• 제목/요약/키워드: Lt. main bronchus

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Capillary Hemangioma of the Left Main Bronchus in an Infant

  • Park, Seung-Il;Park, Esther;Kim, Yong-Hee;Park, Seong-Hae;Park, In-Chul
    • Journal of Chest Surgery
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    • 제35권10호
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    • pp.736-739
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    • 2002
  • 모세혈관종은 소아에서 가장 흔한 혈관종양으로 기관에서 발생되는 경우는 가끔 보고되고 있으나, 기관지에 발생하는 경우는 매우 드물다. 본원에서는 좌측 주기관지에 모세혈관종이 있고, 이로 인해 좌측 폐의 심한 폐기종이 유발된 생후 4개월된 환아에 대해 좌측 주기관지 소매절제술을 성공적으로 치험하였기에 보고하는 바이다.

기관내 분비물로 인한 무기폐: 4례 보고 (Atelectasis by Bronchial Secretion: Report of Four Cases)

  • 이선희;김세화;이홍균
    • Journal of Chest Surgery
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    • 제6권1호
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    • pp.41-46
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    • 1973
  • This is a report on four cases of atelectasis which were implicated as one case of mucoid impaction and three cases of blood clots in main bronchus. The 1st case was found to be massive atelectasis on Lt. entire lung due to mucoid impaction with pulmonary tuberculosis. This case was performed the Lt. pneumonectomy. There are contain-ing impacted yellowish-gray jelly like thick materials on the Lt. whole bronchial trees and pathologic findings were consistent with tuberculosis including caseation necrosis and multinucleated giant cell on whole left lung thoroughly in microscopic findings. The 2nd and 3rd case [25 years old female and 30 years old female] were diagnosed as one sided entire lung ateletasis which were led by accumulation of old blood clots on bronchus following incomplete expectoration of sudden massive hemoptysis from pulmonary tuberculosis lesion. These two cases were recovered by removal of blood clots and bronchial irrigation under bronchoscopy. Follow up chest film revealed well aeration. The 4th case [45 years old] was taken the removal of old blood clots and tissue debris under the bronchoscopy as bronchial obstruction following massive hemoptysis. The cytologic findings revealed the class III in fresh sputum and class 1V in bronchial irrigation which may suggest of malignancy. However, we could not found the causative lesions suggestive malignancy by the bronchography and other diagnostic measurements.

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기관및 기관지 협착증 환자의 외과적 치료 (Surgical Management of Tracheal and Bronchial Stenosis)

  • 유정훈
    • Journal of Chest Surgery
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    • 제25권11호
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    • pp.1299-1304
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    • 1992
  • We experienced 5 cases of tracheal stenosis and 7 cases bronchial stenosis treated surgically at the Department of Thoracic and Cardiovascular Surgery, School of Medicine, Hanyang University during 5 years. The causes of tracheal stenosis were prolonged endotracheal intubation 1 case, tracheostomy 1 case, the sequela of endobronchial tuberculosis 2 cases and tracheomalacia 1 case. The causes of bronchial stenosis were all endobronchial tuberculosis. The managements of tracheal stenosis were tracheal resection and end to end anastomosis. The resected lengths of trachea were 1.5cm, 3cm and 7.5cm. One case of suglottic stenosis was underwent the resection of trachea, 8cm in length, and the laryngotracheal anastomosis was done, but the re-stenosis of trachea was developed after 4 weeks post-operatively. One case of tracheomalacia was done permanent tracheostomy only, because the entire trachea was adhered to the surrounding tissue. The managements of bronchial stenosis were resection of involved lobe or one lung, in the 5 case. One case with Lt. main bronchial stenosis and atelectasis of Lt. upper lobe was done the lobectomy of Lt. upper lobe only and then, the Lt. pneumonectomy was done re-operatively because the atelectasis of Lt. lower lobe had continued. The other one case with stenosis of Rt. main bronchus, failed the insertion of metalic stent, was underwent the Rt. upper lobe lobectomy, sleeve resection and side to end anastomosis

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외상성 기도 손상의 임상적 고찰 (Clinical Aanalysis of Airway Trauma)

