• 제목/요약/키워드: Emergency thoracotomy

검색결과 49건 처리시간 0.021초

A Life-Threatening Bronchogenic Cyst

  • Han, Sung Joon;Cho, Hyun Jin;Kang, Min-Woong;Yu, Jae Hyeon;Na, Myung Hoon;Kang, Shin Kwang
    • Journal of Chest Surgery
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    • 제51권1호
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    • pp.69-71
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    • 2018
  • A bronchogenic cyst causing cardiac tamponade is a rare condition. We report an unusual case of a bronchogenic cyst that caused cardiac tamponade. A 49-year-old female patient presented at our emergency room with complaints of palpitations and shortness of breath that had lasted for 5 days preceding the visit. Echocardiography revealed a very large cystic mass compressing the left atrium posteriorly, and a large amount of pericardial effusion caused the diastolic collapse of the ventricles. Atrial fibrillation and aggravated dyspnea were observed, and the patient's vital signs were unstable after admission. We therefore performed an emergency operation. The bronchogenic cyst was resected by thoracotomy and the patient was discharged 12 days after the operation without any complications over 5 years of follow-up.

Experiences of Video-assisted Thoracic Surgery in Trauma

  • Noh, Dongsub;Lee, Chan-kyu;Hwang, Jung Joo;Cho, Hyun Min
    • Journal of Trauma and Injury
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    • 제30권3호
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    • pp.87-90
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    • 2017
  • Purpose: Nowadays, Video-Assisted Thoracic Surgery (VATS) is widely used for its benefits, low post-operative pain, excellent anesthetic result and complete visualization of intrathoracic organs. Despite of these advantages, VATS has not yet been widely used in trauma patients. In this study, we aimed to investigate the usefulness of VATS in the chest trauma area. Methods: From January 2016 to December 2016, 203 patients underwent surgical treatment for chest trauma. Their medical records were analyzed retrospectively. Results: Eleven patients underwent thoracic surgery by VATS. Six patients were unstable vital sign in the emergency room. Two patients underwent emergency surgery and the rest patients underwent planned surgery. The common surgeries were VATS hematoma evacuation and wedge resection. There was no conversion to thoracotomy. The surgery proceeded without any problems for all patients. Conclusions: VATS would be an effective diagnostic and therapeutic modality in chest trauma patients. It can be applied to retained hemothorax, persistent pneumothorax, suspicious diaphragm injury and even coagulation of bleeder.

양측 유미흉을 동반한 림프관평활근종증 (Lymphangioleiomyomatosis with Bilateral Chylothorax -1 case report-)

  • 김시욱;최재성;나명훈;임승평;이영;유재현
    • Journal of Chest Surgery
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    • 제37권12호
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    • pp.1029-1031
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    • 2004
  • 림프관평활근종증은 드문 질환이며, 임상경과상 악성으로 분류할 수 있다. 복통을 주소로 입원한 21세 여자 환자가 골반 내시경을 통해 난소 황체 출혈을 지혈하였고, 그 후 유미성 복수로 개복하여 후 복막에 위치한 낭성 종양을 절제하여 림프관평활근종증으로 조직 진단 받았다. 홀몬 치료 중 유미흉이 발생하여 흉부외과에서 개흉하여 림프액 누출부위를 봉합결찰하였고, 10% 포타딘 관주로 유미흉은 호전되었으나 유미성 복수가 재발하였으며 진단 6개월에 전신 쇠약과 호흡 부전으로 사망하였다.

심장손상 4례에 대한 치험 (Penetrating Wounds of the Heart: A Report of Four Cases)

