• 제목/요약/키워드: Surgical exploration

검색결과 145건 처리시간 0.021초

식도암의 외과적 요법에 관한 연구 (surgical treatment of esophageal cancer)

  • 김용진;김주현
    • Journal of Chest Surgery
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    • 제17권4호
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    • pp.819-828
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    • 1984
  • Between September 1973 and December 1983, 61 patients with carcinoma of the esophagus were treated surgically at the Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital. Among 61 patients, male patients were 51 cases, female 10 cases and the age ranged from 21 years old to 72 years old with the average of 54.6 years old. Min symptoms of esophageal cancer were dysphagia (91.5%), weight loss (40.4%), pain(27.6%), and the average symptom duration was 3.85 months. The anatomical locations of esophageal cancer in preoperative esophagogram revealed 41.7% in middle 1/3, 8.3% in esophagograstic junction or cardia. Among 61 cases, 9 cases were managed by feeding gastrostomy due to inoperability, 8 cases by exploratory thoracotomy or lapatotomy only without curative or palliative resection, and 44 cases by curative or palliative resection with reconstruction. Among 52 cases of exploration, 44 cases were managed with curative or palliative resection of cancer and the resectability revealed 84.6% in operated cases. Among palliative or curative resected group, the esophagogastrostomy was performed in 40 cases (90.9%), esophagojejunostomy in 3 cases(6.8%), esophagectomy only in 1 case(2.3%). Postoperative complications were noticed in 12 cases, such as anastomotic leakage in 7 cases(15.6%), empyema in 2 cases (4.4%), respiratory failure in 2 cases (4.4%), anastomotic stricture in 1 case (2.2%). among 7 postoperative anastomotic leakage, 2 patients died as a result of that complication and the operative mortality revealed 4.3%. During follow-up work, the mean survival period was 19.3 months in patients who discharged hospital alive, and the 2 year survival rate was 34.6%.

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Hydrocephalus due to Membranous Obstruction of Magendie's Foramen

  • Kasapas, Konstantinos;Varthalitis, Dimitrios;Georgakoulias, Nikolaos;Orphanidis, Georgios
    • Journal of Korean Neurosurgical Society
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    • 제57권1호
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    • pp.68-71
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    • 2015
  • We report a case of non communicating hydrocephalus due to membranous obstruction of Magendie's foramen. A 37-year-old woman presented with intracranial hypertension symptoms caused by the occlusion of Magendie's foramen by a membrane probably due to arachnoiditis. As far as the patient's past medical history is concerned, an Epstein-Barr virus infectious mononucleosis was described. Fundoscopic examination revealed bilateral papilledema. Brain magnetic resonance imaging demonstrated a significant ventricular dilatation of all ventricles and turbulent flow of cerebelospinal fluid (CSF) in the fourth ventricle as well as back flow of CSF through the Monro's foramen to the lateral ventricles. The patient underwent a suboccipital craniotomy with C1 laminectomy. An occlusion of Magendie's foramen by a thickened membrane was recognized and it was incised and removed. We confirm the existence of hydrocephalus caused by fourth ventricle outflow obstruction by a membrane. The nature of this rare entity is difficult to demonstrate because of the complex morphology of the fourth ventricle. Treatment with surgical exploration and incision of the thickened membrane proved to be a reliable method of treatment without the necessity of endoscopic third ventriculostomy or catheter placement.

Recanalization of Completely Thrombosed Non-Giant Saccular Aneurysm Mimicking as De Novo Aneurysm

  • Choi, Yong-Su;Kim, Dae-Won;Jang, Sung-Jo;Kang, Sung-Don
    • Journal of Korean Neurosurgical Society
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    • 제48권4호
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    • pp.354-356
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    • 2010
  • Partial thrombosis of giant aneurysms is not uncommon however, complete angiographic occlusion occurs less frequently. In the case of non-giant aneurysms, complete thrombosis and recanalization has been rarely reported. A 31-year-old man presented to the emergency department with sudden bursting headache. Brain computed tomography (CT) revealed diffuse subarachnoid hemorrhage on the left side. Both CT angiography (CTA) and digital subtraction angiography showed suspicion of small left anterior choroidal artery aneurysm. We performed surgical exploration. In the operation field, anterior choroidal artery aneurysm of $2{\times}2\;mm$ with broad neck and friable appearance was observed. Because we could not clip without sacrificing the anterior choroidal artery, we performed wrapping only. Follow up CTA after 7 months demonstrated 4 mm right internal carotid artery bifurcation aneurysm. The patient underwent aneurismal neck clipping. During the operation, $9{\times}13\;mm$ sized thrombosed aneurysm was detected and completely clipped. We initially thought this aneurysm to be a de novo aneurysm however, it was an aneurysm that had recanalized from a completely thrombosed aneurysm. This case report provides an insight into the potential for complete thrombosis and recanalization of non-giant aneurysms.

