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Tuberculous Esophageal Perforation -Report of A case- (결핵성 식도천공 수술치험 1예)

  • 박강식
    • Journal of Chest Surgery
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    • v.12 no.1
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    • pp.61-66
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    • 1979
  • This is a report of a case of tuberculous esophageal perforation, which was surgically treated.. The patient was 32-year-old Korean female patient, who complained swallowing difficulty for` 4 weeks duration. Esophagogram was shown irregular filling defects in the upper one third of esophagus, about 4 cm in length. It was noticed that a small amount of contrast media was leaked out from the involved area of esophagus into the right mediastinum. It was highly suggested that abscess formation was due to perforation of esophageal cancer. Esophagoscopy revealed no definitive evidence of perforation of esophagus, but punch biopsy specimen of esophageal mucosa was shown acute and chronic inflammatory changes. Operation was performed under impression of esophageal cancer. In the right-sided upper mediastinum, a walnut-sized abscess cavity which was connected with esophagus through a fistulous tract was noted. A portion of cavity submitted for frozen section was shown tuberculous inflammation. The abscess cavity, fistula tract, and involved esophageal wall were removed. The perforated esophagus was closed layer by layer. The tuberculous changes were confirmed by histopathologic examination postoperatively. The postoperative course was uneventful.

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Traumatic Injury of Diaphragm (외상성 횡격막 손상)

  • 신호승
    • Journal of Chest Surgery
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    • v.28 no.3
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    • pp.308-312
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    • 1995
  • A 5-year retrospective study of 14 patients with diaphragmatic injuries revealed 9 blunt and 5 penetrating injuries. In the blunt trauma group, 7 were left and 2 were right side. The penetrating diaphragmatic wound consist of 3 left and 2 right sided. Sex ratio was 11: 3, with male predominanace. Preoperative diagnosis was possible in 9 cases and delayed diagnosis [greater than 24 hours occured in 5 cases.Simple chest X-ray was diagnostic or highly suggestive in 7 cases. 7 cases were diagnosed diaphragmatic injuries by computed tomography, fiuroscopy or by explorative operation. All of the cases had association injury. 11 cases of diaphragmatic ruptures were corrected through thoracotomy and 3 cases needed exploratory laparotomy. One death occured after operation due to associated injuries and respiratory failure. Blunt and penetrating diaphragmatic injuries remain a diagnostic challenge and associated injuries, delayed diagnosis determine the outcome.

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Fluoroscopy-guided intra-articular steroid injection for sternoclavicular joint arthritis secondary to limited cutaneous systemic sclerosis: a case report

  • Sencan, Savas;Guler, Emel;Cuce, Isa;Erol, Kemal
    • The Korean Journal of Pain
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    • v.30 no.1
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    • pp.59-61
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    • 2017
  • We report a case of fluoroscopy-guided intraarticular steroid injection for sternoclavicular joint (SCJ) arthritis caused by limited cutaneous systemic sclerosis (SSc). A 50-year-old woman diagnosed with limited cutaneous SSc presented with swelling and pain in the right SCJ. MRI revealed signs of inflammation consistent with right-sided sternoclavicular joint arthritis. After the failure of oral medications, we performed fluoroscopy-guided injection in this region. She reported complete resolution of her symptoms at 4 and 12-week follow-ups. This outcome suggests that a fluoroscopy-guided SCJ injection might be a safe and successful treatment option for sternoclavicular joint arthritis.

Missed Traumatic Rupture of the Diaphragm

  • Ryu, Sang Woo;Chekar, Jaykey;Yi, In Ho;Seo, Bo Ra;Park, Seong Huek;Go, Seong Ju
    • Journal of Trauma and Injury
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    • v.30 no.1
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    • pp.16-20
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    • 2017
  • A 48-year-old man came to the emergency department with altered consciousness and hemoperitoneum following a pedestrian traffic accident. He underwent immediate emergency laparotomy, and on the second day, he required craniectomy because of increase of intracranial hemorrhage. A chest radiograph taken 7 days after admission, showed elevation of the right hemi-diaphragm, and follow-up chest CT showed a right-sided rupture of the diaphragm, which was surgically repaired. Rupture of the diaphragm can be easily overlooked and the diagnosis delayed, especially in unstable patients with multiple trauma or altered level of consciousness, as in the case reported here.

