• Journal of Chest Surgery
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• 제24권10호
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• pp.1028-1032
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• 1991

A 17-year-old man was admitted for chronic anterior chest pain and dyspnea. He was undergone pericardiocentesis for chylopericardium and thoracostomy tube drainage for right sided chylothorax. Approximately 2000ml per day from right chest tube was drained during 20 days Supradiaphragmatic ligation of thoracic duct was performed and there was no drainage postoperatively and immediately antituberculous medication was done.

• Journal of Chest Surgery
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• 제33권2호
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• pp.193-194
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• 2000

A 45-year-old woman was diagnosed as having chylothorax after a mitral valve replacement for mitral stenosis. direct injury of lymphatics in thymus a ramification of thoracic duct was presumed to be responsibe for this complication. Four weeks of conservative treatment failed and surgical treatment was performed, We report a case of surgical treatment for chlyothorax after and open heart surgery.

• Investigative Magnetic Resonance Imaging
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• 제23권3호
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• pp.276-278
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• 2019

The cisterna chyli, a dilated lymphatic sac in the retrocrural space, is usually located to the right of the aorta. We report a case of a left-sided cisterna chyli, which was incidentally detected on the radiologic examinations of a preoperative workup for cholangiocarcinoma. Computed tomography (CT) and magnetic resonance (MR) images revealed a cisterna chyli measuring 2.5 cm in length in the left retrocrural space. The dilated lumbar lymphatics joined with the cisterna chyli, which was continuous with the left-sided thoracic duct. To the best of our knowledge, this is the second antemortem case of a left-sided cisterna chyli in literature. The cisterna chyli can mimic retrocrural lymphadenopathy, solid tumor with cystic degeneration, abscess or hematoma. The left-sided cisterna chyli should be referred to as a structure so as to be cautious in surgical approach.

• Archives of Plastic Surgery
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• 제49권4호
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• pp.549-553
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• 2022

Chylothorax is a rare disease and massive lymph fluid loss can cause life-threatening condition such as severe malnutrition, weight loss, and impaired immune system. If untreated, mortality rate of chylothorax can be up to 50%. This is a case report of a 3-year-old child with iatrogenic chylothorax. Despite conservative treatment and procedures, like perm catheter insertion, the patient failed to improve the respiratory symptoms over 3 months of period. As an alternative to surgical option, such as pleurodesis and thoracic duct ligation which has high complication rate, the patient underwent lymphovenous anastomosis (LVA) and lymph node to vein anastomosis (LNVA). Follow-up at fourth month showed clear lungs without breathing difficulty despite perm catheter removal. This is the first report to show the effectiveness of LVA and LNVA against iatrogenic chylothorax.

• Clinical and Experimental Pediatrics
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• 제56권4호
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• pp.176-181
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• 2013

Purpose: Apical muscular ventricular septal defects (MVSDs), especially in small infants, can be difficult to manage using surgical and percutaneous closure. An intraoperative perventricular procedure is a good option for closing apical MVSDs in small children with or without associated cardiac anomalies. We evaluated the results of hybrid perventricular closure of apical MVSDs performed using an Amplatzer duct occluder (ADO). Methods: We retrospectively reviewed the medical records of 5 patients who underwent hybrid perventricular closure of MVSDs with ADOs, from March 2006 to May 2011. The median patient age at the time of the procedure was 12 months (range, 25 days to 25 months), and the median body weight was 9.1 kg (range, 4.3 to 15 kg). Two patients had multiple ventricular septal defects (VSDs; additional perimembranous VSD in 1 patient and multiple MVSDs in the other) and 3 patients had associated cardiac anomalies; complete transposition of the great arteries in 1 patient and an atrial septal defect in 2 patients. All the procedures were performed on beating hearts, exception in 1 case. The ADO selected for the aortic side was at least 1 to 2 mm larger than the largest VSD in the left ventricle side. Results: The procedure was successful in all patients and each device was well positioned. During the median follow-up of 2.4 years, a small residual VSD was noted in 2 patients who had multiple VSDs and no leakage was seen in the other 3 patients. Conclusion: Perventricular closure of MVSD with an ADO is a good option for patients with apical MVSD. However, careful manipulation is important, especially in the case of small infants.

