• Title/Summary/Keyword: mass ligation

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Retroperitoneal Spinal Extradural Arachnoid Cyst Combined with Congenital Hemivertebrae

  • Park, Se-Hwan;Kuh, Sung-Uk;Lim, Beom Jin
    • Journal of Korean Neurosurgical Society
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    • v.52 no.3
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    • pp.257-260
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    • 2012
  • Spinal extradural arachnoid cysts usually cause symptoms related to spinal cord or nerve root compression. Here, we report an atypical presentation of a spinal extradural arachnoid cyst combined with congenital hemivertebra which was presented as a retroperitoneal mass that exerted mass effects to the abdominal organs. On image studies, the communication between the cystic pedicle and the spinal arachnoid space was indistinct. Based on our experience and the literature of the pathogenesis, we planned anterior approach for removal of the arachnoid cyst in order to focus on mass removal rather than ligation of the fistulous channel. In our estimation this was feasible considering radiologic findings and also essential for the symptom relief. The cyst was totally removed with the clogged 'thecal sac-side' end of the cystic pedicle. The patient was free of abdominal discomfort by one month after the surgery.

Giant Neurofibroma on Both Buttocks (양측 엉덩이의 거대 신경섬유종)

  • Kim, Ji Hoon;Burm, Jin Sik;Kim, Yang Woo;Kang, So Ra;Kim, Hyoung Kyoung
    • Archives of Plastic Surgery
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    • v.36 no.4
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    • pp.512-515
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    • 2009
  • Purpose: Neurofibromatosis(NF) is an autosomal - dominant systemic disease. Up to fifty percent of patients with NF are reported to have concomitant vascular abnormalities. In the resection of a larger NF, the risk of uncontrolled hemorrhage is much higher due to the difficulty of hemostasis of large vessels within the tumor. We ligated the base of the giant NF with a simple loop - shaped ligation before removal of the giant NF in both buttocks. And then we could successfully reduce the amount of hemorrhage during the operation. Methods: A 46 - year - old female patient presented for giant masses of both gluteal area, which has been growing slowly for the last ten years. Each mass was about $30{\times}20cm$ in size. After designing the elliptical resection margin, we tightened the tumor base by using continuous loop - shaped suture ligation(weaving the thread up and down in a loop - shaped pattern, leaving a space of 2 cm between each loop) with a straight needle and prolene 2 - 0. After skin incision, we proceeded the dissection toward the central and inferior side of the mass obliquely while we avoided breaking large vascular sinuses. We resected the tumor in a wedged - shape. Subcutaneous tissue was sutured layer by layer and skin was closed by vertical mattress and interrupted suture. The loop - shaped ligation of the base was removed and compressive dressing was done with gauzes and elastic bandages. Results: Postoperative complications such as infection, hemorrhage, hematoma, and dehiscense did not occur. Perioperatively the patient was sufficiently transfused with five units of blood and two units of fresh frozen plasma. During the subsequent 1 year follow - up, the functional and cosmetic result was excellent. Conclusion: A continuous loop - shaped suture ligation procedure along the base of the giant NF effectively reduced the amount of hemorrhage during the operation, made dissection and ligation of vessels easily and quickly, and shorten the operating time and postoperative recovery time.

Congenital Chylothorax Treated by Ligation of the Thoracic Duct [Report of A Case] (흉관결찰로 치유한 선천성 유미흉치험 1례 보고)

  • Bang, Jong-Gyeong;Han, Seung-Se;Kim, Gyu-Tae
    • Journal of Chest Surgery
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    • v.21 no.1
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    • pp.191-195
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    • 1988
  • Chylothorax in the neonatal period is a rare cause of respiratory distress. Surgical ligation of the thoracic duct is rarely necessary in congenital chylothorax. A 3 day-old newborn delivered by the cesarean section showed signs of respiratory distress suddenly and diagnosed as chylothorax on the right hemithorax. Conservative management such as multiple thoracenteses and tube thoracostomy drainage with nutritional support failed to close the leakage. At age of 60 days, we performed a supradiaphragmatic mass ligature of the thoracic duct visualized after injection of methylene blue into the thigh subcutaneously. Postoperatively, chylous effusion occurred in the left hemithorax and successfully treated with chest tube drainage for several days.

