• Title/Summary/Keyword: 기흉

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A Study of Pathogenesis and Treatment of Spontaneous Pneumothorax (자연성 기흉의 성인과 치료에 대한 고찰)

  • 홍완일;김진식
    • Journal of Chest Surgery
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    • v.1 no.1
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    • pp.11-18
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    • 1968
  • Author studied the possible pathogenesis of spontaneous pneumothorax and its effective treatment in 33 cases, and the results obtained as follows:1) Of the 33 cases, 15 cases were originated from pulmonary tuberculosis, 11 cases were non-tuberculous natures and 7 cases were followed by traumatic chest injuries which were not associated with a laceration of the lung or rib fractures.2) So called "Idiopathic spontaneous pneumothorax" seemed mostly to be caused by rupture of the emphy- sematous blebs.3) Spontaneous pneumothorax, in process of the pulmonary tuberculosis, seemed to be caused by the rupture of blebs which was formed with a pathological process of chronic pulmonary tuberculosis.4) Author experienced interesting cases of giant blebs which had been fully occupied the right thoracic cavity. At first, it was misdiagnosed as extensive spontaneous pneumothorax on X-ray which was revealed extensive pleural air shadow with total atelectasis of the right lung. A pneumonectomy was performed together with the giant multiple blebs.5] Generally, closed thoracotomy with water-sealed drainage is the treatment of choice in spontaneous pneumothorax. However, open thoracotomy and adequate surgical procedures should be undertaken in patients with continuous air leakage or recurrent attack of spontaneous pneumothorax.aneous pneumothorax.

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A Study of Cause and Thoracotomy in Spontaneous Pneumothorax - A Report of 57 Cases - (자연기흉의 원인과 개흉술에 대한 임상적고찰)

  • 김성수
    • Journal of Chest Surgery
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    • v.22 no.5
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    • pp.788-793
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    • 1989
  • We have observed 501 cases of spontaneous pneumothorax from January 1981 to June 1989 at the Department of Thoracic and Cardiovascular Surgery, Chonbuk National University Hospital. Of these, 57 patients have undergone thoracotomy to treat the pneumothorax after closed thoracostomy. These 57 patients were based on this retrospective clinical analysis, and the results were as follows: The ratio of male to female was 4.2:1 in male predominance and the old aged patients, over 50 years old, occupied 47.3% of all patients. Primary spontaneous pneumothorax was 19 cases and secondary spontaneous pneumothorax was 38 cases. The underlying pathology in secondary spontaneous pneumothorax was tuberculosis emphysema and chronic obstructive pulmonary disease in 35 cases. The indications of thoracotomy were persistent air leakage in 23 cases recurrent pneumothorax in 21 cases, inadequate expansion in 13 cases. Rupture of bullae or blebs were most frequent operative and pathologic findings in persistent air leakage group and recurrent pneumothorax group. In inadequate expansion group, predominant finding was destructive lung lesion. Bullectomy and/or bullae ligation was most effective procedures in 36 cases [63%] for operative management of spontaneous pneumothorax. Duration of preoperative and postoperative chest tube indwelling day was 13.35 days and 8.05 days in persistent pneumothorax group, 8.92 days and 7.77 days in recurrent pneumothorax group, 13.23 days and 10.21 days in inadequate expansion group.

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Nontraumatic Pneumothorax -A Review of 56 Cases- (비외상성 기흉의 임상적 고찰)

  • 곽문섭
    • Journal of Chest Surgery
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    • v.2 no.2
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    • pp.133-140
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    • 1969
  • We observed 56 cases of nontraumatic pneumothorax clinically and statistically, which had been experienced at the deparment of chest surgery. St. Mary`s Hospital,Catholic Medical College in theserecent years. 1] In the underlying pathology of spontaneous pneumothorax, nontuberculous origin [60.7%], especially due to pulmonary emphysema or blebs[17.8%], especially due to pulmonary emphysema or blebs[17. 8%], tended to increase as the reports of foreign countries, but tuberculous origin was still high in our country[39.3%]. Considering the 14 cases, unknown underlying pathology, the most of them might have scattered blebs which were not revealed in chest Roentgen films. 2] The principle treatment done in our clinic was as follows; The patients, below 20% lung collapse were treated by bed rest and abdominal respiration. The patients, between 20% and 40% lung collapse were treated by repeated pleural aspiration or closed thoracotomy followed. The cases,over 40% lung collapse were treated by closed thoracotomy initially. 3] The average duration of indweIling catheter was 3 to 4 days in the closed thoracotomy. We used to not remove the indwelling catheter early to promote pleural adhesion. 4] Sometimes, the closed thoracotomy drainage induces bronchial irritation and asthmatic attacks, especially in old age group accompanying pulmonary emphysema. In these cases, respiratory difficulties and acidosis should be prevented and controlled with medical treatment including steroid therapy.

