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Journal : Malang Respiratory Journal

Giant Intrapulmonary Mature Teratoma with Thoracostomy Intervention: A Rare Case Report Indriani, Sri Indah; Simatupang, Elvando Tunggul Mauliate; Bergant, Briliant; Makmur, Andreas; Rangkuti, Ina Farida
Malang Respiratory Journal Vol. 6 No. 1 (2024): March 2024 Edition
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2024.006.01.06

Abstract

Background: Teratoma usually found in mediastinum and rarely found in the lung. Mature teratomas are the most common histological type of germ cell tumours, followed by seminoma. First case reported by Mohr in 1839 and until now only few cases of intrapulmonary teratomas have been reported. Case: A man, 64-years old man, nonsmoker complains of shortness of breath since 6 months and worsened in a week. Patient had history medication for tuberculosis in 2019. Chest Contrast CT-Scan showed hypodense mass and suggestive for benign left lung tumor. TTNA were performed and suggestive for teratoma. Joint conference with several department agree to proceed with thoracostomy. Thoracostomy with wide excision been done to remove the mass and examined for anatomic pathology then confirmed for mature teratoma. During thoracostomy, we cannot removed 100% of the tumor because it adhesive with aorta and parietal pleura. Patient treated in ICU and worsens. Unfortunately, patient passed away four days later. Conclusion: Teratoma is rarely found inside of the lung. Early diagnosis and resection of intrapulmonary teratoma is critical to prevent complications and provide definitive treatment.
Overlapping of Intestinal Tuberculosis with Typhoid Fever as Initial Diagnosis: A Case Report Simatupang, Elvando Tunggul Mauliate; Simbolon, Rohani Lasmaria; Bet, Anwar; Makmur, Andreas; Simatupang, Elcia
Malang Respiratory Journal Vol. 6 No. 2 (2024): September 2024
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2024.006.02.03

Abstract

Background: Extrapulmonary Tuberculosis (ETB) cases have increased to 20-30% of all Pulmonary Tuberculosis (PTB) cases, including Intestinal Tuberculosis (ITB). Overlap between ITB and Typhoid Fever (TF) leads to Diagnostic Delays in ITB. Endoscopic and histopathological examinations are needed as diagnostic support, so comprehensive examination and clinical evaluation are necessary. Accurate diagnosis and management will have significant implications for patient survival. Case: A 23-year-old male patient complained of shortness of breath for three weeks. Previously fever, night shivering, loss of appetite, and weight loss were also experienced. A history of previous hospitalization involving abdominal colic complaints, the patient should be hospitalized twice. Repeated administration of antibiotics with TF diagnosis did not show any clinical improvement. The suspicion of ITB was proven after obtaining positive results from Genexpert (GE) of Faeces and clinical response after Anti Tuberculosis Drugs (ATD) administration. Overall, there were clinical, laboratory and radiological improvements in patients with clinical abdominal colic and fever experienced in the last 2 months. Conclusion: Challenge ATD delivery and GE of Faeces can be used as an indicator of suspects ITB so overlap between ITB and TF can be predicted. A comparative diagnostic study of abdominal colic and recurrent fever should also be extended so that it can be continued with several diagnostic support.
Successful Autologous Blood Patch Pleurodesis: A Safe and Useful Treatment for Persistent Pneumothorax in Former Pulmonary Tuberculosis and Aspergillosis in Pregnant Women Purnama, Nori; Simatupang, Elvando Tunggul Mauliate; Fauzi, Zarfiardy Aksa; Indriani, Sri; Yovi, Indra; Hatta, Hariadi; Zulmaeta
Malang Respiratory Journal Vol. 6 No. 1 (2024): March 2024 Edition
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2024.006.01.04

Abstract

Background: Autologous Blood Patch Pleurodesis (ABPP) is one of the treatment options for persistent pleural air leaks especially in patients who are not suitable for surgical intervention. Persistence pneumothorax is defined as pneumothorax of more than five days duration. It is associated with increased morbidity and cost of care. The most widely accepted treatment for it is pleurodesis. Several types of pleurodesis have been proposed, including surgical approaches and the instillation of different chemicals in the intrapleural space. ABPP has proven to be a simple, inexpensive, efficacious and safe method. We present the case of the first patient with Persistent Pneumothorax we have treated Successfully with ABPP. ABPP is currently rarely and uncommonly used, but it provides benefits especially in special conditions with easier, cheaper, and quite effective procedures. Case: A female 35-year-old pregnant women patients with Former Tuberculosis (FTB) come to our hospital with complaints breathlessness and chest pain worsening since 3 days before admitted to our hospital. Chest radiography showed spontaneous pneumothorax with GeneXpert (GE) sputum Mtb Not Detected but there is Aspergillosis from Fungal Culture. Water Sealed Drainage (WSD) was inserted in right pleural for almost 1 month and this patient discharge with pneumostat. One month after that she come again with Persistence Pneumothotax, so that we do the pleurodesis with Blood Patch and get the improvement from clinical status. Antifungals are continued for an initial 4-6 weeks while an outpatient evaluation is conducted. Conclusion: ABPP is a safe, inexpensive and efficacious treatment for persistent pleural air leak. Autologous Blood Patch administration may be considered for patients with Persistent Pneumothorax.