• Tuberculosis and Respiratory Diseases
• /
• 제72권2호
• /
• pp.177-181
• /
• 2012

Activated charcoal is an inert substance and it is used in standard therapy in patients with acute intoxication. Charcoal has some side effects such as pulmonary aspiration, gastrointestinal complications, and electrolyte abnormalities. Although aspiration of charcoal is a rare complication, it can cause fatal sequelae. We report a 69-year old man who developed acute respiratory failure associated with charcoal aspiration after management of glyphosate poisoning. The patient was drowsy and suffered severe vomiting during transport to our hospital. On arrival, acute respiratory failure was observed due to charcoal aspiration, but the clinical state was improved with repeated bronchoscopy with a bronchoalveolar lavage (BAL). We presumed that the aspirated charcoal was an important factor in evoking a lung injury. Early bronchoscopy with a BAL might be an effective method for eliminating charcoal from the lung, especially in the case of a large amount of aspiration, and be helpful in decreasing respiratory failure due to charcoal aspiration.

• Tuberculosis and Respiratory Diseases
• /
• 제77권4호
• /
• pp.193-196
• /
• 2014

Acute airway obstruction after hemoptysis occurs due to the presence of blood clots. These conditions may result in lifethreatening ventilation impairment. We report a case of obstruction of the large airway by endobronchial blood clots which were removed using bronchoscopic cryotherapy at the bedside of intensive care unit. A 66-year-old female with endometrial cancer who had undergone chemotherapy, was admitted to the intensive care unit due to neutropenic fever. During mechanical ventilation, the minute ventilation dropped to inadequately low levels and chest radiography showed complete opacification of the left hemithorax. Flexible bronchoscopy revealed large blood clots obstructing the proximal left main bronchus. After unsuccessful attempts to remove the clots with bronchial lavage and forceps extraction, blood clots were removed using bronchoscopic cryotherapy. This report shows that cryotherapy via flexible bronchoscopy at the bedside in the intensive of intensive care unit is a simple and effective alternative for the removal of endobronchial blood clots.

• 한국임상수의학회지
• /
• 제26권4호
• /
• pp.336-339
• /
• 2009

5킬로그램의 4년령의 중성화된 수컷 시츄견이 식욕부진과 만성 기침을 주증상으로 내원하였다. 이 환견은 병력청취, 신체검사, 임상병리검사, 방사선 진단, 심초음파 검사 및 기관지경 검사를 근거로 기관기관지 이물로 진단되었다. 그 이물은 밥알 부스러기들로 확인되었고 기관지경을 이용한 세기관지 세척 후 진공 흡인을 통해 제거되었다. 진공 흡인으로 채취된 세척 이물의 세균 및 곰팡이 배양과 폐 기생충에 대한 검사는 음성을 보였다. 환견은 진단 후 7일 동안 테오필린, 프레드니솔론, 독시사이클린, 엔로플록사신, 아세틸시스테인, 실리마린, 수크랄페이트를 처방 받았다. 이물제거와 약물치료 후 식욕의 증진과 기침 증상은 완전히 없어졌다. 이 증례 보고는 기관지경 기술을 통해 호흡기의 이물의 진단평가와 제거가 가능함을 보여준다.

• Tuberculosis and Respiratory Diseases
• /
• 제46권1호
• /
• pp.122-128
• /
• 1999

저자들은 타질환으로 입원중 기관지내시경검사상 우연히 발견된 과립세포종 2예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• Tuberculosis and Respiratory Diseases
• /
• 제43권3호
• /
• pp.467-471
• /
• 1996

저자들은 발열 및 마른기침을 주소로 내원한 20세 여자에서 기관지내시경검사 및 기관지조직 검사로 기관지 방선균증을 확진하고 소디움페니실린 정맥주사 및 테트라사이클린 경구투여로 완치한 원발성 기관지 방선균증 환자를 경험하였기에 문헌고찰과 함께 보고 하는 바이다.

• Tuberculosis and Respiratory Diseases
• /
• 제43권6호
• /
• pp.1028-1034
• /
• 1996

기관지 평활근종은 기관지에 발생하는 양성 종양의 하나이며, 반복되는 폐렴이나 치료에 반응하지 않는 기관지 천식 환자에서 의심해 볼 수 있다. 이의 고전적인 치료는 수술적 절제술이지만, 치료 기관지경술이 시작된 이후 기관지경하에서 절제하려는 노력이 보고되고 있다. 저자들은 Nd-YAG laser와 bronchial snare를 이용하여, 굴곡성 기관지경하 성공적으로 절제한 2예를 경험하였기에, 이를 문헌고찰과 함께 보고한다.

