• Title/Summary/Keyword: Surgical exploration

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A case of diaphragmatic hernia associated with pregnancy (임신으로 인한 횡격막 탈장 1례)

  • Sohn, Kwang-Hyun;Lee, Nam-Soo;Lee, Geon-ju
    • Journal of Chest Surgery
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    • v.13 no.2
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    • pp.154-157
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    • 1980
  • A twenty three year old, Primigravida and 32 week pregnant woman who has been complained dyspnea, chest pain, nausea and vomiting was admitted to this chest surgical department on Feb. 19, 1979. Physical findings were those of acutely ill appearance, decreased thoracic excursion and absence of breath sounds in the left hemithorax. Roentgen examination of the chest revealed reticular cystic densities in the left, particularly in lower lung field with collapse of the left lung. Correction of the diaphragmatic hernia was carried out with reduction and repair of the hernia through transperitoneal approach. On exploration, the defect of the diaphragm was 12 x 12 cm in size and was located posterolateral area of left diaphragm. Hernia contents were stomach, spleen, omentum and splenic flexure of large bowel. The baby was normal full term spontaneous delivered at 36th POD. Diaphragmatic hernia complicated by pregnancy is a rarity and mortality is extremely high. Therefore, the literatures have reviewed and the case is reported.

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Cavernous Hemangioma of Mediastinum: A Case Report (종격동 해면상 혈관종: 1례 보고)

  • Hahn, Young-Sook;Kim, Sea-Wha;Lee, Hong-Kyun
    • Journal of Chest Surgery
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    • v.11 no.1
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    • pp.108-111
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    • 1978
  • The cavernous hemangioma often occur on the skin and mucosal surfaces of the body, but are also found in many viscera, particularly the liver, spleen, pancreas and occasionally in the brain. But it is rarely encountered in the mediastinum, but when found occur predominantly in the anterior mediastinum. It can occur in any age and have no characteristic symptoms or roentgenographic findings including angiocardiography. Inspite of its histologic benignancy, it may be locally invasive and can result in rib erosion or adjacent structural compression. Usually, surgical exploration is not only the sole means of assuring a diagnosis and the only treatment. Recently, we experienced one case of cavernous hemangioma in the anterior mediastinum, which was removed surgically, being proved to be cavernous hemangioma on histologic examination. Related literatures were reviewed.

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A Case of Sparganosis (Sparganosis의 1예(例))

  • Song, O.D.;Rim, H.J.;Lee, J.S.
    • Journal of agricultural medicine and community health
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    • v.5 no.1
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    • pp.46-48
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    • 1980
  • A case of sparganosis was presented. Sparganosis is not infrequent tissue helminthiasis in Korea and the incidence has been evidently increased. The patient was a 50-year-old Korean male who had a habit of eating raw flesh of fresh water fish. He first noticed the appearance of two peanut-sized masses in the right subcostal region, however, the two masses enlarged gradually to a pigeon egg size during 5 years. On surgical exploration, one larva (61 cm in length and 4 to 6 mm in width) from two masses was extracted. It was moved actively in warm physiological saline solution.

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Perforation of an Idiopathic Small Bowel Ulceration after Blunt Abdominal Trauma in a Child (소아에서 복부둔상 후 발견된 특발성 소장 궤양의 천공 1예)

  • Jeong, Yeon-Jun;Yu, Hee-Chul;Kim, Jae-Chun
    • Advances in pediatric surgery
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    • v.5 no.2
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    • pp.141-145
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    • 1999
  • Idiopathic small bowel ulceration distal to the duodenum is rare. Less than 5 % of the reported cases were in children. In the majority of the patients, a single ulcer of unknown cause is found in the jejunum or ileum. The diagnosis is difficult and usually made at the time of surgical exploration for complications, such as perforation, hemorrhage or obstruction. We treated a pediatric patient with perforation of an idiopathic ileal ulceration. The child was an 11-year-old boy who sustained blunt abdominal trauma. The involved ileal segment was resected. Pathologic findings were compatible with idiopathic small bowel ulceration. The clinical and pathological aspects of idiopathic ulcerations are discussed, and the literature reviewed.

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Fluid Accumulation in Preexisting Bullae (기존의 낭포성 병변에 발생한 공기-수면 음영)

  • In, Kwang-Ho;Kang, Kyung-Ho;Yoo, Se-Hwa
    • Tuberculosis and Respiratory Diseases
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    • v.39 no.3
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    • pp.278-281
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    • 1992
  • Air fluid level in a large ring shadow poses a diagnostic problem. But a new development of fluid level in preexisting bullous lesion is another problem. A 60 year old man with chronic obstructive lung disease was noticed to have multiple bullae. A few years later fluid level was newly developed in some of the bullae. Fluid level persisted for several months and later completely filled the space. Surgical exploration revealed pus collection in the bullae and epidermoid carcinoma in the nearby bronchi.

