• 제목/요약/키워드: Congenital fistula

검색결과 175건 처리시간 0.025초

유아기의 개심술14례 보고 (Open Heart Surgery During The First 12 Months Of Life)

  • 안혁;서경필
    • Journal of Chest Surgery
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    • 제14권4호
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    • pp.381-387
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    • 1981
  • Fourteen Infants with congenital cardiac anomalies underwent primary surgical Intervention within the first 12 months of life. There were eight patients with ventricular septal defect, two with total anomalous pulmonary venous return [TAPVR], and the remainders with tetralogy of Fallot, transposition of great arteries [d-TGA], Taussing-Bing malformation, and coronary A-V fistula. The age of the patients ranged from 5 to 12 months, with a mean age of 9.9 months. The mean weight was 6.7 Kg [3.8 to 9.5 KS]. Congestive heart failure persisting despite intensive medical treatment was present In 8 patients [56%], and was the most common indication for operation. Early operation was necessary in 5 of these patients [35%], because of failure to thrive and recurrent pulmonary infection. In one patient with TOF, frequent hypoxic spell prompted the necessity for early operation. In cases of VSD, TAP. VR, TOF, and coronary A-V fistula, Intracardiac repair was done with conventional cardiopulmonary bypass, chemical cold cardioplegia, and topical myocardial cooling. Deep hypothermic circulatory arrest with surface induced cooling, followed by core cooling and core rewarming, was employed .for better exposure in the cases of d-TGA and Taussing-Bing malformation. The results were however, not satisfactory. The overall mortality was 28 per cent. There were no deaths in the eight patients with VSD. The one with coronary A-V fistula survived. The other 5 cases all expired either on the table or immediately after operation. The non-fatal post-operative complications included low cardiac output, respiratory insufficiency, bleeding, and temporary A-V block. The causes of death were prolonged circulatory arrest time in d-TGA, complete A-V block and low cardiac output in TOF and Taussing-Bing malformation and prolonged bypass time and Inadequate correction in TAPVR.

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Ebstein`s 심기형의 개심수술 8예 (Open Heart Correction Of Ebstein`S Anomaly: A Report Of 8 Cases)

  • 김삼현
    • Journal of Chest Surgery
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    • 제14권4호
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    • pp.388-398
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    • 1981
  • Fourteen Infants with congenital cardiac anomalies underwent primary surgical Intervention within the first 12 months of life. There were eight patients with ventricular septal defect, two with total anomalous pulmonary venous return [TAPVR], and the remainders with tetralogy of Fallot, transposition of great arteries [d-TGA], Taussing-Bing malformation, and coronary A-V fistula. The age of the patients ranged from 5 to 12 months, with a mean age of 9.9 months. The mean weight was 6.7 Kg [3.8 to 9.5 KS]. Congestive heart failure persisting despite intensive medical treatment was present In 8 patients [56%], and was the most common indication for operation. Early operation was necessary in 5 of these patients [35%], because of failure to thrive and recurrent pulmonary infection. In one patient with TOF, frequent hypoxic spell prompted the necessity for early operation. In cases of VSD, TAP. VR, TOF, and coronary A-V fistula, Intracardiac repair was done with conventional cardiopulmonary bypass, chemical cold cardioplegia, and topical myocardial cooling. Deep hypothermic circulatory arrest with surface induced cooling, followed by core cooling and core rewarming, was employed .for better exposure in the cases of d-TGA and Taussing-Bing malformation. The results were however, not satisfactory. The overall mortality was 28 per cent. There were no deaths in the eight patients with VSD. The one with coronary A-V fistula survived. The other 5 cases all expired either on the table or immediately after operation. The non-fatal post-operative complications included low cardiac output, respiratory insufficiency, bleeding, and temporary A-V block. The causes of death were prolonged circulatory arrest time in d-TGA, complete A-V block and low cardiac output in TOF and Taussing-Bing malformation and prolonged bypass time and Inadequate correction in TAPVR.

