• Title/Summary/Keyword: 심장 탈장

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Closure of VSD in a Patient with Tracheostoma-A case report- (기관절개구가 있는 환아에서 심실중격결손증의 치험-1례보고-)

  • 김상익;박철현;박국양;오상준
    • Journal of Chest Surgery
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    • v.34 no.3
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    • pp.246-251
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    • 2001
  • 심장 탈장은 심낭을 열고 전폐절제술을 시행 후 드물게 발생되는 합병증으로 수술이 끝날때나 수술직후 발생된, 44세 남자환자에서 심낭을 열고 좌측 폐를 전절제술 후 심낭 결손부위를 인공조직으로 봉합하였다. 수술이 종료될 때 심장탈장이 발생되어 개흉에 의한 응급 복원을 시행하였으나 심한 저 산소성 뇌 손상이 발생되었다.

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Hiatal Hernia in Neonate (신생아의 식도 열공 탈장)

  • 임용택;정승혁;김민용;김병열;이정호
    • Journal of Chest Surgery
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    • v.34 no.2
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    • pp.184-188
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    • 2001
  • 선천성 횡경막탈장은 2000∼5000명의 신생아 당 한명 꼴의 발생율을 가진 드문 질환이다. 그 중 신생아에서 열공탈장은 더욱 희귀한 질환이다. 저자는 생후 1주일된 신생아의 선천성 복합열공탈장을 경험하였다. 진단은 빠른 시간내 이루어졌으며 수술은 우측 흉곽절제술을 통해 탈장된 장기를 복원하고 Belsey-mark IV 술식을 시행하였다. 환아는 술후 3일째 음식을 먹었고 퇴원 6개월후 지금까지 별 문제없이 잘 지내고 있다.

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Thoracoscopic Repair of a Right-sided Congenital Diaphragmatic Hernia -A case report - (흉강경을 이용한 우측 선천성 횡격막 탈장 수술 -1예 보고-)

  • Jo, Tae-Jun;Lee, Jae-Woong;Lee, Weon-Yong;Hong, Ki-Woo;Ahn, Su-Min;Kim, Kun-Il
    • Journal of Chest Surgery
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    • v.40 no.2 s.271
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    • pp.155-158
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    • 2007
  • A congenital diaphragmatic hernia, which mainly occurs in the left thorax, requires an emergency operative procedure during the neonatal periods. A right-sided congenital diaphragmatic hernia is rare, and often detected after the neonatal period due to the mild symptoms. Traditionally, the treatment repairs the diaphragmatic defect via a thoracotomy. However, good results of thoracoscopic repairs have been reported. Herein, the case of a 5-month-old girl, who received a thoracoscopic repair of a right-sided congenital diaphragmatic hernia, is reported.

Repair of Morgagni Hernia through the Abdominal Approach - A case report - (복부접근법을 이용한 Morgagni Hernia의 교정 - 1예 보고 -)

  • Hwang, Jung-Joo;Kim, Do-Hyung;Lee, Yang-Deok;Kim, Kil-Dong
    • Journal of Chest Surgery
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    • v.40 no.10
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    • pp.722-725
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    • 2007
  • Morgagni's hernia constitutes about 3% of all the congenital diaphragm hernias. It is usually asymptomatic and it is frequently found coincidentally during routine diagnostic testing in adulthood. It is usually diagnosed by simple chest X-ray, but when this condition is without intestinal herniation, then chest CT or other modalities are necessary. Operative repair is desirable when there is the risk of strangulation of the intestine. The trans-thoracic or trans-abdominal approaches are possible to treat this malady. We report here on one case for which we successfully used a laparoscopic approach to treat this problem.

