• Title/Summary/Keyword: thoracotomy pain

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A clinical evaluation of 76 chest injuries (흉부손상 76례에 대한 임상적 관찰)

  • 윤갑진
    • Journal of Chest Surgery
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    • v.17 no.1
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    • pp.110-117
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    • 1984
  • A clinical evaluation was performed on 76 cases of chest injury experienced at department of Chest Surgery, Capital Armed Forces General Hospital during the past 3 years period from January 1981 to August 1983. 1.The most common cause of the chest trauma was gun shot by which 26 cases were injured among 44 cases [57.9%] of penetrating injury. Remaining 32 cases [42.1%] were injured by non-penetrating blunt trauma. 2.Hemopneumothorax was observed in 60 cases [78.9%], those were caused by both penetrating [65%] and non-penetrating [35%] injuries. 3.Rib fracture was found in 58.7% of total cases and with rib fracture, clavicle fracture was combined at 19.6% and sternal fracture, at 8.7%. 4.Most common symptoms were chest pain and dyspnea, and most common signs were breath sound diminution and subcutaneous emphysema. 5.Common site of rib fracture was from 4th rib to 8th rib [69.4%]. 6.In 58 cases [76.3%], patients were treated with operation including open thoracotomy [25 cases]. 7.Overall mortality was 5.3%[4 cases] and causes of death were septic shock and respiratory failure.

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Surgical treatmetn of aortic dissection(DeBakey type IIIa) -A case report- (대동맥 박리증 (DeBakey type IIIa) 의 수술적 치료 -치험 1례-)

  • Im, Tae-Geun;Choe, Sun-Ho
    • Journal of Chest Surgery
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    • v.24 no.5
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    • pp.522-528
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    • 1991
  • A successful repair of aortic dissection of descending thoracic aorta was performed in a 48 year old man. The patient was visited ER because of abruptly onset chest pain. On admission, Chest film showed mediastinal widening and undertaken chest CT, echocardiogram and angiogram There was evidence of dilation on descending aorta with internal separation of intimal calcification. Aneurysmal sac with dissection was noted from just below left subclavian artery to 2cm above of diaphragm. He underwent thoracotomy and the impending ruptured aneurysm of the aorta was replaced with a Woven Dacron graft[20Yo Albumin preclotted] using LA-femoral bypass. Postoperative course was uneventful.

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A Study on the Results of Surgical Treatment of Spontaneous Pneumothorax - 336 Cases in 269 Patients - (자연기흉의 임상적 고찰 -336례 보고-)

  • 신호승
    • Journal of Chest Surgery
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    • v.21 no.5
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    • pp.871-876
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    • 1988
  • Spontaneous pneumothorax is a common surgical problem and occurs most frequently in male patients under 40 years of age. The records of 336 cases in 269 patients, diagnosed and treated as spontaneous pneumothorax during the period of 1981, Jan.- 1987, Dec., at the department of thoracic and cardiovascular surgery, college of medicine, Hallym university, were reviewed retrospectively. The results were as follows; 1. Spontaneous pneumothorax was commonly found between the age of 20-40[55%]. 2. Sexual ratio of male to female was 4.4:1. 3. The most common symptoms were dyspnea and chest discomfort or chest pain. 4. Pulmonary tuberculosis was the most common cause of the disease[30.8%]. 5. Recurrent rate after closed thoracotomy drainage was 28.2%, and not recurred after operation. 6. Bullae or blebs were found most commonly at the apical segment of both upper lobes.

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Benign Clear Cell Tumor of the Lung -Report of a case- (폐에 발생한 양성 투명세포종 -치험 1례 보고-)

  • Lim, Cheong;Kim, Kwhan-mien;Sung, Sook-whan;Kim, Joo-Hyun
    • Journal of Chest Surgery
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    • v.28 no.9
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    • pp.861-864
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    • 1995
  • We experienced a case of benign clear cell tumor, a very rare form of lung tumor. A forty-year-old male complained of non-specific right flank pain for 1 month prior to admission. Under the suspicion of a benign lesion, an exploratory thoracotomy was done. Since the first case was reported in 1963 by Leibow and Castleman, about 40 cases have been reported worldwide by 1993. Basically it was believed to be a benign lesion but in certain cases, it showed malignant behavior. Simple surgical excision is satisfactory to this benign lesion. But close long-term follow up is mandatory. We report this first case in Korea with the review of literature.

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Clinical Analysis of the Mediatinal Neurogenic Tumor -18 case report- (종격동에 빈발하는 신경종에 대한고찰 -18례 임상 경험-)

  • 최영호
    • Journal of Chest Surgery
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    • v.27 no.11
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    • pp.938-941
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    • 1994
  • Neurogenic tumors of the mediastinum may have an intraspinal component connected by a narrowed segment of tumor in the intervertebral foramen, then have symptoms of back pain,lower extremity tingling sensation. CT scan or MRI demonstrated a Dumbbell-shaped mass density compressing spinal canal, enlargement of the foramen, erosion of bone, and intervertebral widening. We report the analysis of the 18 cases of neurogenic tumors on posterior mediastinum and Dumbbell type tumors are 3 cases among the 18 cases. The neurilemmomas were 12 cases[67%], the ganglioneuroma were 5 cases[28%], and neuroblastoma was one case[5%]. The successful removal was done in all cases, a standard thoracotomy and laminectomy was done in Dumbbell type tumors.There was no postoperative neurological complications.

