• Title/Summary/Keyword: Mediastinitis

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Cardiac Valve Replacement: A Report of 145 Cases (인공심장판막에 의한 심장질환수술에 관한 연구)

  • 이영균
    • Journal of Chest Surgery
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    • v.11 no.4
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    • pp.501-515
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    • 1978
  • The purpose of this communication is to review the 390 cases of chest trauma, treated at Department of Thoracic and Cardiovascular Surgery, School of Medicine Kyungpook National University from 1960 to 1977. Patients were grouped into two: group `60s [1960-1969] of 103 cases and group `70s [1970-1977] of 257 cases. As the number of cases of each group showed, chest trauma cases increased three times in `70s . The main causes of trauma were auto accident, falling down, industrial injury and stab wound in that order for both groups. Eighty per cent of cases of `60s were between 20 and 59 years and 73.8% of same age range for `70s. Rib fracture of fourth to eighth rib was the most common lesion in both `60s and `70s group. The incidence of hemothorax or hemopnemothorax significantly increased among `70s group than `60s. Clinical manifestations of chest pain and dyspnea remained most frequent symptoms for both groups. The pertinent principles of treatment for the chest trauma were conservative therapy, closed thoracotomy and open thoracotomy. Closed thoracotomy was performed more freely during the period of 1970-1977, with encouraging clinical results. Very few cases of complications other than pneumothorax or hemopneumothorax occurred. Those are fibrothorax, asphyxia, atelectasis and mediastinitis. The overall mortality was 3.9% for the `60s and 2.1% for the `70s group. The possible causes of death of 14 cases of chest trauma whom died on arrival during 1970-1977 were analyzed.

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Chest Trauma (흉부 외상)

  • 김송명
    • Journal of Chest Surgery
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    • v.11 no.4
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    • pp.488-500
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    • 1978
  • The purpose of this communication is to review the 390 cases of chest trauma, treated at Department of Thoracic and Cardiovascular Surgery, School of Medicine Kyungpook National University from 1960 to 1977. Patients were grouped into two: group `60s [1960-1969] of 103 cases and group `70s [1970-1977] of 257 cases. As the number of cases of each group showed, chest trauma cases increased three times in `70s . The main causes of trauma were auto accident, falling down, industrial injury and stab wound in that order for both groups. Eighty per cent of cases of `60s were between 20 and 59 years and 73.8% of same age range for `70s. Rib fracture of fourth to eighth rib was the most common lesion in both `60s and `70s group. The incidence of hemothorax or hemopnemothorax significantly increased among `70s group than `60s. Clinical manifestations of chest pain and dyspnea remained most frequent symptoms for both groups. The pertinent principles of treatment for the chest trauma were conservative therapy, closed thoracotomy and open thoracotomy. Closed thoracotomy was performed more freely during the period of 1970-1977, with encouraging clinical results. Very few cases of complications other than pneumothorax or hemopneumothorax occurred. Those are fibrothorax, asphyxia, atelectasis and mediastinitis. The overall mortality was 3.9% for the `60s and 2.1% for the `70s group. The possible causes of death of 14 cases of chest trauma whom died on arrival during 1970-1977 were analyzed.

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Application of radiographic images in diagnosis and treatment of deep neck infections with necrotizing fasciitis: a case report

  • Kim, Young-Joo;Kim, Ju-Dong;Ryu, Hye-In;Cho, Yeon-Hee;Kong, Jun-Ha;Ohe, Joo-Young;Kwon, Yong-Dae;Choi, Byung-Joon;Kim, Gyu-Tae
    • Imaging Science in Dentistry
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    • v.41 no.4
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    • pp.189-193
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    • 2011
  • The advent and wide use of antibiotics have decreased the incidence of deep neck infection. When a deep neck infection does occur, however, it can be the cause of significant morbidity and death, resulting in airway obstruction, mediastinitis, pericarditis, epidural abscesses, and major vessel erosion. In our clinic, a patient with diffuse chronic osteomyelitis of mandible and fascial space abscess and necrotic fasciitis due to odontogenic infection at the time of first visit came. We successfully treated the patient by early diagnosis using contrast-enhanced CT and follow up dressing through the appropriate use of radiographic images.