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A Clinical Review of the Cause of the Primary Spontaneous Pneumothorax (원발성 자연기흉의 원인에 대한 고찰)

  • 권오우
    • Journal of Chest Surgery
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    • v.27 no.2
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    • pp.132-135
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    • 1994
  • By the early half of the 20th century, the most common cause of spontaneous pneumothorax was considered to be tuberculosis. But recently ruptures of the subpleural emphysema and/or blebs are considered as the major causes of spontaneous pneumothorax. To evaluate the causes of spontaneous pneumothorax, the authors reviewed the 96 patients who were consecutively diagnosed and treated by thoracotomy for spontaneous pneumothorax at the Department of Thoracic and Cardiovascular Surgery, Seoul Advenist Hospital, from May, 1988 to April, 1993. The patients who had clinical and radiological evidence of tuberculosis or other specific parenchymal lung diseases were excluded from this review. All patients were negative for tuberculous bacilli on sputum studies. The pathologic results were as follows : subpleural emphysema[25], blebs[27], subpleural emphysema and blebs[25], pleural fibrosis[10], tuberculosis[8], and parasitic granuloma[1]. Three of the patients who were diagnosed to be tuberculosis by pathologic findings were progressed to active pulmonary tuberculosis on the follow-up chest PA films. The authors conclude that all patients with spontaneous pneumothorax must be evaluated periodically for tuberculosis and that patients who were diagnosed to be tuberculosis by postoprative pathologic report need the administration of the prophylactic antituberculous drug, because the prevalence of tuberculosis remains relatively high rate in our country.

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A Case Report of Tension Pneumopericardium Following Blunt Chest Trauma (흉부둔상에 의한 긴장성 심막기종 1예 체험)

  • Sohn, Sang-Tae;Kim, Eung-Soo;Kang, Jong-Yeol;Song, Dong-Seop
    • Journal of Chest Surgery
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    • v.42 no.6
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    • pp.803-806
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    • 2009
  • A 49-year-old man visited our hospital via the emergency room. He had suffered chest trauma by falling down. His chest X-Ray showed pneumomediastinum with pneumopericardium. We checked the Chest CT, and it showed pneumopericardium without any injury to the other organs, the compressed heart and a minimal pneumothorax on the left hemithorax. Closed thoracostomy was then done under local anesthesia. We then performed open pericardiostomy under general anesthesia. We got a good result and so we report on this case.

$^{86}Rb$ Distribution in the Lung of the Rabbit with Pneumothorax (가토 기흉에서 본 $^{86}Rb$의 분포)

  • Huh, Kap-To
    • The Korean Journal of Nuclear Medicine
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    • v.6 no.1
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    • pp.51-59
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    • 1972
  • $^{86}Rb$ uptake of some organs and tissues, ego both lungs, both renal cortices. small intestine, liver and skeletal muscle were studied in the control and the rabbit subjected to pneumothorax. $^{86}Rb$ in the form of chloride mixed with physiological saline was intravenously. injected. The doses were $100{\mu}c$ for a rabbit. The rabbits were sacrificed at intervals of 10, 20, 40, and 60 seconds after the injection of $^{86}Rb$, by the injection of saturated KCI solution. After sacrification, the organ and tissue sample were quickly removed. $^{86}Rb$ uptake in gm of the organs and tissues were measured. On the basis of uptake value, administered doses and body weight, % dose/gm tissues per 200 gm body weight was calculated. Followings were the results; 1. Pneumothorax resulted in a marked elevation in $^{86}Rb$ uptake value of collapsed lung and returned to normal level lately. 2. Contralateral lung of pnemothorax also showed marked elevation in $^{86}Rb$ uptake value and recovered to normal level. 3. Initial $^{86}Rb$ uptake value of liver, small intestine of the rabbit with pneumothorax showed some elevation as compared to control, but that of late stage were similar with control. 4. Local blood flow determination by means of $^{86}Rb$ uptake were inadequate in the collapsed lung of pneumothorax. 5. It was suggested that the mechanism for the initial elevation of $^{86}Rb$ uptake value in each organs and tissue were different from each other.

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A case Report of Soeumin Pneumothorax (소음인 기흉 환자 치험1례(例))

  • Park, Se-Jung;Kwon, Seok-Dong;Jeon, Soo-Hyung;Kim, Jong-Won
    • Journal of Sasang Constitutional Medicine
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    • v.20 no.3
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    • pp.184-189
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    • 2008
  • 1. Objectives Pneumothorax is defined as the presence of air or gas in the pleural cavity causing chest pain and shortness of breath. Primary spontaneous pneumothoraces (PSPs) occur in people without underlying lung disease or trauma to the thorax. We have tried researching effect of herbal medicine Doksampalmulkeunja-rang(獨蔘八物君子湯) in PSPs. 2. Methods This patient with PSPs which size was more than 30% of Rt. lung, who had been experienced the recurrences of PSPs in Lt. lung for three times, was treated by Doksampalmulkeunja-tang(獨蔘八物君子湯) diagnosed by Soeumin. 3. Results Doksampalmulkeunja-tang(獨蔘八物君子湯) was effective against the chest discomfort and shortness of breath. The chest test was improved. 4. Conclusions The treatment with herb-medicine may have effect on PSPs symptom of Soeumin by raising the stagnant yang qi. Further Sasang medical study on PSPs is needed for recurrence prevention.

