The irrational yet irrestible urge to know or make known.
The CC is a "club" founded by a small group of medical professionals, who have made a pastime of turning medical cases and discussions into medically irrelevant history lessons, philosophical rants, and displays of one-upsmanship. The official premise, since the "club" was named, has been to exchange and discuss various books, movies, and ideas. Sometimes we eat sushi.
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.
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.
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.
ReplyDeleteThe 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.
9. also the pathogenesis many times is due to the dissection of the IMA and resulting "raw" pleural surface.
ReplyDeleteIt helps me visualize cause and effect, now I only need to remember when I see the next case.