• Title/Summary/Keyword: Closed thoracostomy

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T-cell Non-Hodgkin`s Lymphoma originating in the wall of Chronic Tuberculous Empyema - One Case Report - (결핵성 만성 농흉벽에 원발한 T 세포형 악성 임피종;1례 보고)

  • 송우철
    • Journal of Chest Surgery
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    • v.25 no.10
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    • pp.1102-1106
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    • 1992
  • A 66-year-old male patient was admitted due to chest pain and dyspnea of 1 year duration, He had history of treatment for tuberculosis and pleurisy, about 40 years ago. At another hospital the patient underwnt closed thoracostomy drainage for six months, and thereafter the symptom gradually aggrevated. Under the diagnosis of chronic tuberculous empyema, decortication was performed. The peel attached to the posterolateral aspect of chest wall, there was an area of soft tissues with pale-brown discoloration, extending to intercostal muscles, but sparing overlying muscles. The biopsy specimen of the lesion was pathologically diagnosed as diffuse, large T-cell non-Hodgkin`s lymphoma. A review of the literature showed that malignant lymphoma of this type have been reported exclusively from Japan but never from other countries including Korea. After 1 year of followup period, the patient is well and stable.

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Modified Eloesser's Operation and Its Result In Chronic Empuema with Poor General Condition or Chachecic State (만성 농흉에 대한 Modified Eloesser's Operation 과 그 의의)

  • 최종범
    • Journal of Chest Surgery
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    • v.12 no.2
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    • pp.82-88
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    • 1979
  • During the past 3 years, 15 patients who could not be anesthetized generally because of poor general condition or cachecic state, of 111 patients with empyema, have been treated with modified Eloesser`s operation under the local anesthesia with 2% procaine. There were 13 males and 2 females ranging from 21 years to 61 years of age. The etiology was tuberculosis [6 cases], pyogenic pneumonia [5 cases], lung abscess [1 case], post-trauma [2 cases] and malignancy[1 case]. " The over-all mortality rate was 6.7%[1 case] and cause of its death was poor oral feeding because of post-traumatic psychosis. Modified Eloesser`s operation was performed after closed tube thoracostomy and irrigation with 1% zephanon solution for over 2 weeks. And then the other operation was not performed and all patients except 1 case appeared good progression (Complete healing; 4 cases, Progressive healing 10 cases, death: 1 case).

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A Clinical Study for the Empyema (114 cases) (농흉의 임상적 고찰 (114례))

  • 이동준
    • Journal of Chest Surgery
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    • v.7 no.1
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    • pp.47-60
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    • 1974
  • During the past 10 years 114 patients with empyema have been treated in hospital of Chonnam University. There were 87 males and 27 females ranging from 20 days to 70 years of age. The etiology was pyogenic pneumonia in 36.7%, tuberculosis in 22.7%, paragonimiasis in 8.8%, post-thoracotomy in 5.4%, post-trauma in 4.4%, lung abscess in 3.5%, malignancy in 3.5%, post-esophageal operation in 1.8%, and sterile in 10.5%. The over-all mortality rate was 2% [3 patients]. The majority of deaths occurred in patients with associated systemic illness [liver cirrhosis in I, and renal tuberculosis in I] and resistant tuberculosis for anti-tuberculosis drugs in one patient. Adequate drainage and obliteration of the pleural space continues to be the most important aspect of treatment and can frequently be achieved by closed chest tube thoracostomy in acute empyema especially in children. The more chronic thick-walled or loculated cavities require open drainage [open window therapy], decortication, thoracoplasty, sterilization, and myoplasty for closure of tracheobronchial fistula.

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A Clinical Study of Thoracic Injuries: 190 Cases (흉부손상의 임상적 고찰: 190예)

  • 이지원
    • Journal of Chest Surgery
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    • v.14 no.2
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    • pp.123-126
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    • 1981
  • 190 cases of the thoracic injuries experienced at the department of chest surgery, Chungnam National University Hospital, for 5 years from Jan. 1976 till Dec 1980, were analysed. The results are as follows; 1. The incidence rate of male to female was 5.1:1. The common age groups were 3rd, 4th and 5th decades, and the most common age group in the penetrating injury was 3rd decade. 2. The most common mode of the nonpenetrating injuries was a traffic accident [63.0%], and the most commonly used tool in the penetrating injuries is a knife [66.7%]. 3. The most common nonpenetrating injury was rib fracture [73.9%], and the common fracture sites were 5th, 6th, 7th and 8th ribs [especially, 7th rib]. The incidence rate of flail chest was 15% of the cases of the rib fractures. 4. The common associated injuries of the nonpenetrating were long bone fracture [18.3%], brain contusion [15.9%], and clavicle fracture etc.. 5. The common method of surgical treatment were closed thoracostomy [46.7%], thoracentesis, and open thoracotomy [7.4%] etc.. 6. The overall mortality was 2.8%. [Nonpenetrating; 0.8%, Penetrating; 6.3%]

