• Journal of Chest Surgery
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• 제56권2호
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• pp.140-142
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• 2023

The azygos vein sometimes merges abnormally across the right upper lobe of the lung and it hangs at the lower edge of a membranous septum, called the meso-azygos. The septum invaginates the lobe and makes a fissure. The smaller medial part of the right upper lobe is called an azygos lobe. A 16-year-old male patient was diagnosed with right-sided pneumothorax, and a closed thoracostomy was done in the emergency room. During elective wedge resection including the bulla, the meso-azygos, abnormal azygos vein, and azygos lobe were detected. We reviewed the computed tomography images and found that the azygos lobe had re-expanded laterally, not medially, to the meso-azygos after the closed thoracostomy in the emergency room. The patient had been diagnosed with left-sided pneumothorax a year ago, and no one noticed the azygos lobe at that time. We report the intraoperative findings and comparative images of a migratory azygos lobe.

• Journal of Chest Surgery
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• 제23권4호
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• pp.698-706
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• 1990

Congenital Cystic Lung Disease is a spectrum of closed related anomalies that arise during an early stage of embryonic lung bud maturation-namely bronchogenic cyst, congenital lobar emphysema, pulmonary sequestration and congenital cystic adenomatoid malformation. And they show similar surgical strategies. So they are called as the term bronchopulmonary-foregut malformations, firstly proposed by Gerle[1968]. From Aug. 1979 to Aug 1989, 47 patients were operated upon on Dept. of Thoracic & Cardiovascular Surgery at the CUMC. There were 21 females and 26 males ranging in age from age of 21 day to age of 56 year [15 cases under 15 years old]. 30 patients had bronchogenic cysts - 23 of intrapulmonary type, 7 of mediastinal type in location. Affected lobes and locations were as follows: 11 in upper lobe, 3 in middle lobe, 11 in lower lobe and anterosuperior, middle, and posterior mediastinal type were 3, 2, 2 respectively. There were 9 pulmonary sequestrations[all intralobar type] with the distribution of 5 in right lower lobe and 4 in left lower lobe. And associated anomalies were presented with arterial supply originating from thoracic aorta[8 cases], abdominal aorta[1 case] and with venous drainage into azygos vein[1 case]. They all were operated upon lower lobectomy [8 case], pneumonectomy[1 case] in case of pulmonary hypoplasia Congenital lobar emphysema and congenital cystic adenomatoid malformation had 4 cases respectively. Their affected lobes were as follows: the former were 3 in upper lobes, 1 in middle lobe and the latter were 3 in upper lobe, 1 in lower lobe. They were treated with lobectomy and segmentectomy. Diagnosis was aided by chest X - ray, bronchography, aortography, DSA and CT scan, They all were confirmed by pathologic exams. There were no hospital death but few minor morbidities such as, atelectasis-pneumonia[2], wound infection[2], prolonged chest tube placement[2]. We experienced surgical treatments of 47 cases for 10 years and reported them with literature review.

• Journal of Chest Surgery
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• 제6권2호
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• pp.159-164
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• 1973

Bronchopulmonary sequestration is a congenital malformation characterized by a cystic portion of the lung that derives its arterial blood supply through anomalous aberrant vessel directly of the systemic circulation. An aberrant systemic vessel supplying the lung was reported by Huber in 1777. Although this lesion is uncommon disorder, there are several reports on operative death caused by exanguinating hemorrhage from the aberrant arteries to the bronchopulmonary sequestration to that it has received a great deal of attention. Two type of bronchopulmonary sequestration have been identified: Intralobar pulmonary sequestration is usually contained within the visceral pleura of a pulmonary lobe and its venous drainage to the pulmonary venous system. Extrapulmonary sequestration is usually within the pleural sheath its own and its vasculature drains into the azygos or hemiazygos system. we presented one case of intralobar pulmonary sequestration which led to motor paralysis, chylothorax and hemorrhage that are consequent on postoperative complication.

• Journal of Korean Neurosurgical Society
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• 제50권3호
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• pp.248-251
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• 2011

Intracranial pial arteriovenous fistulas (AVFs) are rare vascular lesions of the brain. These lesions consist of one or more arterial connection to a single venous channel without true intervening nidus. A 24-year-old woman visited to our hospital because of headache, vomiting, dizziness and memory disturbance that persisted for three days. She complained several times of drop attack because of sudden weakness on both leg. Cerebral angiograms demonstrated a giant venous aneurysm on right frontal lobe beyond the genu of corpus callosum, multiple varices on both frontal lobes fed by azygos anterior cerebral artery, and markedly dilated draining vein into superior sagittal sinus, suggesting single channel pial AVF with multiple varices. Transarterial coil embolization of giant aneurysm and fistulous portion resulted in complete disappearance of pial AVF without complication.

• Journal of Chest Surgery
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• 제22권2호
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• pp.308-314
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• 1989

Pulmonary sequestration is a congenital malformation characterized by an area of embryonic lung tissue that derives its blood supply from an anomalous systemic artery. Two forms recognized: extralobar and intralobar. Extralobar form is a very rare congenital malformation, usually located in the lower chest, and may be found in newborn infants at the time a congenital diaphragmatic hernia is repaired. Large sequestrated segments may be cause acute respiratory distress in the neonate. The condition is asymptomatic in 15 per cent of patients. This report presents two cases of pulmonary sequestration which misdiagnosed a superior mediastinal tumor and a benign lung tumor. First case was 30-year-old male patient and chief complaints were dyspnea, dry cough and right chest pain. Chest X-ray showed a homogenous increased density of smooth margin at the right superior mediastinal area and suggested a benign mediastinal tumor. And so explothoracotomy was made without other special studies. Second case was 28-year-old male patient. One month ago, he had tracheostomy and right closed thoracostomy due to massive hemoptysis and spontaneous hemothorax. Chest X-ray showed a benign cystic lesion at RLL area. At the time of operation, in first case, a mass of adult fist size was placed medial to the right upper lobe and densely adhesive to trachea, SVC and esophagus. Blood supply of the mass was bronchial arteries of trachea and RUL bronchus and drained to SVC and azygos vein through anomalous systemic veins. There was no bronchial communication on Frozen biopsy. In 2nd case, large cystic lesion contained old blood hematoma was located in RLL and anomalous blood vessel from thoracic aorta was drained to posterior segment of RLL. In operation field, intralobar pulmonary sequestration was diagnosed, and RLL lobectomy was carried out.

• Journal of Chest Surgery
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• 제29권2호
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• pp.223-226
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• 1996

선천성 낭종양 선종양 기형과 외엽형 폐격리증은 각각드문 질환으로 이 두가지 질환이 퐁반되는 경우는 매우 드물다 본원에서는 출생 후 호흡시 흥벽 함몰과 빈호흡을 보인 생후 3주된 남아에서 컴퓨터 단층촬영을 통해 우폐하엽의 선천성 낭종성 선종양기형을의심하여 개흥술을시행하였다. 수술소견상 우폐하엽의 낭종성 병변 이외에 독립된 늑막에 둘러싸인채 비정상적인 혈류 공급을 받고 있는 종괴를 발견하여 하행 흉부 대동맥으로 부터 공급되는 2개의 동맥 가지와기정맥으로 유입되는 정맥분지를 결찰한 후 우하엽절제술과 더불어 격리폐를 절제하였다. 병리검사로 상기 두질환의 동반례로확진 하였고 환자는 건강한 모습으로 퇴원할 수 있었다.