• Journal of the Korean Society of Radiology
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• v.85 no.3
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• pp.661-667
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• 2024

Afferent loop syndrome (ALS) is a rare complication of gastrectomies and gastrointestinal reconstruction. This can predispose patients to fatal conditions, such as cholangitis, pancreatitis, and duodenal perforation with peritonitis. Therefore, emergency decompression is necessary to prevent these complications. Herein, we report two cases in which transcholecystic duodenal drainage, an alternative decompression treatment, was performed in ALS patients without bile duct dilatation. Two patients who underwent distal gastrectomy with Billroth II anastomosis sought consultation in an emergency department for epigastric pain and vomiting. On CT, ALS with acute pancreatitis was diagnosed. However, biliary access could not be achieved because of the absence of bile duct dilatation. To overcome this problem, a duodenal drainage catheter was placed to decompress the afferent loop after traversing the cystic duct via a transcholecystic approach. The patients were discharged without additional surgical treatment 2 weeks and 1 month after drainage.

• Journal of Chest Surgery
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• v.30 no.2
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• pp.213-218
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• 1997

Pseudoaneurysm of the thoracic aorta is potentially fatal. However, reports of such cases are rare even in large series. We report four cases of thoracic aortic pseudoaneurysm who underwent surgical repair, The causes were considered as infection in two cases (VSD repair, descending thoracic aortic aneurysm resection) and blunt chest trauma by traffic accident in two patients. The pseudoaneurysms developed on ascending aorta suspected as sites of arterial and cardiolplegic needle insertion in one patient. The others were located at descending thoracic aorta immediatly below the left subclavian artery. One patient died of sepsis associated with bile peritonitis and others were followed up from 10 to 18 months with specific morbidity. This study suggest that the incidence of pseudoaneurysm of the thoracic aorta followed by open heart or aorctic surgery can be repaired succesfuly and careful inspection of associated injury is very important in cases of traumatic thoracic pseudoaneurysm.

• Journal of Veterinary Clinics
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• v.29 no.1
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• pp.87-92
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• 2012

A six months old, male Shih Tzu dog was referred to the Veterinary Medical Teaching Hospital at Kangwon National University, for lethargy, respiratory embarrassment. Survey radiography revealed enlarged cardiac silhouette due to displacement of gas-filled intestine in the pericardium. Although there were no specific clinical signs, this case was diagnosed as peritoneopericardial diaphragmatic hernia (PPDH) based on the results of positive contrast radiography and thoracic ultrasonograpic findings. In addition, the thickened gall bladder wall observed in ultrasonography, increase of alkaline phosphatase and neutrophils indicated cholecystitis. Two hepatic lobes and gall bladder were severely necrotized and adhere to the diaphragm. Direct reduction of the herniated organs might cause hepatic hemorrhage and bile juice leakage which may induce very poor prognosis. To solve the problems, the adhered organs were dissected with part of diaphragm, and lobectomy with cholecystectomy was performed for prevention of some possible complications including peritonitis. This is case report describing resection of part of diaphragm adhered to herniated organ reduce the risk of possible hepatic hemorrhage during surgical correction of PPDH followed bycholecystectomy and lobectomy.

• Journal of Chest Surgery
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• v.30 no.7
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• pp.686-692
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• 1997

This study represents an attempt to present an analysis of early surgical results in 15 cases of aortic surgery conducted at Chonnam University Hospital between February 1994 to August 1995. The subject, 9 males and 6 females, ranged in age from 32 to 73 years with a mean age of 55.07$\pm$ 1176 years. The patients were treated for dissecting aortic aneurysm in nine, atherosclerotic aneurysm in 4, and traumatic aortic aneurysm in two. There were 9 cases of median stemotomy, 4 cases of posterolateral thoracotomy, and 2 cases of thoracoabdominal incision. Graft replacement of ascending aorta andfor partial or total aortic arch were performed in 9 patients, descending aorta andfor t oracoabdominal aorta in 3 and total aorta in 1, Two traumatic aortic aneurysms were closed directly. Associate procedures were resuspension of aortic valve in three patients and elephant trunk procedure, coronary reimplantation and aortic valve replacement in one patient. Nine patients underwent operation for ascending aorta andfor aortic arch with retrograde cerebral perfusion during deep hypothermia and circulatory arrest. Perfusion pressure was maintained below 25 mmHg and the mean duration of circulatory arrest was 56.67 $\pm$ 29.25 minutes. Three patients underwent graft replacement of desending thoracic and thoracoabdominal aorta during deep hypothermia and circulatory arrest. Three patients died of traumatic bile peritonitis, multioragn failure, and rupture of residual dissecting aortic aneurysm by malignant hypertension. Postoperative complications included reoperation for bleeding in 4 patients, temporary confusion in 3, pulmonary complication in 3, and pericardial effusion in .