• Tuberculosis and Respiratory Diseases
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• v.38 no.4
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• pp.347-356
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• 1991

Endobronchial tuberculosis is a serious disase because it frequently leaves airway obstruction as the complication, and the treatment of airway obstruction is generally troublesome. In the tumorous type of endobonchial tuberculosis, the bronchial patency is partially or completely compromised with lymph node contents when the necrotic focus of the lymph node ruptures into the bronchial lumen to form a bronchoglandular fistula. To investigate the transition of endobronchial lesion and to evaluate the therapeutic role of bronchoscopic electrocautery in the tumorous type of endobronchial tuberculosis, we performed electrocautery in addition to the combination chemotherapy with steroid and anti-tuberculous drugs in two cases which had airway obstruction proximal to lobar bronchus with the impairment of pulmonary function. We also treated another two cases only with chemotherapy and we have followed up four cases over a 36-month period. In cases that bronchoscopic electrocautery was done, the bronchial patency was completely restored and the impairment of pulmonary function disappeared just after cautery and these effects have remained for 12 months or more. But in cases of medical treatment only, bronchial stenosis was inevitable as the tumorous type of endobronchial tuberculosis changed to the stenotic type with fibrosis. It can be concluded that bronchoscopic electrocautery can nip the occurence of bronchial stenosis in the bud when it is applied in addition to combination chemotherapy with steroid and antituberculous drugs in the tumorous type of endobronchial tuberculosis.

• Journal of Chest Surgery
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• v.23 no.2
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• pp.416-420
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• 1990

The strictured esophagus is not removed usually in corrosive injury. But corrosion carcinoma and the late complications such as esophago-bronchial fistula, chronic mediastinal abscess, diverticulum can occur in case that strictured & inflamed esophagus be remained. Recently transhiatal esophagectomy is being done with low mortality and morbidity. So we are reporting 2 cases of esophageal stricture in young patients which were treated with transhiatal esophagectomy and esophagocologastrostomy. All of 2 cases were successfully treated and recovered. Postoperative esophageal function tests showed the mild reflux but it did not count clinically.

• Journal of Chest Surgery
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• v.22 no.2
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• pp.342-347
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• 1989

A 4-year-old male developed the esophageal perforation after air-gun shut injury in the thorax. The esophageal perforation was found on esophagogram at the next day after the accident. Because of delayed diagnosis, mediastinitis and pyopneumothorax were developed. The general conditions of the patient were very critical with sepsis on admission. Therefore, two staged operation was planned. At the first stage, exclusion and diversion of the esophagus was carried out to treat chemical pneumonitis due to gastric contents through the esophago-bronchial fistula by gastroesophageal reflux. Clinical conditions of the patient were improved after the first stage operation. At the second stage, the esophageal reconstruction with right colon was performed.

• Journal of Chest Surgery
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• v.36 no.9
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• pp.674-677
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• 2003

Staple closure of bronchial stump was compared with manual suture closure among 100 cases of pneumonectomy during the recent 5-year period, We have reviewed the incidence of bronchpleural fistula between autosutured group and manual sutured group. Material and Method: During the recent 5-year period, 100 patients underwent pneumonectomy at Hanyang University Hospital. Staple closure of bronchial stump was performed in 65 patients and manual suture in 35 patients. There were 55 males and 10 females in the autosutured group, and 26 males and 9 females in manual sutured group, which showed no significant statistical difference between the two groups. The mean ages of patients for autosutured group and manual sutured group were 56.7$\pm$10.3 years and 61.4$\pm$9.2 years, respectively, which showed no significant statistical difference between the two groups. There were 38 cases of left pneumonectomy and 27 cases of right pneumonectomy in autosutured group, and 22 cases of left pneumonectomy and 13 cases of right pneumonectomy in manual sutured group. There were 53 cases of malignancy and 12 cases of benign imflammatory disease in autosutured group, and 27 cases of malignancy and 7 cases of benign imflammatory disease in manual sutured group. Result: The incidence of bronchopleural fistula was 6.1％ in autosutured group and 5.7％ in manual sutured group. The incidence of other postoperative complication between the two groups showed no significant statistical difference. Conclusion: The incidence of bronchopleural fistula between autosutured group and manual sutured group was not different stastically. Both method for closure of bronchial stump can be performed in pneumonectomy.