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Clinical study of empyema thoracis (농흉의 임상적 연구)

  • 남구현
    • Journal of Chest Surgery
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    • v.16 no.1
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    • pp.171-175
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    • 1983
  • The authors made a clinical study of 107 cases of empyema who were treated at Department of Thoracic Surgery of Chungnam National University Hospital during the period of Jan. 1976 through Aug. 1982 and compared the empyema of infant and children with that of adults. Following was the remits: 1. Male was predominant to female with the ratio of 2.5 to 1 and adult to infant was 2.6 to 1. 2. The cardinal symptoms were dyspnea, coughing, chest pain and fever. 3. Positive remit of bacteriological culture study was reported in 57% and the most common causative organism was staphylococcus in infant and childhood, E. coil in adult. 4. Most frequent predisposing factors of thoracic empyema in infant and childhood was pneumonia [53%], and in adult was pulmonary tuberculosis [40%]. 5. Treatment were combined with antibiotics therapy and several surgical procedures for empyema. 24 cases [22.4%] required open thoracotomy. 6. The mortality rate was 7.4% [8/107]. 86 cases [80.4%] were discharged with recovery and improvement.

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A clinical evaluation of spontaneous pneumothorax (특발성 기흉에 대한 임상적 연구)

  • 정덕용
    • Journal of Chest Surgery
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    • v.17 no.3
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    • pp.511-515
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    • 1984
  • In this study, 213 cases of the spontaneous pneumothorax experienced at the department of thoracic and cardiovascular surgery, Chungnam National University Hospital during from April, 1977, till Dec, 1983 were reviewed. 1.Sex ratio of the studied patients was 7.19;1 showing high incidence male patients. The incidence according to the age group showed that 20.2%, 18.3% of the patients belong to the age group 6th, 5th decade respectively. 2.The etiologic factors were as follows, tuberculous origin in 50.2%, unknown origin in 28.2%, COPD in 3.3%, bullae in 8.5%. The site was right in 47.9% and left in 44.1%, bilateral in 8%. 3.The clinical symptoms were frequently dyspnea in 35%, chest pain in 27.5%. 4.The employed method of treatment were as follow, bed rest with oxygen inhalation in 1.9%, closed thoracostomy in 95.8%, open thoracotomy in 7.98%, which bullectomy was performed in 12 cases and pneumonectomy in 3 cases and lobectomy in 1 case and decortication with simple closure of bleb was performed in remaining 1 case. 5.The duration of closed thoracostomy was longer in tuberculosis, which average duration was 11.28 days. 6.The overall recurrent rate was 12.3%.

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A Case Report of Traumatic Tracheoesophageal Fistula (외상성 기관식도루 -수술체험 1례-)

  • 최승호
    • Journal of Chest Surgery
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    • v.27 no.10
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    • pp.888-892
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    • 1994
  • Acquired, traumatic tracheoesophageal fistula [TEF] is rare and difficult problem to manage. This 55 years old man met with a roller accident of a tractor. During accident, he received a penetrating injury on the left upper sternal border. At local clinic, he received closed thoracotomy drainage [CTD]for relief of pneumothorax[left]. Three days after CTD, he complained abdominal pain and hematemesis. The endoscopy revealed large ulcer at the stomach, so he received subtotal gastrectomy. On 10th day post subtotal gastrectomy, he developed aspiration and coughing from a TEF. The esophagogram showed large TEF at the mid-trachea level. So he transfered to our hospital for operation. This patient was operated on for late TEF three weeks after injury. We have used absorble 4-0 Vicryl sutures to repair trachea. We repair all esophageal injuries with two layers of nonabsorbable silk suture. Where suture line on the esophagus, the strap muscle was interposed for reinforcement. And for feeding, the feeding jejunostomy was performed. Postoperatively the osteomyelitis of the manubrium site was developed, so on the 30th postoperative day, an ostectomy of manubrium, both clavicle and fight 1st, 2nd ribs, and the pectoralis major musculo-cutaneous flap coverage were performed.

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Non-Anastomotic Rupture of a Woven Dacron Graft in the Descending Thoracic Aorta Treated with Endovascular Stent Grafting

  • Lee, Youngok;Kim, Gun-Jik;Kim, Young Eun;Hong, Seong Wook;Lee, Jong Tae
    • Journal of Chest Surgery
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    • v.49 no.6
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    • pp.465-467
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    • 2016
  • The intrinsic structural failure of a Dacron graft resulting from the loss of structural integrity of the graft fabric can cause late graft complications. Late non-anastomotic rupture has traditionally been treated surgically via open thoracotomy. We report a case of the successful use of thoracic endovascular repair to treat a Dacron graft rupture in the descending aorta. The rupture occurred 20 years after the graft had been placed. Two stent grafts were placed at the proximal portion of the surgical graft, covering almost its entire length.

Bronchial Rupture following Blunt Chest Trauma - 1 case report - (외상성 기관지 파열)

  • Choe, Yong-Dae;Jo, Jung-Gu;Kim, Gong-Su
    • 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.

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