• Journal of Chest Surgery
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• v.25 no.10
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• pp.1001-1012
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• 1992

13 cases of traumatic diaphragmatic ruptures were treated at the department of thoracic and cardiovascular surgery in Lee-Rha general hospital, Cheong-Ju, Choong Cheong Buk Do, between Oct. 1989 and Feb. 1992. The above 13 cases were reviewed in this study. And the following results were obtained. 1. Sex ratio is 11: 2 with male dominance 2. The 9 cases were due to blunt trauma and other 4 cases were due to penetrating injury. 3. Right side injury was more common than left[7: 5] and there was 1 case of central type which ruptured through subepicardial diaphragm. 4. All of the cases had association injury. 5. Preoperative diagnosis was possible in the 9 cases and others were diagnosed during operation under other indication. 6. Finger exploration was one of effective diagnostic procedure. 7. All of diaphragmatic ruptures was corrected through thoracotomy and exploratory laparotomy was done in 6 cases. 8. A patient died after operation due to associated injuries.

• Journal of Chest Surgery
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• v.25 no.10
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• pp.1013-1019
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• 1992

A clinical evaluation was performed on 1, 110 cases of chest trauma treated at the Department of Chest Surgery, Chonnam University Hospital, during the past 23 years from January 1968 to June 1990. The ratio of male to female was 5.5: 1. The most common causes of chest trauma was stab wounds in penetrating trauma and traffic accidents in nonpenetrating trauma. The most common injuries in chest trauma were hemothorax in penetrating trauma and rib fracture in nonpenetrating trauma. Hemothorax or pneumothorax was observed in 592 cases [53.3%] of the total cases and rib fracture was observed in 527 cases[47.5%] of the total cases. Rib fracture was prevalent from the 3th to 8th rib, and 1st and 2nd rib fractures were associated with major thoracic injuries and other organ injuries. Open thoracotomy was performed in 163 cases[14.7%] and conservative nonoperative treatment in the others. Overall mortality rate was 8.5%[94 cases], and common causes of the death were shock and respiratory insufficiency.

• Journal of Chest Surgery
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• v.11 no.1
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• pp.97-101
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• 1978

Primary cyst of the diaphragm is a rather uncommon disease. This is a report of a case of diaphragmatic cyst, located in the tendinous portion of the right diaphragm. The patient had no specific symptoms in the respiratory systems, but suffered from gastrointestinal symptoms [indigestion, epigastralgia, and loss of appetite etc.] for 2 months. Accidentally, on a simple chest x-ray examination, a round homogenous mass density was discovered. Tomography showed a well circumscribed parenchymatous mass. So a coin lesion in the medial segment of the right lower lobe was suspected. A thoracotomy was performed. There were no pathological findings in the lung and pleura. A ping-pong ball sized round mass, which was soft, elastic and fluctuated,was noted in the tendinous portion of the diaphragm. It was enucleated completely without diaphragmatic rupture, and diagnosed as a primary diaphragmatic cyst [fibrous-walled] by the histopathologic examination. Postoperative course was uneventful.

• Journal of Chest Surgery
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• v.10 no.1
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• pp.59-64
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• 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
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• v.20 no.2
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• pp.317-322
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• 1987

Records of 15 patients who underwent operation for constrictive pericarditis at this department from 1976 through 1984 were reviewed. All had hemodynamically significant pericardial constriction preoperatively, and pericardial disease was confirmed at operation. There were 12 males and 3 females in this series. Range of age varied from 7 years to 51 years. Clinical and histological study revealed granulomatous pericarditis compatible with the diagnosis of tuberculosis in 5 patients, non-specific chronic inflammatory changes in 6 patients and pyogenic pericarditis in 2 patients. Pericardiectomy was performed through a median sternotomy [11 cases] or bilateral anterior thoracotomy [4 cases]. The postoperative complications were observed in 4 patients. Low cardiac output was the most common complication [2 patients]. In 13 cases, excluding 2 operative deaths, preoperatively all were in New York Heart Association Class III or IV. At the time of discharge II [85%] were in Class I or II. 4 Cases were reoperated after original pericardiostomy and all resulted in marked improvement. Early surgical intervention is advisable in all patients in whom cardiac constriction is caused by either a thickened pericardium or a pericardial effusion before myocardial dysfunction occurs.

