Thoracic Surgery for the Acute Care Surgeon

Description

Series Foreword Preface Contents Low-Resource Environments Epidemiology and Global Disparities Diagnosis History Physical Exam Labs Imaging Chest Radiography Ultrasound Pulmonary Exam Pneumothorax Pulmonary Edema/Consolidation Pleural Effusion Cardiac Function Extended Focused Assessment with Sonography in Trauma (eFAST) Computed Tomography Diagnostic Modality Pitfalls Management Pain Anesthesia Blood Transfusion Tube Thoracostomy Indications Procedure Management Pitfalls and Challenges Thoracotomy Indications Procedure Management Pitfalls and Challenges Pericardial Drainage and Pericardiectomy Indications Procedure Management Pitfalls and Challenges Tracheostomy and Cricothyroidotomy Indications Procedure Management Pitfalls and Challenges Conclusion References Part I: Acute Surgery Thoracic Emergencies Esophageal Rupture Introduction Etiology Presentation Diagnosis Physical Examination Imaging Plain Radiographs Contrasted Esophagography Computerized Tomography Endoscopy Thoracentesis Management Initial Management Nonoperative and Hybrid Approaches to Management Endoscopic Management Endoscopic Stenting Endoscopic Clipping and Suturing Endoscopic VAC Operative Management Surgical Approach Management of Intrathoracic Esophageal Rupture Video-Assisted Thoracoscopic Surgery (VATS) Thoracotomy Primary Repair Buttressed Repair with Autologous Tissue Exclusion Resection Postoperative Management Sepsis Nutrition Drains and Wound Care Stent Migration Complications and Outcomes Leak Stricture/Stenosis Mortality Conclusions References Incarcerated Hiatal Hernia Introduction Clinical Presentation Diagnosis and Preoperative Work-up Surgical Treatment Technique of Laparoscopic Repair Management of Acute Presentations Conclusions References Pulmonary Embolism Introduction Pathophysiology Classification Diagnosis Clinical Decision Rules PERC Wells Score Geneva Score D-Dimer Diagnostic Imaging Venous Duplex Chest Radiography Radionucleotide (V/Q) Scan Pulmonary Angiogram CT Scan MRI V/Q Single-Photon Emission Computed Tomography Cardiac/Hemodynamic Evaluation Troponin Natriuretic Peptides Electrocardiogram CT ECHO Prognostication Management Medical Therapy Anticoagulation Thrombolysis Inhaled Nitric Oxide Catheter-Directed Therapy Catheter-Directed Thrombolysis Catheter-Directed Embolectomy Surgery Extracorporeal Life Support (ECLS) Prevention Conclusion References Empyema and Effusions Pleural Empyema Introduction Epidemiology and Pathogenesis Diagnosis Classification Treatment Pleural Effusion Introduction Plural Space Physiology Evaluation of Plural Effusion Treatment References Pericarditis and Pericardial Effusions Acute Pericarditis Epidemiology Etiology Clinical Presentation and Diagnosis Management Post-Cardiac Injury Syndrome Idiopathic, Viral and Immune-Mediated Acute Pericarditis Recurrent Pericarditis Uremic Pericarditis Purulent Pericarditis Tuberculous Pericarditis Pericardial Neoplasms Prognosis Constrictive Pericarditis Etiology Clinical Presentation and Diagnosis Management Cardiac Tamponade Etiology Clinical Presentation and Diagnosis Management Pericardial Procedures Pericardiocentesis Pericardiotomy and Pericardial Biopsy Pericardioscopy Pericardiectomy References Necrotizing Lung Infections Introduction Bacteriology and Other Causative Organisms Diagnosis Treatment and Surgical Indications Conclusion References Incidental Pulmonary Nodule Part 1: Incidental Finding on Imaging Identification and Prediction Models Part 2: Intraoperative Pulmonary Lesion Bullous Disease Lung Masses Chronic Effusion/Trapped Lung Pleural Plaques Traumatic Pulmonary Pseudocyst Cavitary Lung Lesions Empyema Empyema Necessitans Massive Hemoptysis Congenital Pulmonary Sequestration References Chylothorax Introduction Anatomy Etiology Diagnosis Imaging Treatment Non-surgical Management Surgical Management Thoracic Duct Embolization Video-Assisted Thoracoscopic Ligation Thoracotomy Transabdominal Approaches Complications Conclusion References Part II: Trauma Rib Fractures and Chest Wall Injury Demographics, Epidemiology and Clinical Significance Chest Wall Injury Biomechanics Sternal Fractures Chest Wall Trauma Scoring Systems Organ Injury Scale Rib Fracture Score Chest Trauma Score Rib Score Clinical Rib Score Surgical Management Patient Positioning and Incision Exposition and Fracture Reduction Sternal Fracture ORIF Rib and Sternal Fracture Nonunions Chest Wall Injury Reconstruction References Pneumothorax and Hemothorax Incidence and Etiology Chest Wall Injury Associated Injuries Physical Examination and Initial Management Radiographic, Sonographic, and Laboratory Evaluation Specific Injuries Open Chest Wound Pneumothorax Etiology and Presentation Diagnosis Management