• Title/Summary/Keyword: 종격동질환

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Video-assisted Thoracoscopic Surgery for Mediastinal Lesions (종격동 질환의 비디오 흉강경 수술)

  • 김연수;김광택;손호성;김일현;이인성;김형묵;김학제
    • Journal of Chest Surgery
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    • v.31 no.1
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    • pp.40-45
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    • 1998
  • Recently, video-assisted thoracoscopic surgery for mediastinal lesions has been considered a new effective therapeutic method. From March, 1992 to April, 1997, 33 cases of video assisted thoracoscopic surgery for mediastinal lesions were performed. Gender distribution was 16 males and 17 females. Average age was 42 years old(ranged from 14 to 69). The locations of lesions were anterior mediastinum in 14 cases, middle mediastinum in 5 cases, posterior mediastinum in 11 cases, and superior mediastinum in 3 cases. These included 9 neurilemmomas, 5 benign cystic teratoma, 4 pericardial cysts, 2 ganglioneuroma, 2 thymus, 2 thymic cyst, 1 thymoma, 2 esophageal leiomyomas, 1 dermoid cyst, 1 lipoma, 1 malignant lymphoma, 1 bronchogenic cyst, 1 pericardial effusion, and 1 Boerhaave's disease with empyema. Working window was needed in 6 cases. We converted to open thoracotomy in 6 cases. Reasons of convertion to open thoracotomy were large sized mass(1), severe adhesion(3), and difficult location to approach(2). The average operation time was 116min($\pm$56 min). The average chest tube drainage time was 4.7days. The average hospital stay was 8.7 days. Operative complications were atelectasis(2), empyema with mediastinitis(1), recurrent laryngeal nerve palsy(1), and plenic nerve palsy(1). In conclusion, VATS for mediastinal lesions were performed with shorter operation time and hospital stay, and lesser complications and pain than those of conventional thoracotomy.

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A Case of Spontaneous Pneumomediastinum without Direct Cause

  • Lee, Sam-Beom;Kim, Jung-Ho;Do, Byung-Soo
    • Journal of Yeungnam Medical Science
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    • v.20 no.2
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    • pp.212-216
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    • 2003
  • 자연성 종격동 기종은 젊은 연령에서 주로 직접적인 이유가 없이 발생되는 흔치 않은 질환으로 응급실에서 급성 흉통의 원인으로 감별해야할 질환중의 하나이다. 간혹 응급상황이 발생하여 응급 처치를 받을 수 있다고 하지만 대부분에서 보존적인 치료로 호전이 되는 양호한 질환이기도 하다. 저자들은 15세 남자에게 특별한 유발 요인이 없이 발생하였고 입원치료 없이 응급의료 센터에서 바로 퇴원한 자연성 종격동 기종 1례를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

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Idiopathic Mediastinal Fibrosis (2 case) (특발성 종격동 섬유증 2례에 대한 보고)

  • Jung, Jae-Seung;Lee, Sung-Ho;Son, Ho-Sung;Cho, Seong-Joon;Sun, Kyung;Kim, Kwang-Taik;Jung, Woon-Young;Kim, Han-Kyeom;Kim, Hyoung-Mook
    • Journal of Chest Surgery
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    • v.36 no.2
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    • pp.113-117
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    • 2003
  • Idiopathic mediastinal fibrosis is very rare. We report two cases of a 41-year-old man and 65-year-old man who presented with backache and vocal cord palsy, subsequently confirmed to be idiopathic mediastinal fibrosis. Preoperative chest computed tomography showed a mediastinal mass and thoracoscopic biopsy was preformed. The mass was hard, dense and partially calcified, and adhered the adjacent mediastinal structure. Postoperative medical treatment was not performed, and during 5 and 7 month follow-up has not demonstrated any complication.

Treatment of Esophageal Stenosis by Idiopathic Mediastinal Fibrosis - A case Report - (특발성 종격동 섬유화에 의한 식도협착의 치료 - 1례 보고 -)

  • 박기성;박창권;유영선;이광숙;최세영;김재범;이재훈;권건영;금동윤
    • Journal of Chest Surgery
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    • v.34 no.11
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    • pp.883-886
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    • 2001
  • Mediastinal fibrosis is uncommon but may result in entrapment and erosion of vital mediastinal structures by fibrous tissues. Idiopathic mediastinal fibrosis involved esophagus is very rare, and only a few cases have ever been reported. Such idiopathic mediastinal fibrosis involved esophagus is an enigmatic inflammatory fibrous tissue proliferation, but the treatment has not yet been clearly defined. We had successfully treated in such a case with partial esophagolysis and esophagomyotomy.

