Tuesday, December 21, 2010

don't look at this yet!


posted by joe @ 12/21/2010 02:20:00 PM   2 comments


At 2:44 PM, Blogger joe said...

Despite my admonition, I am sure you looked. I am so proud of myself for finally linking something that I will have to leave it up.

The case was a large hemothorax following CABG. It interests me on several points: 1. this is the second one in my patients I have seen. 2. This large effusions aren't very common. 3. It is common to have effusions post-cabg. 4. It took so long and a CT to make the dx.5. the extent of the left-sided effusion and the concept that the diaphragm is "inverted" as my pt's was. 6. the pleural fluid of a hemothorax has a high LDH--duh, RBCs are packets of LDH. 7.the effusions may resolve with watching and/or repeat thoracentesis. 8. the concept of "trapped lung due to negative intra-parietal pressure and need for subsequent surgery(thoracoscopy). All things considered it was a learning case for me.

At 7:49 AM, Blogger joe said...

9. also the pathogenesis many times is due to the dissection of the IMA and resulting "raw" pleural surface.
It helps me visualize cause and effect, now I only need to remember when I see the next case.


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