We recommend the transabdominal subcostal approach in patients with Morgagni hernia for surgical exposure, easy repair of the hernia sac, and low morbidity.

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BackgroundTraumatic asphyxia is probably much more common than the surgical literature shows and should always be kept in mind as a possible complication of injuries of the chest and abdomen. AimsTraumatic asphyxia or Perte’s syndrome results from a severe crush injury causing sudden compression of the thorax. During a 3-year period, we treated five cases of traumatic asphyxia, which we report in this manuscript.MethodsThe patients were all male, ranging in age from 26 to 64. They suffered different types of crushing injuries: industrial accidents in two patients, run over by motor vehicles in two patients, and a farm accident in one patient. Most of the patients suffered some associated injuries, including fracture of the sternum in one patient, fracture of the right clavicle in one patient, and bilateral hemopneumothoraces in one patient. ResultsThe treatment included bilateral chest tube thoracostomy in one patient, and the others required supportive treatment. There was no mortality.ConclusionTreatment for traumatic asphyxia is supportive, and patient recovery is related to the generally associated injuries. Traumatic asphyxia should always be kept in mind as a possible complication of injuries of the chest and abdomen.

Cefuroxime as a prophylactic agent in major thoracic surgical operations was marginally more effective than cefepime, and presented an additional cost advantage.

Iodopovidone is an effective, safe, cheap, and easily available agent for pleurodesis. On the other hand, topical applications of iodopovidone may cause thyroid dysfunction. The purpose of this retrospective study was to determine the effects of intrapleural administration of iodopovidone on thyroid function. Twelve patients have undergone iodopovidone pleurodesis so far. A mixture of 20 ml 10% iodopovidone and 80 ml 0.9% saline solution was administered into the pleural cavity through the chest tube. Thyroid hormone (TSH, TT4, TT3, FT4, FT3) levels were routinely measured just before pleurodesis, and at the 24th and 72nd h of pleurodesis. No statistically significant alteration in thyroid function was determined (P>0.05). We did not observe any signs or symptoms of hyper- or hypothyroidism in any patient. Nine patients had a complete response to pleurodesis (75%). One patient who had undergone iodopovidone pleurodesis suffered from a moderate degree of transient chest pain. In conclusion, iodopovidone pleurodesis is safe and does not cause any thyroid dysfunction in normal adults.