• Journal of Chest Surgery
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• 제21권2호
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• pp.379-382
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• 1988

We have experienced a case of right side chylothorax following closed chest injury. A 35-year-old man in his car was accidentally collided against obstacles on September 19, 1986 resulting in a contusion on right anterior chest wall. The only complaint noted on admission was right chest pain. Chest X-ray showed near total radiopaque density of right thorax. Conservative treatment of closed tube thoracostomy at right pleural cavity through midaxillary 7th intercostal space had been continued for 25 days without improvement. Chyle outflow through the chest tube was averaging 1,700cc per day. Oversewing of the thoracic duct and pleura by silk and pledgetted prolene sutures were done. There was no complication and recurrence till postoperative 20 days. Chylothorax following closed chest injury was never reported in this country, and will be a interesting clinical case report.

• Journal of Chest Surgery
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• 제11권1호
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• pp.102-107
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• 1978

This is a report of a chylous cyst in the mediastinum found in a 61 year old Korean female patient who suffered from mild swallowing difficulty and right chest discomfort. These symptoms had developed 5 years previously when chest P-A view showed thumb-tip sized mass shadow in right mediastinum, just right to ascending aorta. Esophagogram revealed an indentation of midesophagus. Follow up checks showed growing mass shadow which suggested aneurysm of ascending aorta. On admission chest X-ray revealed a well circumscribed infant head sized mass density along the right heart border and middle mediastinal border, and extended near to the middle clavicular line in right chest cavity. Aortogram revealed no relationship between the mass and aorta. Right thoracotomy was performed under impression of mediastinal tumor. There was a large cyst containing 700 cc of milky fluid. There was no connection to the thoracic duct nor adjacent organs. The fluid was analyzed chemically and identified the fluid as chyle. The origin of the isolated chylous cyst was uncertain postoperative course was uneventful.

• Journal of Chest Surgery
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• 제37권8호
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• pp.718-721
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• 2004

유미흉은 여러 가지 원인에 의하여 유미액이 흉강 내로 유출되는 질병으로 드물게 하지의 림프 부종과 관련되어 유미흉이 발생한다. 본 교실에서 하지의 림프부종과 동반된 유미흉을 경험하였기에 보고하는 바이다. 우측 하지 부종이 있어 치료를 받아오던 14세 남자 환자가 흉통과 호흡곤란을 주소로 내원하였다. 과거력상 특발성 하지의 림프 부종으로 치료를 받고 있으며 흉부사진촬영에서 좌측 흉수가 발견되었고 검사실 소견상 유미액으로 판명되었다. 환자는 하지 림프부종과 동반된 유미흉으로 진단되어 흉강경을 이용한 흉관결찰술을 시행하였다.

• Journal of Chest Surgery
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• 제52권6호
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• pp.409-415
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• 2019

Background: Postoperative chylothorax may be caused by iatrogenic injury of the collateral lymphatic ducts after thoracic surgery. Although traditional treatment could be considered in most cases, resolution may be slow. Radiological interventions have recently been developed to manage postoperative chylothorax. This study aimed to compare radiological interventions and conservative management in patients with postoperative chylothorax. Methods: We retrospectively reviewed periprocedural drainage time, length of hospital stay, and nil per os (NPO) duration in 7 patients who received radiological interventions (intervention group [IG]) and in 9 patients who received conservative management (non-intervention group [NG]). Results: The baseline characteristics of the patients in the IG and NG were comparable; however, the median drainage time and median length of hospital stay after detection of chylothorax were significantly shorter in the IG than in the NG (6 vs. 10 days, p=0.036 and 10 vs. 20 days, p=0.025, respectively). NPO duration after chylothorax detection and total drainage duration were somewhat shorter in the IG than in the NG (5 vs. 7 days and 8 vs. 14 days, respectively). Conclusion: This study showed that radiological interventions reduced the duration of drainage and the length of hospital stay, allowing an earlier return to normal life. To overcome several limitations of this study, a prospective, randomized controlled trial with a larger number of patients is recommended.

• Journal of Chest Surgery
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• 제42권2호
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• pp.263-267
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• 2009

혈성 흉수를 동반한 췌흉강루는 췌가성낭포 파열 혹은 췌관 폐쇄에 의해 생기는 드문 질환이다. 만성 음주력이 있는 48세 남자가 다량의 우측 총수로 내원하였다. 흉수 내 아밀라제와 리파제가 상승되어 있었고, 전산화 단층촬영에서 췌가성낭포 파열에 의한 췌흉강루로 진단되었다. 최초 치료로 흉관 배액, 금식, 총정맥영양 및 췌장액 분비억제제 등의 보존적 치료를 시행하여 증상이 호전되었으나, 이후 출혈성 췌가성낭포가 커지고 혈성 흉수가 재발하여 수술적 치료를 하였다. 환자는 특별한 합병증 없이 수술 후 27일째 퇴원하였다.