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May-Thurner 증후군과 동반된 장골동맥-장골정맥루: 증례 보고 (Ilio-Iliac Arteriovenous Fistula with May-Thurner Syndrome: A Case Report)

  • 김태현;연재우;김혁중;장석기
    • 대한영상의학회지
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    • 제85권1호
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    • pp.235-239
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    • 2024
  • 장골동맥-장골정맥루는 드문 질환으로 일으키는 주요 요인으로는 선천성 이상 발생, 의인성, 외상 등이 있다. 그중에서도 May-Thurner 증후군과 동반된 장골동맥-장골정맥루에 대한 문헌은 매우 드물다. 이에 따라, 저자들은 80세 남성에서 발생한 May-Thurner 증후군과 동반된 장골동맥-장골정맥루의 증례를 보고하고자 한다. 컴퓨터단층촬영 및 혈관조영술을 통해 매우 넓은 범위의 장골동맥-장골정맥루를 확인하였고 이에 대해 다양한 크기의 색전용 코일 및 1400-2000 ㎛ 크기의 젤라틴 입자를 사용하여 색전술을 시행하였다. 색전술 이후, 추적을 위해 시행한 복부-골반 컴퓨터단층촬영에서 왼쪽 다리의 부종이 개선됨을 확인하였다.

H형 기관지 식도루에 대한 임상 경험 (Clinical Experience of H-type Tracheoesophageal Fistula)

  • 조휘동;남소현;조민정;김태훈;김대연;김성철;김인구
    • Advances in pediatric surgery
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    • 제17권2호
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    • pp.154-161
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    • 2011
  • Tracheoesophageal fistula without esophageal atresia (H-type TEF) is a congenital anomaly that is characterized by a fistula between the posterior wall of the trachea and the anterior wall of the esophagus, not accompanied by esophageal atresia. The purpose of this study is to investigate the clinical characteristics, diagnostic time, the side of cervical approach and short term result after surgery by searching medical records of patients treated for H-type TEF. The search was done at University of Ulsan, Department of Pediatric Surgery of Asan Medical Center, and the total number of patients from May 1989 to December 2010 was 9 with M:F ratio of 1:2. The median gestational age was $39^{+6}$ ($32^{+6}{\sim}41^{+0}$) wks. Seven out of nine patients were born at term and the other two were born premature. The clinical presentation was aspiration pneumonia, difficulty in feeding, chronic cough, vomiting, abdominal distension and growth retardation. The symptoms presented right after birth. The diagnosis was made with esophagography and the median time of diagnosis was 52 days of life. The majority of surgical corrections were performed within two weeks of diagnosis (median; 15d, range; 1d - 6m). Six patients had associated anomalies, and cardiac anomalies were most common. The cervical approach was utilized in all cases (right 2, left 7). Transient vocal cord palsy and minor esophageal leakage complicated two cases. Although the diagnosis of H-type TEF was difficult and often delayed, we had a good short term result. The left cervical approach was preferred.

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관상동맥-폐동맥 누공 1예 (A Case of Coronary-Pulmonary Artery Fistula)

  • 이경해;왕준광;신성준;김미옥;김태형;손장원;윤호주;신동호;박성수;김경수
    • Tuberculosis and Respiratory Diseases
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    • 제56권4호
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    • pp.420-425
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    • 2004
  • 관상동맥-폐동맥 누공은 비교적 드문 질환으로 선천적 원인이 대부분이나 최근 흉부 시술이나 방사선 치료의 증가로 점차 후천적 원인이 많아지는 추세이다. 증상이 비특이적이어서 진단이 늦어질 수 있어 주의를 요한다. 저자들이 경험한 환자는 기존의 폐질환 증상 때문에 심장 혈관 질환의 진행을 예측하기 어려웠다. 약간의 논쟁이 있으나 원인에 계 없이 크기가 작은 누공에서는 추적관찰이, 중등도 이상의 크기이거나 확장 가능성이 있는 경우에는 누공을 막거나 원인혈관을 제거하는 방법이 장되고 있다. 예후는 대체로 양호한 편이다.