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Biphasic Pulmonary Blastoma detected by Pneumothorax (기흉에 의해 발견된 이상성 폐 모세포종)

  • Kim, Yong Hwan;Lee, Sun Hee
    • Tuberculosis and Respiratory Diseases
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    • v.55 no.4
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    • pp.408-412
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    • 2003
  • Pulmonary blastoma is a rare primary lung neoplasm composed of a mixture of immature mesenchyme and epithelium that morphologically mimics embryonal pulmonary structure. Microscopically, tumors could be divided into two classes; those composed solely of malignant glands of epithelial components (well-differentiated fetal adenocarcinoma) and those with biphasic appearance. A 51-year-old man was admitted with left sided pneumothorax. After closed thoracostomy, chest X-ray showed a circular mass in the left lower zone. The tumor was diagnosed as adenocarcinoma as a result of percutaneous needle aspiration biopsy, and left lower lobectomy was performed. The patient was diagnosed as having biphasic pulmonary blastoma on postoperative histological assessment. This case is the first reported patient with biphasic pulmonary blastoma detected by pneumothorax.

Thoracoplasty and Myoplasty for Operative Treatment of Postpneumonectomy Empyema - A Case Report - (전폐절제술후 발생한 농흉의 흉곽성형술과 근성형술을 이용한 수술치험 -1례 보고-)

  • 윤양구
    • Journal of Chest Surgery
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    • v.22 no.5
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    • pp.851-856
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    • 1989
  • Initial successful treatment of postpneumonectomy empyema depends to a large extent on adequate dependent drainage of the empyema sac and the use of antibiotics. But definite control of the infected space remains a disturbing and controversial area in the field of thoracic surgery. A 55-year-old man had a right pneumonectomy for tuberculosis with the development of postoperative thoracic empyema and in October 1973. Postoperatively, an empyema developed and the condition was managed with closed drainage and an open window thoracostomy. He was transferred to our institution in October 1988, and underwent thoracoplasty for the obliteration of the empyema space, resulting in a remaining space. The remaining space after thoracoplasty was obliterated by myoplasty using a rotation flap of splitted pectoralis major muscle three months later. He was discharged with uneventful course 12 days after operation, and continues to do well 3 months following operation. Our experience shows that thoracoplasty and myoplasty offer an effective alternative method of management of post-pneumonectomy empyema.

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A Case of Spontaneous Hemothorax with a Ruptured Variceal Phrenic Vein

  • Juhyun, Lee;Sung Kwang, Lee;Jinhong, Wi;Yoo Sang, Yoon;Il-Yong, Han;Yang Haeng, Lee
    • Journal of Chest Surgery
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    • v.55 no.6
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    • pp.482-484
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    • 2022
  • Spontaneous hemothorax is rare, with limited data available on its etiology and treatment. We report a case of massive spontaneous hemothorax with a ruptured variceal phrenic vein during pregnancy, likely a complication of the Kasai procedure. Despite closed thoracostomy, the patient's symptoms and imaging findings did not improve. Emergent open thoracotomy and bleeding control were performed.

Traumatic Diaphragmatic Hernia (외상성 횡경막 허니아)

