Ventilator Management of Bronchopleural Fistula Secondary to Methicillin-Resistant Necrotizing Pneumonia in a Pregnant Patient with Systemic Lupus Erythematosus.

Managing mechanical ventilation in patient with bronchopleural fistula with coexisting acute respiratory distress syndrome is a challenging situation for the intensivist. We are reporting a case of a pregnant patient with systemic lupus erythematosus on immunosuppressive medications who developed methicillin-resistant necrotizing pneumonia complicated by bronchopleural fistula and acute respiratory distress syndrome.

A novel technique for the reconstruction of resected sternoclavicular joints: A case report with a review of the literature.

Sternal metastasis in thyroid cancer is an uncommon occurrence with only a handful of cases of chest wall resections being done. Sternal reconstruction for both primary and secondary tumors has been performed using various techniques and materials such as the mesh, methyl acrylate resin, and steel plates; however, this is a case of papillary thyroid cancer involving the sternum in a 50-year-old woman who had resection of the sternum with reconstruction using titanium bars and clips (STRATOS system) fixed to the clavicles with an underlying Proceed mesh. STRATOS system showed good recovery postoperatively.

Intrapleural fibrinolytic therapy (IPFT) in loculated pleural effusions--analysis of predictors for failure of therapy and bleeding: a cohort study.

Objectives: To assess risk factors associated with failure and bleeding in intrapleural fibrinolytic therapy (IPFT) for pleural effusions.

Design: Retrospective case series.

Setting: Two tertiary-care centres in North America.

Laparoscopy in the treatment of a giant true epiphrenic diverticulum with migration of the gastrointestinal anastomosis staples.

Our case is a 62-year-old diabetic man with a long-standing history of regurgitation, halitosis, recurrent chest infection, and most recently upper gastro-intestinal bleeding. He was diagnosed 10 years earlier with an epiphrenic esophageal diverticulum, and also has a family history of this condition. Barium study revealed a 10 x 10 cm epiphrenic diverticula with a 4 cm neck, the lower margin of the opening lying 6 cm from the gastro-esophageal junction.

Laparoscopic enucleation of a duodenal lipoma, with review of the literature.

We present a case of duodenal lipoma in a 53-year-old lady causing symptoms of vomiting and abdominal discomfort, treated by laparoscopic enucleation. Lipomas of the duodenum are rare tumors with less than 230 cases reported in the literature, most of these are from autopsy records rather than clinical experience. Most recent reports are of endoscopic excision of these tumors while operative procedures, although less frequent, have been described for specific indications.