• Journal of Chest Surgery
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• 제29권7호
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• pp.785-788
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• 1996

간농양에 이은 급성 화농성 심낭염은 드문 질환이다. 급성화농성 심낭염은 적절한 치료가 이루어지지 않을 경우 사망율이 매우 높은 위 험한 질환이다. 환자는 32세 남자 환자로 발열, 오한, 상복부동통 및 호흡곤란을 주소로 응급실로 내원 하였다. 단순 흉부사진상 심비대의 소견을 보이고 있었으며, 복부초음파상 간좌엽에 종괴가 있었다. 심초음파상 임박 심장압진의 소견을 보이고 있었다. 응급으로 횡격막천공을 통해 간농양을 배농시켰고 심낭절개술을 시 행하였다. 심낭은 비후되어 두꺼워져 있었고 600m1의 악취가 나는 농액과 괴사조직들이 배액되었다. 섬유소응괴(abrinclot)가심근과유착이 있었다 조직학적 검사상심낭은급성 염증소견과 미세한 괴사 소견을 보이고 있었고, 균배양검사상 혈액과 배농액 에서 모두 Escherichia coli가 나왔다. 환자는 항생제 치료 받고 4주만에 퇴원 했고 심초음파상 약간의 교착성 심낭염의 소견을 보였다.

• Journal of Chest Surgery
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• 제14권3호
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• pp.268-273
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• 1981

• 한국임상수의학회지
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• 제32권5호
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• pp.433-435
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• 2015

12년령의 중성화한 암컷 골든레트리버가 3개월간의 호흡곤란과 기력저하를 주호소로 내원하였다. 심낭삼출물과 심장부위의 종괴가 심장초음파 상에서 확인되었다. 심낭절제술과 종괴 제거가 이루어졌으며 확진을 위해 조직검사를 수행하였다. 종괴는 현미경 검사 상에서 적혈구와 피브린, 호중구로 이루어진 혈종임이 확인되었다. 염증세포와 반응성 섬유 조직에 의해 두꺼워진 중증의 화농성 심낭염 소견이 확인되었으며, 종양 소견은 관찰되지 않았다. 이 증례는 수의학에서 개의 심장혈종에 의한 심낭삼출물 발생의 최초 보고이다.

• Journal of Chest Surgery
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• 제17권2호
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• pp.263-268
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• 1984

Four patients of acute purulent pericarditis were seen at the Jeonbug National University Hospital between January, 1979 and December 1983. All patients were proven to have acute purulent pericarditis by clinical evaluation, bacterial study, and biopsy. Three patients were male and one female. The three patients were in pediatric age. The primary focuses were meningitis, Rt. coxitis, lobar pneumonia, and gastro-enteritis. The causative organisms were staphylococcus aureus in two patients. In the other two patients, organisms were not cultured from the pericardial pus. The reason why the causative organisms were not cultured in pericardial pus was probably due to massive antimicrobial treatment before pus collection. All patients were treated with systemic antibiotic therapy and pericardiostomy with normal saline irrigation. The three patients were treated without specific complication. The one patient developed the chronic constrictive pericarditis. In this patient, pericardiectomy was performed.

• Journal of Chest Surgery
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• 제7권1호
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• pp.79-84
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• 1974

Acute suppurative pericarditis is recognized as a rare disease since development of antibiotics but therapeutically as an important one. To our knowledge, acute suppurative pericarditis alone has not been reported previously in Korea. In this paper, we report 5 cases of acute suppurative pericarditis which were experienced during the period between January 1959 and December 1973. The patients ranged in age from 9 months to 59 years at the time of admission. Four of 5 patients were male and one female. Acute suppurative pericarditis is usually associated with pneumonia, empyema, sepsis, osteoarthritis, lung abscess, cholecystitis or tonsillitis. In our series, pneumonia was the most common associated disease. One patient had osteoarthritis. Pleural effusions were observed in three of the 5 patients. Staphylococcus aureus was cultured from pericardial fluid in 4 patients and also cultured from both pericardial and synovial fluid in one. Three of the 5 patients had cardiac tamponade and one patient required prompt pericardiocentesis. 3 of the 5 patients were treated with antibiotics and pericardiostomy, one with antibiotics and pericardiocentesis, and one with antibiotics and saline irrigation through drainage sinus from the pericardial sac. Four of the five patients were recovered without pericardial constriction. One was discharged with poor condition. In this instance, follow-up study couldn`t be made.

• Journal of Chest Surgery
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• 제37권3호
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• pp.272-274
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• 2004

드문 예인 좌심방이-농양을 수술, 항생제 및 종격동 세척술로 치료한 성공적인 치험 예를 보고하고자한다. 요로감염의 과거력을 가진 9세 여아가 지속적 발열을 주소로 내원하였다. 심초음파와 자기공명 영상에서 다량의 심낭삼출과 좌상심연의 종괴가 관찰되었다. 심낭천자액 균배양에서 포도상구균이 검출되었다. 환아는 체외순환하에 종괴 절제술을 받았는데 종괴는 좌심방이에 위치하였으며 내부는 섬유화농성 농양이 형성되어 있었다. 수술 후 종격동 세척술을 시행하였다. 병리검사소견은 기질화된 혈전을 동반한 섬유화성 벽심내막염이었다. 환아는 특별한 합병증 없이 술 후 21일에 퇴원하였다.

• Journal of Chest Surgery
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• 제17권2호
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• pp.257-262
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• 1984

Acute purulent pericarditis, though not common in incidence after introduction of antibiotics, is still potentially life treating isease. Since 1971, we have experienced 14 cases of acute purulent pericarditis with successful treatment. Among these 14 cases, 9 cases were male and they had high occurrence on their third to fifth decades in age distribution. Isolation of causative organisms were obtained in 11 cases through the bacterial culture of infectious source which was mainly pericardial effusion or blood, and the most frequently recovered organism was the staphylococcus aureus. Pre-existing inflammatory disease preceding to pericarditis, named as antecedent disease, were proved in 12 cases, and among which contiguous extension from the intrathoracic infection such as pneumonia or empyema accounted for the majority of antecedent disease. Pericardiocentesis with administration of antibiotics were tried in all cases, but result in recovery in 1 patient only. Remaining 13 cases had persistent picture of pericarditis and necessitated surgical drainage procedure. Ten of these 13 cases were underwent the open pericardial window using a mode of anterior approach in 4 and subxiphoid approach in 6 cases respectively. Two cases of subxiphoid group were reoperated by the anterior interphrenic pericardiectomy, due to insufficient drain of too thick effusion. In remaining 3 cases, anterior interphrenic pericardiectomy was performed initially because of purulent effusion already changed into fibrinopurulent peel with thickened pericardium. Through the experience of this series, we recommended that pericardiectomy should not be reluctant in purulent pericarditis as a initial surgical procedure for advantage of complete removal of infected space and avoidance of late constrictive pericarditis.