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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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Delayed Left Atrial Perforation Associated with Erosion After Device Closure of an Atrial Septal Defect

  • Kim, Ji Seong;Yeom, Sang Yoon;Kim, Sue Hyun;Choi, Jae Woong;Kim, Kyung Hwan
    • Journal of Chest Surgery
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    • v.50 no.2
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    • pp.110-113
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    • 2017
  • A 43-year-old man who had had a history of atrial septal defect (ASD) device closure 31 months previously presented with abrupt chest and back pain along with progressive cardiogenic shock and cardiac arrest. After resuscitation, he was diagnosed with cardiac tamponade. Diagnostic and therapeutic surgical exploration revealed left atrium (LA) perforation due to LA roof erosion from a deficient aortic rim. Device removal, primary repair of the LA perforation site, and ASD patch closure were performed successfully. The postoperative course was uneventful. The patient was discharged after 6 weeks of empirical antibiotic therapy without any other significant complications.

Clinical analysis of mediastinal tumor (종격동 종양의 임상적 고찰;34례 임상경험)

  • 박재홍
    • Journal of Chest Surgery
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    • v.26 no.12
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    • pp.940-943
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    • 1993
  • Mediastinal tumors have long fascinated the thoracic surgeon of their variety and unpredictability of iagnosis prior to exploration.We report the analysis of the 34 cases of mediastinal tumors,experenced in the dept.of the Thoracic and Cardiovascular Surgery of the National Medical Center.Between the 1993.9-1992.12. The age distribution was relatively even and the mean age was 35 years old.The thymomas were 16 cases [ 47% ].the lipoma were 4 cases [12%].the germ cell tumors were 7 cases [20%].the neurogenic tumors were 3 cases [8%].Histologically analysised .The malignant tumors were 16 cases [17.6%] in classified by hisotlogical types.the tumor size,location,and the clinical manifestation are presented.The successful removal was done in 28 cases [ 100%] among 28 cases of benign mediastinal tumors. Among the 6 cases of malignancy mediastinal tumors, the surgical intervention had done in 5 cases [ 83%] and inoperatable cases were 1 case [16.6%].There was no operative death.

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Congenital Agenesis of Left Diaphragm: Surgical Repair - Report of a Case - (선천성 횡격막 무발육증 수술치험 1례)

  • Lee, Jong-Rak;Lee, Sin-Yeong
    • Journal of Chest Surgery
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    • v.24 no.12
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    • pp.1238-1241
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    • 1991
  • Agenesis of the hemidiaphragm is unusual congenital anomaly associated with a high mortality. A case of congenital agenesis of left diaphragm was experienced in 22-day old male patient who was dyspneic and cyanotic on admission. Emergency exploration through the left eight interspace thoracotomy showed complete agenesis of the left diaphragm. The stomach and transverse colon covered with peritoneal sac was partially herniated into left hemithorax. The left lung was slightly hypoplastic. This neonate had no intestinal malrotation. The defect was reconstructed using Dacron graft. Dacron patch was sutured with interrupted Ethibond to chest wall anteriorly, esophagus aorta and costomediastinal sinus medially, and the tenth rib posterolaterally. Postoperatively, Extubation was performed at 1st day, but some respiratory difficulty was noted. Severe dyspnea was occurred at postoperative 11th day and so reintubation was done. Intermittently ventilatory support and intravenous alimentation were continued for 9 days after that. Thereafter he had no respiratory problems at discharge.

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Surgical Treatment of Renovascular Hypertension Due to Primary Arteritis (원발성 동맥염에 의한 신혈관성 고혈압의 외과적 치료 :1례 보고)

  • 김주이
    • Journal of Chest Surgery
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    • v.14 no.2
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    • pp.175-178
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    • 1981
  • Since the first report by Freeman of renal artery repair for renovascular hypertension in 1954, there has been a gradual improvement in the results of renovascular reconstruction. This is case report of renovascular hypertension due to diffuse primary arteritis, which was performed aorto-bllateral renal bypass graft with using of Y -woven dacron graft. This 33 y-o male has complained intermittent headache, facial edema & malignent hypertension symptoms for 1.5 years. He had the history of Rt. B-K amputation due to unhealed wound after trauma of the Rt. great toe about 7 years ago. The abdominal aortography revealed nearly not visualized the Rt. renal artery & severe narrowing of the Lt. renal arterly. During postop. course, Blood pressure was well controlled. At postop. 3rd week, systolic pressure was down to 130-140mmHg But, diastolic pressure was remained to 100-110mmHg. At postop. 30th day, exploration was done due to intestinal obstruction signs. But severe ischemic enteritis was occured due to fibrotic obstruction of the superior mesenteric artery. The next day, he was dead. in spite of Rt. common iliac artery-sup. mesenteric artery bypass graft.

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