Delayed formation of sterile abscess after zygomaticomaxillary complex fracture treatment with bioabsorbable plates

  • Doh, GyeongHyeon;Bahk, Sujin;Hong, Ki Yong;Lim, SooA;Han, Kang Min;Eo, SuRak
    • 대한두개안면성형외과학회지
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    • 제19권2호
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    • pp.143-147
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    • 2018
  • We present a patient who showed a sterile abscess after facial bone fixation with bioabsorbable plates and screws. He had zygomaticomaxillary complex and periorbital fracture due to falling down. The displaced bones were treated by open reduction and internal fixation successfully using bioabsorbable plate system. However, at postoperative 11 months, abrupt painless swelling was noted on the previous operation sites, left lateral eyebrow and lower eyelid. By surgical exploration, pus-like discharge and degraded materials were observed and debrided. The pathologic analysis revealed foreign body reaction with sterile abscess. This complication followed by bioabsorbable device implantation on maxillofacial bone surgery has been rarely reported in which we call attention to the maxillofacial plastic surgeons.

상악동후벽에 발생한 낭형 복합치아종 (A Peduncular Cystic Compound Odontoma on the Posterior Wall of the Maxillary Sinus)

  • 강병철
    • 치과방사선
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    • 제28권2호
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    • pp.491-503
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    • 1998
  • A cystic compound odontoma in the maxillary sinus occurred in a 13-year-old boy. who had missing right upper third molar without having the history of extraction of the wisdom tooth. He complained nasal stuffiness. headache. and pain on the affected face. resembling any sign and symptoms of the maxillary sinus problems. The cystic compound. sized 2 x 1.5 cm in diameter was pedunculated and attached on the posterior wall of the right maxillary sinus and above the antral floor. The location of the compound odontoma in the maxillary sinus was confirmed after panoramic. waters. spiral tomographic. CT examinations and surgical exploration. Its location was on the medial. posterior. superior to the normal position of the maxillary third molar or the maxillary dental arch. The cystic odontoma in the maxillary sinus made the patient have the signs and symptoms of maxillary sinusitis. The cystic compound odontoma might be originated from the dental lamina of the missing upper right third molar. The 'V principle' of the upper jaw growth and the pneumatization process of the maxillary sinus could explain why the compound odontoma had peduncular shape and the location of odontoma was on the medial. superior to the normal position of the maxillary dental arch.

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두개골의 결손과 동반된 재발성 세균성 뇌막염 2례 (Recurrent Bacterial Meningitis Secondary to Cochlear Aplasia, Right and Acquired Cribriform Plate Defect due to Trauma)

  • 장수희;김선준;김정수
    • Pediatric Infection and Vaccine
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    • 제5권2호
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    • pp.283-288
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    • 1998
  • Recurrent meningitis in children is not only a potentially life threatening condition, but often involves the child in the trauma though repeated hospital admissions and multiple invasive investigations to find the underlying causes. Symptoms and signs of CSF rhinorrhea or otorrhea are infrequent in these patients and difficult to diagnose in young children. All young children treated for meningitis should then be administered an evoked potential audiometry as a post-treatment test. If sensorineural hearing loss is identified, the clinician should be alerted to the possibility of CSF leakage as the cause of the meningitis. Radiologic studies should be performed to rule out preexisting congenital, or acquired, abnormalities requiring surgical exploration. Two young children with recurrent meningitis due to a right cochlear aplasia and a cribriform plate defect caused by trauma are presented to illustrate the problems of diagnosis and management. A review of literatures will also be presented briefly.

