Publications by authors named "Klein Dantis"

12 Publications

  • Page 1 of 1

Mediastinal Hydatidosis with an Unusual Presentation: A rare case report.

Sultan Qaboos Univ Med J 2022 May 26;22(2):300-303. Epub 2022 May 26.

Department of Radiodiagnosis, All India Institute of Medical Sciences, Raipur, India.

Hydatidosis is a common zoonotic disease with a high prevalence in developing countries. While a solitary cyst with unilateral lung involvement is common, bilateral involvement and multiple cysts are rare, only seen in 20% and 30% of the cases, respectively. Likewise, extensive involvement of extrapulmonary tissues and mediastinum is rare. We report an unusual case of mediastinal hydatidosis mimicking an intrathoracic malignancy in a 24-year-old female patient. She presented in the year 2020 with a history of left-sided chest pain and heaviness in the left hemithorax for a period of two months. Diffuse, multiple fluid-filled cystic lesions with internal echoes throughout the mediastinum, lung, pericardium, diaphragm and chest wall were observed in contrast-enhanced computed tomography of the thorax. An incidental cystic lesion in the liver was also noted. Since serology for echinococcosis was negative, a differential diagnosis of intrathoracic malignancy was considered. However, intraoperative and histopathologic findings were suggestive of hydatidosis.
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http://dx.doi.org/10.18295/squmj.4.2021.072DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9155022PMC
May 2022

Surgical outcomes and the factors affecting lung expansion following open window thoracostomy in chronic tuberculous empyema with destroyed lung.

Asian Cardiovasc Thorac Ann 2022 Jul 29;30(6):696-705. Epub 2022 May 29.

Department of Thoracic Surgery, National Institute of Tuberculosis and Respiratory Diseases, New Delhi, India.

Background: Patients with chronic tuberculous empyema and destroyed lung on a prolonged intercostal tube with failed lung expansion considered unsuitable for single-lung ventilation have poor outcomes. The study's objective was to analyze the surgical outcomes and lung expansion factors in these patients following the open window thoracostomy (OWT) procedure.

Methods: In a prospective study, patients (males = 63, females = 12) diagnosed with tuberculosis who underwent OWT were analyzed between 2017 and 2018. Factors including age, sex, side, comorbidities, body mass index (BMI), bacteriological culture, and patency of OWT site were evaluated for lung expansion.

Results: Mean preoperative weight 40.96 ± 5.70 kg increased significantly postoperatively. (30.66%) was the most typical organism isolated and smoking (21.3%) was the common risk factor. At 6-month follow-up, complete lung expansion was noted in 60% of patients, while partial and no expansion is seen in 17.3% and 22.3% patients. Similarly 82.4% patients with pre-operative BMI>18.5 kg/m had complete lung expansion, while with BMI < 18.5 kg/m, 41.7% and 45.8% had partial and no-expansion. Complete lung expansion was seen in 97.1%, 18.2%, and 23.1% of patients with obliterated OWT, sputum, and pleural pus positive for acid-fast bacilli (active disease), while in 57.9% of patients with comorbidities, complete lung expansion was absent.

Conclusion: The analysis of various factors concludes that lung expansion is not affected by age, sex, side of the disease, and co-morbid conditions; however, extensively diseased lungs with low BMI and positive bacteriological culture, especially , active disease, smoking, and patent OWT, interfered with the expansion of the lung.
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http://dx.doi.org/10.1177/02184923221104431DOI Listing
July 2022

Left pulmonary aplasia with multiloculated effusion and pericardial defects in a young adult: a case report.

Pneumologie 2022 Apr 6. Epub 2022 Apr 6.

Pulmonary Medicine, All India Institute of Medical Sciences, Raipur, India.

Pulmonary aplasia is a rare developmental lung anomaly with unknown etiology. Multiloculated effusion and pericardial defects are even less common with no cases reported up until now. Here, we report the first case of an unusual presentation of a 25-year-old female with recurrent cough for four months, who was diagnosed with left pulmonary aplasia with multiloculated effusion and partial pericardial defects, and who underwent uniportal thoracoscopic drainage and pleurectomy.
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http://dx.doi.org/10.1055/a-1778-2880DOI Listing
April 2022

Bochdalek Hernia and Partial Diaphragmatic Agenesis: Pedicled Intercostal Muscle Flap and Mesh Repair in a Young Adult with Sickle Cell Disease.

