• Title/Summary/Keyword: Intrathoracic

Search Result 179, Processing Time 0.027 seconds

Mediastinal Tuberculous Abscess - Report of two cases - (종격동 결핵성 농양: 2례 보고)

  • 표현인
    • Journal of Chest Surgery
    • /
    • v.24 no.8
    • /
    • pp.830-835
    • /
    • 1991
  • Tuberculosis is a chronic disease caused by Mycobacterium tuberculosis, which usually affects the lung but may cause lesions in any organ or tissue of the human body. Mediastinal lymph node involvement is common feature of intrathoracic tuberculosis in children. Sometimes the lymph node may be enlarged and it causes compressive symptoms. Recently we experienced two cases of tuberculous abscess at middle mediastinum. The abscess seemed to be originated from the mediastinal lymphadenitis, and caused the symptoms. Operation was performed by median sternotomy and by posterolateral thoracotomy incision respectively for the purpose of relieving symptoms and diagnosing the mediastinal mass. The symptoms were relieved completely and postoperative course was uneventful.

  • PDF

Surgical Evaluation of Iatrogenic Hypopharyngo-esophageal Perforation (의인성 하인두-식도천공에 대한 외과적 고찰)

  • Park Jae Kil;Cho Kyu Do;Park Kuhn;Wang Young Pil
    • Korean Journal of Bronchoesophagology
    • /
    • v.10 no.2
    • /
    • pp.28-34
    • /
    • 2004
  • Background : Esophageal perforation due to a traumatic endoscopy or intubation is exceedingly rare. If riot noticed immediately or treated promptly, however, the morbidity and mortality is significant. We performed a retrospective review of patients with iatrogenic hypopharyngo-esophageal perforation to assess the outcome of current management techniques. Material and Methods : We retrospectively analyzed all cases iatrogenic hypopharyngo-esophageal perforation diagnosed at our hospital from January, 1999, through April, 2004. The study group consisted of 11 patients (4 men) with a mean age of 47.6 years (range, 21-83 yr). We reviewed the 11 patients with perforated injuries of the hypopharynx or esophagus during the diagnostic or therapeutic procedures. Result: Perforations were due to diagnostic gastroscopy ($54.5\%$, 6/11), esophageal dilation ($27.3\%$, 3/11), endoscopic port insertion ($9.1\%$, l/11), and tracheal intrathoracic ($9.1\%$, 1/11). Seven patients had intrathoracic and 4 had cervical perforations. Treatment included incision and drainage (5), resection and reconstruction (4), drainage only (1), and observation (2). Nonfatal complications included transient pneumonia (1), and wound infection (1). They occurred in advanced mediastinal abscess ]patients. Mortality was $9.1\%$ (1/11) in old patient who managed medically in cervical esophageal perforation. Conclusions : Current mortality rates in iatrogenic esophageal perforation were improved compared to previous published rates of $19\%\;to\;66\%$ for all patients with this condition. We concluded that aggressive and definitive surgery for thoracic esophageal perforations improving the survival rate, whether diagnosed early or late.

  • PDF

Photodynamic Therapy for Neoplasms in Intrathoracic Constructed Stomach (식도암 수술 후 흉곽 내 위장에 발생한 원발성 위암에 대한 광역동치료 -1예 보고 -)

  • Park, Ki-Sung;Ko, Moo-Sung;Kwon, Oh-Choon;Lee, Sub;Kim, Jong-Ki;Jheon, Sang-Hoon
    • Journal of Chest Surgery
    • /
    • v.36 no.10
    • /
    • pp.794-797
    • /
    • 2003
  • Photodynamic therapy (PDT) is a local, endoscopically controlled nonoperative therapeutic technique based on selective sensitization of mucosal, malignant and precancerous lesions of the esophagus, trachea and bronchus prior to light-induced tissue destruction in the department of thoracic and cardiovascular surgery. PDT is effective and safe for palliative treatment of neoplasms in the stomach, esophagus, and lung. But skin phototoxicity is unsatisfactory, therefore optimization of management of post-PDT is necessary for preventing phototoxic side effects of skin. Careful patient education in photoprotection techniques, close patient follow-up, early dermatologic referral and medical treatment are recommended. We performed PDT in a patient with intrathoracic constructed stomach. We report this case with a brief review of literatures, therefore.