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Spontaneous Pneumomediastinum: Clinical Investigation (자연성 종격동 기종의 임상적 고찰)

  • Park Jae Hong;Chei Chang Seck;Hwang Sang Won;Kim Han Yong;Yoo Byung Ha;Kim Dae Hwan
    • Journal of Chest Surgery
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    • v.39 no.3 s.260
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    • pp.220-225
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    • 2006
  • Background: Spontaneous pneumomediastinum is an uncommon, benign, self-limited disorders that usually occurs in young adults without any apparent precipitating factors or disease. The purpose of this study was to review our experience in dealing with this entity and describe a reasonable course of assessment and management. Material and Method: A retrospective case series was conducted to identify adults patients with SPM who were diagnosed and treated in a single institution between 2001 and 2005. Result: Fifteen patients were identified who included 14 men and 1 women with a mean age of 26 years. Presenting symptoms were chest pain in 12 patients ($80\%$), dyspnea in 5 patients ($33\%$), and throat discomfort in 4 patients ($26\%$). Two cases were associated with use of inhalational drugs and 3 cases were associated with exercise. The predisposing factors were asthma, excessive exercise, and vomiting in spontaneous pneumomediastinum. The physical findings were subcutaneous emphysema in 10 patients ($77\%$). Chest radiography and computerized tomography were the diagnostic methods in all cases with CT scan revealing six cases with associated pulmonary abnormalities. Esophagogram and flexible bronchoscopy were selectively used. Fifteen patients ($100\%$) were admitted to the hospital. Their mean hospital stay was 3 days. All patients were conservatively treated. In a follow-up of 3 years no complications or recurrences were observed. Conclusion: Most simple spontaneous pneumomediastinum cases were benign diseases and most of them ($77\%$) had shown typical chest pain, dyspnea and subcutaneous emphysema. Inhalational drug use was not a major cause of SPM; however, increased use of bronchoinhalers was a suspicious cause of SPM.

Spontaneous Pneumomediastinum: Clinical Experience of 24 Patients in Two Medical Center (자연성 종격동 기종: 두 병원에서의 임상 경험 24예)

  • Moon, Hyeon-Jong
    • Journal of Chest Surgery
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    • v.43 no.6
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    • pp.663-668
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    • 2010
  • Background: Spontaneous pneumomediastinum is an uncommon disorder with few cases reported. It usually occurs in young males and has benign self-limiting course without any apparent concomitant factor. It is seen after intrathoracic pressure changes leading to alveolar rupture. The clinical experiences of two medical centers were reviewed to aid in optimal management. Material and Method: Retrospective review between March 2003 and August 2010 with spontaneous pneumomediastinum patients was performed. Result: 24 patients were identified with a diagnosis of spontaneous pneumomediastinum. These 24 patients were comprised of 18 men and 6 women with mean age 18.9 years (range 10 ~ 33). The major initial complaints were chest pain (79.2%), throat pain (62.5%), and subcutaneous emphysema (41.7%). The triggering events were exercise (16.7%), coughing (12.5%) and vomiting (12.5%). No apparent triggering event was noted in 54.2% of patients. In all cases, chest radiograph and computed tomography was done. Diagnostic computed tomography was required in 25%. White blood cell counts and C-reactive protein (CRP) were checked, and their initial mean values were $9,790{\pm}3,240/{\mu}L$ Land $1.31{\pm}1.71mg/dL$, final mean values were $5,440{\pm}1,665/{\mu}L$ Land $0.72{\pm}0.73mg/dL$, respectively. 23 patients were admitted (average $5.0{\pm}1.8$) and the symptoms were self-limiting in all cases without complications. Conclusion: Spontaneous pneumomediastinum is a benign condition with mild inflammatory signs that often presents with chest or throat pain. Secondary causes must be ruled out to avoid an unfavorable outcome with less invasive study. Because of very rare complications and recurrence, outpatient basis and shortened hospitalization may be feasible.

Mediastinal Heterotopic Thyroid Tissue - A case report - (종격동 이소성 갑상선조직 - 1예 보고 -)

  • Lee, Seock-Yeol;Han, Jung-Wook;Lee, Seung-Jin;Lee, Chol-Sae
    • Journal of Chest Surgery
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    • v.42 no.4
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    • pp.537-539
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    • 2009
  • A 47-year old woman was admitted to our hospital for removal of a known mass that was located on the suprasternal notch; specifically, the mass was located on the supero-anterior mediastinuum. The mass was removed by a cervical incision and the histopathologic diagnosis of the resected specimen was hererotopic thyroid tissue with nodular hyperplasia. Mediastinal hererotopic thyroid tissue is a rare malady, so we report here diastinal hererotopic thyroid tissue and we review the relevant medical literature.

Venous Hemangioma Mimicking Mediastinal Solid Mass -A case report- (종격동 고형체로 오인된 정맥혈관종 - 1예 보고 -)

  • Park, Sang-Jun;Cho, Sung-Woo;Lee, Hee-Sung
    • Journal of Chest Surgery
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    • v.43 no.2
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    • pp.208-211
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    • 2010
  • An occurrence of hemangioma in the mediastinum is a very rare, accounting for less than 0.5% of mediastinal tumors. Capillary hemangiomas and cavernous hemangiomas consists of over 90% of mediastinal hemangiomas. However, venous hemangioma has never been reported in South Korea and has also very rarely been reported worldwide. We found mediastinal solid mass, as an incidental finding during a follow-up chest CT scan of a 44-year-old female patient who had undergone colon cancer surgery. We performed a mediastinoscopic biopsy. We did a thoracotomy to remove this mass because hemorrhage and found a totally resected venous hemangioma.