  • 조현민;김영진;류한영;황정주
    • Journal of Trauma and Injury
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    • 제24권1호
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    • pp.7-11
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    • 2011
  • Purpose: Traumatic airway injuries have high rates of mortality and morbidity. Thus, we evaluated the clinical results of trauma-related airway-injury patients. Methods: A clinical analysis was performed for patients with airway trauma who were admitted and treated at the Department of Thoracic and Cardiovascular Surgery, Konyang University Hospital from Dec. 2002 to Dec. 2009. Results: Sixteen patients were admitted and treated. Fourteen patients were male, and the ages of the patients ranged from 16 to 75 years. Six cases were penetrating injuries, 4 were traffic-accident injuries. 3 were fall injuries, and. 3 were other blunt trauma injuries. Anato- mic injuries included 14 trachea cases (87.5%), 1 Rt. main bronchus (6.25%), and 1 Lt. main bronchus cases (6.25%). Diagnosis was made by using computed tomography and bronchoscopy. Five patients were treated with an explothoracotomy, and 7 underwent neck exploration with primary repair. Three patients simply needed conservative management, and 1 patient was treated with a closed thoracostomy. The post-operative mortality rate was 6.25 % (1 patient). Conclusion: Airway trauma is dangerous and should be treated as an emergency, so a high index of suspicion is essential for rapid diagnosis and successful surgical intervention in patients with airway injuries.

기관지내시경하에 시행한 조직생검에 대한 고찰 (Clinical Analysis of Tissue Biopsy Under Fiberoptic Bronchoscopy)

  • 고건성;유장열;박석근;조태권;노관택;김홍기
    • 대한기관식도과학회:학술대회논문집
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    • 대한기관식도과학회 1978년도 제12차 학술대회연제 순서 및 초록
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    • pp.5.1-5
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    • 1978
  • 1968년 Ikeda가 처음으로 flexible fiberoptic bronchoscope를 소개한 후 기관지경의 이용은 급속히 확대되었다. 이에 따라 기관지경검사중에 진단을 목적으로 하는 조직생검도 빈번히 시행하게 되었다. 저자등은 1976년 6월부터 1978년 1월까지 시행한 233례의 기관지경검사중 조직생검을 시행한 71례를 분석관찰한 바 다음과 같은 결과를 얻었다. 1. 20개월간 의뢰된 233례의 기관지경검사중 조직생검이 필요했던 경우는 30.5%인 71례이었다. 2. 조직생검이 필요했던 71례의 주소는 해수(17례), 호흡곤란(16례), 객담(15례) 등이 전체의 60%를 차지하며 흉통, 객혈의 순이었다. 3. 조직생검의 부위는 우상엽기관지가 21.1%로 제일 많았고, 좌주기관지, 좌상엽기관지, 우주기관지, 좌하엽기관지등의 순이었다. 4. 조직생검이 필요했던 71례의 원인질환은 폐암이 80%(57례), 결핵이 15%(11례), 악성중피종, 탄분증, 국균증(aspergillosis)등이 각 1례이었다. 5. 폐암이 생검결과 확진된 것은 57례중 36례로 63%의 진단율을 보였다. 6. 폐암으로 확진된 36례의 병리학적 소견은 편평상피암이 64%(25례), anaplastic 25%(9례), 폐암과 분류할 수 없는 것이 각 1례이었다. 7. 71례중 기관지조영술을 한 예는 51%인 36예이었으며, 그 시기는 기관지경검사전에 시행한 것이 1/4, 후에 시행한 것이 3/4이었다. 8. 71예중 76%(54예)에서, 세포진단학 검사를 병행하였으며, 이 결과는 PAP class V가 15%, class IV가 7.5%, class III가 1.8%이었다.

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기관 삽관후 발생한 좌측 주기관지 파열 - 1례 보고 - (Left Bronchial Rupture Following Endobronchial Intubation - One case report -)

  • 김건일;지현근;김형수;이희성;이원용
    • Journal of Chest Surgery
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    • 제31권10호
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    • pp.1014-1016
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    • 1998
  • 이중관 튜브(double-lumen tube)로 기관 삽관한 후 발생하는 기관지 파열은 극히 드문 합병증이다. 우리 는 기관 삽관후에 발생한 좌측 기관지 파열을 치험하였다. 58세 여자 환자로 수술전 검사상 우하엽에 병 기 IIB의 분화가 잘된 악성 선암으로 진단되었다. 환자는 우하엽절제술을 위하여 로버트쇼 튜브 (Robertshaw tube)로 기관 삽관하였고 수술중 종격동 기종과 환기 장애로 인하여 좌측 주기관지의 파열을 발견하였다. 즉시 좌측 개흉술을 시행하여 기관지 파열부위를 흡수성 봉합사(PDS)로 봉합하였으며 수술 후 별다른 문제없이 회복되었다.