• Tuberculosis and Respiratory Diseases
• /
• 제56권1호
• /
• pp.85-90
• /
• 2004

Rasmussen 동맥류는 공동성 폐결핵에 동반되어 종종 대량객혈을 일으킬 수 있어 임상적으로 중요하다. 그동안 이의 존재나 치료에 대한 보고는 간헐적으로 있어왔으나 본 증례와 같이 기관지내시경으로 직접 병변을 관찰하고 나선식 CT로 Rasmussen 동맥류의 존재를 확인한 경우는 없어 이에 보고하는 바이다. 또한 기관지 내시경 검사시 발견되는 종양 형태의 병변에는 이와 같은 혈관성병변도 있을 수 있으므로 생검 등의 침습적 검사시에 보다 신중해질 필요가 있으며, 기존 질환이 진행된 공동성 폐결핵일 경우에는 더욱 주의를 필요로 한다.

• 한국산학기술학회논문지
• /
• 제12권9호
• /
• pp.4061-4067
• /
• 2011

본 연구는 기관지내시경 검사 시 사전정보제공과 진정제 투여가 환자의 불안 감소와 생리적 변수에 미치는 영향을 확인하기 위하여 2007년 6월 4일부터 12월 28일까지 기관지내시경 검사를 받는 환자 102명을 대상으로 시행되었다. 불안척도는 Spielberger의 STAI를 이용하였고, 사전정보제공소책자를 제작하여 사용하였다. 수집된 자료는 SPSS 14.0을 이용하여 분석하였다. 그 결과, 기관지내시경 검사에 대한 사전정보제공군, 진정제 투여군, 사전정보제공과 진정제를 함께 적용한 세 실험군은 대조군에 비해 수축기(p=.062), 이완기 혈압(p=.189) 변화에 영향을 주지 못하였으나, 환자의 불안(p=.005)과 맥박(p=.033), 호흡(p=.006)의 변화에는 효과적이었으므로 임상에서 적용할 가치가 있을 것으로 본다.

• 대한기관식도과학회지
• /
• 제15권1호
• /
• pp.28-34
• /
• 2009

Background and Objectives: Foreign bodies of upper aerodigestive tract are common problem for primary care physicians. Delayed diagnosis or failure of removal might cause fatal problemsand complications. Therefore proper diagnosis and management is imperative. In this study, we described clinical features of upper aerodigestive tract foreign body, and analyzed efficacy of different management modality. Materials and Methods: 250 cases of foreign bodies in the esophagus and trachea, between Jan. 1998 through Jan. 2009 has been retrospectively analyzed. A total of 24 cases and 226 cases had been found each as airway foreign bodies and esophageal foreign bodies. The clinical features are described and treatment outcomes, prognosis, and rate of complications of each management modality have been compared. Results: In airway foreign bodies, ventilating bronchoscopy yielded better results, 19 success out of 19 trials than fiberoptic bronchoscopy, 3 success out of 5 trials. Hospitalization days after removal of foreign body didn't show difference between two treatment modalities, although patients who had ventilating bronchoscopy had gone through general anesthesia. And there was no complication after removal of foreign body. In esophageal foreign bodies, rigid esophagoscope yielded better results, 99% of successful removal rate, compared to the EGD, only 78% of successful removal rate. There was no difference of hospitalization days between two modalities. And complication rate was even low in patients who had done rigid esophagoscopic foreign body removal. Conclusion: In upper aerodigestivetract foreign body. Rapid diagnosis and successful foreign body removal is important. Removal by rigid scope(ventilating bronchoscope, rigid esophagoscope) revealed less failure in both airway and esophageal foreign bodies.

• Journal of Trauma and Injury
• /
• 제36권3호
• /
• pp.206-209
• /
• 2023

Purpose: Since its implementation, flexible fiberoptic bronchoscopy (FBS) has played an important role in the diagnosis and treatment of tracheobronchial tree and pulmonary disease. Although FBS is often performed by endoscopists, it has also been performed by surgeons, albeit rarely. This study investigated FBS from the surgeon's perspective. Methods: This retrospective study included patients who underwent FBS performed by a single thoracic surgeon between March 2017 and December 2021. Accordingly, the epidemiology, purpose, results, and complications of FBS were analyzed. Results: A total of 47 patients received FBS, whereas 13 patients underwent repeat FBS. Their mean age was 60.7 years. The main organs injured involved the chest (n=22), brain (n=9), abdominal organ (n=7), cervical spine (n=4), extremities (n=4), and face (n=1). The average Injury Severity Score was 22.5. Indications for FBS included atelectasis or haziness on chest x-ray (n=34), pneumonia (n=17), difficult ventilator management (n=7), percutaneous dilatory tracheostomy (n=3), blood aspiration (n=2), foreign body removal (n=2), and intubation due to a difficult airway (n=1). The findings of FBS were mucous plugs (n=36), blood and blood clots (n=16), percutaneous dilatory tracheostomy (n=3), foreign bodies (n=2), granulation tissue at the tracheostomy site (n=2), tracheostomy tube malposition (n=1), bronchus spasm (n=1), difficult airway intubation (n=1), and negative findings (n=5). None of the patients developed complications. Conclusions: FBS is an important modality in the trauma field that allows for the possibility of diagnosis and therapy. With sufficient practice, surgeons may safely perform FBS at the bedside with relative ease.