Early intrapleural instillation of autologous blood is successful in sealing air leak in patients with SSP with persistent air leak, who are not fit or not willing to undergo surgery. It is superior to conservative treatment or late instillation of autologous blood, even if their lungs are not fully expanded.

Double edge technique for thoracotomy closure is easy, rapid, safe and effective in decreasing post-thoracotomy pain with subsequent earlier ambulation and lesser use of analgesics.

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Background: Trauma is a leading cause of mortality globally. Thoracic trauma is a significant cause of morbidity and mortality in both children and adult. Objective: To compare between children and adult after exposure to a blunt chest trauma according to incidence, mechanism of injury, effect of trauma on lung, pleura and ribs and in hospital mortality rate. Patients and methods: A prospective, comparative study included patients with blunt chest trauma attending to the Emergency Department, Menoufia University during the period from November 2019 to April 2020. Results: The outcomes of the study were in the form of incidence, mechanisms of injury, effect of trauma on lung, pleura and ribs and hospital mortality rate in adult and children. There was difference in incidence in studied groups as adult has higher incidence, according to mechanism of injury, motor traffic accident was the main cause of trauma in both groups. Pulmonary contusion was the most common chest injury in both groups but more in children (71%) than in adult (66.7%), chest wall fracture was more in adult (33.3%) than in children (7.1%) and pneumothorax was more in adult (27.3%) than in children (7.1%) exactly as hemothorax. Mortality was observed mainly in adult group (36.4%), while it was (21.4%) in pediatric group. Conclusion: There were differences between children and adult exposed to blunt chest trauma in incidence, effect of trauma on lung, pleura and ribs, and in mortality

Background: Aspiration of foreign body is popular in pediatric age group and is considered as an important cause of respiratory distress and chocking in these children. Management strategies are different according to the mode of presentation. This study aims to assess the efficacy of rigid bronchoscopy and the role of bronchotomy as a safe alternative for failed removal of inhaled foreign body. Methods: We enrolled 254 patients with foreign body aspiration (FBA) up to 14 years old in a retrospective observational study. Our patients were reviewed from the Cardiothoracic Surgery Department and cases referred from Otorhinolaryngology Department, Menoufia University Hospital between June 2010 and July 2017. Using jet ventilation technique, foreign body was removed by the rigid bronchoscopy with either extracting forceps or postural drainage. Surgical interference such as bronchotomy needed in distally impacted foreign bodies (FBs). Results: Our study included 254 patients prepared for bronchoscopic FBs extraction. Most of cases (68.8%) presented early within first week (174 cases). No FBs detected in 44 cases by rigid bronchoscopy, although it was successful in 176 (69.5%) cases with nonimpacted inhaled FBs. 14 cases only needed postural drainage due to inaccessible FBs, another 12 cases failed to extract FB with rigid bronchoscopy but they were managed with flexible bronchoscopy. Bronchotomy was needed for impacted FBs in eight cases (3%). Conclusion: This study's findings support that rigid bronchoscopy is the gold standard in the diagnosis and removal of foreign body aspirations in pediatrics, but rigid bronchoscopy demonstrated less capability in the diagnosis and removal of small distally located foreign bodies. Bronchotomy is safe and effective alternative.