Reconstruction of pulmonary venous conduit with CorMatrix in lung transplant.

Anomalous pulmonary vein anatomy is infrequently encountered during reconstructive lung surgery, especially lung transplantation. Complications of pulmonary venous anastomosis carry high morbidity and mortality. We report a case of anomalous pulmonary vein reconstruction with a decellularized porcine small intestinal submucosa-derived extracellular matrix during bilateral lung transplantation in an 18-year-old woman with cystic fibrosis.

Empyema thoracis complicated by pneumothorax necessitans manifesting as lobulated, localized subcutaneous emphysematous swellings.

We describe a patient with empyema thoracis that had eroded through the apical chest wall to the supraclavicular fossa and lung parenchyma, ultimately leading to a bronchopleural fistula manifesting as lobulated, localized subcutaneous emphysematous swellings over the chest wall and supraclavicular fossa. This is a rarely reported phenomenon and the reason why the lobulated subcutaneous emphysematous swellings remained localized is unknown.

Relapse of giant cell myocarditis supported with veno-arterial extracorporeal membrane oxygenation.

Giant cell myocarditis (GCM) is a fatal form of myocarditis that often presents with acute heart failure. An inflammatory infiltrate with giant cells and myocardial necrosis is characteristic. During the acute presentation, mechanical circulatory support may be necessary for hemodynamic support while immunosuppression is initiated.

Adjunctive use of superoxidized solution in chest wall necrotizing soft tissue infection.

A 39-year-old Indian man presented with necrotizing soft tissue infection of his right forearm and previously undiagnosed diabetes mellitus. The infection progressively worsened to involve his right lateral chest wall despite multiple debridements and systemic antibiotics. His right arm was eventually disarticulated along with wide debridement of the surrounding tissue.

Mycotic coronary artery aneurysm from fungal prosthetic valve endocarditis.

Two cases of mycotic aneurysms of the left anterior descending coronary artery in patients with fungal prosthetic valve endocarditis are reported. One was managed with exclusion and interposition graft, and the other was managed by aneurysm excision, wide debridement, and distal bypass. The current literature and management strategies are reviewed.

Cost Analysis of Vertical Deceleration Injury in the Acute Setting.

Introduction: Vertical deceleration injury is a known but not well understood form of blunt injury in both the urban and rural environment. The purpose of this study was to investigate the financial cost of treatment for this specific mechanism of injury in the acute care setting, and to continue to expand a fall prevention program from our unit.

Method: This is a prospective review of vertical deceleration injuries admitted over a 2-year period to a Level I trauma center.

Retention of extended release nifedipine capsules in a patient with enteric stricture causing recurrent small bowel obstruction.

Medication bezoars from extended release medication have been reported in the literature. This has become an increasing phenomenon with the popularity of extended release formulations, which aim to increase therapeutic compliance. We report on a patient who experienced recurrent bouts of small bowel obstruction, necessitating surgical exploration.