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Congenital Internal Hernia Presented with Life Threatening Extensive Small Bowel Strangulation

  • Lee, Narae;Kim, Su-Gon;Lee, Yeoun Joo;Park, Jae-Hong;Son, Seung-Kook;Kim, Soo-Hong;Hwang, Jae-Yeon
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제16권3호
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    • pp.190-194
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    • 2013
  • Internal hernia (IH) is a rare cause of small bowel obstruction occurs when there is protrusion of an internal organ into a retroperitoneal fossa or a foramen in the abdominal cavity. IH can be presented with acute or chronic abdominal symptom and discovered by accident in operation field. However, various kinds of imaging modalities often do not provide the assistance to diagnose IH preoperatively, but computed tomography (CT) scan has a high diagnostic accuracy. We report a case of congenital IH in a 6-year-old boy who experienced life threatening shock. CT scan showed large amount of ascites, bowel wall thickening with poor or absent enhancement of the strangulated bowel segment. Surgical exploration was performed immediately and had to undergo over two meters excision of strangulated small bowel. To prevent the delay in the diagnosis of IH, we should early use of the CT scan and take urgent operation.

갑상선 혈종의 보존적 치료 1예 (A case of Thyroid Hematoma Managed by Conservative Treatment)

  • 정영도;김덕수;손호진;김정규
    • 대한두경부종양학회지
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    • 제34권1호
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    • pp.45-47
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    • 2018
  • Thyroid hematoma secondary to a blunt trauma is a rare problem. Despite the rarity, it can be a life-threatening condition with tracheal compression. Both surgical exploration and conservative management have been suggested for thyroid hematoma. However, there is still controversy on the optimal treatment. A 67-year old man who progressed severe dyspnea and neck swelling was transferred to the emergency department with a blunt anterior neck trauma after traffic accident. Contrast enhanced neck computed tomography scan showed huge hematoma within the right thyroid gland and slight tracheal deviation without prominent airway obstruction. One day later, anterior neck swelling was aggravated and the patient was intubated to prevent airway obstruction. After 3 days, hematoma resolution was revealed and extubation was done. We report this case with a review of literature.

Periocular Myxoma in a Dog

  • Bae, Jae Hyun;Kim, Jury;Kwon, Seungjoo;Plummer, Caryn;Hillers, Kim;Kim, Min-Su
    • 한국임상수의학회지
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    • 제37권1호
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    • pp.34-37
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    • 2020
  • A 1-year-old castrated male Shih-Tzu dog presented with severe orbital swelling involving the right eye. Physical examination identified a painless swelling of the right periocular tissues and protrusion of the third eyelid. Radiographic examination revealed a well-delineated, spherical (3 × 3 cm) soft tissue mass. Ultrasonography confirmed a hypoechoic, multilobular, tubular cystic structure with hyperechoic foci. Fine needle aspiration was conducted and the cytologic impression revealed copious mucus, increased neutrophilic leucocytes, and foamy macrophages. Th tentative diagnosis was zygomatic sialocele, and the lesion was resected through lateral orbitotomy. Surgical exploration identified a multilobular mass adhering to the zygomatic glands. Both the zygomatic gland and the mass were removed. Histological findings were consistent with those of an inflamed myxoma. No postoperative recurrence occurred within 1 year.

Unrecognized intraorbital wooden foreign body

  • Kim, Young Ho;Kim, Hyonsurk;Yoon, Eul-Sik
    • 대한두개안면성형외과학회지
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    • 제19권4호
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    • pp.300-303
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    • 2018
  • Intraorbital wooden foreign bodies may present difficulties in diagnosis due to their radiolucent nature. Delayed recognition and management can cause significant complications. We present a case report that demonstrates these problems and the sequela that can follow. A 56-year-old man presented with a 3-cm laceration in the right upper eyelid, sustained by a slipping accident. After computed tomography (CT) scanning and ophthalmology consultation, which revealed no fractures and suggested only pneumophthalmos, the wound was repaired by a plastic surgery resident. Ten days later, the patient's eyelid displayed signs of infection including pus discharge. Antibiotics and revisional repair failed to solve the infection. Nearly 2 months after the initial repair, a CT scan revealed a large wooden fragment in the superomedial orbit. Surgical exploration successfully removed the foreign body and inflamed pocket, and the patient healed uneventfully. However, the prolonged intraorbital infection had caused irreversible damage to the superior rectus muscle, with upgaze diplopia persisting 1 year after surgery and only minimal muscle function remaining. We report this case to warn clinicians of the difficulties in early diagnosis of intraorbital wooden foreign bodies and the grave prognosis of delayed management.