• Archives of Plastic Surgery
• /
• v.38 no.3
• /
• pp.323-325
• /
• 2011

Purpose: Breast implant ruptures and displacement are problematic complications after augmentation mammoplasty. The authors report a patient whose cohesive silicone gel implant ruptured and migrated into the pleural cavity after augmentation mammoplasty. Methods: A 23-year-old female had received augmentation mammoplasty at a local clinic a week before visiting our hospital. When the patient's doctor performed a breast massage on the sixth postoperative day, the left breast became flattened. The doctor suspected a breast implant rupture and performed revision surgery. The implant, however, was not found in the submuscular pocket and no definite chest wall defect was found in the operative field. The doctor suspected implant migration into the pleural cavity, and after inserting a new breast implant, the doctor referred the patient to our hospital for further evaluation. The patient's vital signs were stable and she showed no specific symptoms except mild, intermittent pain in the left chest. A CT scan revealed the ruptured implant in the left pleural cavity and passive atelectasis. Results: The intrapleurally migrated ruptured implant was removed by video-assisted thoracic surgery (VATS). There were no adhesions but there was mild inflammation of the pleura. No definite laceration of the pleura was found. The patient was discharged on the first day after the operation without any complications. Conclusion: Surgeons should be aware that breast implants can rupture anytime and the injury to the chest wall, which may displace the breast implant into the pleural cavity, can happen during submuscular pocket dissection and implant insertion.

• Korean Journal of Radiology
• /
• v.20 no.8
• /
• pp.1293-1299
• /
• 2019

Objective: The purpose of this study was to evaluate the diagnostic performance of ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography (¹⁸F-FDG PET/CT) for chronic empyema-associated malignancy (CEAM). Materials and Methods: We retrospectively reviewed the ¹⁸F-FDG PET/CT images of 33 patients with chronic empyema, and analyzed the following findings: 1) shape of the empyema cavity, 2) presence of fistula, 3) maximum standardized uptake value (SUV) of the empyema cavity, 4) uptake pattern of the empyema cavity, 5) presence of a protruding soft tissue mass within the empyema cavity, and 6) involvement of adjacent structures. Final diagnosis was determined based on histopathology or clinical follow-up for at least 6 months. The abovementioned findings were compared between the ¹⁸F-FDG PET/CT images of CEAM and chronic empyema. A receiver operating characteristic (ROC) analysis was also performed. Results: Six lesions were histopathologically proven as malignant; there were three cases of diffuse large B-cell lymphoma, two of squamous cell carcinoma, and one of poorly differentiated carcinoma. Maximum SUV within the empyema cavity (p < 0.001) presence of a protruding soft tissue mass (p = 0.002), and involvement of the adjacent structures (p < 0.001) were significantly different between the CEAM and chronic empyema images. The maximum SUV exhibited the highest diagnostic performance, with the highest specificity (96.3%, 26/27), positive predictive value (85.7%, 6/7), and accuracy (97.0%, 32/33) among all criteria. On ROC analysis, the area under the curve of maximum SUV was 0.994. Conclusion: ¹⁸F-FDG PET/CT can be useful for diagnosing CEAM in patients with chronic empyema. The maximum SUV within the empyema cavity is the most accurate ¹⁸F-FDG PET/CT diagnostic criterion for CEAM.

• Journal of Veterinary Clinics
• /
• v.24 no.4
• /
• pp.636-639
• /
• 2007

Septicemic polyserositis and navel ill associated with Escherichia coli were reported in a 14-day-old male thoroughbred foal. The horse died after showing 12-day history of anorexia, lethargy, lameness and endophthalmus. Grossly, milky yellow abscesses were occupied in umbilicus, umbilical vein and artery. Large amounts of turbid pale yellow fluids were seen in pericardial sac, thoracic and abdominal cavity. Yellowish fibrinous materials were also presented in thoracic and abdominal cavity. Sticky pale yellow fluid and fibrinous materials were filled in stifle joint cavities of both hind limbs. Histologically, fibrino-purulent polyserositis and arthritis were observed. Severe omphalophlebitis with intra-lesional Gram negative bacterial colonies were noted in umbilical vein. Most of mesothelial cells in serosal cavities were severely hypertrophied. Pathogenic E. coli was purely isolated from ascites, thoracic and synovial fluids. Based on the results, the septicemic polyserositis may be originated from the umbilical cord infected with E. coli in this foal.

• Journal of Chest Surgery
• /
• v.29 no.1
• /
• pp.63-66
• /
• 1996

Postoperative empyema thoracis with bronchopleural fistula (BPF) Is uncommon but serious complication. The management remains troublesome area in the field of the general thoracic surgery During the period of October 1993 to December 1994, four patients with postresectional empyema thoracic with BPF were treated consecutively in Ewha Womans University Mokdong Hosp tal. The treatment procedures include irrigation and debridement of the empyema cavity and muscle flap transposition. Follow-up periods after surgery were 4-12 months. Three patients were thought successful, one patient failed. We think that the cause of failure is muscle necrosis of rectos abdominis muscle flap due to vascular injury and infection of muscle due to residual infected debridement of empyema cavity.

