• Title/Summary/Keyword: thoracic cavity

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Tuberculosis-Infected Giant Bulla Treated by Percutaneous Drainage Followed by Obliteration of the Pulmonary Cavity Using Talc: Case Report

  • Heo, Jeongwon;Bak, So Hyeon;Ryu, Se Min;Hong, Yoonki
    • Journal of Chest Surgery
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    • v.54 no.5
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    • pp.408-411
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    • 2021
  • Tuberculosis (TB)-infected giant bullae are rare. A 55-year-old man was referred when an infected bulla did not respond to empirical treatment. Computed tomography showed a giant bulla in the right upper lobe with an air-fluid level and surrounding infiltrate. Sputum culture, acid-fast bacilli (AFB) stain, and polymerase chain reaction (PCR) for TB were negative. Percutaneous drainage of the bullous fluid was performed. AFB stain and PCR were positive in the drained fluid. The patient was given anti-TB drugs and later underwent obliteration of the pulmonary cavity using talc. To summarize, we report a patient with a TB-infected giant bulla that was treated successfully with anti-TB drugs and obliteration of the pulmonary cavity using talc.

Surgical Treatment of Pulmonary Aspergillosis -One Case Report- (폐면균증(肺麵菌症)의 외과적(外科的) 치료(治療) -일례(一例) 보고(報告)-)

  • Kim, Hark Jei;Lee, Nam Soo;Song, Yo Jun;Kim, Hyong Mook
    • Journal of Chest Surgery
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    • v.9 no.2
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    • pp.139-142
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    • 1976
  • A 33 year old male patient was admitted with 20 years history of recurrent hemoptysis. On clinical examination, mild left chest discomfortness and foul odored sputum with occasional rusty hemoptysis were principal complaints noted. Chest X-ray film revealed moderately advanced active tuberculosis lesion on both upper lung fields, and hen-egg sized mass surrounded with linear crescent of air shadow in a cavity on his left upper lung field. On left thoracotomy, dense pleural adhesions on left apicoposterior segmental surface with multiple lymphnode enlargements were noted, and the soft encapsulated mass of $5{\times}5{\times}8cm$ was localized in the apicoposterior segment of the left upper lobe. Apicoposterior segment with anterior segment of the left upper lobe was resected. Cavity was opened to find a rusty grayish colored, fragile mass, which was confirmed as "fungus ball" of aspergillosis by histological section slide with Gomori staining. The authors report one case of pulmonary aspergilloma superinfected with previous long standing pulmonary tbc.

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Urinothorax following Blunt Renal Trauma -One case report - (신장의 둔상에 의한 요흉 - 1예 보고-)

  • Kim Dae Hyun;Youn Hyo Chul;Yi In Ho;Kim Soo-Cheol;Cho Kyu Seok;Park Joo Chul;Kim Bum Shik
    • Journal of Chest Surgery
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    • v.38 no.11 s.256
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    • pp.803-805
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    • 2005
  • Urinothorax occurs when urine leakes into thoracic cavity and it was first reported by Correie in 1968. The mechanism of its occurrence is an accumulation of urine in thoracic cavity by retroperitoneal urinoma formed by urinary tract obstruction or trauma. Retroperitoneal inflammation, malignant neoplasm, kidney transplantation, and kidney biopsy can also induce urinothorax. The diagnosis of urinothorax may be delayed due to its rare incidence rate, but if diagnosis is confirmed the treatment is possible by urinary diversion. We report our experience of a case of urinothorax associated with retroperitoneal urinoma followed by blunt renal trauma with review of literatures.

