• Journal of Chest Surgery
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• 제38권1호
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• pp.80-83
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• 2005

43세 남자 환자가 호흡곤란과 호흡시 나타나는 천명음을 주소로 내원하였다. 환자는 과거력상 1년전에 식도파열로 인하여 식도격리술과 식도위문합수술을 시행받았다. 흉부 컴퓨터 단층촬영상 기관을 압박하는 식도점액류가 마치 종격동 종양처럼 나타났다. 수술은 우측 개흉술을 통하여 식도를 절제하였다. 저자들은 이를 치험하였기에 보고하는 바이다.

• 대한의용생체공학회:학술대회논문집
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• 대한의용생체공학회 1997년도 추계학술대회
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• pp.428-431
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• 1997

This study is the basic research on esophageal balloon dialation with automatic detection of the pressure change in the balloon and analysis using personal computer. In conventional method, the esophageal stricture is cured by surgically. Recently, balloon dialation method has been proposed and is popularized. In balloon dialation, detecting esophageal rupture is very important. When using radiological investigation, the leak of contrast medium is very dangerous. In proposed method, the detection of esopageal rupture can be peformed by detecting and analyze the pressure change of dialation balloon. Experimental system is composed of balloon catheter, pressure pump, pressure sensor, A/D converter and PC.

• Journal of Medicine and Life Science
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• 제21권2호
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• pp.49-52
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• 2024

Massive gastric mucosal ruptures during upper gastrointestinal endoscopy in patients with esophageal hiatal hernias are rare. However, tearing of the gastric mucosa alone, without tearing of the gastroesophageal junction, is even rarer. This study reports a case of a large mucosal rupture that occurred on the posterior wall of the upper body of the stomach during upper gastrointestinal endoscopy in an 83-year-old woman with an esophageal hiatal hernia while sedated. The patient was treated with endoclips for the rupture.

• Journal of Chest Surgery
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• 제25권10호
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• pp.1093-1097
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• 1992

Injury to the esophagus varies from a minor superficial tear to complete rupture of the esophageal wall. We have recently seen one healthy adult male who sustained submucosal dissection of the esophagus while endoscopy. The diagnosis has been made by esophagogram and chest computed tomogram. The therapy was conservative management and good prognosis without complications.

• 대한기관식도과학회지
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• 제5권1호
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• pp.14-21
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• 1999

Perforating injury of the thoracic esophagus leads to an almost Immediate exposure of the mediastinum to both oral secretions and refluxed gastric contents. And necrotizing inflammatory response developed inevitably. So, without proper managements, mediastinitis results in severe dehydration or septic conditions, and consequently the life of the patient can be threaten. We experienced recently 4 cases of esophageal perforation. Three cases were Boerhaave's syndromes and the other one was instrumental perforation in patient with corrosive esophageal stricture. Curative surgical procedures were done in 3 cases and the drainage procedure was only possible in the other one due to hepatic failure. And the patient with the drainage management was dead.

• 대한기관식도과학회지
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• 제15권1호
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• pp.56-59
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• 2009

Tracheal rupture is infrequently reported, but it is considered to be fatal condition. The most common cause of tracheal rupture is neck injury, but, rarely reported after tracheal intubation. We report a 49-year old woman with dyspnea presenting tracheal rupture after endotracheal intubation. It is detected that tracheal rupture with herniation of esophagus at the level of T1 spine by computed tomography and bronchoscopy. We had a successful repair by suturing between tracheal and esophageal wall. The patient was followed up without any complication.

• 대한기관식도과학회지
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• 제9권2호
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• pp.44-48
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• 2003

Rupture of the esophagus is an uncommon condition that can be a formidable challenge to treat. Unless early treatment is applied, life-threatening complications, such as mediastinitis, sepsis, occurs and continue to be associated with a mortality rate of more than 20%. Definitive repair of esophageal perforation is considered the preferred treatment in the past. In the present study, conservative treatment acquired a good results by help of the development of antibiotics and nutritional supportive methods. Iatrogenic causes constituted most of the injuries, followed by external trauma, spontaneous, ingested foreign bodies, and malignancy. The incidence of perforation following ingestion of foreign bodies is very rare, so recommendations regarding treatment remain controversial. We analyzed the course of 31 patients with esophageal perforation by foreign bodies, concentrating on the diagnostic & treatment delay and methods of treatment, complications.