Free Jejunal Transfer Used by Intercostal Artery in the Intrathoracic Esophageal Reconstruction (흉강내 식도재건시 늑간동맥을 이용한 유리 공장 전이술)

  • Kim, Han-Soo;Choi, Sang-Mook;Chung, Chan-Min;Suh, In-Seock
    • Archives of Reconstructive Microsurgery
    • /
    • v.5 no.1
    • /
    • pp.99-105
    • /
    • 1996
  • The reconstruction of esophageal defect after ablative surgery have more difficult than other digestive tract tumor because the restoration of anatomical and physiologic function is difficult, the risk of tumor invasion into the adjacent tissue is large. The reconstruction of cervical esophus was depended on the degree of resection of the esophagus, various reconstruction method was developed to minimize functional deficiency and deformity of cervical region. Recently, the free jejunal transfer or free radial forearm flap was commonly utilized for esophageal reconstruction due to development of technique of the microvascular anastomosis. After the esophageal reconstruction used by free jejunal transfer was reported by Seidenberg in 1951, jejunum is most commonly used for reconstruction of esophgus. Becaue of, it have been tubed anatomical similarity with muscular layer, relative small risk of complication, possible of oral intake within 10 days after operation, and early rehabilitaion. Authors have been treated esophageal defect with free jejunal transfer in 7 patients after resection of lesion in 6 eshageal cancer and 1 esophageal stricture from December 1994 to January 1996. We were transferred jejunum used by intercostal artery as recipient artery in 3 cases, it was satisfied with results. If intercostal artery was utilized as recipient artery for free jejunal transfer, we believe that any site of intrathoracic or intraabdominal esophageal defect is possible to recontruction.

  • PDF

Combined Intrathoracic and Intraperitoneal Splenosis after Splenic Injury: Case Report and Review of the Literature

  • Moon, Chansoo;Choi, Yun-Jung;Kim, Eun Young;Lee, In Sun;Kim, Sae Byol;Jung, Sung Mo;Kim, Se Kyu;Chang, Joon;Jung, Ji Ye
    • Tuberculosis and Respiratory Diseases
    • /
    • v.74 no.3
    • /
    • pp.134-139
    • /
    • 2013
  • Splenosis is defined as an autotransplantation of the splenic tissue after splenic rupture or splenectomy, and occurs most frequently in the peritoneal cavity. Splenosis is usually asymptomatic and is found incidentally. We report a case of combined intrathoracic and intraperitoneal splenosis in a 54-year-old male who worked as a miner for 10 years in his twenties, and was a current smoker. He was referred to our hospital for further evaluation of an incidental left diaphragmatic mass. Positron emission tomography-computed tomography and bronchoscopy were performed to evaluate the possibility of malignancy. There was no evidence of malignancy, but the spleen was not visualized. Reviewing his medical history revealed previous splenectomy, following a dynamite explosion injury. Therefore, splenosis was suspected and technetium-99m-labeled heat-damaged red blood cell scan confirmed the diagnosis. Radionuclide imaging is a useful diagnostic tool for splenosis, which could avoid unnecessary invasive procedures.

The Evaluation of Video-Assisted Thoracic Surgery (비디오 흉부수술의 평가)

  • Seong, Suk-Hwan;Kim, Hyeon-Jo;Kim, Ju-Hyeon
    • Journal of Chest Surgery
    • /
    • v.27 no.12
    • /
    • pp.1015-1022
    • /
    • 1994
  • Over the past few years, video-assisted thoracic surgery [VATS] has been used increasingly for intrathoracic pathologic problems as a less invasive operative techniques. Today it is viewed as a sparing and safe alternative to thoracotomy for a wide spectrum of indications. Using video-assisted operative thoracoscopy, we performed consecutive 150 operations on 148 patients during the initial 2 years of our experience from July 1992 with the following indications: pneumothorax [n=53], hyperhidrosis [n=29], mediastinal mass [n=23], pleural disease [n=13], diffuse parenchymal or interstitial lung disease [n=12], benign pulmonary nodule [n=7], metastatic lung mass [n=3], primary lung cancer [n=3], bronchiectasis [n=2], malignant pericardial effusion [n=2], endobronchial tuberculosis [n=1], esophageal achalasia [n=1], and pulmonary parenchymal foreign body [n=1]. There were no death, and overall complicaton rate was 24.0%[n=36]. The most prevalent complication was persistent air leakage [longer than 5 days] in 14 cases [9.3%]. Persistent pleural effusion [longer than 5 days] occurred in 6 cases [4.0%]. Six patients were converted to an open thoracotomy because of inability to control the operative bleeding [n=3], failed adhesiolysis in bronchiectasis [n=2], and radical excision of an lung cancer [n=1]. Pneumothorax recurred in 3 cases[2.0%]. Other complications were Horner`s syndrome, diaphragm tears, temporary phrenic nerve palsy, hoarseness, subsegmental atelectasis, transient respiratory difficulty, and esophageal mucosal tear. The advantages of this minimally traumatizing operative technique lie in improved visualization, decreased pain, shortened hospital stay, and less postoperative morbidity. The indications of VATS has been extended increasingly to intrathoracic pathologies, but its role in the managements of primary lung cancer and esophageal disease remains to be defined.