• Journal of Chest Surgery
• /
• v.44 no.1
• /
• pp.76-79
• /
• 2011

Right-sided diaphragmatic rupture is less common and more difficult to diagnose than left-sided lesion. It is rarely combined with the herniation of the abdominal organs into the thorax. High level of suspicion is the key to early diagnosis, and a delay in diagnosis is implicated with a considerable risk of mortality and morbidity. We experienced a case of right-sided diaphragmatic rupture combined with complete avulsion of the right kidney and herniation of the liver into the thoracic cavity.

• Journal of Chest Surgery
• /
• v.55 no.2
• /
• pp.171-173
• /
• 2022

A 65-year-old man underwent right trisectionectomy of the liver and reconstruction of the chest wall and diaphragm with a 2-mm Gore-Tex membrane due to recurrent hepatocellular carcinoma. After 3 years, the Gore-Tex membrane in the diaphragm migrated to the abdominal cavity and perforated the colon. We report a rare complication of a Gore-Tex membrane after diaphragm repair.

• Journal of Chest Surgery
• /
• v.43 no.6
• /
• pp.753-757
• /
• 2010

We report hereon a case of double bypass of the esophagus and descending thoracic aorta for the treatment of esophagopleural fistula and aortopleural fistula due to an infected aortic aneurysm after esophageal rupture. A 48 year old man was diagnosed as having esophageal rupture after an accidental explosion. Although he had been treated by esophageal repair and drainage at another hospital, the esophageal leakage could not be controlled and subsequent empyema developed in the left pleura. Further, bleeding from the descending thoracic aorta had developed and he was managed with endovascular stent insertion to the descending thoracic aorta. He was transferred to our hospital for corrective surgery. We performed esophago - gastrostomy via the substernal route, without exploring posterior mediastinum and we let the empyema resolve spontaneously. While he was being managed postoperatively Without any signs and symptoms of infection, sudden bleeding developed from the left pleural cavity. After evaluation for the bleeding focus, we discovered an Infected aortic aneurysm and an aortospleural fistula at the stent insertion site. We performed a second bypass procedure for the infected descending thoracic aorta from the ascending aorta to the descending abdominal aorta via the right pleural cavity. We found leakage at the distalligation site during the immediate postoperative period, and we occluded the leakage using a vascular plug. He discharged without complications and he is currently doing well without any more bleeding or other complications.

• Journal of Chest Surgery
• /
• v.34 no.6
• /
• pp.511-513
• /
• 2001

Migration of Steinmann pins into the thoracic cavity is uncommon, but when occurs it can bring devasting consequences. A Sixty-year-old woman had pinning of the right humerus surgical neck fracture. She was not followed up after discharge Two years later, a chest x-ray film and chest CT showed that the pin had migrated to the right hemithorax. The migrated pins were removed with right anterolateral thoracotomy incision without any difficulties.

• Journal of Chest Surgery
• /
• v.10 no.1
• /
• pp.59-64
• /
• 1977

Mediastinal tumor are frequently encountered in clinical practice. Hanten, in 1955, reported-2 adult patients with spontaneous rupture of mediastinal dermoid cysts into the pleural cavity and also, Thompson, in 1963, reported 2 child patients with spontaneous rupture of mediastinal teratoma into the pleural cavity. Mediastinal teratomas have also been reported rupture into other contiguous structures, such as the bronchus, aorta, pericardium, SVC and esophagus. This report presents an instance of spontaneous rupture of an anterior mediastinal teratoma into the right pleural cavity of a 43 year old female. Despite variable diagnostic procedures, the true nature of the lesion was not determined until a thoracotomy and window formation was performed for adequate drainage of empyema thoracis. Removal of the teratoma and mediastinal window formation resulted in complete cure.

• Journal of Chest Surgery
• /
• v.39 no.8 s.265
• /
• pp.655-658
• /
• 2006

Mesothelial cyst is a rare mediastinal tumor and usually presents in the right cardiophrenic angle. However, it sometimes occurs in atypical locations and it’s locating in the posterior mediastinum, especially, is very rare. A large cystic mass of the posterior mediastinum between pericardium and vertebral body was incidentally recognized in a patient of a 30-year-old woman admitted due to traffic accident. Even though it was very large in size measuring 18 em at longest diameter and is extending mainly to the left pleural cavity, she had no symptomatic complaints. Complete excision was performed through video-assisted thoracoscopic surgery with a additional small working window, which was necessary for dissecting the deepest point to the right pleural cavity. She is in good condition without recurrence on long-term follow-up.