• Title/Summary/Keyword: Spontaneous pain

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Use of stellate ganglion block for treatment of recurrent syncope followed by chest pain

  • Kim, Young-ung;Shin, Yong-joon;Cho, Young Woo
    • Journal of Yeungnam Medical Science
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    • v.35 no.1
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    • pp.104-108
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    • 2018
  • Syncope is defined as a transient loss of consciousness and postural tone, characterized by rapid onset, short duration, and spontaneous recovery. Stellate ganglion block (SGB) is a nerve block method that is used for treatment of neuropathic pain in the head, neck and upper extremities, especially trigeminal neuralgia, postherpetic neuralgia and complex regional pain syndrome. SGB can modulate and stabilize the sympathetic nervous system, which prevents it from overexcitation and improves symptoms of syncope. The authors report a patient who was treated for pain and edema of both upper extremities with SGB, then showed improvement in recurrent syncope followed by chest pain and overall quality of life.

A Study on the Results of Surgical Treatment of Spontaneous Pneumothorax - 336 Cases in 269 Patients - (자연기흉의 임상적 고찰 -336례 보고-)

  • 신호승
    • Journal of Chest Surgery
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    • v.21 no.5
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    • pp.871-876
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    • 1988
  • Spontaneous pneumothorax is a common surgical problem and occurs most frequently in male patients under 40 years of age. The records of 336 cases in 269 patients, diagnosed and treated as spontaneous pneumothorax during the period of 1981, Jan.- 1987, Dec., at the department of thoracic and cardiovascular surgery, college of medicine, Hallym university, were reviewed retrospectively. The results were as follows; 1. Spontaneous pneumothorax was commonly found between the age of 20-40[55%]. 2. Sexual ratio of male to female was 4.4:1. 3. The most common symptoms were dyspnea and chest discomfort or chest pain. 4. Pulmonary tuberculosis was the most common cause of the disease[30.8%]. 5. Recurrent rate after closed thoracotomy drainage was 28.2%, and not recurred after operation. 6. Bullae or blebs were found most commonly at the apical segment of both upper lobes.

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Spontaneous Spinal Epidural Hematoma in an Infant : A Case Report and Review of the Literature

  • Lim, Jae-Joon;Yoon, Soo-Han;Cho, Ki-Hong;Kim, Sang-Hyun
    • Journal of Korean Neurosurgical Society
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    • v.44 no.2
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    • pp.84-87
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    • 2008
  • Spontaneous spinal epidural hematoma (SSEH) is rare in children. especially in infants, in whom only 12 cases have been reported. Because of the nonspecificity of presenting symptoms in children, the diagnosis may be delayed. We report herein a case of SSEH in a 20-month-old girl who initially presented with neck pain, and developed lower extremity motor weakness and symptoms of neurogenic bladder 2 weeks prior to admission. The magnetic resonance imaging showed an epidural mass lesion extending from C7 to T4, and the spinal cord was severely compressed by the mass. After emergency decompressive surgery the neurologic function was improved immediately. Two months after surgery, the neurological status was normal with achievement of spontaneous voiding. We suggest that surgical intervention can provide excellent prognosis in case of SSEH in infants, even if surgery delayed.

A Case of Spontaneous Common Iliac Atery Dissection

  • Noh, Juho;Rhee, Il;Kim, Minsung;Lee, Jonghyun;Kim, Kisu;Park, Byungwhan
    • Kosin Medical Journal
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    • v.33 no.3
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    • pp.431-437
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    • 2018
  • Spontaneous and isolated dissection of the limb arteries without involvement of the aorta is extremely rare, and has been reported previously in pregnant patients in association with collagen vascular disease, and in cases of high-energy trauma or intensive activity in athletes. There is no consensus yet on indications for medical or surgical therapeutic modality. Due to the rarity of spontaneous dissection of external iliac artery, its natural history has been poorly described. A healthy 50-year-old male with normotension was admitted with an acute onset of left flank pain. Left external iliac artery dissection was diagnosed by abdominal computed tomography.

