Post operatively she developed an air and bile leak. A subsequent ERCP was performed and the plastic biliary stent removed from the bile duct. There was a suspicion of contrast in the bronchial tree on this examination. A further CT scan demonstrated a pleural effusion, diaphragmatic disruption and a collection under the diaphragm consistent with bronchobiliary fistula. Her bilioptysis settled ...

Prolonged air leak (PAL), defined as air leak more than 5 days after lung resection, has been associated with various adverse outcomes. However, studies on intraoperative risk factors for PAL are not sufficient. We investigated whether the intraoperative ventilatory leak (VL) can predict PAL. A retrospective study of 1060 patients with chest tubes after lung resection was conducted. Tidal volum...

A case of acquired tracheoesophageal fistula (TEF) is presented in a 44-year-old female who presented with acute respiratory failure due to bilateral aspiration pneumonia. The patient had persistent air leak while on mechanical ventilation and underwent bronchoscopy which revealed the above etiology. Histopathology showed Barrett's esophagitis. The patient underwent primary closure followed by ...

Bronchial fistulae in communication with atmospheric pressure can be identified by the presence of a squeaking sound heard over the chest wall during a Valsalva maneuver. Furthermore, these leak sounds can help identify the size, location, and communications of the bronchial fistulae. The size of the leak can be inferred by the pitch of the leak sound. Large leaks produce low pitched sounds, sm...

Feature selection is an essential step for data classification used in fault detection and diagnosis processes. In this work, a new approach is proposed, which combines a feature selection algorithm and a neural network tool for leak detection and characterization tasks in diesel engine air paths. The Chi square classifier is used as the feature selection algorithm and the neural network based ...

A patient with Marfan's syndrome had spontaneous intracranial hypotension secondary to a proved CSF leak. It is postulated that the leak was caused by minor, unrecognised trauma rupturing spinal arachnoid diverticula. The diverticula were probably pre-existing abnormalities complicating the Marfan's syndrome. It is concluded that patients with spinal meningeal defects may be at increased risk o...

OBJECTIVE To investigate the trends in mortality, as well as in the timing and cause of death, among extremely preterm infants at the limit of viability, and thus to identify the clinical factors that contribute to decreased mortality. METHODS We retrospectively reviewed the medical records of 382 infants born at 23-26 weeks' gestation; 124 of the infants were born between 2001 and 2005 (peri...

Secondary spontaneous pneumothorax can be difficult to manage especially in patients with advanced lung disease and respiratory failure. Such patients are unfit for surgery and may endure prolonged hospital stays with chest drains in situ. We describe two such cases where the air leak was persistent despite conventional management. Ambulatory devices which we ordinarily use to manage pneumothor...

Air medical transport of patients suffering of highly infectious diseases is typically performed employing portable isolation chambers. Although the likelihood of decompression flight emergencies is low, sustainability of the devices used is crucial. When a standard isolation unit was subjected to an explosive cabin decompression of 493 hPa, simulating a 32808 ft flight level accident, leak tig...

The development of a persistent air leak after pneumothorax can be encountered in patients with underlying structural lung disease. In those with advanced malignancy or other comorbidities, the ability to tolerate general anesthesia and thoracoscopic procedures may limit definitive management. We describe the case of a 68-y-old male with refractory acute myelogenous leukemia presenting with rec...