Airway management in a displaced comminuted fracture of the mandible and atlas with a vertebral artery injury: A case report

  • Paramaswamy, Rathna
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.18 no.3
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    • pp.183-187
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    • 2018
  • Complex cervical spine fractures are a serious complications of maxillofacial trauma and associated with high mortality and neurological morbidity. Strict vigilance in preventing further insult to the cervical spine is a crucial step in managing patients who are at risk for neurologic compromise. We report a rare case of a right transverse process of atlas fracture with right-sided vertebral artery injury that was associated with a comminuted fracture of the body and angle of the mandible, which restricted mouth opening. Airway management was performed by an awake fiber-optic nasotracheal intubation, where neck movement was avoided with a cervical collar. Vertebral artery injuries may have disastrous consequences, such as basilar territory infarction and death, and should be suspected in patients with head and neck trauma. After mandibular plating, the patient was on cervical collar immobilization for 12 weeks and anti-coagulant therapy.

Intussusception after Colonoscopy: A Case Report and Review of Literature

  • Hassan, Wan Amir Wan;Teoh, William
    • Clinical Endoscopy
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    • v.51 no.6
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    • pp.591-595
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    • 2018
  • Intussusception after colonoscopy is an unusual complication. A MEDLINE search revealed only 7 reported cases. We present a report of a 28-year-old man who developed abdominal pain several hours after routine colonoscopy and in whom computed tomography (CT) revealed colocolic intussusception. We postulate that this condition is iatrogenic and induced by suctioning of gas on withdrawal of the colonoscope. A common observation among the reported cases was abdominal pain several hours after colonoscopy and right-sided intussusception. All cases had colonoscopy reaching the right side of the colon. Treatment for adult intussusception remains controversial with regard to reduction versus resection, especially given the high association with a pathological cause and malignancy. Among the 8 reported cases, only the current case did not require surgery. A combination of benign colonoscopy, CT, and the clinical picture should provide sufficient information to initially choose a more conservative treatment approach.

Nationwide incidence estimation of colorectal cancer by subsite of origin in Korea (한국인에서 대장-직장암의 해부학적 부위별 발생률 조사)

  • Park, B.J.;Lee, M.S.;Ahn, Y.O.;Heo, D.S.;Kim, D.H.;Kim, H.;Yew, H.S.;Park, T.S.
    • Journal of Preventive Medicine and Public Health
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    • v.29 no.3 s.54
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    • pp.555-563
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    • 1996
  • Nationwide incidence survey was conducted to estimate the annual incidence rates of colorectal cancer among Koreans between Jan 1, 1988 and Dec 31, 1989. The population of the incidence survey was the beneficiaries of Korea Medical Insurance Corporation (KMIC), which were about 4,500,000 persons. The medical records of patients with diagnosis of either ICD-9 153(colon cancer), 154(rectal caner), 197(secondary malignant neoplasm of digestive and respiratory system), or 211(benign neoplasm of digestive system) were abstracted for the period with the standard format. The diagnosis was confirmed by one oncologist through the review of these abstracts. The numerator of the rate was finally defined as the incident colorectal cancer cases diagnosed between July 1, 1988 and June 30, 1989. The crude annual incidence of colorectal cancer for men was 13.1 per 100,000 and 10.6 for women, which was still low when compared with those of Japan and China during the same period. Age-adjusted sex ratio was 1.2 for right-sided colon cancer and 1.9 for left-sided colon cancer. The excess of right colon cancer among postmenopausal women was remarkable, so further analytical approach would be needed to investigate which factors are related with this phenomenon.