선천성 장관폐쇄의 방사선학적 분석 (Radiologic Analysis of Congenital Origin Intestinal Obstruction in Neonate and Childhood)

  • 황미수;변우목;김선용;장재천
    • Journal of Yeungnam Medical Science
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    • 제4권1호
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    • pp.33-42
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    • 1987
  • 1983년 5월부터 1987년 6월까지 영남대학교 영남의료원에서 선천성 장관폐쇄증으로 내원한 25예를 대상으로 각각의 임상소견 및 방사선학적 소견을 분석하여 다음과 같은 결과를 얻었다. 1. 비후성유문협착증 6예, 중장이상회전증 4예, 선천성 거대결장 8예, 쇄항 5예, 십이지장폐쇄증 및 회장폐쇄증이 각각 1예였다. 2. 남여비는 16:9였으며, 특히 비후성유문부협착증은 6예중 5예가 남아였다. 3. 비후성유문부협착증은 전예에서 상부위장관조영에서 특징적인 String sign 및 beak sign, shoulder sign 등을 나타냈다. 4. 1예의 십이지장폐쇄증은 double bubble sign을 보였고, 회장폐쇄증은 단순복부 사진상 폐쇄성소장공기팽창과 대장조영술에서는 microcolon을 나타내었다. 5. 4예의 중장이상회전증에서는 대장조영술상 맹장이 우측 상복부에 있었으며 2예는 Ladd's band에 의한 십이지장폐쇄를 보였다. 6. 선천성거대결장은 8예가 전부가 직장 및 하부 S자결장에 국한되어 나타났으며, 1예에서는 장염을 동반하였다. 7. 쇄항은 5예중 3예가 low type, 2예가 high type였고, 4예에서 회음부 및 비뇨생식기에 루관을 형성하였다. 위와 같은 결과와 함께 각각의 발생학적 기전과 방사선학적 소견의 문헌 고찰을 통하여 보다 신속하고 정확한 진단을 내리는데 도움을 주고자 하였다.

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젖소 필유계(泌乳係)의 착유장애(搾乳障碍)에 관한 조사(調査) (An Investigation on Milking Disturbances of Mammary System)

  • 정창국;남치주;신동우
    • 대한수의학회지
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    • 제21권2호
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    • pp.151-159
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    • 1981
  • An investigation on various causes of milking disturbances resulting from injuries and abnormalities of mammary system were made in 2,179 Holstein cows. To perform this investigation, 69 dairy farms of the suburban area of Seoul city, Gyeonggi-do and Chungnam provinces were andomly selected and subjected. Diagnosis was made by means of inspection and palpation of teat, insertion of teat canula, checking milk machines, anamneses and farm records. This investigation was, actively done from March 1977 to February 1979, The results obtained were summerized as follows; 1. It was found that 446 cows, accounting for 20.48% of 2,179 cows inspected, had supernumerary teats. Among them 53.59% had one, 43.72% had two, 2.47% had three, and 0.22% had four supernumerary teats, respectively. 2. Dry off quarters were found in 158 quarters which turned out to be 1.8% of 8,716 quarters inspected. Among dry off quarters, 62.02% seemed to be caused by mastitis, 30.37% by acquired teat obstructions, and 7.59% by congenital blind teats and glands respectively. 3. Teat sphincter stenosis was found in 154 teats of 50 cows, which represents 1.76% of 8,716 teats and 2.29% of 2,179 cows inspected, respectively. Among 154 teats with teat sphincter stenosis, 138 teats (85.7%) of 33 cows were found to be congenital and revealed highest incidence. 4. Loose sphincter was found in 78 teats of 36 cows, which figure 0.89% of 8,7l6 teats and 1.69% of 2,179 cows inspected, respectively. Among 78 teats with loose sphincter, 52 teats (66.66%) of 13 cows were found to be congenital and revealed highest incidence. 5. Injured teat tip caused by over milking of milk machine, was found in 229 teats of 156 cows, which figure 2.63% of 8,716 teats and 7.15% of 2,179 cows observed, respectively. 6. Other miscellaneous injuries and congenital abnormalities of teats and udders were diagnosed as follows: The teat laceration was found in 34 teats (0.39% of 8,716 teats), fissure of teat skin in 24 teats (0.28% of 8,716 teats), stricture of teat cistern in 21 teats (0.24% of 8,716 teats), teat fistula in 12 teats (0.14% of 8,716 teats), papillomas on testes in 8 teats (0.09% of 8,716 teats). Knothole orifice in 7 teats (0.08% of 8,716 teats), subcutaneous abscess of udder in 5 quarters (0.05% of 8,716 teats), membraneous obstruction of teat cistern in 4 teats (0.05% of 8,716 teats), and congenital short teat in 8 teats (0.09% of 8,716 teats), respectively.

