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위늑막루에 의한 농흉의 치험 - 1예 보고 -

Management of Empyema Caused by a Gastropleural Fistula - A case report -

  • 이성광 (인제대학교 의과대학 부산백병원 흉부외과학교실) ;
  • 이양행 (인제대학교 의과대학 부산백병원 흉부외과학교실) ;
  • 전희재 (인제대학교 의과대학 부산백병원 흉부외과학교실) ;
  • 윤영철 (인제대학교 의과대학 부산백병원 흉부외과학교실) ;
  • 황윤호 (인제대학교 의과대학 부산백병원 흉부외과학교실) ;
  • 박경택 (인제대학교 의과대학 부산백병원 흉부외과학교실) ;
  • 최창수 (인제대학교 의과대학 부산백병원 외과학교실)
  • Lee, Seong-Kwang (Department of Thoracic and Cardiovascular Surgery, Pusan Paik Hospital, College of Medicine, Inje University) ;
  • Lee, Yang-Haeng (Department of Thoracic and Cardiovascular Surgery, Pusan Paik Hospital, College of Medicine, Inje University) ;
  • Jeon, Hee-Jae (Department of Thoracic and Cardiovascular Surgery, Pusan Paik Hospital, College of Medicine, Inje University) ;
  • Yoon, Young-Chul (Department of Thoracic and Cardiovascular Surgery, Pusan Paik Hospital, College of Medicine, Inje University) ;
  • Hwang, Youn-Ho (Department of Thoracic and Cardiovascular Surgery, Pusan Paik Hospital, College of Medicine, Inje University) ;
  • Park, Kyung-Taek (Department of Thoracic and Cardiovascular Surgery, Pusan Paik Hospital, College of Medicine, Inje University) ;
  • Choi, Chang-Soo (Department of General Surgery, Pusan Paik Hospital, College of Medicine, Inje University)
  • 투고 : 2009.11.06
  • 심사 : 2009.12.15
  • 발행 : 2010.06.05

초록

위늑막루는 이전의 폐수술 병력, 위궤양의 합병증, 외상, 악성종양 등에 의해 일어날 수 있는 흔하지 않은 합병증이다. 10년전에 위장천공의 외과적 봉합술을 받았던 62세 여자 환자로 좌측 농흉이 발생하여 개흉하에 흉막 박피술을 시행하였다. 수술 후 4일째, 음식물이 흉관을 통해서 배액 되어서 응급 위식도 조영술을 시행하였다. 위식도 조영술상 위늑막루를 발견하였다. 환자는 위전절제술 및 횡경막 봉합을 시행하고, 이전의 흉부창상을 통해 흉강을 세척하였다. 특별한 문제 없이 수술 후 11일째 퇴원하였다.

Gastropleural fistula is a rare complication of prior lung surgery, gastric ulcer, trauma and malignancy. A 62 year old female patient who had received surgical repair of a perforated gastric wall 10 years prior, underwent open pleural decortication. At 4 days after surgery, food residuums were noticed at the chest bottles. Hence, an emergency esophagogram was done. The esophagogram revealed a gastropleural fistula. The patient received a total gastrectomy, intra-abdominal diaphragmatic repair and massive thoracic saline irrigation through a previous thoracic wound. The patient was discharged 11 days after surgery without other morbidity.

키워드

참고문헌

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피인용 문헌

  1. 한양방 병용치료를 통한 만성적 농흉의 완화 치험 1례 vol.38, pp.2, 2010, https://doi.org/10.22246/jikm.2017.38.2.252