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Continuous "Over and Over" Suture for Tricuspid Ring Annuloplasty

  • Park, Kwon-Jae;Woo, Jong-Soo;Jeong, Sang-Seok;Yi, Jung-Hoon
    • Journal of Chest Surgery
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    • v.45 no.1
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    • pp.19-23
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    • 2012
  • Background: A ring implantation in the tricuspid annulus requires many interrupted mattress sutures for correction of tricuspid regurgitation (TR). In this study, tricuspid ring annuloplasty was performed by 2-0 polypropylene continuous suture instead of multiple interrupted 2-0 polyester mattress sutures, and the efficacy of the method was evaluated. Materials and Methods: This study included 20 patients who underwent tricuspid ring annuloplasty by continuous suture between May 2009 and July 2010. Four of the patients had an isolated TR, and the rest had a left-sided cardiac lesion. The concomitant tricuspid annuloplasty was performed after the left-sided heart surgery was completed and a Duran flexible ring prosthesis was used. Results: There was no perioperative mortality or conduction problem. More than a moderate degree of TR was improved to less than a mild degree after the procedure. After the ring annuloplasty, the right atrial volume decreased from $123.7{\pm}69.2mL$ to $74.5{\pm}37.4mL$, and the mean right atrial pressure was lowered from $18.7{\pm}12.2mmHg$ to $8.9{\pm}5.5mmHg$. Conclusion: The continuous "over and over" suture may be a useful procedure for fixing the ring to the annulus and making an intentional annular placation in performing tricuspid ring annuloplasty.

A Case Report of a Right-sided Hemichorea Patient Diagnosed with Chorea Hyperglycemia Basal Ganglia Syndrome : A Combined Western-Korean Medicine Approach (우반신 무도증을 호소하는 Chorea Hyperglycemia Basal Ganglia Syndrome 환자에 대한 증례보고 : 양한방 복합치료적 접근으로)

  • Kim, Sung Yoon;Park, Jun Hyeong;Ahn, Jae Hyun;Jo, Jung Jae;Lee, Seung Min;Kang, Jung Won;Nam, Dong Woo
    • Journal of Acupuncture Research
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    • v.33 no.1
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    • pp.117-125
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    • 2016
  • Objectives : The purpose of this report is to introduce a rare case of a patient with Chorea Hyperglycemia Basal Ganglia syndrome (C-H-BG) whose initial medical interventions were started 2 weeks after the onset, and to suggest the possibility of treatment using a combined Western-Korean medicine approach. Methods : A 75-year-old female C-H-BG patient complaining of persistent right-sided hemichorea was treated with a therapy that combined Korean and Western medicine from April 4, 2015 to April 29, 2015. Improvements of symptoms were measured by a motor assessment of Unified Huntington's Disease Rating Scale (UHDRS), Visual Analog Scale (VAS) and the number of involuntary movements. Results : Motor assessment of UHDRS, VAS and the number of involuntary movements all showed a gradually improving tendency during 26 days of admission treatment. However, the patient's hemichorea persisted. Conclusion : Rapid blood sugar control is the most important treatment for C-H-BG, because pathologic changes of basal ganglia seem to become irreversible as time goes by. A combined Western-Korean medicine approach to treating C-H-BG seems effective not only in reducing hemichorea, but also in the management of accompanying symptoms such as muscle pain and general weakness.

Perforation of azygos vein and right-sided hydrothorax caused by peripherally inserted central catheter in extremely low birth weight infant (초극소 저출생 체중아에서 중심 정맥 도관술로 발생한 홀정맥 파열과 우측 흉수증 1례)

  • Ha, Kee Soo;Shin, Jung Yeon;Hwang, Mi Jung;Choi, Young Ok;Shin, Dong Han;Jang, Gi Young;Choi, Byung Min;Yoo, Kee Hwan;Hong, Young Sook;Son, Chang Sung
    • Clinical and Experimental Pediatrics
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    • v.49 no.8
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    • pp.902-905
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    • 2006
  • We report a case in which routine chest roentgenograms of an 840 g infant led to the belief that the peripherally inserted central catheter (PICC) was appropriately positioned within the superior vena cava when, in actuality, it was within the azygous arch. Although many cases of pleural effusions have been reported to be caused by a central venous catheter, a right-sided hydrothorax caused by azygous vein rupture from the use of a PICC is an extremely rare complication. Sudden changes in the condition of a preterm infant with PICC should raise the suspicion of a catheter-related problem.