• Title/Summary/Keyword: diverticulum

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Treatments of Esophageal Perforation - A Report of 14 cases - (식도천공의 치료)

  • Gu, Ja-Hong;Jo, Gap-Ho;Kim, Gong-Su
    • Journal of Chest Surgery
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    • v.24 no.11
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    • pp.1107-1114
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    • 1991
  • We have experienced fourteen patients of esophageal perforation at the department of thoracic and cardiovascular surgery, Chonbuk National University Hospital during the period from mar. 1980 to Oct. 1990. The ratio between male and female patients was 5 : 9, and their age ranged from 22 years to 69 years. The causes of th eesophageal perforation were iatrogenic in 6 cases, foreign body 5 cases, diverticulitis 2 cases, and postpneumonectomy 1 case. The locations were cervical esophagus in 2 cases, upper thoracic in 2 cases, mid-thoracic 4 cases, and lower thoracic 6 cases. The underlying diseases associated with perforation were lye stricture, diverticulum, achalasia, and postpneumonectomy empyema. The treatments were supportive in 6 cases and combined with surgical measures in 8 cases. surgical measurs were as follows : incision and drainage in 2 cases, esophagectomy with esophagogastrostomy 3 cases, esophagocardiomyotomy with partial fundoplication in 1 case, simple closure with myoplasty and thoracoplasty 1 case, and empyema drainage and gastrostomy 1 case. There was no mortality.

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Intramural Esophageal Cyst with Ciliated Epithelium -A Report of Case- (식도 벽내에 발생한 식도 낭종)

  • 신화균
    • Journal of Chest Surgery
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    • v.27 no.9
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    • pp.812-814
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    • 1994
  • The esophageal cyst result from a wrong cleavage of the primitive gut in the 4 weeks embryo. In embryo and after seperation of the tracheal diverticulum, the esophagus is lined with ciliated cells which are able cover a "cystic duplication". It is often difficult to distinguish between the bronchogenic and the esophageal cyst. Pathological findings showed the presence of a ciliated epithelium without cartilage which was diagnosed as an esophageal cyst. The patient was 21 year old man for evaluation of the cyst in the posterior mediastinum. The cyst was located the intramural esophagus. Microscopically, the cyst was lined with ciliated columnar epithelium and there was no evidence of cartilage. The cyst was confirmed as the intramural esophageal cyst.geal cyst.

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Congenital Bronchoesophageal Fistula in Adult -Report of Three Cases- (성인의 선천성 식도기관지루 3례 보고)

  • Lee, Yong-Hun;Choe, Pil-Jo;U, Jong-Su
    • Journal of Chest Surgery
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    • v.28 no.5
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    • pp.525-529
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    • 1995
  • We have experienced three cases of congenital bronchoesophageal fistula which is rare and usually has an insidious clinical course. The patients included a thirty year old man and thirty six, thirty eight year old women respectively. Bronchiectatsis was found in all three cases, and bronchoesophageal fistula was found in one case preoperatively by esophagography and esophagoscopy, and other two cases operative field. The fistula was found between right lower esophagus and right lower lobe in all cases and esophageal diverticulum in one case. So they belonged to type I[1 case , II[2 cases of Braimbridge and Keith`s classification of congenital bronchoesophageal fistula . The fistulectomy was performed in all cases and concomitant lobectomy [2 cases and bilobectomy [1 case were done. There were toxic hepatitis in two cases and prolonged air leakage in one case postoperatively. They were discharged on recovered state and have continued to do well.

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Idiopathic Giant Esophageal Diverticula in a Dog

  • Park, Seon-Ah;Choi, Chi-Bong;Chang, Hwa-Seok;Chung, Dai-Jung;Lee, Jae-Hoon;Kang, Eun-Hee;Yang, Wo-Jong;Kim, Dae-Hyun;Chung, Wook-Hun;Kim, Hwi-Yool
    • Proceedings of the Korean Society of Veterinary Clinics Conference
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    • 2008.10a
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    • pp.172-172
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    • 2008
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Video-Assisted Thoracoscopic Division of Vascular Rings

  • Lee, Jung Hee;Yang, Ji-Hyuk;Jun, Tae-Gook
    • Journal of Chest Surgery
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    • v.48 no.1
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    • pp.78-81
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    • 2015
  • This study reports our early experience with thoracoscopic division of vascular rings. Three patients were reviewed; their ages at surgery were 25 months, 4 years, and 57 years. All patients were suffering from complete vascular rings involving combinations of the right aortic arch, left ligamentum arteriosum, Kommerell's diverticulum, and retroesophageal left subclavian artery. The median surgical time was 180.5 minutes, and the patients showed immediate recovery. Three complications, namely chylothorax, transient supraventricular tachycardia, and left vocal cord palsy, were observed. Our early experience indicates that thoracoscopic division of a vascular ring may provide early recovery and could be a promising operative choice.