Bilateral Chylothorax Due to Blunt Spine Hyperextension Injury: A Case Report

  • Lee, Hohyoung;Han, Sung Ho;Lee, Min Koo;Kwon, Oh Sang;Kim, Kyoung Hwan;Kim, Jung Suk;Chon, Soon-Ho;Shinn, Sung Ho
    • Journal of Trauma and Injury
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    • v.32 no.2
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    • pp.107-110
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    • 2019
  • Bilateral chylothorax due to blunt trauma is extremely rare. We report a 74-year-old patient that developed delayed bilateral chylothorax after falling off a ladder. The patient had a simple 12th rib fracture and T12 lamina fracture. All other findings seemed normal. He was sent home and on the 5th day visited our emergency center at Halla Hospital with symptoms of dyspnea and lower back pain. Computer tomography of his chest presented massive fluid collection in his right pleural cavity and moderate amounts in his left pleural cavity with 12th rib fracture and T11-12 intervertebral space widening with bilateral facet fractures. Chest tubes were placed bilaterally and chylothorax through both chest tubes was discovered. Conservative treatment for 2 weeks failed, and thus, thoracic duct ligation was done by video assisted thoracoscopic surgery. Thoracic duct embolization was not an option. Postoperatively, the patient is now doing well and happy with the results. Early surgical treatment must be considered in the old patient, whom large amounts of chylothorax are present.

Chest Wall Reconstruction Using Latissimus Dorsi Myocutaneous Flap (광배근피판을 이용한 외상성 흉벽 결손의 재건 1례)

  • 이호철;류한영
    • Journal of Chest Surgery
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    • v.29 no.2
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    • pp.239-243
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    • 1996
  • Chest wall reconstruction Is difficult because of the physiological and anatomical functions of thoracic cavity where the thoracic cavity must be stabilized in order to prevent paradoxical motion, and adequate protection must be provided to the mediastinal structures. A 37-year-old male patient with full-thickness defect on the left anterior thoracic cavity due to traffic accident was treated. Emergency operation was performed for debridement and bleeding control, and on postoperative 25 days, chest wall reconstruction was performed as a second-stage operation. Left anterior chest wall was reconstructed with latissimus dorsi myocutaneous flap which had thoracodorsal arterial pedicle, and split-thickness skin grift from the left thigh was done. After chest wall reconstruction, spontaneous self-respiration was possible without ventilatory support. The pulmonary function test performed at postoperative 3 months revealed 80% of predicted values (FVC, FEV1.0). The postoperative result of chest wall reconstruction using latissimus dorsi myocutaneous flap was excellent anatomically, physiologically and aesthetically.

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Surgical Removal of the Lung Lobe Metal Foreign Body in a Dog

  • Hwang, Yawon;Kang, Jihoun;Chang, Dongwoo;Kim, Gonhyung
    • Journal of Veterinary Clinics
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    • v.34 no.2
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    • pp.108-111
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    • 2017
  • A 4-year-old, weighing 7.6 kg, castrated male, Pug presented with ingestion of gastric cavity foreign body. Physical examination revealed panting, retching and hyper-salivation. Blood chemistry and complete blood cell count were normal, but hypophosphatemia was observed. An abdominal radiograph revealed the foreign body (FB), round shape and 2 cm length, at the pyloric region of stomach. A thoracic radiograph revealed an incidental metal FB, 3.5 cm length, at the cranial portion of the diaphragm. An upper gastrointestinal endoscopy was performed to remove the FB in the stomach and then a peach-pit was removed. However the metal FB was not found in the esophagus therefore a lateral thoracotomy was performed. A right lateral thoracotomy through the $7^{th}$ intercostal space was accomplished to expose the right caudal lung lobe. After open the thoracic cavity, foreign body was not observed by gross evaluation and caudal lung lobe was attached to the diaphragm. The FB was identified inside the lung lobe and surrounded by granulation tissue. The metal FB (sewing needle) was removed with blunt dissection and incised lung lobe was sutured using absorbable suture material PDS 4-0 with interrupted suture. A thoracotomy tube was inserted into the thoracic cavity during surgery. Patient's respiration became stable after surgery. A chest tube was removed 3 days after surgery. No complications were noted and the dog was discharged 4 days after surgery. In small animal, foreign body ingestion is a common reason for emergency. After ingestion of the FB, perforation through the esophagus and migration to inside the lung lobe is not common in small animals. In this case, thoracic metal FB was identified incidentally and removal of a thoracic FB with thoracotomy was performed successfully.

