• Title/Summary/Keyword: posterior mediastinum

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Video-assisted Thoracoscopic Surgery for Mediastinal Lesions (종격동 질환의 비디오 흉강경 수술)

  • 김연수;김광택;손호성;김일현;이인성;김형묵;김학제
    • Journal of Chest Surgery
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    • v.31 no.1
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    • pp.40-45
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    • 1998
  • Recently, video-assisted thoracoscopic surgery for mediastinal lesions has been considered a new effective therapeutic method. From March, 1992 to April, 1997, 33 cases of video assisted thoracoscopic surgery for mediastinal lesions were performed. Gender distribution was 16 males and 17 females. Average age was 42 years old(ranged from 14 to 69). The locations of lesions were anterior mediastinum in 14 cases, middle mediastinum in 5 cases, posterior mediastinum in 11 cases, and superior mediastinum in 3 cases. These included 9 neurilemmomas, 5 benign cystic teratoma, 4 pericardial cysts, 2 ganglioneuroma, 2 thymus, 2 thymic cyst, 1 thymoma, 2 esophageal leiomyomas, 1 dermoid cyst, 1 lipoma, 1 malignant lymphoma, 1 bronchogenic cyst, 1 pericardial effusion, and 1 Boerhaave's disease with empyema. Working window was needed in 6 cases. We converted to open thoracotomy in 6 cases. Reasons of convertion to open thoracotomy were large sized mass(1), severe adhesion(3), and difficult location to approach(2). The average operation time was 116min($\pm$56 min). The average chest tube drainage time was 4.7days. The average hospital stay was 8.7 days. Operative complications were atelectasis(2), empyema with mediastinitis(1), recurrent laryngeal nerve palsy(1), and plenic nerve palsy(1). In conclusion, VATS for mediastinal lesions were performed with shorter operation time and hospital stay, and lesser complications and pain than those of conventional thoracotomy.

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A Case of Posterior Mediastinal Plasmacytoma Confounded by Community-Acquired Pneumonia

  • Heo, Dahee;Boo, Ki Yung;Jwa, Hyeyoung;Lee, Hwa Young;Kim, Jihyun;Kim, Seong Taeg;Seo, Hye Mi;Han, Sang Hoon;Maeng, Young-Hee;Lee, Jong Hoo
    • Tuberculosis and Respiratory Diseases
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    • v.78 no.3
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    • pp.262-266
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    • 2015
  • Plasmacytomas are extramedullary accumulations of plasma cells originating from soft tissue. Mediastinal plasmacytoma is a rare presentation. A 67-year-old man recovered after antibiotic treatment for community-acquired pneumonia. However, on convalescent chest radiography after 3 months, mass like lesion at the right lower lung field was newly detected. Follow-up chest computed tomography (CT) revealed an increase in the extent of the right posterior mediastinal mass that we had considered to be pneumonic consolidations on previous CT scans. Through percutaneous needle biopsy, we diagnosed IgG kappa type extramedullary plasmacytoma of the posterior mediastinum.

Treatment of Traumatic Sternoclavicular Joint Anterior Dislocation with a Sternal Fracture (흉골 골절과 동반된 외상성 흉쇄관절 전방 탈구의 치료)

  • Choi, Sung;Shin, Dong-Ju;Hwang, Seong-Mun
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.1
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    • pp.76-81
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    • 2021
  • A traumatic dislocation of the sternoclavicular joint is a rare injury, and among them, anterior dislocation is more common than a posterior dislocation. Posterior dislocation is a potential risk by compressing the mediastinal structures, but an anterior dislocation has not been considered a risk. Traumatic sternoclavicular joint anterior dislocation associated with anterior angulation of a sternal fracture can develop mediastinal compression and have a risk in the same way as a posterior dislocation. This case report is about a traumatic sternoclavicular joint anterior dislocation with a sternal fracture accompanied by mediastinal compression that was treated surgically using a plate and showed relatively good clinical results. This rare case is reported along with a review of the relevant literature.

A Case of Congenital Paraesophageal Hiatal Hernia in Infancy

  • Jang, Won-Nyung;Park, In-Su;Park, Kwi-Won;Yoo, Seon-Young;Lee, Jin;Cho, Sang-Hee
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.15 no.2
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    • pp.100-104
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    • 2012
  • Esophageal hiatal hernia is the hernia of a part of or the whole of stomach to posterior mediastinum through esophageal hiatus. Esophageal hiatal hernia can be classified as sliding hiatal hernia (type I), paraesophageal (type II), combined sliding and paraesophageal (type III), and complex paraesophageal (type IV). Type III and IV are clinically classified as paraesophageal hernia. The authors by chance found cystic mass filled with air in the lower lobe of the right lung during the treatment of mycoplasma pneumonia of 10 month-old patient. It was found to be paraesophageal hernia on the chest computed tomography and treated with the operation. As complex paraesophageal hernia is not usual among infants, the authors report it here with literature review.