• Journal of Chest Surgery
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• 제5권1호
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• pp.45-56
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• 1972

Esophageal perforation is one of the most grave prognostic problems among thoracic and general surgical emergencies which necessitate urgent operative measures. In Korea,there are still many persons ingesting lye for suicidal attempt and thoracic surgeons in Korea have more chances to deal with lye burned esophagus with or without instrumental perforation than those in Western countries. Main cause of esophageal perforation in Korea is instrumental perforation in patients with lye stricture of the esophagus during diagnostic endoscopy or therapeutic bouginage. Other causes are corrosion of the esophagus due to ingestion of caustic agents, pathologic perforation, surgical trauma, stab wound and spontaneous rupture of the esophagus in our series. Therapeutic measures are various,and depend on duration of perforation, severity of its complications, pathology of perforated portion of the esophagus and degrees of inflammation at the point of perforation. The most important therapeutic measures are prevention of this grave condition during esophagoscopy, bouginage and surgical procedures on lungs and mediastinal structures and to make early diagnosis with prompt therapeutic measures. During the period of January, 1959, to December, 1971, the authors experienced 65 cases ofesophageal perforation including acquired esophagorespiratory fistula at Dept. of Chest Surgery, the National Medical Center in Seoul, and obtained following results in the series. 1. Female were 35 cases, and peak age incidence was 2nd and 3rd decades of life. 2. Among 65 cases, 43 were corrosive esophagitis or benign stricture of the esophagus due to caustic agents, 7 were patients with esophageal cancer. and there were 5 cases of esophageal perforation developed after pneumonectomy or pleuropneumonectomy. 3. Causes of perforation are instrumental perforation in 45, acute corrosion in 7, pathologic perforation in 7, surgical trauma in 3, stab wound in 2 cases, and one spontaneous rupture of the esophagus. 4. Most frequent sites of esophageal perforation were upper and mid thoracic esophagus, and 8 were cases with cervical esophageal perforation. 5. Complications of esophageal perforation were mediastinitis in 42, empyema or pneumothorax in 35, esophagorespiratory fistula in 12, retroperitoneal fistula or abscess in 5,pneumoperitoneum in 3, and localized peritonitis in 1 case. 6. Cases with malignant esophagorespiratory fistula were only 3 in the series which is predominant cause of acquired esophagorespiratory fistula in Western countries. 7. Various therapeutic measures were applied with mortality rate of 27.7% in the series. 8. In usual cases early treatment gave better prognosis, and least mortality rate in cases with perforation in mid thoracic esophagus. 9. Main causes of death were respiratory complications,acute hemorrhage with asphyxia, and septic complications. 10. Esophageal perforation developed after pneumonectomy gave more difficult therapeutic problems which were solved in only 1 among 5 cases.

• Journal of Chest Surgery
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• 제32권8호
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• pp.765-767
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• 1999

기관 삽관으로 인한 기관 기관지 파열은 매우 드문 합병증이다. 저자들은 이중관 튜브의 삽관후 발생한 기관 파열을 경험하였다. 76세 여자 환자가 간헐적인 기침과 흉부 불편감을 주소로 내원하였다. 재발된 선천성 좌측주 기관지 식도 루 진단하에 수술을 시행하였다. 수술중 우연히 기관파열이 관찰되었고 기관파\ulcorner은 풍선의 과팽창에 의한 것이었으며 파열부위의 기관을 prolene과 흡수성 봉합사를 이용하여 단단 문합 하였다. 수술후 환자는 합병 증없이 퇴원하였으며 외래를 통해 추적 관찰 중이다.

• Journal of Chest Surgery
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• 제19권4호
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• pp.744-749
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• 1986

Even in the hands of the expert endoscopists, an occasional instrumental perforation of the esophagus occurs. But instrumental perforation of the esophagus should not be difficult to diagnose if the possibility is borne in mind. Occasionally patient with esophageal perforations show little reaction at first, but usually they develop systemic manifestation if surgical management is delayed. Early surgical drainage of esophageal perforation is very important & effective therapeutic method. The delayed surgical treatment of esophageal perforation would have increased the morbidity & mortality by allowing mediastinitis & empyema thoracis. We have experienced 6 cases of delayed surgical management of instrumental perforation of esophagus from May 1974 to April 1986 in the department of thoracic and cardiovascular surgery, Yonsei University, college of the medicine. The ages ranged from 4 years to 57 years. The underlying esophageal diseases consisted of esophageal stricture in 3 cases, foreign bodies in the esophagus in 2 cases and esophageal ca. in one case. Most clinical manifestations on admission were high fever, chest discomfort, chest pain, dysphagia and subcutaneous emphysema. Most complications due to esophageal rupture were acute mediastinitis with or without empyema thoracis. Failure to diagnose promptly and failure to promptly institute adequate treatment undoubtedly were largely responsible for this patients death. All 6 patients had been taken delayed surgical drainage more than 24 hours following esophageal perforation. One patient had been in the open drainage state for long time and the another patient has been in the tracheostomy with postintubation vocal cord ulceration. The third patient died due to respiratory failure and sepsis due to fulminant mediastinitis & empyema thoracis. Even if the patients with esophageal perforation have been taken delayed surgical management, the patients should be survived with aggressive & effective surgical drainage with intensive post-operative care.