• 제목/요약/키워드: diverticulum

검색결과 147건 처리시간 0.021초

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

  • 박창권
    • Journal of Chest Surgery
    • /
    • 제16권2호
    • /
    • pp.231-242
    • /
    • 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.

  • PDF

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

  • 김은영;정규환;박태진;박귀원;정성은;김현영
    • Advances in pediatric surgery
    • /
    • 제16권2호
    • /
    • pp.117-125
    • /
    • 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.

  • PDF

선천성 우심방 류의 수술치험 1례 보고 (Surgical Repair of the Congenital Aneurysm of the Right Atrium)

  • 유양기;김정원;정성호;박정준;윤태진;서동만;김영휘;고재곤;박인숙
    • Journal of Chest Surgery
    • /
    • 제35권1호
    • /
    • pp.56-59
    • /
    • 2002
  • 우심방과 관상정맥동의 선천성 기형은 크게 4 가지로 분류되는데, 전반적으로 확장된 우심방, 단일 낭성 게실(saccular diverticula), 다발성 낭성 게실, 그리고 우심방이나 관상정맥동에서 발생한 류(aneurysm)이다. 환아는 평소 건강하였으며, 우연히 시작된 상기도 감염증상으로 내원하여 시행한 단순 흉부 촬영 및 심초음파에서 다른 동반 기형 없이 우심방의 심한 확장을 발견하였다. 확장된 우심방은 심폐기 보조하에서 광범위한 절제를 시행하였으며, 병리학적 검사에서는 심내막 및 심외막에 경도의 섬유화를 동반한 국소 다발성 심근소실의 소견을 보였다. 본원에서는 6세 환아의 선천성 우심방 류를 광범위한 우심방 절제를 통해 교정했기에 이에 문헌 고찰과 더불어 증례 보고하는 바이다.

식도 질환의 외과적 치료 (Surgical Treatment of Esophageal Disease)

  • 우석정
    • Journal of Chest Surgery
    • /
    • 제26권8호
    • /
    • pp.627-632
    • /
    • 1993
  • A clinical study was performed on 64 cases of the esophageal diseases experienced at the Department of Thoracic & Cardiovascular Surgery of Kyungpook University Hospital from Jan. 1988 through Dec. 1992. The results were as follows: The most common esophageal disease was cancer which occurred in 37.5% of the total. In esophageal cancer patients, 24 cases were operated on and cancer resection was feasible in 19 cases with 2 cases of hospital death. The overall 1 year survival rate was 41.6% and the most favorable follow up result was revealed in stage I group. Esophageal stricture occurred in 22 cases and its causes were alkali and acid. The most common stricture site was mid-esphagus. Colon interposition was performed on 15 cases. Achalasia occured in 8 cases and was treated with modified Heller`s myotomy. Esophageal perforation occurred in 6 cases and its operative mortality rate was 16.6%. Two patients with congenital bronchoesophageal fistula were treated with surgical division. The first case, which occurred in an adult, is of Braimbridge,s typeII classification. The second one which occured in an child with sequestration, is of Braimbridge,s type IV classification. Diverticulectomy was performed in 1 case of esophageal diverticulum. Enucleation of tumor was performed in 1 case of esophageal leiomyoma.

  • PDF

컴퓨터단층촬영술을 이용한 수술 후 편측 성대마비의 진단보고 (Finding Report of Unilateral Vocal Cord Paralysis Using Computed Tomography)

  • 김민수;성현호;강성식;손희정;김태형;정유선
    • 대한방사선기술학회지:방사선기술과학
    • /
    • 제41권5호
    • /
    • pp.505-509
    • /
    • 2018
  • VCP (Vocal Cord Paralysis) is rare but one of most serious complications related to endotracheal intubation. This report is a clinical experience of radiography and laryngeal EMG (Electromyography) assessment for the VCP. A 50-year-old woman with hoarseness, which was occurred after urethral diverticulum excision was examined by laryngoscopy. As a result of laryngoscopy, VCP was observed in left side of her vocal cord, and then recurrent laryngeal nerve damage was detected with additional CT (Computed tomography) scan and laryngeal EMG. After that, the vocal cord movement was recovered as normal state with regular conservative treatment for the 6 months.

Voice Change Due to Paratracheal Air Cysts

  • Rhee, Youn Ju;Han, Sung Joon;Chong, Yoo Young;Cho, Hyun Jin;Kang, Shin Kwang;Lee, Choong-Sik;Kang, Min-Woong
    • Journal of Chest Surgery
    • /
    • 제49권4호
    • /
    • pp.313-316
    • /
    • 2016
  • Paratracheal air cysts are a rare entity in which cystic formation occurs adjacent to the trachea. Most patients with paratracheal air cysts are asymptomatic, and the cysts are detected incidentally on chest radiograph or computed tomography (CT) scan. Most symptomatic patients complain of pulmonary symptoms or repeated respiratory infection. Rarely, the air cysts can lead to paralysis of the recurrent laryngeal nerve as a result of direct compression. We report a case of a 59-year-old male patient who presented with voice change, and the cause was identified as paratracheal air cysts on a chest CT scan. Surgical resection via video-assisted mediastinoscopy was performed, and the voice recovered immediately after the operation.

