• Klíčová slova
• ENVIRONMENT *, OCCUPATIONAL DISEASES *, PULMONARY EMPHYSEMA/etiology *,
• MeSH
• emfyzém * MeSH
• lidé MeSH
• nemoci z povolání * MeSH
• plicní emfyzém etiologie   MeSH
• životní prostředí * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

74 year-old-man, former smoker, with chronic obstructive pulmonary disease GOLD grade 4, group D, with emphysema component, treated in a pulmonary rehabilitation program, on oxygen therapy and nocturnal bi-level positive airway pressure (BiPAP) ventilation. During the night he had a traumatic rib fracture (5-11th right ribs) but still he used BiPAP ventilation during the sleep. In the morning after he presented with a diffuse and massive emphysema in the face, thorax and abdominal regions. On physical examination, the patient presented with massive swelling and crepitus on palpation. A chest computed tomography (CT) scan confirmed a diffuse subcutaneous emphysema and revealed a mediastinal emphysema and bilateral small pneumothorax. A fast resolution of the emphysema was of paramount importance as the patient was severely agitated due to his inability to open both eyes, and the need to reintroduce BiPAP ventilation as soon as possible. It was placed a fenestrated subcutaneous catheter on left hemithorax and a subcutaneous ostomy on right hemithorax for comparative purpose. It was also performed a confluent centripetal massage towards drainage orifices, with immediate and substantial improvement of emphysema, especially in left hemithorax, and progressive ocular opening. Further emphysema absorption occurred during hospitalization.

• Klíčová slova
• chronic obstructive pulmonary disease, extensive subcutaneous emphysema, pneumomediastinum, subcutaneous emphysema, venous catheter,
• MeSH
• chronická obstrukční plicní nemoc komplikace   terapie   MeSH
• fraktury žeber diagnostické zobrazování   MeSH
• lidé MeSH
• mediastinální emfyzém diagnostické zobrazování   terapie   MeSH
• oxygenoterapie MeSH
• počítačová rentgenová tomografie * MeSH
• senioři MeSH
• subkutánní emfyzém diagnostické zobrazování   terapie   MeSH
• trvalý přetlak v dýchacích cestách MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

Chronic obstructive pulmonary disease (COPD) is one of the three leading causes of death worldwide. If the feature of the disease is dominated by emphysema, we speak of an emphysematic phenotype. Interventional treatment is a standard part of the management of patients with the emphysematic phenotype of COPD. Interventional methods are surgical and endoscopic. An important point in the indication of these methods is the correct selection of profitable patients. In addition to the correct execution of the individual procedure, periprocedural management, anticipation, and optimal handling of complications in the field of severe functional disability have an important effect on the care results.

• Klíčová slova
• COPD, Emphysema, Lung transplantation, endoscopic volume reduction, lung volume reduction surgery, volume reduction,
• MeSH
• chronická obstrukční plicní nemoc * komplikace   chirurgie   MeSH
• emfyzém * komplikace   chirurgie   MeSH
• kvalita života MeSH
• lidé MeSH
• plicní emfyzém * chirurgie   etiologie   MeSH
• pneumektomie škodlivé účinky   metody   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

• Klíčová slova
• EMPHYSEMA *, LUNGS *,
• MeSH
• bronchografie * MeSH
• emfyzém * MeSH
• lidé MeSH
• plíce * MeSH
• plicní emfyzém * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

INTRODUCTION: The paper presents unusual symptoms as a complication of therapeutic colonoscopy. CASE REPORT: A 70-year-old polymorbid female patient in chronic dialysis program underwent argon plasma coagulation treatment of leaking angioectasias in the cecum and ascending colon. Shortly after the procedure she presented with shortness of breath and subcutaneous emphysema of the neck which was initially misdiagnosed as swelling. Further tests revealed pneumoperitoneum, subcutaneous emphysema and pneumomediastinum. Considering the high risks for our patient (comorbidities, obesity), a laparoscopic approach was indicated. During laparoscopy neither peritonitis nor intestinal perforation were found. The patient recovered without complications after further complex treatment. CONCLUSION: Shortness of breath and subcutaneous emphysema are not typically among the first symptoms of colonoscopic perforation. Our case confirms that we should bear this complication in mind and when suspected, the diagnostic process should be started without delay.