A Lung Abscess Combined with Mediastinal Air Shadow (종격동 공기음영을 동반한 폐농양)

  • Choi, In-Keun;Lee, Sin-Hyung;Lee, Sang-Youb;Cho, Jae-Youn;Shim, Jae-Jeong;In, Kwing-Ho;Yoo, Se-Hwa;Kang, Kyung-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.1
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    • pp.142-146
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    • 1999
  • A 55-year-old-female was admitted for the evaluation of mass shadow on chest film. She complained of fever, chilling, cough, and whitish sputum. She did not give any history of choking or coughing when she ate. The chest CT showed lung aoocess in right lower lobe with extension of infiltration and air shadow in mediastinum. The esophagoscopy and esophagography were performed to find the cause of mediastinal infiltration, and bronchoesophageal fistula was detected in esophagography. The patient complained of severe chilling and febrile sensation after esophagography, mediastinitis aggravated by thin barium was suggested clinically. So, surgical drainage of lung abscess and thin barium was done urgently. One month after operation, follow-up of esophagoscopy and esophagography were done, the bronchoesophageal fistula was not detected.

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Clinical Analysis of Cervical Necrotizing Fasciitis (경부 괴사성 근막염의 임상적 고찰)

  • Park, Byung Kuhn;Lee, Do-Joon;Lee, Sang Joon
    • Korean Journal of Bronchoesophagology
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    • v.17 no.1
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    • pp.46-49
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    • 2011
  • Background and Objectives Cervical necrotizing fasciitis is a fulminant disease associated with necrosis of connective tissue, spread along the fascial plane, and high mortality. We analyzed the clinical characteristics and treatment outcome of this rare fatal disease. Materials and Methods We retrospectively reviewed the medical records of 19 patients treated for cervical necrotizing fasciitis from January 1999 to January 2009. Mean age was 53.7 years. Results The most common predisposing illness was tonsillitis (36.8%), followed by odontogenic infection (15.7%). Diabetes mellitus was most common underlying disease. Liver cirrhosis and chronic renal failure were found in 2 patients each. All patients were treated with combination of parenteral antibiotics and wide surgical debridement by transcervical and/or thoracotomy approach. Multiple surgical debridements were performed in 7 patients. Tracheotomy was performed in most of the patients (88.8%). Period of total hospitalization and Intensive care unit was 23 days and 10.1 days. Two patients died of disease and overall survival rate was 89.4%. Conclusion Early surgical management and care in intensive care unit are essential for cervical necrotizing fasciitis. Possible complications such as respiratory failure, mediastinitis or sepsis should be carefully evaluated.

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Cervical Mediastinotomy on the Complication of the Esophageal Foreign Body (경부 종격절제술에 의한 식도이물 합병증의 치험례)

  • Lee, Jong-Won;Jung, Kwang-Sik;Jung, Myung-Kyun;Cho, Sook;Cho, Sung-Woon
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1983.05a
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    • pp.5.1-5
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    • 1983
  • Esophageal foreign body is not uncommon problem among the esophageal disease and it is cured by removal of foreign body under the esophagoscopy in the most case. But it can cause esophageal perforation, periesophageal abscess, mediastinitis, pneumothorax, pyothorax, lung abscess and subcutaneous emphysema, and then may threat the life if early diagnosis and prompt management is not carried out. Esophageal perforation can be developed by sharp pieces of metal, bone or long term lodgement of foreign bodies in the esophagus. The authors have experienced the patient with periesophageal abscess after drawing out the sharp fish bone, and achived the good result by drainage via cervical mediastinotomy with continuous irrigation.

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Management of Esophageal Perforation: Analysis of the Risk Factors Affecting the Outcome (식도 천공의 치료와 예후에 영향을 미치는 인자의 분석)

  • Park, Kyoung-Taek;Han, Il-Yong;Cho, Kwang-Hyun
    • Korean Journal of Bronchoesophagology
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    • v.16 no.2
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    • pp.126-130
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    • 2010
  • Background: The esophageal perforation is related to high morbidity and mortality rates if the diagnosis and treatment are delayed. The aim of this study is to evaluate the affecting factors on outcome and prognosis of the patients who suffer from esophageal perforation. Material and Methods: Twenty-six patients were treated with esophageal perforation in our institute from Jan. 1992 to Feb. 2010. We retrospectively reviewed the results of treatment for esophageal perforation to understand the risk factors affecting survival in patients. Results: The subjects are 26 patients suffered with esophageal perforation and the mean age is $52{\pm}17.8$ years old. 16 esophageal perforations were caused spontaneously, 25 cases were treated surgically. The mortality rate is higher in the cases o pre-operative mediastinitis. Conclusion: The shortness time interval until the beginning of treatment should be achieved to reduce the incidence of fatal post-treatment morbidity and mortality.