흉부 수술에 있어 수직액와 근육보존 개흉술의 적용 (Vertical Axillary Muscle Sparing Thoracotomy in Thoracic Surgery)

  • 원태희;성숙환
    • Journal of Chest Surgery
    • /
    • 제28권1호
    • /
    • pp.42-46
    • /
    • 1995
  • Vertical axillary muscle sparing thoracotomy is newly appeared and excellent alternative method of standard posterolateral thoracotomy.It has many advantages compared to standard posterolateral thoracotomy , less postoperative pain, well preserved thoracic muscle strength, full range of motion of the shoulder girdle and attractive cosmetic results. We performed vertical axillary muscle sparing thoracotomy in 36 patients from November 1993 to July 1994. The ages of the patients ranged from 6 months to 71 years[mean 45.1 years , and the patients consisted of 20 males and 16 females.The preoperative diagnosis were as follows : lung cancer in 17 patients, tbc destroyed lung in 7, bronchiectasis in 3, bullous emphysema in 3 and the others are mediastinal tumor, bronchogenic cyst, lung abscess, empyema, esophageal diverticulum, and CCAM [congenital cystic adenomatoid malformation . The operative procedures were as follows : lobectomy and bilobectomy in 16 patients, segmentectomy in 4, wedge resection in 3, penumonectomy in 7, and the others were open biopsy, lobectomy with diaphragm excision, sleeve right upper lobectomy, decortication, mediastinal mass excision, and esophageal diverticulectomy. We had 6 complications : postoperative bleeding in 2 cases, operative wound infection, arrrhythmia[atrial fibrillation , Horner`s syndrome, hoarseness. The subcutaneous seroma occurred in 4 cases but did not require drainage and relieved within 4 weeks spontaneously. We concluded that vertical axillary muscle sparing thoracotomy could be done in most of all thoracic surgery with safety. Comparing to standard posterolateral thoracotomy vertical axillary muscle sparing thoracotomy has many advantages such as less postoperative pain, well preserved muscle strengths and good cosmetic results.

  • PDF

닭의 괴사성 장염에 대한 병리학적 연구 (Pathological changes on naturally occuring necrotic enteritis in chicken)

  • 김홍집;강문일;정운익
    • 대한수의학회지
    • /
    • 제37권1호
    • /
    • pp.161-166
    • /
    • 1997
  • From January of 1991 to December of 1992, 42 chickens collected from 21 poultry farms and also diagnosed as necrotic enteritis(NE) was examined clinical signs, gross and histopathological findings. Main clinical signs were characterized by decreased appetite, mild to severe depression, reductance to move, ruffled feathers, greenish to yellow-browinish diarrhea sometimes including blood. As progressed, diseased chickens showed feces mixed with necrotic debris which detached from the intestinal mucosa and mostly resulted in the death. In chronic cases, there were dirty feathers around cloaca due to diarrhea and notably retarded growth. Principle gross lesions were usually confined to the jejunum and ileum, especially toward the lower part of Meckel's diverticulum. The part of small intestine was frequently distended with gas, and also showed mucosal congestion and hemorrhages with varying degrees. Sometimes, the intestinal mucosa was thickened, and also covered with fibronecrotic psuedomembrane. In addition, there were focal necrosis and severely multifocal ulcreation in the mucosa of small intestine. Major histopathological findings included villous necrosis and erosion of the small intestine covering with lots of bacterial colonies, inflammatory cell infiltration in the lamina propria, and dilatation and hyperplasia of crypts. Luminal exudate contained bacterial colonies, fibrin, erythrocytes, and desquamated epithelium. Thirteen(61.9%) out of 21 NE-occurring farms were complicated with intestinal coccidiosis.

  • PDF

소아 장중첩증의 병리적 유발병변 (Pathologic Lead Points in Childhood Intussusception)

  • 장선모;강수환;이정훈;허영수
    • Advances in pediatric surgery
    • /
    • 제6권1호
    • /
    • pp.50-55
    • /
    • 2000
  • Pathologic lead points are found in a few intussusception patients. To evaluate the pathologic lead points in childhood intussusception, a retrospective review of 227 operated cases of intussusception treated at the Yeungnam University Hospital from January 1986 to April 1999. The patients were divided into 2 groups; idiopathic group 209 cases, (92.1 % and lead points group 18 cases, 7.9 %). Intussusception developed between age two months and six months in both groups. Enteroenteric type of intussusception was relatively more frequent in the lead point group than in idiopathic group. The lead points were veil (10 cases, 52.6 %), Meckel's diverticulum(3 cases, 15.8 %), lymphoma(3 cases, 15.8 %), ectopic pancreas(2 cases, 10.5 %), Henoch-Sch$\ddot{o}$nlein purpura(1 cases, 5.3 %). The bowel resection rate was 44.4 % in the lead point group and 8.6% in idiopathic group. The recurrence rate was 5.56 % in lead points group and 1.44 % in idiopathic group.

  • PDF