• Klíčová slova
• argon plasma coagulation, iatrogenic colonoscopic perforation, pneumoperitoneum, subcutaneous emphysema,
• MeSH
• argonová plazmakoagulace škodlivé účinky   MeSH
• lidé MeSH
• mediastinální emfyzém * terapie   komplikace   MeSH
• pneumoperitoneum * etiologie   terapie   MeSH
• pneumotorax * diagnóza   MeSH
• senioři MeSH
• subkutánní emfyzém * etiologie   terapie   diagnóza   MeSH
• Check Tag
• lidé MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

OBJECTIVES: To determine the exact incidence of lung cancer, pulmonary emphysema and pleural effusion we decided to carry out an autopsy study. METHODS: In this autopsy study carried out over two years, we compared the results of autopsy findings with the clinical data in accompanying records of the deceased. RESULTS: Among the 708 deceased subjects, there were 398 males and 310 females with a median age of 71 years. At autopsy, 55 cases of lung carcinoma (BCA) were found, of which 24 have not been identified during life (44%). Among the deceased with BCA, emphysema was also observed at autopsy in 40% of the cases. Pulmonary emphysema was described macroscopically in 28% of the full set of 708 deceased, whereas the accompanying records of the deceased described this condition in only 12% of the cases. Microscopic changes compatible with emphysema were identified in 54% of the examined lungs. Pleural effusions were described in the accompanying records of 13% of the deceased, while the autopsies showed this condition in 33% of the deceased. BCA was accompanied by effusion in 25% of the cases. CONCLUSIONS: The obtained results show that the studied conditions are present in more cases than are reported by clinicians. The study confirms the commonly accepted association between lung cancer and emphysema.

• Klíčová slova
• autopsy pathology, emphysema, lung cancer, pleural effusion,
• MeSH
• dítě MeSH
• dospělí MeSH
• incidence MeSH
• lidé středního věku MeSH
• lidé MeSH
• mikroskopie MeSH
• mladiství MeSH
• mladý dospělý MeSH
• nádory plic diagnostické zobrazování   mortalita   MeSH
• pitva MeSH
• pleurální výpotek diagnostické zobrazování   mortalita   MeSH
• plicní emfyzém diagnostické zobrazování   mortalita   MeSH
• příčina smrti MeSH
• prospektivní studie MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH

The present indications for surgery are mainly large or increasing bullae that result in compression of apparently good lung tissue, and the complications of bullous diseases such as pneumothorax. The results of local resection of localized giant bullae are dramatic. The resection of small bullae generally has little effect on lung function. Lobectomy should not be done until bullae have been removed locally and the remaining lung has been tested by positive ventilation. The indications for the resection of large bullae in the presence of diffuse emphysema require very careful individual study. Pulmonary function tests are mandatory but computed tomography is the single most useful method of assessing the extent of the bullous disease and the underlying lung disease. If the underlying lung is diffusely cystic then any surgical treatment is palliative only.

• MeSH
• dospělí MeSH
• lidé MeSH
• plíce patologie   MeSH
• plicní emfyzém diagnostické zobrazování   patologie   chirurgie   MeSH
• pneumektomie MeSH
• rentgendiagnostika MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

• Klíčová slova
• PULMONARY EMPHYSEMA/diagnosis *,
• MeSH
• emfyzém * MeSH
• lidé MeSH
• plicní emfyzém diagnóza   MeSH
• reziduální objem plic * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

• Klíčová slova
• MUSIC *, PULMONARY EMPHYSEMA/etiology *,
• MeSH
• emfyzém * MeSH
• hra a hračky * MeSH
• hudba * MeSH
• lidé MeSH
• plicní emfyzém etiologie   MeSH
• vítr * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

Spontaneous pneumothorax, pneumomediastinum and subcutaneous emphysema are serious complications of COVID-19 infection caused by SARS-CoV-2, occurring in approximately 1% of hospitalized patients. The risk increases with the accumulation of risk factors, namely moderate or severe illness, high-flow oxygen therapy and noninvasive ventilation. The pathophysiology may be contributed to by patient self-inflicted lung injury. Hypoxia-induced respiratory effort in patients with pneumonia puts an enormous load on certain parts of their lungs, leading to subsequent progression of lung tissue damage. These complications start with destruction of the alveolar membrane, accompanied by emergence of a pulmonary bulla. Rupture of the bulla results in air leaking to the pleural space (pneumothorax). In the case of pneumomediastinum, the air spreads within the peribronchial interstitium along the airways to the mediastinum and subcutaneous tissues (Macklin effect). While pneumomediastinum and subcutaneous emphysema resolve spontaneously in most cases, pneumothorax treatment depends on its magnitude. While small pneumothorax may be managed conservatively, large pneumothorax usually requires active treatment with an acute chest drain; the latter is also associated with worse prognosis and a higher chance of death. We report air-leak complications in nine COVID-19 patients, of whom seven had spontaneous pneumothorax and four of them died. Three patients developed spontaneous pneumomediastinum together with subcutaneous emphysema, with two of them surviving. One patient with combination of pneumothorax, pneumomediastinum and subcutaneous emphysema died. These complications may accompany moderate or severe COVID-19-associated pneumonia, mostly the late phase of the disease. They should be considered when patients complain of sudden chest or back pain or worsening respiratory insufficiency.

• MeSH
• COVID-19 * komplikace   MeSH
• kyslík MeSH
• lidé MeSH
• mediastinální emfyzém * diagnóza   etiologie   terapie   MeSH
• pneumotorax * etiologie   terapie   MeSH
• puchýř komplikace   MeSH
• SARS-CoV-2 MeSH
• subkutánní emfyzém * komplikace   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• kyslík MeSH