  • PDF

Expression of MAGE A 1-6 and SSX 1-9 Genes in the Sputum and Cancer Tissue of the Lung Cancer Patients (폐암환자의 객담 및 암 조직에서 MAGE A 1-6와 SSX 1-9 유전자의 발현)

  • Lee, Yeun-Jae;Lee, Jang-Hoon;Lee, Jung-Cheul;Lee, Kwan-Ho
    • Tuberculosis and Respiratory Diseases
    • /
    • v.70 no.4
    • /
    • pp.315-322
    • /
    • 2011
  • Background: A variety of diagnostic modalities for lung cancer have been developed. To achieve efficient and early detection of lung cancer, we tried to measure the expression rates of the melanoma associated gene (MAGE) and synovial sarcoma on X chromosome (SSX) genes. Methods: We designed primers for the SSX gene. In addition to the pre-developed MAGE A primer, using an SSX gene primer was attempted to increase the detection rate. We obtained cancer tissues and cancer-free lung tissues from resected lung, sputum from lung cancer patients who had not undergone surgery, and sputum from healthy people and patients with benign intrathoracic diseases. Results: The sensitivity of the MAGE or SSX gene RT-PCR to identifying cancer tissue of the 69 lung cancer patients was 95.2% for squamous cell carcinoma (scc), 87.0% for adenocarcinoma, and 100% for small cell carcinoma. The mean sensitivity value was 94.2% (p=0.001). For adenocarcinoma, the additional use of the SSX gene resulted in a higher expression rate than MAGE alone (87% vs. 69.6%). The expression rate for the cancer-free lung tissue was 14.3% in scc, 17.4% in adenocarcinoma, and 25.0% in small cell carcinoma. In the induced sputum of 49 lung cancer patients who had not undergone surgery, the expression rate for one of the two genes was 65.5%. The expression rate for the sputum of healthy people and benign intrathoracic diseases by MAGE or SSX gene reverse transcription polymerase chain reaction (RT-PCR) was 3.8% and 17.7%. Conclusion: Detecting lung cancer using the expression of MAGE and SSX genes in lung cancer tissue has high sensitivity.

A Case of Cogenital Esophageal Hiatal Hernia Simulating Chest Mass (흉부 종괴로 오인된 선천성 식도열공 탈장 1례)

  • Rhou, Hye-Mi;Moon, Eun-Kyung;Lee, Dong-Chul;Im, Hye-Kyung;Yu, Jae-Hong;Sul, Ji-Young;Kim, Jong-Chul
    • Pediatric Gastroenterology, Hepatology & Nutrition
    • /
    • v.2 no.2
    • /
    • pp.211-216
    • /
    • 1999
  • The esophageal hiatal hernia is a herniation of an abdominal organ, usually the stomach, through the esophageal hiatus into thoracic cavity. It is a rare disease, usually congenital and frequently associated with gastroesophageal reflux and other congenital malformations in children. It is classified according to their anatomic characteristics as type I (sliding hiatal hernia), type II (paraesophageal hiatal hernia), type III (combined hiatal hernia) and type IV (multiorgan hiatal hernia). We experienced a case of type III congenital esophageal hiatal hernia simulating chest mass on simple chest x-ray because of right intrathoracic stomach secondary to congenital esophageal hiatal hernia and organoaxial rotation in 10 months male. After the operation, he showed an improved general condition and was discharged at the 14th hospital day. We report the case with the brief review of the related literatures.

  • PDF