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한우송아지에서 선천적 항문 무형성증의 외과적 교정례 (Congenital Anal Atresia in a Korean Native Calf)

  • 이상묵;김정은;장광호
    • 한국임상수의학회지
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    • 제23권3호
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    • pp.380-382
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    • 2006
  • A 6-day-old male Korean native calf was referred to Veterinary Teaching Hospital, College of Veterinary Medicine Kyungpook National University because of dyschezia with atresia me. Clinical signs included anorexia, dyschezia, abdominal distention and depression. In radiographic examination, the intestinal loops are filled with gas and there is a fistula connecting the large intestine to the urethra. Colostomy was performed immediately and atresia am was healed on 28 day after colostomy without Buy other complication.

대동맥동 동맥류 파열 - 1례 보고 - (Ruptured Sinus of Valsalva Aneurysm - A Case Report -)

  • 김성수;조중구;김공수
    • Journal of Chest Surgery
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    • 제22권4호
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    • pp.687-692
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    • 1989
  • Aneurysm of the sinus of Valsalva is an uncommon cardiac anomaly, usually congenital in origin, which may occur as an isolated defect or in conjunction with other cardiac malformation. This report is a case of a ruptured sinus of Valsalva aneurysm with ventricular septal defect in a 18-year-old female patient who complained progressive exertional dyspnea. She underwent operative management using total cardiopulmonary bypass. The fistula originated from the right coronary sinus and ruptured into the right ventricle and coexistent lesion was supracristal ventricular septal defect. The repair was done through aortic and right ventricular approach. The ruptured sinus of Valsalva was closed with pledget suture and the ventricular septal defect was closed with patch. The postoperative result was good.

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이중관 기관 삽관후 발생된 기관파열 - 1례 보고 - (Tracheal Rupture Following Double-lumen Endotracheal Tube Intubation -One Case Report-)

  • 박승일;원준호;이종국
    • Journal of Chest Surgery
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    • 제32권8호
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    • pp.765-767
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    • 1999
  • 기관 삽관으로 인한 기관 기관지 파열은 매우 드문 합병증이다. 저자들은 이중관 튜브의 삽관후 발생한 기관 파열을 경험하였다. 76세 여자 환자가 간헐적인 기침과 흉부 불편감을 주소로 내원하였다. 재발된 선천성 좌측주 기관지 식도 루 진단하에 수술을 시행하였다. 수술중 우연히 기관파열이 관찰되었고 기관파\ulcorner은 풍선의 과팽창에 의한 것이었으며 파열부위의 기관을 prolene과 흡수성 봉합사를 이용하여 단단 문합 하였다. 수술후 환자는 합병 증없이 퇴원하였으며 외래를 통해 추적 관찰 중이다.

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