• Tuberculosis and Respiratory Diseases
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• v.46 no.1
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• pp.136-141
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• 1999

Broncholith is a calcified lymph node which partially or completely erodes into the bronchial lumen and broncholithiasis is a relatively rare condition which related to late tissue response to healing granulomatous pulmonary infections, most commonly histoplasmosis or tuberculosis. The prominent symptoms of broncholithiasis are coughing followed by hemoptysis and symptoms related to bronchial obstruction. The complications include bronchoesophageal fistula and aortotracheal fistula. We report one case of broncholithiasis caused by Aspergillus. The case was a 53 year-old house wife whose chief complaints were recurrent fever, chill and malaise. The chest film revealed an avoid hazziness on the right middle lobe and chest cr scan showed consolidation of lateral segment of right middle lobe with calcified small low attenuated lesion in right middle lobe bronchus. Aspergillosis confirmed by pathology after bronchoscopic removal of impacted Aspergillus containing muddy plug from lateral segmental branch of right middle lobe bronchus.

• Journal of Chest Surgery
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• v.2 no.2
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• pp.147-154
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• 1969

This is a report on a total of 11 cases of esophageal perforation in the department of thoracic surgery, Chonnam University Hospital during the period of 8 years from 1962 to 1969. They occurred by the following agents, that is,lye solution[7 cases], fish bone[2 cases]. compress air [one case], strong acid [one case]. The perforated portions of esophagus were cervical esophagus in 2 cases, upper third of esophagus in 5 cases, middle third of esophagus in 3 cases and lower third of esophagus [abdominal esophagus] in one case. 4 cases out of cases of esophageal perforation after ingestion of Lye solution were due to Bougination to improve esophageal stenosis: 2 cases occurred 2 months after ingestion of Lye solution and the remaining 2 cases, 2 to 3 weeks after Lye solution ingestion. Therefore, It is realized that Bougination for esephageal stricture by Lye solution is particularly dangerous. The complication after esophageal perforation were mediastinitis,[10 cases], right pyothorax with mediastinitis [8 cases], peritonitis [4 cases], esophago-bronchial fistula[one case]. Owing to the various complications above mentioned, surgical approach to esophageal perforation is accordingly complicated and a combination of more than two of the following different procedures were properly used case by case, that is. gastrostomy or jejunostomy for feeding and esophageal rest,thoracotomy and chest drainage, lung decortication for pyothorax, primary closure of compress air perforation and esophago-bronchial fistula, mediastinostomy, retrosternal esophagoplasty using right colon to Lye stricture etc. 5 cases[45. 5%] of 11 cases were expired and the rest of 6 cases[54.5%]were survived with complete accomplishment of surgical procedures and satisfactory healing in 4 cases and interruption of follow up in 2 cases because of poor economical condition of the patients.

• Tuberculosis and Respiratory Diseases
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• v.69 no.2
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• pp.119-123
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• 2010

Bronchobiliary fistula is a rare disorder consisting of an abnormal communication between the bronchial tree and the biliary duct. In Western countries, trauma, postoperative biliary stenosis, and biliary lithiasis are the predominant causative factors of bronchobiliary fistula. Bilioptysis (bile stained sputum) is a pathognomic finding for bronchobiliary fistula. To date, there are just a few reported cases of bronchobiliary fistula after sclerosis of a liver cyst. We describe the case of a 74-year-old woman who developed bronchobiliary fistula after sclerosing therapy of a liver cyst. The diagnosis was confirmed by the presence of bilioptysis and the chest and dynamic liver CT findings. The patient was successfully treated with antibiotics and percutaneous transhepatic catheter drainage.

