Introduction: Long-distance transportation of a patient in an unstable condition is a challenging operation. When circumstances require using a commercial flight it is even more so.
Case Report: A 57-yr-old man in Israel underwent extrapleural pneumonectomy for mesothelioma, following which he developed a massive chylothorax of more than 6 L x d(-1). Due to the failure of medical treatment and the high operative risk under such conditions, it was decided to transfer him to the United States by commercial flight for a percutaneous, fluoroscopy-guided closure of the thoracic duct. The patient was accompanied by a physician and a nonmedical assistant and occupied a first-class seat enclosed by curtains. He arrived at the departure airport in a hypovolemic state with low cardiac output and blood pressure of 78/60 Torr. During the flight he was treated with intravenous fluids, chest physiotherapy, and oxygen. In addition, fibrin clots blocked the drainage system on two occasions, requiring corrective action. On arrival in the United States the patient's condition had improved: his blood pressure was 123/91 Torr with a capillary oxygen saturation of 95% without supplementary oxygen. During the 18 h in transit (11 h in flight) he had lost more than 5 L of lymph.
Conclusion: Under carefully controlled circumstances it is possible to use commercial flights to transport patients whose condition is unstable and complicated. Safety can be increased by focusing on the specific problems associated with the clinical condition and anticipating possible adverse events during the flight.
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http://dx.doi.org/10.3357/asem.2518.2009 | DOI Listing |
Cureus
November 2024
Department of Thoracic Surgery, Tenri Hospital, Tenri, JPN.
Chylous ascites, a rare but severe complication of abdominal surgery, often results from lymphatic vessel damage during procedures, such as extended resection and lymphadenectomy. Although conservative management through dietary modifications and medications is the primary approach, refractory cases may lead to severe complications including nutritional deficiencies and even death. Herein, we report a case of refractory chylous ascites that progressed to chylothorax after extended right hepatectomy with lymph node dissection for intrahepatic cholangiocarcinoma.
View Article and Find Full Text PDFFront Med (Lausanne)
September 2024
Department of Abdominal Surgery, Guiqian International Hospital, Guiyang, China.
Asian Cardiovasc Thorac Ann
May 2024
Pediatric Cardiology, Pediatrics, Hamad Medical Corporation, Doha, Qatar.
Objective: A single centre experience with chylothorax in post cardiac surgical patients.
Methods: Retrospective review.
Results: Chylothorax developed in 55 out of 873 operated patients (6.
Turk Gogus Kalp Damar Cerrahisi Derg
January 2024
Department of Thoracic Surgery, Başkent University Faculty of Medicine, Ankara, Türkiye.
Chylothoraces are mostly secondary to trauma and tumors, and rarely idiopathic. Chylothoraces secondary to lung tumors are mostly seen postoperatively. In this article, we, for the first time, present massive chylothorax developing after diagnostic transthoracic Tru-cut biopsy in a lung adenocarcinoma case.
View Article and Find Full Text PDFCells
January 2024
Institute of Human Genetics, University Hospital Bonn, 53127 Bonn, Germany.
Besides visceral heterotaxia, null mouse embryos exhibit general edema and perinatal lethality. In humans, congenital chylothorax (CCT) is a frequent cause of fetal hydrops. In 2021, Correa and colleagues reported ultrarare compound heterozygous variants in exhibiting in two consecutive fetuses with severe hydrops, implicating a direct role of in fetal hydrops formation.
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