• Advances in pediatric surgery
• /
• 제20권2호
• /
• pp.58-61
• /
• 2014

Palpable inguinal mass in children should be differentiated from inguinal hernia, hydrocele, lymph node, and tumor. Though using ultrasonography, fatty tumor would be misdiagnosed as incarcerated inguinal hernia containing fatty component. We experienced the huge inguinal lipoblastoma in 5-year-old girl mimicking recurrent incarcerated hernia. Laparoscopic exploration revealed it was not incarcerated hernia but well demarcated bulging mass from abdominal wall. Mass was about $10{\times}4{\times}3cm$ and extended from internal inguinal ring to saphenous opening. It was near total excised because of right external iliac vein injury. Pathologically, it was proven as lipoblastoma containing mature adipocyte with lipoblast and fibrous septa. Postoperatively, we noticed a segmental thrombotic occlusion of external iliac vein. After 1 year, she has no symptom related to occluded vessel. The remained lipoblastoma showed no interval change. Even lipoblastoma has a good prognosis with low recurrence rate, we need careful follow-up.

• Journal of Trauma and Injury
• /
• 제31권2호
• /
• pp.103-106
• /
• 2018

Fat embolism refers to the presence of fat droplets within the peripheral and lung microcirculation with or without clinical sequelae. However, early diagnosis of fat embolism is very difficult because the embolism usually does not show at the computed tomography as a large fat complex within vessels. Forty-eight-year-old male with pedestrian traffic accident ransferred from a local hospital by helicopter to the regional trauma center by two flight surgeons on board. At the rendezvous point, he had suffered with dyspnea without any airway obstruction sign with 90% of oxygen saturation from pulse oximetry with giving 15 L of oxygen by a reserve bag mask. The patient was intubated at the rendezvous point. The secondary survey of the patient revealed multiple pelvic bone fracture with sacrum fracture, right femur shaft fracture and right tibia head fracture. Abdominal computed tomography was performed in 191 minutes after the injury and fat embolism with Hounsfield unit of -86 in his right common iliac vein was identified. Here is a very rare case that mass of fat embolism was shown within common iliac vein detected in computed tomography. Early detection of the fat embolus and early stabilization of the fractures are essential to the prevention of sequelae such as cerebral fat embolism.

• Pediatric Infection and Vaccine
• /
• 제16권1호
• /
• pp.87-91
• /
• 2009

세균성 근염은 화농성 관절염, 봉와직염, 골수염, 혈전 정맥염, 다발성 근염, 혈종, 좌상, 종양과 감별이 필요하며 진단에 MRI가 도움이 된다. 저자들은 A군 사슬알균에 의한 화농성 근염을 조기에 진단하여 clindamycin으로 치료하였고 심부정맥 혈전증까지 합병되었던 환자를 경험하였다. 성인에서는 증례로 보고된 바가 있지만 국내에서는 아직 보고가 없어 이를 보고하는 바이다.

• Journal of Chest Surgery
• /
• 제54권3호
• /
• pp.214-217
• /
• 2021

In rare cases, levoatrial cardinal vein may occur as an isolated condition without additional congenital anomalies. Depending on the direction and flow of the shunt, this pathology may produce symptoms; alternatively, it may be asymptomatic, as in the case presented in this study. In asymptomatic cases, complications, such as paradoxical embolism and brain abscess, can arise later. In the 11-year-old patient whose case is presented here, the levoatrial cardinal vein was asymptomatic and incidentally detected. The percutaneous closure method was applied first. However, by 16 hours after the procedure, the occluder device had embolized to the iliac artery. Emergency surgery was performed; first, the occluder device was removed, and levoatrial cardinal vein ligation was then performed via a mini-thoracotomy. The symptoms, diagnosis, and treatment modalities of isolated levoatrial cardinal vein are discussed in the context of this case described herein.

• 한국임상수의학회지
• /
• 제28권1호
• /
• pp.63-70
• /
• 2011

To consider the iliac fossa as the vascular anastomosis site of kidney transplantation for the short-term study of acute rejection in pigs. Twelve domestic pigs weighing 39~48 kg underwent heterotopic renal allgraft transplantation. The experimental animals were divided into 2 groups in terms of renal vascular anastomosis site; the external iliac artery and vein were used in iliac fossa model (n = 6), the abdominal aorta and the caudal vena cava inferior to the kidney were used in abdominal cavity model (n = 6). Renal function was evaluated by daily measurement of plasma creatinine and BUN concentrations. The experiments' health including postoperative complications was also assessed daily for 8 days after transplantation. After euthanazation gross and histopathologic analysis was performed. All six pigs in iliac fossa model developed neuropraxia and lameness of the ipsilateral pelvic limb. However, no necrosis was observed in any pigs. In the abdominal cavity model, durations of both the surgical operation and the vascular anastomosis were significantly longer than those in the iliac fossa model. Furthermore, ischemia injury of the transplanted kidney was increased in abdominal cavity model, which induced accelerated-acute immune response from day 4 after transplantation. Despite of pelvic limb complication, the iliac fossa model showed more advantages including not only less ischemia time related to easy vascular anastomosis, but also less immune response during the acute rejection period. The results indicate that the iliac fossa model may be appropriate to the study of acute rejection in porcine kidney transplantation.