A Case of Paratracheal Air Cyst Causing Dyspnea (호흡곤란을 유발한 기관주위 공기낭 1 예)

  • Han, Chang-Hee;Park, Sung-Ho;Choi, Kyung-Min;You, Ji-Hoon
    • Korean Journal of Bronchoesophagology
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    • v.15 no.1
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    • pp.64-67
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    • 2009
  • Paratracheal air cysts are rare lesions and detected incidentally during CT scan or autopsy. Histopathologic diagnoses of paratracheal air cysts include trachocele, tracheal diverticulum and lymphoepithelial cyst. The cysts are lined by ciliated columnar epithelium and have communication with trachea. Previous reports suggested an association with obstructive lung disease because of increased expiratory pressures in these patients. Most of these cysts are asymptomatic but rarely cause productive cough, wheezing, recurrent laryngeal nerve paralysis and difficult intubation. We report a case of paratracheal air cyst causing dyspnea with a review of literature.

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Simultaneous laparoscopic removal of a Todani type II choledochal cyst and a microlithiasic cholecystitis

  • Alfonso Grottesi;Simonetta Iacovitti;Paolo Ciano;Francesco Borrini;Maddalena Zippi
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.26 no.3
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    • pp.281-284
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    • 2022
  • Diverticula of the choledochus, better known as Todani type II cysts, are very rare and represent a predominantly pediatric pathology. Their identification by radiological methods, even if occasional, requires clinical doctors to request a surgical consultation, even for asymptomatic subjects, to proceed with their removal, given the risk of associated neoplasms. The laparoscopic approach for surgical treatment of these cysts has been recently introduced with excellent results. Due to the poor clinical records, currently there are neither shared protocols about their management nor long-term follow-up of operated patients. We report a case of an adult female suffering for years from biliary colic due to the presence of a duodenal diverticulum associated with microlithiasis' cholecystitis, who was laparoscopically treated, with excellent results in terms of symptomatic regression, reduced hospitalization, and no surgery-related complications.

Surgical experience of esophageal disease: report of 75 cases (식도질환의 외과적 치료 75례)

  • 박창권
    • Journal of Chest Surgery
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    • v.16 no.2
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    • pp.231-242
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    • 1983
  • A clinical study was performed on 75 cases of the esophageal cancer and benign esophageal diseases experienced at Department of thoracic & cardiovascular surgery, School of Medicine, Keimyung University during 3 year period from 1978 to 1982. Of 75 cases of the surgical esophageal diseases, there were 35 patients of the esophageal cancer. 17 patients of benign esophageal stenosis, 10 patients of esophageal perforation, 4 patients of diverticulum. 3 patients of achalasia, 2 patients of congenital T-E fistula, one of upper esophageal web, one of esophageal foreign body, one of leiomyoma and patient of hemangioma. First, esophageal carcinoma was more frequent in men than in women by a ratio of five to one, and the peak incidence occurred in the 5th to 6th decade. Dysphagia was the most common symptom in 88.6 percent of our cases. The tumor was located mostly in the middle & the lower one third [91.4%]. The histological diagnosis was made in 35 cases. The squamous cell carcinoma was the most common [82.9%] and the rest was the adenocarcinoma in the lower one third [17.1%]. Thirty-five cases were operated and resection was feasible in the twenty-five patients [71.4%] with 2 cases of hospital mortality [5.7%]. All but two of the esophageal stenosis were caused by corrosive esophagitis and ages ranged from 7 to 70 years with average age of 32 years. Corrective operations were performed on 17 patients of esophageal stenosis of whom 12 patients had esophagocologastrostomy, 3 patients esophagogastrostomy and in non-corrosive esophageal stenosis one case and esophagoplasty and another case had release of external compression. There was one complication of stenosis of the esophageal perforation were traumatic in five cases, empyema in three cases, caustics in one case and postemetic in one case. 10 patients of the esophageal perforation underwent operation: primary closure in 5 cases, two staged colon interposition in 2, esophagogastrostomy in 1 and closed thoracotomy in 2 cases There were 2 complications of leakage of anastomosis sites in postoperative period. 4 patients of traction type of diverticulum underwent diverticulectomy & 3 patients of achalasia underwent modified Heller`s operation. 2 patients of congenital esophageal atresia had distal tracheoesophageal fistula & underwent one staged operation with the results of one death caused by pneumonia. Upper esophageal web had divulsion through the esophagoscope and foreign body in upper esophagus was removed through cervical esophagotomy. One case of leiomyoma in esophagus had esophagectomy and reconstruction with right colon. And one case of hemangioma in esophagus had esophagectomy & esophagogastrostomy.