A Case of Budd-Chiari Syndrome Associated with Alveolar Echinococcosis

  • Cakmak, Erol;Alagozlu, Hakan;Gumus, Cesur;Ali, Celiksoz
    • Parasites, Hosts and Diseases
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    • v.51 no.4
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    • pp.475-477
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    • 2013
  • Although alveolar echinococcosis (AE) can cause a serious disease with high mortality and morbidity similar to malign neoplasms. A 62-year-old woman admitted to a hospital located in Sivas, Turkey, with the complaints of fatigue and right upper abdominal pain. On contrast abdominal CT, a $54{\times}70{\times}45$ mm sized cystic lesion was detected in the left lobe of the liver that was seen to extend to the posterior mediastinum and invade the diaphragm, esophagus, and pericardium. The cystic lesion was seen to be occluding the inferior vena cava and left hepatic vein at the level where the hepatic veins poured into the inferior vena cava. Bilateral pleural effusion was also detected. We discussed this secondary Budd-Chiari Syndrome (BCS) case, resulting from the AE occlusion of the left hepatic vein and inferior vena cava, in light of the information in literature.

Paraesophageal Hernia with Gastric Erosion - A Case Report - (식도주위 열공 탈장에서 병발한 위미란의 치험)

  • Baek, Hong-Gyu;Yu, Hoe-Seong
    • Journal of Chest Surgery
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    • v.26 no.4
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    • pp.337-341
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    • 1993
  • Since the first deliberate repair of hiatal hernia by Wm. J. Mayo in 1911, counterless procedure have been performed to correct herniation of the stomach into the posterior mediastinum. Recently,we experienced 51 years old female patient with large paraesophageal hernia and complete intrathoracic stomach which combined with multiple gastric erosion with chronic blood loss. So gastric ulcer within a diaphragmatic hernia is a distinct physiophathologic and clinical entity that our patient suffered from severe anemia due to chronic blood loss. The hernia was repaired transabdominally including reduction of stomach, excision of sac, closure of defect, anterior gastropexy, and gastr6stomy. Because of absent gastroesophageal refiux, no another antireflux procedure was required and erosion was managed by H2 receptor blocker.

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Mediastinoscopy: 18 Cases (종격동경 검사: 18례 보고)

  • 이남수
    • Journal of Chest Surgery
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    • v.10 no.2
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    • pp.349-354
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    • 1977
  • Mediastinoscopy is a surgical endoscopic technique used mainly for examination and biopsy of lesions of the superior and posterior middle mediastinum. It is particularly concerned with diseases that primarily or secondary involve the paratracheal and parabronchial lymphatics. A total of 18 cases of mediastinoscopy are presented with a detailed analysis of indications and results. Of these mediastinoscopy was positive in i0 [56%] and negative in 8 [44%]. The 10 positive mediastinoscopies were diagnostic in 4 patients with malignant lymphoma, 5 patients with carcinoma of the lung, one patient with active pulmonary tuberculosis. Of 8 negative mediastinoscopies, one was inoperable due to recurrent laryngeal nerve involvement, 7 patients were subjected to radical resection. Complications of mediastinoscopy were developed in 2 cases, one was minimal degree of subcutaneous emphysema on anterior chest wall, and the other was widening of right mediastinal border due to hematoma. Two complications were completely absorbed after 7 days.

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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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Paraesophageal Hiatal Hernia: One Case Report (식도 열공 허니아 치험예)

  • Lee, Young;Kim, In-Koo;Suh, Dong-Hyeon;Kim, Tae-Woon;Lee, Ho-Sung
    • Journal of Chest Surgery
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    • v.11 no.3
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    • pp.355-358
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    • 1978
  • The esophageal hiatal hernia is a rare disease entity in children, Especially, the paraesophageal hiatal hernia is an extremely rare. We had experienced a paraesophageal hiatal hernia in 6 month old male baby. He had postprandial vomiting for 4 months. The chest P-A and right lateral X-ray films were shown a round homogenous density in posterior mediastinum. On laparotomy, we couldn`t see the stomach in operative field. We reduced the stomach through the widened esophageal hiatus and repaired hiatal opening. His operative course was uneventful and discharged on the 9th postoperative day.

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Azygos Vein Aneurysm - A Case for Elective Resection by Video-assisted Thoracic Surgery

  • Lee, Deok-Heon;Keum, Dong-Yoon;Park, Chang-Kwon;Kim, Jae-Bum;Rho, Byung-Hak
    • Journal of Chest Surgery
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    • v.44 no.4
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    • pp.304-306
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    • 2011
  • An azygos vein aneurysm is a very rare cause of a posterior mediastinal mass. Once the diagnosis has been confirmed, no treatment is usually required. However, the aneurysm can thrombose, and this may lead pulmonary thromboembolism, or the aneurysm may rupture. In these instances, the excision of the mass is recommended. Video-assisted thoracic surgery techniques have considerably improved. If it is necessary to remove the aneurysm, video-assisted thoracic surgery may be a good option for surgical treatment. We report a case of an aneurysm of the azygos arch that was successfully resected by video-assisted thoracic surgery.