Tracheobronchial disruption is uncommon in blunt chest trauma. Many of these patients die before reaching the hospital. In the majority of survivors diagnosis is occasionally delayed resulting in complications like airway stenosis and lung collapse. Thus it is important to have radiological follow up after severe thoracic trauma. Sleeve resection can be an excellent option to conserve lung tissue in delayed presentation of bronchial transection.

The clinical features and successful management of a patient with right main bronchus disruption after blunt chest trauma are described. The presentation was one of bilateral tension pneumothoraces. A high index of suspicion, coupled with appropriate airway management at presentation, was vital for the successful treatment of this patient. Surgical resection using a sleeve lobectomy, an operation rarely used in trauma patients, was highly effective in this patient, and the technique is described in this report.

An unusual case of aortic arch dissection from a patent ductus arteriosus (PDA) is described. An adult man had been diagnosed as suffering from pectus excavatum and PDA 10 years before. At that time the pectus was repaired, but he failed to return for surgery on the PDA and the sub-sternal strut for pectus repair was also never removed. Recently he was admitted in a peripheral hospital with chest infection. Patent ductus arteriosus murmur was audible on clinical examination. The chest X-ray showed a widened mediastinum and the pectus strut. On further investigations dissection of the aortic arch was discovered and arch replacement performed.

Neuroendocrine tumours are characterised by the expression of high affinity binding sites for somatostatin. The detection of bronchial carcinoid tumours through scintigraphic imaging is described in two patients using the novel radiolabelled somatostatin analogue indium-111 pentetreotide.

Birefringent pulmonary talc granuloma are often found in lung biopsies from intravenous drug abusers (IVDA) but their clinico-pathological significance remains undefined.

HistopathologyVolume 21, Issue 4 p. 383-384 Spontaneous post-partum rupture of a patent ductus arteriosus A.G. JAYAKRISHNAN, Corresponding Author A.G. JAYAKRISHNAN Departments of Cardiothoracic Surgery, Mater Misericordiae Hospital, Dublin, IrelandAddress for correspondence: Mr A.G. Jayakrishnan, Department of Cardiothoracic Surgery, Kings College Hospital, Denmark Hill, London SE5 9RS, UK.Search for more papers by this authorB. LOFTUS, B. LOFTUS Departments of Pathology, Mater Misericordiae Hospital, Dublin, IrelandSearch for more papers by this authorP. KELLY, P. KELLY Departments of Pathology, Mater Misericordiae Hospital, Dublin, IrelandSearch for more papers by this authorD.A. LUKE, D.A. LUKE Departments of Cardiothoracic Surgery, Mater Misericordiae Hospital, Dublin, IrelandSearch for more papers by this author A.G. JAYAKRISHNAN, Corresponding Author A.G. JAYAKRISHNAN Departments of Cardiothoracic Surgery, Mater Misericordiae Hospital, Dublin, IrelandAddress for correspondence: Mr A.G. Jayakrishnan, Department of Cardiothoracic Surgery, Kings College Hospital, Denmark Hill, London SE5 9RS, UK.Search for more papers by this authorB. LOFTUS, B. LOFTUS Departments of Pathology, Mater Misericordiae Hospital, Dublin, IrelandSearch for more papers by this authorP. KELLY, P. KELLY Departments of Pathology, Mater Misericordiae Hospital, Dublin, IrelandSearch for more papers by this authorD.A. LUKE, D.A. LUKE Departments of Cardiothoracic Surgery, Mater Misericordiae Hospital, Dublin, IrelandSearch for more papers by this author First published: October 1992 https://doi.org/10.1111/j.1365-2559.1992.tb00413.xCitations: 7AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinkedInRedditWechat No abstract is available for this article. References 1 Rushton DI, Dawson IMP. The maternal autopsy. J. Clin. Pathol. 1982; 35; 909–921. 2 Mitchell RS, Siefert FC, Miller DC, Jamieson SW, Shumway NE. Aneurysm of the diverticulum of the ductus arteriosus in the adult. J. Thorac. Cardiovasc. Surg. 1983; 86; 400–408. 3 Tsujimoto S, Hirose K, Ohyagi A. A ruptured large aneurysm of the ductus arteriosus. Br. Heart J. 1987; 57; 289–291. 4 Ohtsuka S, Kakihana M, Ishikawa T et al.. Aneurysm of patent ductus arteriosus in an adult: findings of cardiac catheterisation, angiography, and pathology. Clin. Cardiol. 1987; 10; 537–540. 5 Lees MM, Scott DB, Slawson KB, Kerr MG. Haemodynamic changes during caesarian section. J. Obstet. Gynaecol. Br. Cwelth. 1968; 75; 546–551. Citing Literature Volume21, Issue4October 1992Pages 383-384 ReferencesRelatedInformation

Six patients in a thoracic unit developed sternal osteomyelitis and costochondritis following median sternotomy. Five of the patients were operated on in another hospital. Gentamicin and methicillin resistant Staphylococcus aureus was isolated in pure culture in each case. The S. aureus isolate from 2 patients was of the same phage type suggesting cross-infection. Antibiotic prophylaxis administered in the perioperative period was ineffective. One patient, treated with amikacin (to which all of the strains were sensitive in vitro) and cefuroxime, died from overwhelming infection in spite of débridement and resuturing of the wound. The remaining 5 patients were cured with vancomycin therapy usually coupled with surgical intervention.

A series of 100 consecutive cases of lobectomy combined with sleeve resection of the bronchus for malignant disease of the lung is presented. In 13 of these cases a sleeve resection of the appropriate pulmonary artery was also carried out. An operative mortality of 8% was encountered and a crude 5-year survival of 40% was achieved. A comparison of absorbable and non-absorbable suture materials for the bronchial anastomosis indicated that the absorbable suture, Polyglycolic Acid (Dexon), minimized the morbidity from complications at the bronchial anastomosis.