Diaphragmatic Hernia as a Complication of Pedicled Omentoplasty (유경 대망이식술의 합병증으로 발생한 횡격막탈장)

  • 윤찬식;정재일;김재욱;구본일;이홍섭
    • Journal of Chest Surgery
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    • v.34 no.12
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    • pp.968-971
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    • 2001
  • Pedicled omentoplasty is effective in thoracic surgery, but it is associated with several postoperative complications. A case of diaphragmatic hernia as a complication of pedicled omentoplasty in a 65-year-old male is reported. Because aortoesophageal fistula occurred three months after the patch aortoplasty for mycotic aneurysm of descending thoracic aorta, he underwent ascending thoracic aorta to abdominal aorta bypass surgery with resection of thoracic aortic aneurysm and esophagorrhaphy with wrapping of the esophageal suture line and the stumps of aorta with pedicled omental flap. Three years after the operation, herniation of the stomach developed. The pedicled omental flap was ligated and divided, and the diaphragm defect was repaired.

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Pleural Incarceration of the Transverse Colon after Transthoracic Esophagectomy - A case report - (개흉적 식도절제술 후 횡행결장의 흉강 내 탈장 - 1예 보고 -)

  • Jang, Hee-Jin;Lee, Hyun-Sung;Zo, Jae Ill
    • Journal of Chest Surgery
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    • v.42 no.1
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    • pp.115-118
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    • 2009
  • A 65 year-old man, who underwent transthoracic esophagectomy for mid-thoracic esophageal squamous cell carcinoma, suffered from an incarcerated herniation of the transverse colon through a defect in the left mediastinal pleura. The patient had a gas collection in the left lower lung field and this then insidiously progressed; the final result was total collapse of the left lung and hemodynamic compromise. The life-threatening herniation of the transverse colon into the pleural cavity after pervious esophagectomy was corrected by emergency laparotomy. Postoperative pulmonary complications after esophagectomy can induce potentially lethal transhiatal herniation because of the danger of intestinal obstruction or strangulation. The optimal approach to transhiatal herniation after esophagectomy is prevention.

Differentiation between Morgagni Hernia and Pleuropericardial Fat with Using CT Findings (CT 소견을 이용한 Morgagni 탈장과 심막주위지방의 감별)

  • Kim Sung-Jin;Cho Beum-Sang;Lee Seung-Young;Bae Il-Hun;Han Ki-Seok;Lee Ki-Man;Hong Jong-Myeon
    • Journal of Chest Surgery
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    • v.39 no.8 s.265
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    • pp.573-578
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    • 2006
  • Background: Generally hernia is diagnosed with simple chest or gastrointestinal x-ray. Sometimes CT or MRI can give lots of information for the diagnosis. However, there was no study for the differentiation with using CT findings between Morgagni hernia and pleuropericardial fat. The aim of this study was to evaluate the useful CT findings for differentiating Morgagni hernia from pleuropericardial fat. Material and Method: We retrospectively analyzed CT scans of eight patients with Morgagni hernia and 20 patients with abundant pleuropericardial fat without peridiaphragmatic lesions. All CT scans were performed with coverage of the whole diaphragm in the inspiration state. We evaluated 1) the presence of the defect of the anterior diaphragm, 2) the interface between the lung and fat, 3) the angle between the chest wall and fat, 4) the continuity between the extrapleural fat and fat, 5) the presence of the vessels within fat, and 6) the presence of a thin line surrounding fat. Result: In all cases with Morgagni hernia, the defect of the anterior diaphragm was seen. The interface was well-defined, smooth, and convex to the lung. The angle with the chest wall was acute. The continuity with the extrapleural fat was not seen. In the cases with abundant pleuropericardial fat, the defect of the anterior diaphragm was seen in three (15%). The interface was usually irregular (n=10) and flat (n=17). The angle with the chest wall was variable. The continuity with the extrapleural fat, that was markedly increased in amount, was usually seen (n=16). The thin line surrounding fat was seen in four cases with Morgagni hernia, however, not seen in all cases with pleuropericardial fat. All of the above findings were statistically significant, however, vessels within fat was not significant to differentiate Morgagni hernia (n=8/8) from pleuropericardial fat (n=14/20). Conclusion: The useful CT findings of Morgagni hernia were fatty mass with sharp margin, convexity toward lung, acute angle with chest wall, and thin line surrounding hernia. Branching structure within fatty mass representing omental vessels that has been known as a characteristic finding of Morgagni hernia was not useful for differentiating Morgagni hernia from pleuropericardial fat.