Clinical, Radiographic, Echocardiographic, Intraoperative Findings of Diaphragmatic Hernia in a Pomeranian Dog (포메라니안견에서 발생한 횡격막허니아의 임상학적, 방사선학적, 초음파학적 및 수술적 소견)

  • 정순욱;박수현;이충헌;신영규;정월순
    • Journal of Veterinary Clinics
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    • v.16 no.2
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    • pp.478-481
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    • 1999
  • A 8 years old male Pomeranian weighing 4 kg was referred because of coughing of 4 months' duration. Heart sounds and cardiac apex beat were showed more intense on the right side. On radiographic views, loss of normal line of the diaphragm, gas-containing intestines and stomach in thoracic cavity, and right displacement of heart were observed. Ultrasonography revealed that liver located adjacent to the heart. Although the dog died due to severe respiratory disorder in surgical procedure, in thoracic and abdominal surgery, a large defect was found in the left and right ventral muscular portion and left central tendon of the diaphragm, extending from the esophageal hiatus to rib. Left and right cranial lobe of liver, small intestines, stomach and spleen were herniated in the thoracic cavity. Because of the size and chronicity of the defect in the diaphragm, closure was impossible with an abdominal muscle graft.

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Radiological assessment of pectus excavatum in a Pekingese dog

  • Cho, Sung-Jin;Hong, Sun-Hwa;Chung, Yung-Ho;Kim, Ok-Jin
    • Korean Journal of Veterinary Service
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    • v.35 no.3
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    • pp.251-254
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    • 2012
  • Pectus excavatum (PE) is a ventral chest wall deformity, also known as funnel chest, sunken chest, chondrosternal depression or koilosternia. The 4 months old, 1.3 kg intact-female Pekingese dog was evaluated for acute semicoma and convulsion. The client reported that this patient have had chronic loss of appetite, intermittent dyspnea and palpable sunken breast. The other littermates did not show any abnormalities. On physical examination, cachexia (BCS 1/5), concave sternum, flatten thoracic cavity and cardiac murmur were observed. On radiographic study, the caudal sternum cave to vertebrae and narrowing thoracic cavity. The severities of thoracic deformity were evaluated by deformation indices such as-Frontosagittal index (FSI) and vertebral index (VI). Moderate to severe PE was founded by the radiological measurements.

Intra-thoracic Parathyroid Adenomatosis: A Case Report

  • Kim, Wan Kee;Kim, Dong Kwan;Choi, Se Hoon;Kim, Hyeong Ryul;Kim, Yong Hee;Park, Seung-Il
    • Journal of Chest Surgery
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    • v.46 no.4
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    • pp.302-304
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    • 2013
  • Ectopic mediastinal parathyroid adenomas are rare, but can be life-threatening. Resection is indicated in those cases accompanied by hypercalcemia, especially in young patients. Although most mediastinal parathyroid adenomas can be removed by a cervical approach, a transthoracic approach is needed when the adenoid tissues are located deep within the thoracic cavity. We describe the case of a 37-year-old female who underwent excision of an intrathoracic ectopic parathyroid adenoma after parathyroidectomy four months earlier.

Thoracic Splenosis after Splenic and Diaphragmatic Injury

  • Ha, You Jin;Hong, Tae Hee;Choi, Yong Soo
    • Journal of Chest Surgery
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    • v.52 no.1
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    • pp.47-50
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    • 2019
  • Thoracic splenosis is a rare disease that develops as a result of autotransplantation of splenic tissue into the thoracic cavity following splenic and diaphragmatic injury. We report the case of a 53-year-old man with a chief complaint of heartburn and cough. He had a history of traumatic diaphragmatic rupture treated with surgical repair and splenectomy 15 years ago. Imaging studies revealed a paraesophageal mass, and surgical resection was performed considering the possibility of Castleman disease or an esophageal submucosal tumor. Pathologic results showed findings of normal splenic tissue. The patient was discharged on postoperative day 5 without any complications.