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Surgical Resection of Thoracic Duct Lymphangioma

  • Bok, Jin San;Jun, Jae Hyun;Lee, Hyun Joo;Park, In Kyu;Kang, Chang Hyun;Kim, Young Tae
    • Journal of Chest Surgery
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    • v.47 no.4
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    • pp.423-426
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    • 2014
  • A 67-year-old male patient came to the hospital due to lung cancer and mediastinal cystic mass which was suspected to be esophageal duplication cyst. Video-assisted thoracoscopic surgery (VATS) was performed and intra-operative finding suggested it as a cystic mass along the thoracic duct. Thoracic duct was ligated and the cyst was completely resected. A 48-year-old female patient visited the hospital for dysphagia. Mediastinal cystic mass was suspected to be an esophageal duplication cyst. Intraoperative finding suggest a thoracic duct lymphangioma. After thoracic duct ligation, the mass was completely resected with VATS. Postoperative chylothorax did not develop in both cases.

Complete Testicular Feminization Syndrome - a Case Report - (완전 고환성 여성화 증후군 1예)

  • Cho, Ma-Hae;Nam, Eun-Sook
    • Advances in pediatric surgery
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    • v.12 no.1
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    • pp.47-52
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    • 2006
  • Testicular feminization syndrome (TFS) is a genetic disorder due to androgen insensitivity of the target organs. The most common clinical presentation of complete TFS is inguinal hernia in the infant or primary amenorrhea in the adolescence. A 7-year old phenotypically female patient was seen with a complaint of a right inguinal mass. Under the diagnosis of right inguinal hernia, high ligation was performed. Six months later, the patient showed a left inguinal mass. On operation, the mass looked like a testis. The external genitalia were normal female, but a uterus and ovary were not identified. Chromosome study showed a 46, XY karyotype and the levels of serum testosterone and dihydrotestosterone were increased after HCG stimulation. The patient was diagnosed as complete TFS and underwent bilateral gonadectomy 6 months later.

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Intralobar Puhnonary Sequestration - Report of one case - (폐 내엽형 격절부:1례 보고)

  • 김승규
    • Journal of Chest Surgery
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    • v.25 no.5
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    • pp.541-543
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    • 1992
  • We experienced a case of intralobar pulmonary sequestration preoperatively confirmed. The 10 years old male patient was admitted beacuse of recurrent episode of coughing and production of purulent sputum. the chest X-ray showed a dense mass containing a large cyst with air-fiuid level in right lower lung field. An aortogram was performed and revealed that the sequestrated portion of the RLL was supplied by an aberrant large artery arising directly from the lower thoracic aorta. After division and ligation of the aberrant artery in pulmonary ligament, the right lower lobectomy was performed and the patient`s postoperative course was uneventful.

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Traumatic Pseudoaneurysm of the Superficial Temporal Artery due to Gardner Traction

  • Lee, Hyun-Seok;Jo, Kwang-Wook;Lee, Sun-Ho;Eoh, Whan
    • Journal of Korean Neurosurgical Society
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    • v.48 no.3
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    • pp.291-293
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    • 2010
  • We report a case of pseudoaneurysm of the parietal division of the superficial temporal artery (STA) secondary to iatrogenic head injury due to Gardner traction. A 54-year-old man presented with a pulsatile, cystic, and painless mass in the right anterior temporal region which developed three weeks after head fixation via Gardner traction. At the time of discovery, the mass was 10 mm in diameter, compressible and disappeared after manual compression of the proximal STA. A bruit was audible over the mass, which was thought to be a pseudoaneurysm. A computed tomography angiogram (CTA) showed a pseudoaneurysm of the parietal division of the right ST A. The tip of the pseudoaneurysm was thrombosed and was both red and tender. The pseudoaneurysm was thought to be filled with infected thrombus, and the mass was resected with ligation of the proximal and distal ends of the STA. A pseudoaneurysm of the STA should be suspected when there is a history of possible vessel injury, such as a history of head-pin fixation, and when a patient presents with a pulsatile, cystic mass near the temple. Pseudoaneurysms can be successfully treated by excision.