Clinical Evaluation of Spontaneous Pneumothorax -A Review of 244 Cases- (자연 기흉의 임상적 고찰 -244례-)

  • 김병린
    • Journal of Chest Surgery
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    • v.27 no.4
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    • pp.292-296
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    • 1994
  • From March, 1985, to June, 1993, 244 patients with 345 episodes of spontaneous pneumothorax treated at Koryo General Hospital were reviewed. Most of the patients were male, and the ratio of male to female was 8:1. The average age of the patients with spontaneous pneumothorax was 32.8 years old. The site of pneumothorax was revealed left side in 53.3%, right side in 42.6%, and bilateral in 4.1%. The cause of pneumothorax were shown primary spontaneous pneumothorax in 73.4%, and secondary spontaneous pneumothorax in 26.6%. The underlying pathologic lesion in secondary spontaneous pneumothorax showed pulmonary tuberculosis in 56patients[86.1%], COPD in 4patients[6.2%], bronchial asthma in 2patients[3.1%], lung cancer in 2patients[3.1%], and pneumoconiosis in a patient[1.5%]. The usual clinical symptomes were dyspnea, chest pain and chest discomfort. Recurrence rate was as follow; 2nd episode 33.6%, 3rd episode in 26.8%, and above in 4th episode in 18.2%. All the patient of pneumothorax was treated as following; Closed thoracostomy tube drainage in 127patients, bullectomy in 88patients, lobectomy in 5patients, wedge resection in 2patients, conservative treatment with oxygen therapy in 21patients, and video assisted thoracoscopic bullectomy in a patient. The course of treatment of all of the patients were smooth and uneventful.

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Clinical Evaluation of Pneumomediastinum in Adult (성인에서 기종격증의 임상적 고찰)

  • Lee, Seok-Gi;Im, Jin-Su;Jo, Nam-Su
    • Journal of Chest Surgery
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    • v.28 no.12
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    • pp.1150-1154
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    • 1995
  • Pneumomediastinum[Mediastinal emphysema is characterized by the presence of air in the mediastinum, and classified as spontaneous[occurring without obvious cause or secondary[caused by a trauma or artificial ventilation . To study the clinical evaluation of pneumomediastinum, data were obtained from 20 patients. The incidences of spontaneous pneumomedisastinum were 5 and those of secondary pneumomedistinum were 15 cases. The mean age was 21.2$\pm$3.4 years[$\pm$SD in spontaneous pneumomediastinum and 44.1$\pm$20.0 years[$\pm$SD in secondary pneumomediastinum. There were 16 male and 4 female patients. The common presenting compliants were retrosternal pain in 19 patients[95% , dyspnea in 12[60% , and hoarsness in 2[10% . The predisposing factors were asthma,excessive exercise and vomiting in spontaneous pneumomediastinum;trauma, artificial ventilation, tracheostomy, the rupture of trachea or esophagus in secondary pneumomediastinum. The physical findings were subcutaneous emphysema in 17 patients[85% , Hamman`s sign in 11 patients[55% and decreased cardiac dullness in 2 patients[10% . Spontaneous pneumomediastinums were managed conservatively, however, surigical procedures were needed in secondary pneumomediastinums. There was no recurrence, but one patinet died of tension pneumomedistinum. We concluded that spontaneous pneumomediastinum is uncommon, usually benign, and self-limited and secondary pneumomedistinum due to trauma or artificial ventilation is more increasing, and necessitates the early, aggressive intervention.

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Thymolipoma associated with spontaneous pneumothorax: report of a case (자연기흉을 합병한 흉선지방종의 치험례)