• Journal of Chest Surgery
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• v.20 no.2
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• pp.358-366
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• 1987

A case of malignant fibrous histiocytoma [MFH] of left pulmonary artery was reported in the 27 year-old male. He was admitted because of hemoptysis for several times. Chest x-ray revealed nodular lesions in left hilar area and left upper lobe. A left thoracotomy was performed followed left upper lobectomy. The main tumor was originated from the pulmonary arterial bifurcation and proximal portion of the left pulmonary artery. By light microscopy, there were many pleomorphic giant cells, which displayed the storiform pattern. And in those area, dilated or compressed vascular channels were involved by tumor cells, suggesting origin of This tumor. Pulmonary artery angiography and chest CT revealed this tumor was originated from pulmonary artery. It would be the first reported primary malignant fibrous histiocytoma of the pulmonary artery in our country. Postoperative prognosis was uneventful, but recently he was suffered from dyspnea, that was noticed by OVD follow-up for 1 month, probably the heart failure sign due to pulmonary arterial flow obstruction.

• Journal of Chest Surgery
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• v.23 no.5
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• pp.968-975
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• 1990

An aortobronchial fistula is a rare complication of aneurysm of the aorta. The fistula starting from a chronic traumatic aortic aneurysm is exceptionally rare. Our observation concerns a patient of 26 with previous chest trauma who had atelectasis of left lung following dyspnea and hemoptysis. Aortography and surgical intervention revealed that this was a chronic traumatic aortic aneurysm of descending thoracic aorta, which developed a fistula in the bronchus. She underwent left posterolateral thoracotomy and the surgical repair of the aneurysm was performed with a woven Dacron patch graft using a temporary external bypass between the ascending and the descending aorta. The fistula in the bronchus was closed with simple interrupted sutures. In the immediate postoperative period, double vision, headache, and hoarseness developed but returned normal.

• Journal of Chest Surgery
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• v.4 no.2
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• pp.87-90
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• 1971

The mediastinal lipoma is an extremely rare tumor in children. Since the orininal description by Fothergill in 1781, about 120 cases have been reported in the world literature. Of these, less than 10 have been reported in children below the age of 12. We had experienced a posterior mediastinal lipoma in 3 year old boy. He did not complain of any subjective symptoms. Routine X-ray film revealed a huge round homogenous mass density in the posterior mediastinum. On posterior thoracotomy incision,bright yellow,well encapsulated, partly 1obular adipose mass was found in the posterior mediastinum. The tumor mass was removed easily,being proved to be lipoma on histopathologic examination. His postoperative course was uneventful and discharged on the 12th postoperative day.

• Journal of Chest Surgery
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• v.25 no.10
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• pp.1121-1124
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• 1992

Rupture of a bronchus is an unusual result of blunt trauma to the chest. We experienced a case of bronchial rupture caused by blunt chest trauma without external wound or rib fracture. This case was a 13 years old male who was elementary school student. He was compressed on anterior chest by basket ball goal post being failed down on the afternoon of admission day. After this accident, he was suffered from progressive dyspnea and chest pain. The bronchial rupture was confirmed by bronchogram, The operation was performed through standard posterolateral thoracotomy incision along the 5th rib course. The right upper lobe bronchus and intermediate bronchus was completely transected. The right upper lobectomy was done. The ruptured intermediate bronchus was connected direct simply. Post-operative course was uneventful. Thus we report this case of traumatic bronchial rupture with review of literature.

• Journal of Chest Surgery
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• v.28 no.6
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• pp.610-618
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• 1995

Three neonates with interrupted aortic arch with VSD underwent one stage repair using revised technique of cardiopulmonary bypass with short period of circulatory arrest. A left posterolateral thoracotomy was made to permit mobilization of the descending aorta and placement of polytetrafluoroethylene[PTFE graft for distal aortic perfusion. Then the patient was placed in the supine position and a median sternotomy was performed to permit the proximal dissection, VSD repair, and direct anastomosis between the ascending aorta and descending aorta. This technique has advantages to facilitate direct anastomosis between the ascending aorta and the descending aorta, to lessen circulatory arrest time, and to prevent dangerous laceration and post-operative narrowing of the thin small ascending aorta at cannulation site. There was no operative mortality but postoperative stenosis developed in one case which was relieved with balloon aortoplasty.