Does bilateral uterine artery ligation have negative effects on ovarian reserve markers and ovarian artery blood flow in women with postpartum hemorrhage?

  • Verit, Fatma Ferda;Cetin, Orkun;Keskin, Seda;Akyol, Hurkan;Zebitay, Ali Galip
    • Clinical and Experimental Reproductive Medicine
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    • v.46 no.1
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    • pp.30-35
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    • 2019
  • Objective: Bilateral uterine artery ligation (UAL) is a fertility-preserving procedure used in women experiencing postpartum hemorrhage (PPH). However, the long-term effects of this procedure on ovarian function remain unclear. The aim of this study was to investigate whether bilateral UAL compromised ovarian reserve and ovarian blood supply. Methods: This prospective study included 49 women aged between 21 and 36 years who had undergone a cesarean section for obstetric indications. Of these, 25 underwent uterine bilateral UAL to control intractable atonic PPH. The control group consisted of 24 women who had not undergone bilateral UAL. Standard clinical parameters, the results of color Doppler screening, and ovarian reserve markers were assessed in all participants at 6 months after surgery. The clinical parameters included age, parity, cycle history, body mass index, and previous medication and/or surgery. Color Doppler screening findings included the pulsatility index (PI) and resistance index (RI) for both the uterine and ovarian arteries. The ovarian reserve markers included day 3 follicle-stimulating hormone (FSH) levels, antral follicle count, and $anti-M\ddot{u}llerian$ hormone (AMH) levels. Results: There were no significant differences in the ovarian reserve markers of day 3 FSH levels, antral follicle count, and AMH levels between the study and control groups (p> 0.05 for all). In addition, no significant differences were observed in the PI and RI indices of the uterine and ovarian arteries (p> 0.05 for all). Conclusion: In this study, we showed that bilateral UAL had no negative effects on ovarian reserve or ovarian blood supply, so this treatment should be used as a fertility preservation technique to avoid hysterectomy in patients experiencing PPH.

A case of Angiomatosis on the Chest Wall -1 Case Report- (흉벽에 발생한 혈관종증 -1례 보고-)

  • 권오우
    • Journal of Chest Surgery
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    • v.27 no.11
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    • pp.973-976
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    • 1994
  • Angiomatosis [ or Diffuse Hemangima] is a rare condition in which large segments of the body are involved by proliferating vessels. By now, some authers say that this lesion begins during early intrauterine life when the limb buds form, grow proportionately with the fetus, and consequently affect large areas of the trunk or extremity. The majority of angiomatoses present during childhood or infancy as swelling, induration, or discoloration of the affected area. The patient was 13 year old male and had no specific signs and symptoms except palpable mass on the left lateral chest wall from childhood and a painful tender mass on the posterior chest wall for 5 days before admission. The chest PA showed no abnormalities.The operation was done with the resection of left 10th rib and 9th and 10th intercostal muscles including masses and the ligation of the both intercostal and feeding vessels of the masses. The pathologic result was angiomatosis involving intercostal muscles and rib.

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A Case Report of Arteriovenous Malformation on the Chest Wall (흉벽에 발생한 동정맥기형 -1례 보고-)

  • 박성용;심성보
    • Journal of Chest Surgery
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    • v.29 no.7
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    • pp.802-806
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    • 1996
  • Arteriovenous malformations are vascular anomalies containing a communication between artery and vein without an intervening capillary bed and also are the most dangerous of vascular malformations being hemodynamically active. Treatment must be careful usually limited and considered in the phase of activity of hemodynamics. The patient was 29-year-old female and had no specific signs and symptoms except buldging, pal- pable mass on the right posterolateral chest wall from several years ago and it was gradually growing from that time. The operation was done with ligation of the right 9th, 1 Oth intercostal arteries and dissection from other normal tissues and then excised the arteriovenous malformation mass and its feeding vessels. The pathologic result was arteriovenous malformation.

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