  • 이철범
    • Journal of Chest Surgery
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    • v.14 no.2
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    • pp.135-139
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    • 1981
  • Thymolipoma is extremely uncommon benign mediastinal tumor consisting of fatty and thymic tissue. Only 50 verified cases have been reported in the world literatures. This one case is the first reported example of surgically treated thymolipoma associated with spontaneous pneumothorax. A thirty-two year old male patient had been in good health until two days prior to admission, when he noted sudden dyspnea associated with an aching pain over the left precordium. The dyspnea and chest pain had become progressively worse. The physical examination revealed that left hemithorax was tympanic sound on percussion and absence of breathing sound on auscultation and point of maximal impulse was located on the 4th intercostal space at the left sternal border. Emergency closed thoracostomy was performed under the impression of tension type spontaneous pneumothorax of the left lung. After closed thoracostomy, point of maximal impulse was not changed inspire of full expansion of the left lung and chest X-ray was strongly suggested pericardial effusion or cardiomegaly which couldn`t account for by clinical course and hemodynamic evidence. EKG, echocardiogram, bronchofiberoscophy, bronchogram and diagnostic thoracentesis was performed. On Dec. 8, 1980, operation was performed under the impression of mediastinal tumor in the anterior mediastinum. At left posterolateral thoractomy, a large fatty mass, measuring 35 x 27 x 13 Cm in dimension and weighing 3350 gm, was resected and multiple bullae on the apicoposterior segment of the left upper lobe was resected and continuously sutured. The pathologic diagnosis of the fatty mass was thymolipoma. The postoperative course was uneventful and discharged in good general conditions.

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Median Sterontomy for Bilateral Resection of Emphysematous Bullae (정중 흉골 절개술을 통한 양측의 기종성 폐포의 절제)

  • 이성윤
    • Journal of Chest Surgery
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    • v.23 no.4
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    • pp.720-730
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    • 1990
  • The complicated pulmonary emphysema including “Giant bullae” and spontaneous pneumothorax often involve both lungs, and controversy exists concerning which is the more rational means of surgical treatment-bilateral simultaneous operation or two staged operation. We report three cases of the complicated bilateral bullous emphysema and two cases of bilateral spontaneous pneumothorax treated through median sternotomy. We performed the ligation of bullae, bullectomy, cystectomy, wedge resection, and left lower lobectomy through median sternotomy. No technical problems were encountered through this approach, which provided maximum benefit with one operation In conclusions, median sternotomy may be appropriate for resection of emphysematous bullae, specially in a severe COPD patient who may be poorly tolerated the superimposed loss of respiratory function due to incisional pain, because median sternotomy permit bilateral exploration, minimal impairment of pulmonary function, simultaneous restoration of pulmonary function, less incisional pain than routine lateral thoracotomy.

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Massive Spontaneous Diaphragmatic Rupture Induced by a Squatting Position

  • Kim, Su Wan;Lee, Seogjae
    • Journal of Chest Surgery
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    • v.46 no.3
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    • pp.230-233
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    • 2013
  • While a diaphragmatic rupture commonly results from trauma to the abdomen and chest, a spontaneous diaphragmatic rupture is very rare. A 68-year-old male presented with chest pain that had originated while doing farm work in a squatting position. Images revealed a 5 cm defect of the left diaphragmatic dome, and the entire stomach was displaced into the thorax. The diaphragmatic defect was round and half had a well-demarcated margin. The remaining fragile tissue was completely excised and was closed primarily. The patient was uneventfully discharged and resumed with a normal diet 10 days after the operation.

A Case of Bilateral Spontaneous Tension Pneumothorax Associated with Mycoplasma pneumoniae Infection (Mycoplasma pneumoniae 폐렴에 동반된 양측 특발성 긴장성 기흉 1례)

  • Lee, Jae Won;Heo, Mi Young;Kim, Hae Soon;Lee, Seung Joo
    • Clinical and Experimental Pediatrics
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    • v.45 no.3
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    • pp.401-405
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    • 2002
  • Mycoplasma pneumoniae(M. pneumoniae) is the leading cause of pneumonia in school-age children and young adults. The clinical courses are usually mild but recently, severe cases were reported such as lung abscess, Swyer-James syndrome and adult respiratory distress syndrome. Spontaneous pneumothorax associated with M. pneumoniae infection is rare. Carlisle reported a 6-year-old patient with bilateral spontaneous pneumothorax associated with M. pneumoniae infection and Koura also reported a 18-year-old girl with repeated. M. pneumoniae pneumonia with recurrent pneumothorax. We experienced bilateral spontaneous tension pneumothorax and subcutaneous emphysema associated with M. pneumoniae infection in a 6-year-old boy who presented with dyspnea, chest pain, and neck swelling. We reported it as the first case in Korea.