|Discussion in 'All Categories' started by Dr Manoj Sangoi (M.D. paed. ) - Apr 21st, 2013 5:20 am.|
Dr Manoj Sangoi (M.D. paed. )
|I am a 53 yrs old practicing pediatrician, non smoker, non alpha 1 anti trypsin deficient.
I had my first episode of primary spontaneous pneumothorax on the left side at the age of around 20 yrs (in 1980). In spite of multiple ICDs (totaling 3), the pneumothorax would either persist or recur soon. This went on for approx 3 months.
Just when a thoracotomy was being contemplated, it appeared to resolve and the surgery was postponed.
Few years down the line, I again started feeling some heaviness in the left lower chest, off and on, with prolonged symptom free periods in between.
Every time when symptomatic, an x ray would show a very small localized air pocket in the lower left side. The adhesions formed by the repeat ICDs would probably hold the lung from collapsing and the general opinion would be that it doesn't merit any intervention.
While the left side was silent for quiet sometime, in 2007, my right lung collapsed and would behave similarly as the left had behaved in 1980. Repeat ICDs with trials of medical pleurodesis with tetracycline and bleomycin were attempted, but in vein. (Plain XRC and CT Scan 2008 attached)
A VATS Rt bulla stapling with pleurectomy was successfully done in March 2008, with remarkable recovery, with ICD removed after 8 days post surgery.
After an asymptomatic period of more than 3 yrs (during which I even took many flights), I started getting mild symptoms again on the left side (since July 2011), this time mainly only a feeling of bubbling in the lower back every-time while bending down, with occasional mild heaviness in the left lower chest. Plain x ray again showed a very limited left lower localized sliver of air.
The symptoms persisted continuously for almost 20 months (till today) while leading a very normal active life. A CT Scan done in June 2012 (attached) showed small fissural air pocket with ? some bullae, but a well expanded lung.
Intervention was considered but thought unwise in view of the minimal symptoms and very small pneumothorax.
The symptoms seemed to increase from feb 2013, with mild cough appearing and heaviness in lt hemithorax with lt shoulder pain becoming more prominent, with very mild exertional dyspnoea.
Plain Xray done in March 2013 (attached) showed a much larger collapse of the lower lobe.
Surgical intervention was planned and pre op CT was worse (2 Apr 2013 attached).
On 3rd of April a VATs adhesiolysis with partial pleurectomy was done, without attempting to search actively for the original leak site, hoping that the pleurodesis would take care of the leak.
It was a difficult surgery with very strong stray adhesions holding the lung at places, and the upper lobe badly compressed and adherent posteromedially. Handling of the lung caused fresh leaks.
Current situation 17 days after surgery the ICD is still in place draining air, and the lung has refused to expand completely, ( though better than before) inspite of lung exercises and negative suction appliied for 2-3 days 7 days after surgery.
All my 3 sibs have had one episode of PSP with one of them requiring unilaeral stapling of bulla and partial pleurectomy.
What should be the further course of action?
How early one should do redo surgery?
How important is it to find the original leak site?
How easy to identify the leak? On table? Pre op?
Different surgical options
re: persistent pneumothorax with persistent air leak post VATS pleurodesis by Dr J S Chowhan - Apr 23rd, 2013 8:50 am
Dr J S Chowhan
|Dear Dr Manoj Sangoi
We have discussed your case with Dr. Arun Prasad (FRCS)Senior Thoracoscopic Surgeon. According to him you should wait for three month for spontaneous healing and expansion of lung to occur but if the situation does not come under control you may need thoracotomy.
Dr J S Chowhan
Accessing Expertise Anywhere: Free Online Medical Advice by World Laparoscopy Hospital
In an age where information is at our fingertips, the World Laparoscopy Hospital is taking the concept of accessibility and expertise to a whole new level. This renowned medical institution is offering a valuable service that transcends geographical boundaries - free online medical advice.
The Power of Digital Health
The digital revolution has significantly transformed the way we access healthcare information and connect with medical professionals. World Laparoscopy Hospital has harnessed this power to provide a platform where individuals from around the world can seek medical guidance from top-notch experts without leaving their homes.
The Importance of Medical Advice
Medical advice is a fundamental aspect of healthcare. It serves as a bridge between patients and the knowledge and experience of healthcare professionals. Timely and accurate medical advice can be a lifeline, offering reassurance, guidance, and potentially life-saving information.
World Laparoscopy Hospital: A Beacon of Medical Excellence
World Laparoscopy Hospital is globally recognized for its excellence in Minimal Access Surgery and surgical training. The institution's commitment to innovation, research, and patient care is evident in its mission to extend free online medical advice to those in need.
Key Features of World Laparoscopy Hospital's Online Medical Advice Service:
Expertise Across Specialties: The hospital boasts a roster of expert physicians, surgeons, gynecologists, urologists, and pediatric surgeons. This diverse range of specialists ensures that individuals can receive advice on a wide spectrum of medical issues.
Accessibility: The online platform breaks down geographical barriers. Patients from any corner of the world can access this service, making it especially beneficial for those in remote or underserved areas.
Convenience: Online medical advice is available 24/7, providing the convenience of seeking guidance at any time, day or night. This accessibility is particularly crucial for urgent medical queries.
Privacy: World Laparoscopy Hospital maintains strict patient confidentiality, ensuring that sensitive medical information remains secure.
Multilingual Support: Recognizing the global nature of its audience, the hospital offers support in multiple languages, enhancing accessibility for non-English speakers.
Holistic Guidance: The hospital's expert physicians provide comprehensive advice, addressing not only immediate concerns but also offering insights into long-term health and well-being.
The provision of free online medical advice aligns with World Laparoscopy Hospital's mission to empower patients and enhance healthcare outcomes. It allows individuals to take an active role in managing their health and seeking expert guidance when needed.
A Source of Reassurance and Knowledge
In times of uncertainty, illness, or when facing medical questions, World Laparoscopy Hospital's free online medical advice offers a ray of hope. It's a source of reassurance, a font of knowledge, and a testament to the potential of digital health in improving lives.
World Laparoscopy Hospital's commitment to providing free online medical advice represents a significant step towards democratizing healthcare. It brings the expertise of world-class medical professionals to anyone with an internet connection, offering guidance, hope, and the promise of better health. In an era defined by connectivity, this institution stands as a beacon of medical excellence in the digital landscape.
If you have a surgical concern and can’t reach a doctor right away, or you’re not sure where else to ask a qualified laparoscopic surgeon, you can get our Medical Help through this Forum of World Laparoscopy Hospital which is available 24 hours a day, Just fill-up the form given and within few our the answer of your question will be posted on this forum. Please keep in mind we answer the question only related to laparoscopic surgery. You can also search and browse thousands of answer already posted on this forum
Using Free Medical Advice Related to Laparoscopic Surgery Service, you can send your questions to our Laparoscopic Surgeon and the Doctor will reply within few hour. It’s as if you are having an email exchange with your very own private surgeon! As soon as you post your question, a qualified laparoscopic surgeon will start answering it. Our expert can help you learn more about the treatment and procedure options available to you for different health problems and diseases.They’ll also give you information to discuss with your doctor when deciding what kind of surgical treatment is best for you.
The Doctor will provide you with the all the medical information you need, and will guide you as you choose a course of action, all from the comfort of your home or office. No more sitting in the waiting room for hours just to get some basic information from your laparoscopic surgeon; no more self-diagnosis after reading pages and pages of confusing and contradictory Online information.
World Laparoscopy Hospital gives you the personalized health information you need to decide on the right treatment for you. The information that you provide will be seen by every person for education and information purpose so please not write your real name.