Surg J (N Y) 2021 Oct 23;7(4):e363-e365. Epub 2021 Dec 23.

Department of Anesthesiology, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India.

Congenital Bochdalek hernia (BH) in an adult is rare and has an unusual presentation. They are confined to the pediatric age group with an incidence of 1:3,000 live births. It rarely persists asymptomatic until adulthood. Surgical repair by thoracic, abdominal, or thoraco-abdominal approach is the treatment of choice with diaphragmatic reconstruction in associated diaphragmatic agenesis. With only 10 cases of BH with partial diaphragmatic agenesis reported to date, we discuss the rarity, unusual presentation, and management of BH in a young adult with sickle cell disease that has not been reported in the literature.
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http://dx.doi.org/10.1055/s-0041-1740628DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8702300PMC
October 2021

Ruptured hydatid cyst presenting as recurrent pneumothorax with co-existing pulmonary tuberculosis and uniportal thoracoscopic management: first Indian report.

Kardiochir Torakochirurgia Pol 2021 Sep 5;18(3):183-185. Epub 2021 Oct 5.

Department of Cardiothoracic Surgery and Pulmonary Medicine, All India Institute of Medical Sciences, Raipur, India.

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http://dx.doi.org/10.5114/kitp.2021.109399DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8525271PMC
September 2021

Uniportal video-assisted thoracoscopic surgery in a two-year-old chronic empyema patient: challenges faced in the first case from the Indian subcontinent.

Kardiochir Torakochirurgia Pol 2021 Sep 5;18(3):177-179. Epub 2021 Oct 5.

Department of Anaesthesiology and Critical Care, All India Institute of Medical Sciences, Raipur, India.

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http://dx.doi.org/10.5114/kitp.2021.109402DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8525282PMC
September 2021

SARS-CoV-2 Sequel: Pulmonary Mucormycosis with a Mycotic Aneurysm in a Transplant Recipient.

Tuberc Respir Dis (Seoul) 2021 Oct 3;84(4):335-337. Epub 2021 Aug 3.

Department of Anesthesiology, All India Institute of Medical Sciences, Raipur, India.

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http://dx.doi.org/10.4046/trd.2021.0098DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8497769PMC
October 2021

Pulmonary sclerosing pneumocytoma masquerading adenocarcinoma with co-existing BRAF V600E and PTEN mutation.

Cancer Treat Res Commun 2021 29;28:100429. Epub 2021 Jun 29.

Department of Nuclear Medicine, All India Institute of Medical Sciences, Raipur, India.

We report a case of a massive primary sclerosing pneumocytoma (PSP) involving the right lower lobe adhering esophagus with small synchronous PSP on the superior segment of the left lower lobe with concurrent mutation for B-RAF proto-oncogene, serine/threonine kinase (BRAF V600E), and phosphatase and tensin homolog (PTEN) gene in a young female. She underwent right lower lobectomy and mediastinal lymph node dissection under single lung ventilation with tumor-free margins on diagnosis-based findings of preoperative computed tomography-guided biopsy and positron emission tomography. Histopathology was suggestive of PSP-papillary variant with concurrent mutation of BRAF V600E and PTEN genes. Post-operative follow-up at four weeks was uneventful. She has to undergo wedge resection for the contralateral disease after six weeks following recovery from the first surgery.
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http://dx.doi.org/10.1016/j.ctarc.2021.100429DOI Listing
February 2022

Brief overview of surgical aspect of autologous arterio-venous fistula for dialysis access.

Asian Cardiovasc Thorac Ann 2021 Jul 7:2184923211029496. Epub 2021 Jul 7.

Department of Cardiovascular and Thoracic Surgery, All India Institute of Medical Sciences Raipur, Raipur, India.