• Journal of Chest Surgery
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• v.21 no.3
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• pp.594-600
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• 1988

We had been experienced 6 cases of congenital esophagobronchial fistula which underwent surgical intervention in all cases. Of the 6 patients, 5 patients were male, one patient was female. The mean age of patients was 37.8 years old and clinical symptom free period was 27.1 years. According to Braimbridge`s classification, they were belonged to the type II[3 cases], type III[2 cases], <% type I[1 case]. Pre-operative diagnosis was available in 4 cases and the 2 cases could be diagnosed at operation field. The fistulectomy were performed in all cases, concomitant segmental resection[1 case], lobectomy[1 case], bi-lobectomy[1 case], and pneumonectomy[3 cases] were combined.

• Tuberculosis and Respiratory Diseases
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• v.62 no.6
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• pp.531-535
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• 2007

The esophagus is a rate site for rarely involved site of tuberculosis. The most common cause of esophageal tuberculosis is secondary involvement from adjacent tuberculous lymphadenitis. Esophago-nodal or esophagobronchial fistulas may be formed when tuberculous lymph nodes erode the adjacent esophageal or bronchial wall. We report a patient diagnosed with esophageal tuberculosis, which was complicated by an esophago-mediastinal fistula, by endoscopy, sputum acid fast bacilli (AFB) stain, chest computed tomography (CT), and an esophagogram. The patient was treated with antituberculous agents and chest CT and endoscopy showed that the fistula had closed completely.

• Journal of Chest Surgery
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• v.22 no.2
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• pp.272-289
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• 1989

Benign lung tumors compose a heterogeneous group of solid growths that present variations in clinical features, depending on whether the origin is within the bronchus on lung parenchyma or from visceral pleura. Benign tumors of the lung are relatively uncommon, and series are to be found in the literature and the classification of benign tumors of the lung continues to be controversial because of disagreement concerning the origin and prognosis of many common lesions. We adopt Liebows original classification but excluded bronchial adenoma which no longer considered as benign tumor and added pulmonary A-V fistula and congenital cystic adenomatoid malformation. We analyzed 61 cases of benign tumors which were composed of 16 original Korean cases and 45 cases which were reported on journal of Thoracic & Cardiovascular Surgery. The results were. [1] Incidence; Of 61 cases, chondromatous hamartoma was 2 cases [41 %], congenital cystic adenomatoid malformation 10 cases [16.4 %], pulmonary A-V fistula 5 cases [8.1 %], sclerosing hemangioma 4 cases [6.5 %], teratoma, plasma cell granuloma & mesothelioma were 3 cases [4.9%], Castlemans disease 2 cases [3.3%], and mucous gland adenoma, paraganglioma, and leiomyoma 1 case [1.6 %]. [2] Age & Sex distribution; Male 30 cases and female 31 cases. Mean age was 31.4 years old. [3] Main symptom; was coughing, 32.8%, and no symptom, 24.6%. [4] Sixty eight percentage of chest film showed mass density, and 4 cases showed calcification, 2 cases had lobulation. [5] Size of mass was large and multiple mass was 2 cases. Endobronchial tumors were 9 cases, 14.9 %. [6] Three cases of endobronchial tumor were preoperatively diagnosed by bronchoscopy and 2 cases of pulmonary A-V fistula were diagnosed by pulmonary arteriography. [7] Seven cases, 11.5%, had associating diseases such as bronchogenic cyst, thymic cyst, Schwannoma, situs inversus, bronchiectasis and bronchogenic carcinoma. [8] Minor resection such as excision 8i: wedge resection were 15 cases, 26.2 %, and 6 cases, 75.4 %, of lobectomy were performed including 5 cases of pneumonectomy 5 cases had. [9] Postoperative complications; One case, 1.6 %, expired due to respiratory insufficiency. Two cases had re-operation due to bleeding and hemoptysis.