• 제목/요약/키워드: Cavitary lesion

검색결과 61건 처리시간 0.029초

폐실질내 골절된 늑골의 합입에 의한 대량각혈 (Massive Hemoptysis Due to Impaction of Fractured Rib into the Lung Parenchyme - 1 Case Report -)

  • 이용재
    • Journal of Chest Surgery
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    • 제25권7호
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    • pp.711-715
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    • 1992
  • Massive hemoptysis is defined as pulmonary hemorrhage of more than 600ml to 800ml within 24hours. Among the many causes, the most common include pulmonary tuberculosis, abscess, bronchiectasis, cystic fibrosis bronchial carcinoma. Most acute episodes of hemoptysis last less than 24 hours and gradually subside. However, when the hem-optysis is massive, it carries a mortality rate of 50% to 100%. It is generally agreed that surgery is the treatment of choice for patients with massive hemoptysis. We had the one case of 39 year-old male with recurrent massive hemoptysis. In the past history, he had pulmonary tuberculosis 20 years ago but no chest trauma, Previous chest CT showed well defined cavitary lesion with calcification on RUL Under the bronchoscope finding, we indentified active bleeding from right upper lobe bronchus without end-obronchial lesion. Therefore, emergency thoracotomy was done with impression of hem-optysis due to pulmonary tuberculosis. But operative findings were as follows ; the 4th fractured rib was impacted into the lung parenchyme with severe adhesion and middle lobe was not inflated. So, Upper and middle lobectomy were performed. He was diagnosed finally by operative and pathological findings as massive hemoptysis due to impaction of fractured rib into the lung parenchyme and discharged without complication.

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Chronic Spinal Epidural Hematoma Related to Kummell's Disease

  • Kim, Heyun-Sung;Lee, Seok-Ki;Kim, Seok-Won;Shin, Ho
    • Journal of Korean Neurosurgical Society
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    • 제49권4호
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    • pp.231-233
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    • 2011
  • Chronic spinal epidural hematoma related to Kummell's disease is extremely rare. An 82-year-old woman who had been managed conservatively for seven weeks with the diagnosis of a multi-level osteoporotic compression fracture was transferred to our institute. Lumbar spine magnetic resonance images revealed vertebral body collapse with the formation of a cavitary lesion at L1, and a chronic spinal epidural hematoma extending from L1 to L3. Because of intractable back pain, a percutaneous vertebroplasty was performed. The pain improved dramatically and follow-up magnetic resonance imaging obtained three days after the procedure showed a nearly complete resolution of the hematoma. Here, we present the rare case of a chronic spinal epidural hematoma associated with Kummell's disease and discuss the possible mechanism.

폐국균증에 대한 외과적치료;11례 보고 (Surgical Treatment of Pulmonary Aspergillosis; 11 Cases Report)

  • 조재호
    • Journal of Chest Surgery
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    • 제26권5호
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    • pp.380-383
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    • 1993
  • Aspergillosis is not only the problem increasing the freguency for recent decades but also a serious one. Coexistent pulmonary diseases are frequent and the most common antecedent disease is Tuberculosis with healed cavitary lesion. Interest of the surgeons is aroused because of it`s predilection to sudden life-threatening, exsanguinating pulmonary hemorrhage. 11 patients with pulmonary aspergillosis evaluated at this hospital in a 7-year period, and the results were as follows: 1.male to female ratio was 1:1.75. 2.The most common symptom was gross or microscopic hemoptysis[72.7%]and other symptoms were chest pain[9.1%] and chronic productive coughing[9.1%]. 3.The right upper lobe was most common involving site[81.8%] 4.Surgical interventions were 8 cases of lobectomy, 1 case of lobectomy with wedge resection, 2 cases of wedge resection. 5.Post-operative complications developed in 5 patients and were 4 cases of wound infections, 2 cases of empyemas, 1 case of bleeding, 1 case of atelectasis.

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폐 aspergillosis의 외과적 치료 - 5예 보고 - (Surgical Treatment of Pulmonary Aspergillosis - 5 Cases -)

  • 신형주
    • Journal of Chest Surgery
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    • 제24권1호
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    • pp.64-71
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    • 1991
  • Pulmonary aspergillosis is a rare disease, most commonly presenting pre-existing cavitary disease. In Department of thoracic and cardiovascular surgery, Chonbuk National University, 5 patients have been recognized as having this disorder from 1988 to 1990, June. Of the 5 patients, three were female and two were male. Age ranged from 30 to 53 years, the average age was 38.4 years. The most common presenting symptoms were blood-tinged sputum, hemoptysis, coughing, and chest pain Pulmonary tuberculosis occupied 8-% of underlying pulmonary disease. The locations of lesion were right upper lobe in 3 cases, left upper lobe in 1, and right lower lobe in l. All of these patients were treated by surgical resection. The operative procedures were as follows: lobectomy, 3 cases; segmentectomy, 1 case; lobectomy and segmentectomy, 1 case. There was no death in early and late postoperative period. Empyema and dead space developed in two cases, respectively. The postoperative empyema was treated with open thoracostomy and the dead space was carefully observed. During follow-up, there was no recurrence.