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Hematoma-Filled Pneumatocele after CT-Guided Percutaneous Transthoracic Needle Lung Biopsy: Two Case Reports (컴퓨터단층촬영 유도 경피적 바늘 생검 이후에 발생한 혈종으로 채워진 기종: 두 건의 증례 보고)

  • Se Ri Kang
    • Journal of the Korean Society of Radiology
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    • v.84 no.1
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    • pp.311-317
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    • 2023
  • CT-guided percutaneous transthoracic needle biopsy (PTNB) plays a key role in the diagnosis of pulmonary abnormalities. Although the procedure is considered safe and effective, there exists a potential for complications, such as pneumothorax, hemorrhage, hemoptysis, air embolism, and tumor seeding. However, pneumatoceles after CT-guided PTNB have been rarely reported. Herein, we report two cases of pneumatoceles that developed immediately after PTNB for primary lung cancer. A pneumatocele filled with hematoma should be considered in cases with a newly developed nodule along the needle tract during short-term follow-up CT after PTNB.

Modified Thoracoscopic Bullectomy (흉강경하 기낭절제술의 변형 술식)

  • Park, Chan-Beom;Cho, Min-Seob;Sa, Young-Jo;Lee, Jong-Ho;Jin, Ung;Kwon, Jong-Bum;Cho, Deog-Gon;Park, Kuhn;Cho, Kyu-Do;Kim, Chi-Kyeong
    • Journal of Chest Surgery
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    • v.36 no.12
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    • pp.937-942
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    • 2003
  • Morbidity, the use of analgesics, the amount of postoperative drainage and the postoperative hospital stay were reduced in VATS for pneumothorax. However, some authors preferred minithoracotomy to VATS because the rate of recurrence after VATS were between 5% and 10%. Therefore, we present a modified thoracoscopic bullectomy (MTB) which we believe has the advantages of conventional VATS and minithoracotomy. Material and Method: Sixty-six patients who received the operation from January 2002 to December 2002 were divided into 3 groups. Twenty-six patients were treated by axillary minithoracotomy and thirteen by conventional VATS and 18 by modified thoracoscopic bullectomy, The mean age was 21.9 years (range, 16∼35 years) for minithoracotomy group, 20.6 years (range, 17∼28 years) for conventional VATS group and 22.6 years (range, 16∼39 years) for MTB group. The mean follow-ups were 11.4 months for minithoracotomy group, 9.5 months for conventional VATS group and 4.7 months for MTB group. Result: The mean duration of operation was 55.79$\pm$23.35 minutes in MTB and 44.23$\pm$19.24 minutes in conventional VATS (p=0.333). The number of staplers being used was 1.63 $\pm$0.76 in MTB, 1.41$\pm$0.64 in minithoracotomy (p=0.663), and 2.92$\pm$1.19 in conventional VATS (p<0.001). The duration of indwelling chest tube was 1.63$\pm$0.76 day in MTB, 4.07$\pm$ 1.41 day in minithoracotomy (p<0.001) and 4.46$\pm$2.33day in conventional VATS (p<0.001). Hospital length of stay was 3.26$\pm$0.81 day in MTB, 6.04$\pm$2.21 day in minithoracotomy (p<0.001) and 6.69$\pm$3.33 day in conventional VATS (p<0.001). The number of postoperative complication and recurrence were 2 in minithoracotomy (7.4%), 5 in conventional VATS (38.5%) and 1 in MTB (5.6%). Conclusion: Modified thoracoscopic bullectomy is an effective procedure in the treatment of spontaneous pneumothorax.

Differential Lung Ventilation Therapy for Reexpansion Pulmonary Edema - Report of 2 cases - (분리형 폐환기법을 이용한 재팽창성 폐부종의 치료 -2예 보고 -)

  • 김덕실;김성완;김대현;이응배;전상훈
    • Journal of Chest Surgery
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    • v.36 no.7
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    • pp.527-530
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    • 2003
  • Reexpansion pulmonary edema is a rare complication of the treatment of lung collapse secondary to pneumothorax, pleural effusion, or atelectasis. But occasionally, severe morbidity and death may result. Reexpansion pulmonary edema occurs when chronically collapsed lung is rapidly reexpanded by evacuation of large amounts of air or fluid. In the treatment of the chronically collapsed lung, physicians must remember the possible events and prevent the complications. When the difference in airway resistance or lung compliance between the two lungs is exaggerated, conventional mechanical ventilation might lead to preferential ventilation with hyperexpansion of one lung and gradual collapse of the other. Differential ventilation has been advocated to avert this problem. By differential lung ventilation, we successfully treated a severe reexpansion pulmonary edema in two patients. Therefore we suggest that differential lung ventilation is the treatment of choice for severe reexpansion pulmonary edema.