• Journal of Chest Surgery
• /
• 제35권6호
• /
• pp.483-486
• /
• 2002

71세 남자 환자로 좌측 총장골 동맥의 완전 폐쇄를 동반한 복부 대동맥류로 수술하였다. 술 전, 좌측 대퇴 및 장골 정맥에 동반된 만성 심부정맥 혈전증은 진단하지 못 하였다. 동맥류 절제술 및 우측은 외측 장골동맥에, 좌측은 대퇴동맥에 문합한 Y-graft 치환술과 대퇴동맥간 우회술을 시행하였으나, 술 후 반복적인 부종과 통증이 발생하였고 점차 악화되어 결국 광범위한 정맥 혈전증으로 사망하였다. 본례는 만성 심부정맥 혈전증을 동반한 폐쇄성 대동맥 장골 동맥 질환에 있어 수술적 치료 및 합병증에 관한 보고이다.

• Vascular Specialist International
• /
• 제34권4호
• /
• pp.117-120
• /
• 2018

The endovascular recanalization of the iliocaval system has replaced venous surgical reconstructions as the primary treatment option in severe post-thrombotic syndrome (PTS). We herein present a 51-year-old female with previous deep venous thrombosis, complicated with PTS with a large and complex circumferential calf ulcer measuring 25 cm of length in the left lower extremity. Venogram revealed a complete and extensive occlusion in the left iliofemoral system. A surgical bypass from the left common femoral vein to the right common iliac vein was performed. Patient recovered well and after 12 months postoperation her large wound is healing favorably with a clean and well granulated bed. Iliofemoral venous bypass is a feasible treatment for non-healing ulcer of lower extremity.

• 대한정형외과학회지
• /
• 제55권4호
• /
• pp.343-347
• /
• 2020

메이-터너 증후군(May-Thurner syndrome)은 장골 정맥 압박 증후군으로 알려져 있고 좌하지의 총 정맥 유출로가 압박되어 부종, 통증 또는 혈전(심부정맥 혈전증)을 유발할 수 있는 상태이다. 특히 우측 총 장골 동맥과의 교차 지점에서 좌측 총 장골 정맥이 압박되는 형태가 전형적이다. 저자들은 우측 인공 슬관절 전치환술을 시행한 75세 여자 환자에서 메이-터너 증후군이 합병된 증례를 치료하였고 이를 보고하고자 한다. 수술을 시행한 후 좌측 하지의 부종과 통증에 대해 혈관 조영술 및 컴퓨터 단층촬영을 이용해 메이-터너 증후군을 진단하였다. 혈전용해제와 혈전제거술를 사용하여 혈전을 제거한 후 혈관 성형술 및 정맥 내 스텐트를 삽입하였다. 한국에서 인공 슬관절 전치환술 후 메이-터너 증후군이 합병된 증례는 보고된 바가 없다. 이에 저자들은 문헌고찰과 함께 보고하고자 한다.

• Journal of Chest Surgery
• /
• 제21권6호
• /
• pp.990-995
• /
• 1988

Seventeen cases of vascular injuries treated in Chungnam National University Hospital during the period from Apr. 1980 to Sep. 1988 were reviewed. Common causes of injuries were stab wound, automobile accidents and iatrogenic injuries. Of the 11 arterial injuries, 3 were femoral artery which was the commonest in frequency, the next was 2 cases of subclavian, common carotid, iliac artery. Of the 10 venous injuries, the subclavian vein and internal jugular vein were common in frequency. The most frequent type of injuries was laceration[13 cases in 21]. Vascular reconstruction was done by lateral suture repair in 8 cases, autogenous vein graft in 2, prosthetic vascular graft in 5, direct anastomosis in 1 case. Simple ligation was done in 5 cases. There was 1 case of visual field defect as a sequelae in right common carotid artery transaction and 1 case of mortality.

• Journal of Chest Surgery
• /
• 제25권10호
• /
• pp.1141-1145
• /
• 1992

A rare syphilitic abdominal aortic aneurysm associated with pulmonary embolism and deep vein throbosis is reported. We have experienced a huge infrarenal syphilitic abdominal aortic aneurysm which caused venous compression at left common iliac vein. A 29 year-old female was admitted via emergency room due to several episodes of hemoptysis. Clinical evaluation for this patient revealed a couple of small ill-defined masss densities on the both lung field and abominal aortic anuerysm. Emergency wedge resections of left upper and lower lobes were performed because of a massive hemoptysis. Pathologic diagnosis showed pulmonary infarction. 20 days after thoracotomy an elective operation on abdominal aortic anuerysm was successfully carried out and post operative pathology finding showed syphilitic aortitis.