Patients with the end-stage renal disease require renal replacement therapy in renal transplant, peritoneal dialysis, and intermittent hemodialysis. Hemodialysis remains the primary modality for renal replacement therapy. Excellent vascular access is a mainstay for performing hemodialysis. Here we present a brief review of the various surgical aspects of AV fistula creation. Preoperative physical examination and judicious use of the imaging modalities to define the artery and venous mapping provide a good outcome of the fistula formation. Surgical creation of RC-AVF is preferred for the end-stage renal disease patient. The end-to-side anastomosis between the radial artery and cephalic vein has shown very good results.
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http://dx.doi.org/10.1177/02184923211029496DOI Listing
July 2021

An innovative technique of chest wall stabilization and reconstruction in traumatic flail chest: The figure-of-eight suture with polypropylene mesh and musculofascial flap.

Chin J Traumatol 2022 Mar 6;25(2):122-124. Epub 2021 May 6.

Department of General Surgery, All India Institute of Medical Sciences, Bhopal, India.

Surgical stabilization of the flail chest is challenging and has no established guidelines. Chest wall integrity and stability are the main factors that ensure the protection of intrathoracic organs and an adequate respiratory function. Here, we report a novel chest wall reconstruction technique in a 45-year-old man with a traumatic left flail chest and open pneumothorax diagnosed both clinically and radiographically. Rib approximation and chest wall reconstruction was done using intercostal figure-of-eight suture and polypropylene mesh with vascularized musculofascial flap. The patient improved gradually and was discharged after three weeks of total hospital stay. He returned to regular working after a month with no evidence of respiratory distress or paradoxical chest movement. Follow-up visit at one year revealed no lung hernia or paradoxical chest movement. This is a novel, feasible and cost-effective modification of chest wall reconstruction that can be adopted for thoracic wall repair in case of open flail chest, which needs emergency surgical interventions even in resource constraint settings.
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http://dx.doi.org/10.1016/j.cjtee.2021.04.009DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9039433PMC
March 2022

A maze of pearls in the chest.

Indian J Thorac Cardiovasc Surg 2021 May 18;37(3):360-361. Epub 2021 Feb 18.

Department of CVTS, All India Institute of Medical Sciences, Raipur, Chhattisgarh India.

Hydatid disease is a prevalent disease in India. The most common organs involved are the liver and the lungs. Most of the time, the lung cysts are single and large. Multiple cysts have been described in literature but they are generally bilateral. We present here a case of multiple hydatidosis which involved only one lung, but occupied all the segments of the lung. The cysts were numerous and interconnected giving the appearance of a maze. The images of the computed tomography (CT) scan reveal that there was very little identifiable lung tissue. But after surgery, the healthy lung tissue expanded and occupied the chest cavity.
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http://dx.doi.org/10.1007/s12055-021-01141-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8079582PMC
May 2021

Intercostal Muscle Cavernous Haemangioma: A Chest Wall Pandora's Box.

Eur J Case Rep Intern Med 2021 27;8(1):002248. Epub 2021 Jan 27.

All India Institute of Medical Sciences, Bhopal, India.

Background: Haemangiomas are uncommon chest wall tumours arising outside the rib cage. Their occurrence in intercostal muscle is extremely rare.

Aim: We describe a case of intercostal muscle cavernous haemangioma as a differential diagnosis for chest wall swelling.

Case Description: We describe an 18-year-old male patient with an asymptomatic left-sided chest wall swelling. Contrast-enhanced computed tomography revealed a well-defined homogenously non-enhancing mass lesion arising from the seventh intercostal muscle with differential diagnoses of various chest wall tumours. Clinical presentation and imaging findings were inconclusive, but histopathological examination following excision biopsy revealed a cavernous haemangioma. The present case emphasizes the importance of histopathological diagnosis when clinical and radiological examination is inconclusive. Hence, it is necessary to consider intercostal muscle haemangiomas as a differential diagnosis for chest wall tumours in the absence of a feeding vessel.

Conclusion: Despite its rare occurrence, intercostal muscle haemangioma must be considered as a differential diagnosis in chest wall tumours even in the absence of a feeding vessel. We believe that histopathology can provide a definitive diagnosis when most investigative procedures are inconclusive.

Learning Points: Haemangiomas are rare chest wall tumours and even rarer when they originate from intercostal muscle.Intercostal muscle haemangiomas should be included in the differential diagnosis of chest wall tumours even in the absence of a feeding vessel.The present case emphasizes the importance of histopathological diagnosis when clinical and radiological examinations are inconclusive.
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http://dx.doi.org/10.12890/2021_002248DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7875575PMC
January 2021
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