• Title/Summary/Keyword: Thoracic Wall

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Development of a Chest Wall Deformity after Conservative Treatment for a Sternal Fracture

  • Kim, Do Wan;Jeong, In Seok;Na, Kook Joo;Song, Sang Yun;Lee, Kyo Seon;Kang, Seung Ku
    • Journal of Trauma and Injury
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    • v.29 no.4
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    • pp.184-186
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    • 2016
  • Although sternal fractures are relatively common, treatment has not been clarified. Thus, the authors report a case of a patient with a sternal fracture associated with a thoracic spinal fracture who had received conservative treatment, but the outcome was not satisfactory.

Traumatic aneurysm of descending thoracic aorta: report of one case (외상성 흉부대동맥류치험 1례 보)

  • Ahn, Hyuk;Chang, Byung-Chul;Lim, Seung-Pyung
    • Journal of Chest Surgery
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    • v.17 no.1
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    • pp.67-73
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    • 1984
  • A 25 years old male patient with traumatic aneurysm of descending thoracic aorta was treated successfully. He was admitted due to blunt trauma to the chest wall as falling down into water. He has been treated with closed thoracotomy and close observation. After a month simple chest film showed abnormal mass shadow around the aortic knob. Aortogram revealed aneurysm of descending thoracic aorta. Aneurysm was resected and replaced with woven Dacron graft with aid of Gotts shunt. His postoperative course was uneventful.

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Repair of Postinfarction Ventricular Septal Defect (심근경색 후 발생한 심실중격결손의 수술)

  • Choi, Jong-Bum;Cha, Byoung-Ki;Lee, Sam-Youn;Choi, Soon-Hoo
    • Journal of Chest Surgery
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    • v.39 no.12 s.269
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    • pp.906-912
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    • 2006
  • Background: Ventricular septal defect(VSD) is rare but feared complication after acute myocardial infarction. The patient could survive by surgery only, but the surgical mortality is still high. We investigate the surgical result and predictors for early surgical mortality. Material and Method: Between August 1993 and February 2006, 8 patients (male, 2: female, 6) with postinfarct VSD underwent surgical repair. Seven patients had one-vessel disease of left anterior descending artery, and 6 of them had wide extension of infarction to posterior septal wall as well as anterior septal wall of both ventricles. One patient had concomitant coronary bypass grafting to a coronary lesion unrelated to the infarction. Two patients had concomitant tricuspid annuloplasty and 1 patient mitral valvuloplasty. Result: Surgical mortality was 37.5%(3 patients). They all had only one-vessel disease of left anterior descending artery, which made extended posterior septal wall infarction as well as anterior septal wall infarction of both ventricles. In preoperative M-mode echocardiographic study of left ventricle, they had lower ejection fraction than survivors($34.9{\pm}4.2\;vs.\;54.8{\pm}12.3$; p=0.036). Conclusion: Most of patients with postinfarction VSD had one-vessel disease of left anterior descending artery. Early surgical mortality occurred in the patients with poor ejection fraction of left ventricle and the wide anterior septal wall infarction extending to the posterior septum.

Long-Term Treatment Results in Soft Tissue Sarcomas of the Thoracic Wall Treated with Pre-or-Postoperative Radiotherapy - a Single Institution Experience