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Management of Pediatric Small Bowel Intussusception: Spontaneous Reduction vs Operation (소아의 소장 중첩증의 치료 : 자연 정복 vs 수술적 치료)

  • Kim, Eun-Young;Jung, Kyu-Whan;Park, Tae-Jin;Park, Kwi-Won;Jung, Sung-Eun;Kim, Hyun-Young
    • Advances in pediatric surgery
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    • v.16 no.2
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    • pp.117-125
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    • 2010
  • Unreduced small bowel intussusception requires operative treatment although the rate of spontaneous reduction is 60 to 70 %. The aim of this study is to compare clinical characteristics and outcome between spontaneous reduction and operation group and to analyze factors related to decisions to treat small bowel intussusceptions. The records of 25 patients with small bowel intussusceptions treated in Seoul National University Children's Hospital from January 1999 to August 2009 were reviewed respectively. Spontaneous reduction group (n=12, 48 %) had signs and symptoms of vomiting, abdominal pain, currant jelly stool, abdominal distension, fever, increased CRP but no rebound tenderness. One of them had been diagnosed with Henoch-Schonlein purpura and no one displayed pathologic leading point by image study. Operation group (n=13, 52 %) consisted of patients who had primary surgery. Their signs and symptoms were similar to spontaneous reduction group. Seven of them had underlying diseases such as Crohn' disease, ALL, Lymphoma, Peutz-Jeghers syndrome (n=3), post-transplanted state of liver and 2 of them displayed Peutz-Jeghers polyp and Meckel's diverticulum as pathologic leading point by preoperative ultrasonography. Mean relieve interval (interval between onset of symptoms and reduction/operation) was 1.78 days in spontaneous reduction group and 2.25 days in operation group (p=0.341). Seven of operation group had manual reduction and 6 out of 7 received segmental resection of the small bowel. No one of them underwent manual reduction and all of them underwent segmental resection were found to have pathologic leading points [Peutz-Jeghers polyp (n=3), Meckel's diverticulum (n=2), lymphoma (n=1)] during operation. In conclusion, 48% of small bowel intussusceptions resolved spontaneously. Patients' symptoms and relieve intervals were not related to the operative decisions. We therefore recommend significant factors for determining treatment plan such as change of clinical symptoms, underlying disease or pathologic leading point by imaging.

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A Case of Intussusception Arising from Heterotopic Pancreas in Ileum (회장에 발생한 이소성 췌장에 의한 장중첩증 1례)

  • Rhim, Jung Woo;Koh, Eun Suk;Park, Jae Ock
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.7 no.2
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    • pp.274-277
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    • 2004
  • The heterotopic pancreas is defined as the presence of pancreatic tissue lacking anatomical and vascular continuity from the main body of pancreas. Its incidence has been reported as widely ranging from 0.55~13.7% in autopsy studies and 0.2% in upper abdominal laparotomies. The most common sites are the antrum of stomach, duodenum and proximal jejunum. But, lesions have also been found in the ileum, Meckel diverticulum, common bile duct and the esophagus. Most cases are incidentally encountered during surgery, and on rare occasions, epigastric pain, hemorrhage, gastric outlet obstruction and intussusception have been directly attributable to the presence of the heterotopic pancreas. A 3-month-old boy presented with 1-day history of vomiting and irritability. Intussusception was confirmed on ultrasound scan. At laparotomy there was an irreducible ileoileal intussusception, the intussuscepted portion of ileum was resected and end to end anastomosis was performed. Histologically, the mass was found to be composed of pancreatic tissue.

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