 1Jichi Medical University, Department of General Thoracic Surgery, Shimotsuke, Japan.AbstractResidual space empyema, that is a life threatening complication after major pulmonary resection, is based on postresectional hematoma, wound suppuration, and/or bronchopleurl fistula, demanding different strategies from parapneumonic empyema. Optimal managements should be occasionally completed in relation to the patient's physical conditions, serological findings, pathogens, and bronchopleural fistula. Bronchoscopic intervention can be a useful tool for a bronchopleural fistula when small. Thoracoscopic intervention can overcome the intractable residual space empyema. These interventions can save such invasive procedure as open window thoracotomy or thoracoplasty leading to damage pulmonary function as well as cosmetics, and prolong hospitalization. Vacuum-assisted closure system other than conventional thoracoplasty or thoracomyoplasty can be of help to obliterate the residual space empyema cavity after open window thoracotomy.
Kyobu geka. The Japanese journal of thoracic surgery.Kyobu Geka.2013 Jul;66(8 Suppl):735-40.
Residual space empyema, that is a life threatening complication after major pulmonary resection, is based on postresectional hematoma, wound suppuration, and/or bronchopleurl fistula, demanding different strategies from parapneumonic empyema. Optimal managements should be occasionally completed in r
PMID 23917195

Japanese Journal

右肺上葉切除後の菌球を伴う有瘻性アスペルギルス膿胸に対しendobronchial Watanabe spigotsを併用した筋皮弁充填術が有効であった1例

正津晶子,諸星隆夫,藤井慶太,益田宗孝
気管支学 : 日本気管支研究会雑誌 36(2), 171-175, 2014-03-25
症例.79歳男性.肺癌による右肺上葉切除後の遺残腔に増大傾向のある結節影が出現した.アスペルギルス症の診断で前医で内科的治療を開始されたが,副作用のために中断したところ血痰が出現したため,手術適応に関し当院を紹介された.開窓術にて菌球を除去し,約3か月後に広背筋皮弁による充填を行ったが感染を併発したため,vacuum-assisted closure(VAC)療法を開始した.有瘻性で感染コントロー …
NAID 110009807532

膿胸と鑑別を要した顆粒球コロニー刺激因子(G-CSF)産生悪性胸膜中皮腫の1例

高萩亮宏,松田英祐,田尾裕之,田中俊樹,佐野史歩,岡部和倫
気管支学 : 日本気管支研究会雑誌 35(2), 145-149, 2013-03-25
症例. 75歳,男性.左胸痛と発熱で前医を受診し,胸部CT検査で左胸腔内の不整な胸膜肥厚と被包化胸水を認め,当院紹介となった.血液検査や胸水細胞診では悪性腫瘍が否定できなかったため,全身麻酔下の胸腔鏡下胸膜生検を施行し,病理検査で上皮型悪性胸膜中皮腫と診断した.術後も炎症反応が改善しないため血中の顆粒球コロニー刺激因子(G-CSF)測定を行い, 356pg/ml(基準値39.0pg/ml以下)と高 …
NAID 110009597485

EWSを用いた気管支充填術が奏効した胸郭成形術後有瘻性膿胸の1例

樽川智人,安達勝利,西井洋一,藤本源,井端英憲,大本恭裕
気管支学 : 日本気管支研究会雑誌 34(6), 573-576, 2012-11-25
背景.有瘻性膿胸の治療は,全身状態不良や高齢などの理由で外科治療が困難な場合がある.症例. 87歳男性. 2009年6月に有瘻性膿胸に対し胸郭成形術を施行した.膿胸の再燃を来したため全身麻酔下にendobronchial Watanabe spigot (以下EWS)による気管支充填術を施行し,完全な瘻孔閉鎖が可能であった.結論.有瘻性膿胸に対するEWS充填術は非常に有用であると考えられた.
NAID 110009562563