  • Jang, Bong-Hyeon;Han, Seung-Se;Kim, Gyu-Tae
    • Journal of Chest Surgery
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    • v.20 no.4
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    • pp.839-846
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    • 1987
  • The records of 10 patients with traumatic diaphragmatic hernia seen from November 1977 through July 1987 were reviewed. All the patients had a transdiaphragmatic evisceration of abdominal contents into the thorax. We treated 7 male and 3 female patients ranging in age from 3 to 62 years. In 8 patients, diaphragmatic hernia followed blunt trauma and in 2 patients, stab wounds to the chest. The herniation occurred on the right side in 3 patients and on the left side in 7. All the patients sustained additional injuries: rib fractures [7 patients], additional limb, pelvic and vertebral fractures [6], closed head injury [2], lung laceration [1], liver laceration [1], renal contusion [1], ureteral rupture [1], and splenic rupture [1]. Organs herniated through the diaphragmatic rent included the omentum [6 patients], stomach [4], liver [4], colon [3], small intestine [1], and spleen [1]. For right-sided injuries, the liver was herniated in all 3 patients and the colon, in 1. in the initial or latent phase, dyspnea, diminished breath sounds, bowel sounds in the chest were noted in 4 patients, and in the obstructive phase, nausea, vomiting, and abdominal pain were found in all 3 patients. Two patients had a diagnostic chest radiograph with findings of bowel gas patterns, and an additional 8 had abnormal but nondiagnostic studies. Hemothorax, pleural effusion or abnormal diaphragmatic contour were common abnormal findings. Three patients were operated on during the initial or acute phase [immediately after injury], 4 patients were operated on during the latent or intermediate phase [3 to 210 days], and 3 patients were operated on during the obstructive phase [10 to 290 days]. Six patients underwent thoracotomy, 2 required thoracoabdominal incision, and 2 had combined thoracotomy and laparotomy. Primary suture was used to repair the diaphragmatic hernia in 9 cases. One patient required plastic repair by a Teflon felt. Empyema was the main complication in 2 patients. In 1 patient, the empyema was treated by closed thoracostomy and in 1, by decortication and open drainage. There were no deaths.

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Treatment of Primary Spontaneous Pneumothorax Using a Commercialized 8-French Catheter ($Pleuracan^{(R)}$) (상품화된 8 Fr 흉부 배액도관($Pleuracan^{(R)}$)을 이용한 원발성 자연기흉의 치료)

  • Park, Jung-Sik;Hwang, Yeo-Ju;Park, Kook-Yang;Park, Chul-Hyun;Jeon, Yang-Bin;Choi, Chang-Hyu;Lee, Jae-Ik
    • Journal of Chest Surgery
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    • v.40 no.4 s.273
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    • pp.292-296
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    • 2007
  • Background: This retrospective study was undertaken to assess the effectiveness of the 8-French (Fr) catheter ($Pleuracan^{(R)}$) for the initial treatment of primary spontaneous pneumothorax. Material and Method: Between July 2004 and July 2006, 59 patients (72 cases) underwent a closed thoracostomy for primary spontaneous pneumothorax. We divided these patients into two groups: group T (large bore (>20 Fr) chest tube group) and group P ($Pleuracan^{(R)}$ group). Result: Initially, the $Pleuracan^{(R)}$ catheters were inserted in 41 cases. There were four catheter malfunctions (9.8%) : three cases had a subsequent closed thoracostomy with a large bore chest tube. Ultimately, there were 34 cases in group T and 38 cases in group P. There were no significant differences in indwelling catheter time ($T:\;2.1{\pm}1.5\;days,\;P:\;2.1{\pm}1.3\;days$), hospital stay ($T:\;6.4{\pm}5.4\;days,\;P:\;5.2{\pm}2.9\;days$) and complications (T: 3%, P: 0%) between the two groups. The percentage of cases that needed intravenous analgesics in group P was 60% (23/38); this was significantly lower than the number for group T (90%, 31/34) (p=0.003). In a subgroup of patients that did not undergo bullectomy(T: 17 cases, P: 19 cases), there were no significant differences in the duration of air leakage ($T:\;0.5{\pm}0.7\;days,\;P:\;0.5{\pm}1.2\;days$) and in the percentage of patients with complete lung re-expansion (T: 94%, P: 84%) between the two groups. Conclusion: Application of the $Pleuracan^{(R)}$ catheter for the initial treatment of primary spontaneous pneumothorax was as effective as the large bore chest tube.

Lung Cancer Presenting as Spontaneous Pneumothorax (자연기흉에 동반된 폐암의 수술치험 1예)

  • 이승훈;안용찬;한정호;김진국
    • Journal of Chest Surgery
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    • v.36 no.7
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    • pp.535-538
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    • 2003
  • Spontaneous pneumothorax accompanying primary lung cancer is rare and its occurrence as an initial sign of primary lung cancer is much rarer. A few articles on spontaneous pneumothorax accompanying lung cancer have been published in Korea so far. Lung cancers, diagnosed after spontaneous pneumothorax, are usually in advanced stage, so that conservative treatment modalities such as closed tube thoracostomy, chemotherapy, or radiotherapy are the mainstream of the treatment. We experienced a case of local recurrence of primary lung cancer in six months after radical resection and radiotherapy of neoplasm performed immediately after the diagnosis by excisional biopsy of bulla, for which resection and pleurodesis had been done under the impression of spontaneous pneumothorax. In this paper, we report the case and follow-up observation of the patient.