  • Oksuz, Didem Colpan;Ozdemir, Sevim;Kaydihan, Nuri;Dervisoglu, Sergulen;Hiz, Murat;Tuzun, Hasan;Mandel, Nil Molinas;Koca, Sedat;Dincbas, Fazilet Oner
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.22
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    • pp.9949-9953
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    • 2014
  • Objective: To evaluate the long term results among patients with soft tissue sarcoma of the thoracic wall. Materials and Methods: Twenty-six patients who were treated with pre-or postoperative radiotherapy between December 1980-December 2007, with a diagnosis of soft tissue sarcoma of the thoracic wall were retrospectively evaluated. Results: The median age was 44 years (14-85 years) and 15 of them were male. A total of 50% of patients were grade 3. The most common histologic type of tumor was undifferentiated pleomorphic sarcoma (26.9%). Tumor size varied between 2-25 cm (median 6.5 cm). Seventeen of the cases had marginal and 9 had wide local resection. Four cases received preoperative radiotherapy and 22 postoperative radiotherapy. Six of the patients with large and high grade tumors received chemotherapy. Median follow-up time was 82 months (9-309 months). Local recurrence and metastasis was detected in 34.6% and 42.3% of patients, respectively. Five-year local control (LC), disease-free survival (DFS), overall survival (OS), and disease-specific survival (DSS) were 62%, 38%, 69%, and 76% respectively. On univariate analysis, the patients with positive surgical margins had a markedly lower 5-year LC rate than patients with negative surgical margin, but the difference was not significant (43% vs 78%, p=0.1). Five-year DFS (66% vs 17%) and DSS (92% vs 60%) rates were significantly worse for the patients who had high grade tumors (p=0.01, p=0.008 respectively). Conclusions: Tumor grade and surgical margin are essential parameters for determining the prognosis of thoracic wall soft tissue sarcoma both in our series and the literature.

Chronic Lhng Abscess Caused By Traumatic Bronchial Foreign Body(Wood) Persisting For 30 Years -A case report- (30년전 흉부외상에 의해 발생한 기관지내 이물(나무)과 이에 병발한 만성 폐농양 -1례 보고-)

  • Oh, Duck-Jin;Lee, Young;Lim, Seung-Pyeung;Yu, Jae-Hyun;Na, Myung-Hoon
    • Journal of Chest Surgery
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    • v.29 no.9
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    • pp.1040-1044
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    • 1996
  • A case with a bronchial foreign body(wood) which had an uncommon way of entry through a wound In the chest wall was described. A 41-year-old man was admitted to our hospital because of chronic cough and profuse purulent sputum. He had been injured by a fragment of wood which penetrated his anterolateral chest wall at 30 years ago. A chest x-ray film reavealed a calcific foreign body, measuring 3.0 by 1.0 cm, in the posterobasal segment of the left lung. Computed nomograp y of the chest demonstrated a calcific foreign body with bronchiectatic change near the diaphragmatic pleura In the left lower lobe. Left lower lobectomy was performed, and the patient remains well without any thoracic symptoms after the operation.

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Pedicle Morphometry for Thoracic Screw Fixation in Ethnic Koreans : Radiological Assessment Using Computed Tomographic Myelography

  • Choi, Yang-Soo;Kim, Young-Jin;Yi, Hyeong-Joong;Kim, Young-Joon
    • Journal of Korean Neurosurgical Society
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    • v.46 no.4
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    • pp.317-321
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    • 2009
  • Objective : In the thoracic spine, insertion of a pedicle screw is annoying due to small pedicle size and wide morphological variation between different levels of the spine and between individuals. The aim of our study was to analyze radiologic parameters of the pedicle morphometry from T1 to T8 using computed tomographic myelography (CTM) in Korean population. Methods : For evaluation of the thoracic pedicle morphometry, the authors prospectively analyzed a consecutive series of 26 patients with stable thoracic spines. With the consent of patients, thoracic CTM were performed, from T1 to T8. We calculated the transverse outer diameters and the transverse angles of the pedicle, distance from the cord to the inner cortical wall of the pedicle, and distance from the cord to the dura. Results : Transverse outer pedicle diameter was widest at T1 ($7.66{\pm}2.14\;mm$) and narrowest at T4 ($4.38{\pm}1.55\;mm$). Transverse pedicle angle was widest at T1 ($30.2{\pm}12.0^{\circ}$ and it became less than $9.0^{\circ}$ below T6 level. Theoretical safety zone of the medial perforation of the pedicle screw, namely, distance from the cord to inner cortical wall of the pedicle was more than 4.5 mm. Conclusion : Based on this study, we suggest that the current pedicle screw system is not always suitable for Korean patients. Computed tomography is required before performing a transpedicular screw fixation at the thoracic levels.