Hemothorax Etiology and Presentation Management Further Reading Pulmonary Contusions and ARDS Definition of ARDS Pathophysiology Respiratory Monitoring Compliance Elastance Transpulmonary Pressure Driving Pressure Mechanical Ventilation in ARDS Patients Controlled Ventilation VT Selection PEEP Selection Recruitment Maneuvers Pronation Assisted Ventilation Extracorporeal Membrane Oxygenation (ECMO) Pulmonary Contusion ARDS: Medical Management Fluid Balance and Administration Pain Management and Muscle Paralysis Steroids Vasodilating Agents Β2 Agonists Vitamins and Statins Aspirin Summary References Tracheal and Bronchial Injury Epidemiology Clinical Presentation Diagnostic Evaluation Imaging Bronchoscopy Exploration Management Airway Control Exposure Repair Tracheostomy Conclusions References Lung Injury Introduction Blunt Injury Evaluation Management Operative Intervention Penetrating Injury Evaluation Management Operative Intervention References Cardiac Injury History Demographics and Etiology Prehospital Issues Emergency Center Presentation and Management Echocardiography Electrocardiogram Subxiphoid Window Emergency Department Thoracotomy Operative Approach Pericardial Injury Postoperative Care Screening for Blunt Cardiac Injury Electrocardiogram Troponin Echocardiography Other Studies Patient Management in BCI Summary References Blunt Thoracic Aortic Injury in Thoracic Surgery for the Acute Care Surgeon Introduction Presentation and Workup Management: Medical Open Repair Management-Endovascular Repair When Is Open Repair Indicated in the Age of TEVAR? Is TEVAR the Answer for All Injuries? Conclusion References Thoracic Vascular Trauma Introduction Diagnosis Innominate Artery Injury Subclavian–Axillary Artery Injury Carotid Artery Internal Jugular Vein Pulmonary Artery Pulmonary Veins Venous Injury Final Comments References Diaphragm Introduction Anatomy Diagnosis and Grading of Diaphragm Injuries Surgical Repair Repair During Exploratory Laparotomy Laparoscopic Repair Thoracoscopic Repair Complex Diaphragm Injuries Complications Conclusion References Part III: Special Considerations Acute Care Pediatric Thoracic Surgical Conditions Esophageal Rupture Presentation Diagnosis Treatment Nonsurgical Treatment Surgical Intervention Caustic Ingestion Presentation Diagnosis and Initial Management Nonsurgical Treatment, Including Alternative and Adjuvant Treatments Surgical Treatment Tracheal Foreign and Esophageal Bodies Airway Foreign Bodies Diagnosis and Initial Management Procedural Intervention Post-Procedural Care Esophageal Foreign Bodies Diagnosis and Initial Management Nonoperative Management, Including Alternative and Adjuvant Treatments Procedural Intervention Button Batteries Spontaneous Pneumothorax Epidemiology and Presentation Assessment Nonoperative Management Operative Intervention Postoperative Considerations Parapneumonic Effusion and Empyema Epidemiology and Presentation Medical Management Surgical and Procedural Intervention Tube Thoracostomy Surgical Cortical Debridement Complications Pediatric Thoracic Trauma and Acute Surgical Care Epidemiology Anatomy and Physiology of the Pediatric Thorax Pathophysiology of Thoracic Injuries Life-Threatening Chest Injuries in the Unstable Patient Tension Pneumothorax Open Pneumothorax (“Sucking Chest Wound”) Massive Hemothorax Flail Chest Cardiac Tamponade Potentially Lethal Chest Injuries in the Stable Patient Pulmonary Contusion With or Without Flail Chest Myocardial Contusion Traumatic Aortic Rupture Traumatic Diaphragmatic Rupture Tracheobronchial Tree Injuries Trachea Bronchus Esophageal Trauma Subcutaneous Emphysema Crushing Injury to the Chest (Traumatic Asphyxia) References Surgical Consideration of Bacteria, Fungi, and Parasites Introduction Lung Abscess Background Diagnosis Treatment Pulmonary Tuberculosis Background Diagnosis Treatment Invasive Pulmonary Aspergillosis Background Diagnosis Treatment Hydatidosis Background Diagnosis Treatment Conclusion References Travel and Transport Physiology and Limitations of Air and Ground Transport Confined Spaces Lighting Noise, Vibration, Turbulence, G-Loading Temperature Gas Laws Available Monitoring and Equipment Imaging Choice of Appropriate Transport Mode Ground EMS HEMS Fixed Wing Critical Care Air Transport Team Commercial Airliner Complications During Transport Pneumothorax Hemothorax Chest Tube Management Pneumomediastinum Tracheobronchial Bleeding Cardiac Tamponade Loss of Airway Management of Specific Injuries During Transport Flail Chest and Pulmonary Contusion Tracheobronchial Injuries Esophageal Injuries Damage Control, the Open Chest Special Considerations During Transport Pain Control Respiratory Therapy Fluid Management ECMO/ECLS Interfacility Transport Safety of Transport References