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각혈을 동반한 폐결핵환자의 임상적 고찰 (Clinical Study of Hemoptysis in Patients with Pulmonary Tuberculosis)

  • 김기만
    • Journal of Chest Surgery
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    • 제22권6호
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    • pp.1049-1055
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    • 1989
  • We have reviewed 73 patients who experienced hemoptysis with pulmonary tuberculosis to analyze the factors contributing hemoptysis and its management The result are; 1. The age group between 30 * 50 years old was major prevalent group [59%]. 2. Sexual ratio was 3.9 to 1, as 58 men and 15 women. 3. In 58 patients [79.5 %], the number of hemoptysis in frequency was less than 5 times. 4. The quantity of hemoptysis was ranged from less than 50 ml to more than 600 ml and 20 patients [27.4%] experienced bleeding more than 600 ml at once. 5. There was no seasonal difference in hemoptysis. 6. The common prodromal symptoms of hemoptysis were coughing, fatigability, hot foreign sensation of throat in order of frequency. 7. In chest roentgenographic finding, the cavitary lesion was the most common finding, 67% [51 cases], and the multiple cavity was 19.2%[14 cases]. 8. 23 patients [31.37%] were operated for control of hemoptysis and pulmonary tuberculosis itself, 7[30.43 %] of them suffered from complication of empyema, respiratory failure, empyema with bronchopulmonary fistula. 9. One patient [4%] was died due to respiratory failure after left thoracoplasty.

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심장으로 전이된 악성 흑색종 - 1례 보고 - (Cardiac Metastasis of Malignant Melanoma - A case report -)

  • 김오곤;홍종면;이석재;홍장수
    • Journal of Chest Surgery
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    • 제32권9호
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    • pp.840-843
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    • 1999
  • 저자는 심장의 우심실내에 입구와 출구를 막는 커다란 전이성 흑색종 1례를 수술치험하였기에 보고한다. 49세 여자환자로 호흡곤란과 전신부종의 증상을 보였다. 심초음파상 우심실내에 커다란 종괴와 심낭액을 보 였다. 심폐 체외순환후 심실내 종괴를 제거하였고, 악성 흑색종으로 판명되었다. 환자는 수술후 30일 현재 양호하다.

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개에서 편측성 난소낭종의 방사선학적 및 초음파학적 진단 2례 (Radiographic and Ultrasonographic Diagnosis of Unilateral Ovarian Cysts)

  • 이기창;최민철
    • 한국임상수의학회지
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    • 제19권3호
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    • pp.367-370
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    • 2002
  • A female, 14-year-old mixed dog weighing 4 kg and a female,8-year-old schnauzer dog weighing 6 kg showing vaginal discharges and vomiting for a few weeks were examined for the preoperative check of anterior cruciate ligament rupture and the recheck after the surgery of nephrectomy. There were no distinct abnormal signs except for the increased CBC at schnauzer dog on blood chemistry analysis. Radiographic and ultrasonographic findings were a large abdominal mass and a cyst-like hypoechogenic or anechogenic cavitary lesion on the ovary region. These findings were consistent with an ovarian cyst. Thereafter highly suspected ovarian cysts by diagnostic imaging were supported by high estrogen concentration on hormonal assay and the results of Pathologic examination as the unilateral ovarian cysts with secondary pyometra.

기관 및 기관지 결핵 61예의 임상적 고찰 (A Clinical Study on 61 Cases of Tuberculous Tracheobronchitis)