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A case of deep neck infection resulting from intubation-induced hypopharyngeal injury (기관내 삽관으로 발생한 하인두 천공에 기인한 심경부 감염 1례)

  • Kim, Min-Soo;Seo, Hyung-Seok;Lim, Hye-Jin;Jung, Jae-Ho;Lee, Kang-Jin;Kang, Jae-Goo
    • Korean Journal of Bronchoesophagology
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    • v.14 no.2
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    • pp.57-63
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    • 2008
  • Hypopharyngeal perforation secondary to tracheal intubation is rare, but may result in severe airway complications that include retropharyngeal abscess, pneumothorax, pneumonia, mediastinitis and death. The most common site of hypopharyngeal perforation is the pyriform sinus and the region of the cricopharyngeus muscle. We report a 62-year old man with intubation-induced hypopharyngeal injury presenting as deep neck infection. The patient presented with dyspnea and pain on the neck. Neck CT scan identified fluid and air collection on the neck from the hyoid bone to the thoracic inlet level. Despite of delayed diagnosis, we successfully operated him by using strap muscle myofascial transposition flap. The patient was followed up for 3 months without any complications.

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Congenital Heart Disease in the Adult - 122 Cases Analysis - (성인의 선천성 심질환;122례 분석)

  • 정신현
    • Journal of Chest Surgery
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    • v.25 no.7
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    • pp.769-776
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    • 1992
  • Total 632 cases of open heart surgery were performed in the department of thoracic and cardiovascular surgery, Pusan Paik Hospital, Inje University from october 1985 to december 1990. Among them, there were 503 cases of congenital heart disease and 129 cases of acquired heart disease. In the cases of 503 congenital heart disease surgically corrected, 122 cases over 15 years of age were reviewed and its results were summarized as follows ; l. In total 122 cases 65 were male and 52 female. 2. There were 54 patients under 20 years of age, 31 between 20 & 24 years, 20 between 25 & 29 and 17 over 30 years of age. The eldest was a 46-year-old female of atrial septal defect group. 3. There were 63 cases of VSD[51.7%], 38 of ASD[31.2%], 11 cases of TOF[9%] and so on. 4. In recovery cases, main post-operative complications were as follows; cardiac tamponade, arrhythmia, low cardiac output syndrome, pulmonary, edema pericarditis, mediastinitis, sepsis and DIC. 5. There were 3 cases of post-operative death in this series, so operative mortality rate was 2.5% compairing with 1.8% of pediatric cases below 15 years of age. 6. This reviewed series reveal that aggressive surgical approach in adult congenital heart disease can be justified with low operative mortality like as pediatric age group.

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Surgical Treatment of Double Chambered Right Ventricle (이강우심실의 수술요법)

  • Park, Jong-Ho;No, Jun-Ryang
    • Journal of Chest Surgery
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    • v.27 no.5
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    • pp.353-363
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    • 1994
  • From January 1978 to December 1992, 59 patients of double chambered right ventricle were repaired. Surgical correction consisted of closure of the ventricular septal defect and resection of anomalous muscle bundles through right ventriculotomy [Group I ; 34 patients] or right atriotomy [Group II ; 25 patients]. Between these two groups, there was no difference in the operation time and the postoperative results. All patients survived. In group I, hemodynamically significant residual ventricular septal defect was found in three and reoperations were necessary. In one patient, subacute bacterial endocarditis developed postoperatively. In group II, complete atrioventricular block developed in one and mediastinitis in two. Follow-up period was from 2 to 75 months [mean 17.1 months]. There was no late death. All patients have remained in sinus rhythm except one patient. Careful evaluation of echocardiographic and catheterization data preoperatively and careful examination of the anatomy intraoperatively are necessary so that double chambered right ventricle should not be overlooked, because most ventricular septal defects are now closed through the right atrium. Repair of double chambered right ventricle is also easily performed through the atrial approach. Transatrial repair should be considered as an alternative to the transventricular approach in patients with this congenital heart defect. Successful surgical correction of double chambered right ventricle is expected with excellent long term results.

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