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소아의 기도이물에 관한 통계적 관찰 (Foreign bodies in air passage in Children)

  • 유장열;오경균;백만기
    • 대한기관식도과학회:학술대회논문집
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    • 대한기관식도과학회 1977년도 제11차 학술대회연제 순서 및 초록
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    • pp.8.5-9
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    • 1977
  • 기도 및 식도이물은 이비후과영역에서 적지않게 경험하게 된다. 그중 특히 유소아에서 발생하는 기도이물은 응급을 요하게 되며 진단 및 치료를 지체함으로써 예기치 않은 불행한 사태를 초래하기도 한다. 유소아에서 주로 보이는 기도이물의 증상은 기침, 기침음, 호흡곤란 등이며 천식, 폐염, 후두염 등으로 혼동되기도 한다. 이물의 종류파 빈도를 환자의 연령, 생활방식, 환경, 문과수준에 따라 그 양상을 달리한다. 저자들은 1975년부터 1977년 4월까지 본원에 내원하여 기도이물의 진단하에 ventilating bronchoscopy, thoracotomy (이중 1례는 사망)을 시행하여 치유된 35례를 분석하였다. 1. 연령층은 1세부터 5세까지가 48%로 가장많고 다음이 0세에서 1세까지 였다. 또한 남과여의 비는 2.1 : 1로 남자가 많았다. 2. 주증상은 호흡곤란, 기침, 기침음의 순서였다. 3. Foreign body의 종류는 peanut, metal, vegetable의 순이였다. 4. 이물의 소재는 주로 우측 주기관지 였으며 우측과 좌측의 비는 2 : 1이었다. 5. 내원까지의 기간은 24시간 이내가 65%로 가장 많았다. 6. 치료는 ventilating bronchoscopy가 27례로 가장 많았으며, 4례는 자연적으로 치유되었다. 이에 과거의 여러 보고들과 비교하여 문헌적 고찰과 함께 보고하는 바이다.

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양성 폐종양의 수술적 치료 (Surgical Treatment of Benign Lung Tumor)

  • 박건;조덕곤;박재길;조건현;왕영필;곽문섭;김세화;이홍균
    • Journal of Chest Surgery
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    • 제25권3호
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    • pp.258-270
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    • 1992
  • Benign lung tumors have been considered as relatively rare disease, which comprise approximately 8 to 15% of all solitary pulmonary lesions that are detected radiographically. We clinically analized 30 cases of benign lung tumors underwent the operation from Jan. 1970 to Aug.1991 in the department of thoracic and cardiovascular surgery, Catholic University Medical College. We adopted the classification presented by the World Health Organization[WHO], modified from Liebow, and added benign mesothelioma. There were 11 males & 19 females ranging in age from 2 years to 68 years old % the mean age was 38 years old. Of all 30 benign lung tumors, hamartomas [14 cases, 49%] were the most common & followed by hemangiomas [9 cases, 30%], 3 cases of benign mesotheliomas % a case of teratoma, papilloma, arteriovenous malformation and inflammatory pseudotumor. 14 cases of tumors were asymptomatic & were incidentally detected by plane chest x-ray In other cases, chief complaints at admission were coughing, chest discomfort, dyspnea, hemoptysis, and fever. Diagnosis were made by pathological examination; exploratory thoracotomy in 23 patients[76.7%], bronchoscopy in 4 patients and percutaneous needle aspiration biopsy in 3 patients. Precisely, preoperative diagnosis for confirmation of benign lung tumor was made only in 7 cases[23.6%]. Tumors were located on Rt.side[24 cases], especially Rt. middle lobe, and Lt.side[6 cases]. Operation methods were as follows: 21 cases [70%] of lobectomy, 2 cases of segmentectomy, 2 cases of wedge resection, 1 case of pneumonectomy, 1 case of bronchotomy, 2 cases of wedge resection, 1 case of pneumonectomy, 1 case of bronchotomy removal of the endobronchial hamartoma which located at the rt. main stem bronchus and 3 cases of complete resection in benign mesotheliomas. There were no operative death. The post operative complications were developed in 3 cases; post pneumonectomy empyema, wound infection and atelectasis. In conclusion, benign lung tumors must be histologically diagnosed to confirm of benignity and to provide limited resection for preservation of the lung tissue, whenever possible.

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