  • 안철민;김형중;황의석;김성규;이원영;김상진
    • Tuberculosis and Respiratory Diseases
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    • 제38권4호
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    • pp.340-346
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    • 1991
  • Tuberculous tracheobronchitis is defined as a specific inflammation of the trachea or major bronchi caused by the tubercle bacillus and recognized as one of the most common and serious complication of pulmonary tuberculosis. It had been a diagnostic challenge in prebronchoscopic era and since 1968, fiberoptic bronchoscopy has been accepted as a safe and valuable diagnostic procedure of tuberculous tracheobronchitis. Now, it remains a troublesome therapeutic problem due to its sequelae such as bronchostenosis, bronchiectasis and bronchial deformity. The authors analyzed the clinical features, radiological findings and bronchoscopic findings with pathologic and bacteriologic study on 61 cases of tuberculous tracheobronchitis and following results were obtained. 1) The peak incidence was in the fourth decade and male to female ratio was 1:3.4. 2) The most common symptom was cough (86.9%) and followed by sputum (49.2%), dyspnea (27.9%), fever (19.8%), weight loss (11.5%), hemoptysis (6.6%), hoarseness (6.6%) and chest discomfort (3.3%) and localized wheezing was heard in 18%. 3) In chest X-ray, consolidation with collapse was observed in 70.5%, and followed by consolidation only (18.0%), mediastinal node enlargement (8.2%), cavitary lesion (6.6%), suspicious hilar mass (3.3%) and miliary lesion (1.6%) and there was no abnormal findings in 4.9%. 4) Bronchoscopy showed hyperplastic lesion in 67.2%, mucosal lesion (18.0%), ulcerative lesion (9.8%) and stenotic lesion (4.9%). The most common site of bronchial lesion was right upper bronchus (36.1%) and followed by right main bronchus (34.4%), left main bronchus (29.5%), left upper bronchus (16.4%), right middle bronchus (8.2%), right lower bronchus (6.6%) and left lower bronchus (3.3%). 5) Chronic granulomatous inflammation with or without caseation necrosis on microscopic examination was confirmed in 69.7%, bronchial washing AFB stain was positive in 34.1%, prebronchoscopic sputum AFB stain was positive in 88.1% and postbronchoscopic sputum AFB stain was positive in 30.1%.

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폐 Aspergillosis의 외과적 치료 (Surgical Treatment of Pulmonary Aspergillosis)

  • 고영상;김민호;김공수
    • Journal of Chest Surgery
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    • 제26권9호
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    • pp.696-700
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    • 1993
  • Pulmonary aspergillosis is relatively rare disease, most commonly presenting pre-existing cavitary disease. This investigation is designed to illustrate the clinical features, preoperative diagnosis and surgical role in the management of this disease. In retrospective review of opeative cases since Jan. 1988, total 16 cases were analysis. Peak incidence of age lies in the 3rd & 5th decade[81.3%].The common presenting symptoms were hemoptysis & blood tinged sputum[90.9%] & all cases had a history of treatment with antituberculous drugs, but the tuberculosis was revealed in only 3 cases in the pathologic studies on specimen after resection. The locations of lesion were upper lobes in 13 cases, lower lobe in 2 cases, and left whole lobe in 1 case. The operative procedures for treatment of aspergillosis were performed. The lobectomy was performed in 7 cases, lobectomy & segmentectomy in 2 cases, lobectomy & decortication in 2 cases, segmentectomy in 3 cases, bilobectomy & segmentectomy in 1 case and pneumonectomy in 1 case. There was one death due to respiratory insufficiency 21 days later,postoperatively, and empyemas & residual space problems were developed in 2 & 3 cases,respectively. The empyemas were treated with open thoracostomy and the dead spaces was filled with granulation tissues within 6 months. During follow up, there was no recurrence. In conclusion, surgical resection is the treatment of choice for symptomatic aspergillosis and needed in asymptomatic patient to prevent possible fatal sequelae in the future.

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폐결핵으로 오인된 폐방선균증의 수술적 치험 1례 (Surgical Treatment of Pulmonary Actinomycosis Mimicking Pulmonary tuberculosis)

  • 백효채;이진구;강정한;정경영;구자승
    • Journal of Chest Surgery
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    • 제35권4호
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    • pp.315-317
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    • 2002
  • 방선균증이 폐를 침범하여 수술을 시행하는 경우는 매우 드물며 본 저자들은 반복적인 객혈을 주소로 내원한 남자 환자에서 폐결핵 의심하에 폐절제 수술을 하였으며 병리소견상 폐 방선균증으로 진단되었기에 보고한다. 환자는 49세 남자로 내원 전 임상증상과 단순 흉부 촬영에서 폐결핵으로 진단 후 결핵약을 복용 중이었으나 지속적인 결핵약 복용에도 증상의 호전이 없고 단순 흉부 촬영 및 흉부 컴퓨터 촬영 상 좌폐 상엽에 동공 형성을 보여 결핵약에 반응을 보이지 않는 폐결핵으로 의심하고 외과적 절제술을 시행하였다. 외과적 절제술 후 병리조직학적 검사 상 sulfur granule을 확인하여 방선균증을 진단하였다. 환자는 수술 후 문제없이 퇴원하여 6개월간 항생제 치료를 받을 예정이다.