Right Atrium Rupture as a Result of Blunt Trauma from a Traffic Accident - One case report - (교통사고에 의한 둔상으로 발생한 우심방 파열 - 1예 보고 -)

  • Jang, In-Seok;Choi, Jun-Young;Kim, Sung-Hwan;Lee, Chung-Eun;Kim, Jong-Woo;Rhie, Sang-Ho
    • Journal of Chest Surgery
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    • v.40 no.1 s.270
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    • pp.66-68
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    • 2007
  • Traumatic cardiac injury is an extremely serious medical condition. It is possible to overlook a cardiac injury where there is no chest wall trauma. We here report the 47-year-old woman who got a crach car accident and had a tear of the right atrium. The distortion force from a decelerating injury may cause cardiac rupture at a fixed point. The most common symptom that alerts the clinician to a potentially fatal cardiac injury is the change in vital signs. Therefore cardiac injury should be considered in any patient with unexplained hypotension who has experienced decelerating trauma, even without external injury to the chest wall.

A Metastatic Giant Cell Tumor of the Soft Tissue of the Thoracic Wall - A case report - (흉벽 연부조직에 발생한 전이성 거대세포종 - 1예 보고 -)

  • Shin, Duk-Seop;Lee, Jang-Hoon;Choi, Jun-Hyuk;Chung, Tae-Eun
    • Journal of Chest Surgery
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    • v.40 no.7 s.276
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    • pp.526-528
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    • 2007
  • A giant cell tumor of bone is a benign bone tumor, but has very high local recurrence rate and, very rarely metastasizes to the lung or a distant area. We report a case of a 29-year-old male patient presenting with a metastatic giant cell tumor of the soft tissue of the chest wall, who underwent a total resection of the radius for recurrence of the giant cell tumor. The tumor was not related to any bony structure of the thorax. We resected the tumor with a wide surgical margin. No evidence of malignancy was seen in the frozen and permanent pathological report.

Myocardial Hamartoma Involving the Posterior Left Ventricular Wall -Surgical Experience of One Case- (좌심실 후벽을 침범한 심근성 과오종 -수술 치험 1예-)

  • Seo Yeon-Ho;Kim Nan-Yeol;Kim Kong-Soo
    • Journal of Chest Surgery
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    • v.39 no.6 s.263
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    • pp.486-489
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    • 2006
  • A 16 year-old boy was admitted to our department because of mild chest discomfort and mild dyspnea. A mass involving posterior wall of the left ventricle near posterior mitral annulus was found on echocardiography and cardiac MRI. Total excision of the mass was performed via posterior ventriculotomy under the cardiopulmonary bypass. The pathologic diagnosis revealed mature cardiac myocyte hamartoma. There was no evidence of arrhythmia and tumor recurrence during the 1 year of follow up after the surgery.

Atypical Type of Descending Necrotizing Fasciitis Spreading into the Lateral Chest Wall: Case Report (흉벽 외측을 타고 내려온 비전형성 하행 경부 괴사성 근막염 1예)

  • Lee, Yong Jik;Lee, Jong Cheol;Lee, Ho Min;Kim, Jung Won;Jung, Jong Phil;Park, Chang Ryul
    • Korean Journal of Bronchoesophagology
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    • v.17 no.1
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    • pp.61-64
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    • 2011
  • Cervical necrotizing fasciitis is a rare but well known life-threatening soft tissue infection primarily affecting the superficial and deep cervial fascial planes. It may rapidly spread into the mediastinum along fascial planes. So, if proper diagnosis and prompt surgical debridement is delayed, the infection may cause descending necrotizing mediastinitis with extensive necrosis of overlying skin, destroying fascia and muscle. Therefore, the key to the successful outcome is early recognition and rapid initiation of definitive radical debridement. The authors report, along with a literature review, a case of cervical necrotizing fasciitis with atypical spreading into the lateral chest wall.

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