  • 이성구
    • Journal of Chest Surgery
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    • 제6권2호
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    • pp.189-194
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    • 1973
  • A cardiac injury is one of the most dramatic and demanding emergencies than may be cared by the surgeon. Four patients who sustained penetrating wound of the heart have been experienced in the Depart-ment of Thoracic Surgery, Kyungpook National University Hospital. They were 3 males and one female. The age was between 21 and 25. All of this series had stab wounds on the heart by instruments of scissors, gimlet, kitchen knife and glass. Injured sites were two cases of right ventricle, one of the right atrium and one of indifinitive with pericardial laceration. Three of these patients have been successfully treated by emergency thoracotomy with 3-0 silk sutures for myocardial penetrating wounds. One of these patients occurred cardiac arrest during surgery and expired, who was in penetrated right ventricular injury through which massive bleeded. The classic clinical description of tamponade, Beck`s triad, seemed to be useful for making diagnosis of the tamponade but not entirely reliable as diagnostic criterion of the tamponade. In the studing of 3 tamponade cases in these series, the triad of Beck was presented in only two cases. Elevated venous pressure was thought to be a valuable diagnostic factor in pericardial tamponade.

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흉부 관통상에 대한 임상적 고찰 (Clinical Observation of Penterating Thoracic Injury)

  • 김성준;이홍식;최형호
    • Journal of Chest Surgery
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    • 제25권3호
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    • pp.283-288
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    • 1992
  • From january 1970 through december 1990, 130 cases of patients with chest penetrating injury were admitted to department of thoracic and cardiovascular surgery in Chosun University Hospital. We analyzed above patients and obtained results were as follows: 1. The ratio of male to female was 7.1:1 in male predominance, and the majority[69.6%] was distributed from 2nd to 3rd decade. 2. The most common cause of chest penetrating injuries was stab wound. 3. 110 cases[84.5%] were arrived to our emergency room within six hours after trauma. 4. The most common injuring mode was hemo, pneumothorax. 5. The frequently injured site of the penetrating chest trauma was left side of the chest [64.65%]. 6. The common associated injuries of penetrating chest injuries were extremities injuries, abdominal injuries, head & facial injuries. 7. The common method of surgical treatment were closed thoracostomy[78 cases], open thoracotomy[20 cases], laparatomy[12 cases]. 8. The overall motality was 3.07%[4/130], and the causes were hypovolemic shock, sepsis and asphyxia.

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소아에서 발생한 외상성 기관지 파열의 수술 치험 -2례 보고- (Surgical Treatment of Bronchial Rupture by Blunt Chest Trauma in Children -2 cases reports-)

  • 나국주;김광휴;안병희;김상형
    • Journal of Chest Surgery
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    • 제29권3호
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    • pp.355-359
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    • 1996
  • Rupture of the main bronchus due to blunt chest trauma is very rare, especially In childhood although the incidence is increasing. Early diagnosis and primary repair not. only restore normal lung function but also avoid the difficulties and complications associated with delayed diagnosis and repair. We experienced 2 cases of right main bronchial rupture caused by traffic accidents. Patients suffered from progressively developing dyspnea and subcutaneous emphysema on the neck, anteriorchest,andanteriorabdominalwall. Emergency operations were performed through right posterolateral thoracotomy incision at the 4th intercostal space. Intraoperatively, the right main bronchus completely transsected and separated. Corrective bronchoplasty was performed with end-to-end anastomosis using interrupted suture with 3-0 Vicryle and the suture line was reinforced with azygos vein and parietal pleural flap. Postoperative courses were uneventful and patients discharged without any specific pro lems.

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진균성 하행 흉부 대동맥류에서 인조 절편 대동맥 성형술 후 발생한 대동맥-식도 누공 -치험 1례 보고- (Aortoesophageal Fistula after Prosthetic Patch Aortoplasty for Mycotic Aneurysm of the Descending Thoracic Aorta)

  • 이홍섭
    • Journal of Chest Surgery
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    • 제33권10호
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    • pp.839-842
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    • 2000
  • Aortoesophageal fistula is an uncommon and fatal complication after surgery of aortic aneurysm. A case of aortoesophageal fistula as a complication of synthetis patch aortoplasty for mycotic aneurysm of descending thoracic aorta is described. After 3 months since patch aortoplasty for mycotic aneurysm of descending thoracic aorta this patient visited the emergency room due to melena and hematemesis. After gastrofiberoscopy and computed tomography the patient was taken ot the operating room. The surgical intervention was performed in two steps. Median sternotomy and midline laparotomy were made. Hemashield's Dacron(16mm) bypass between ascending thoracic aorta and infra-renal abdominal aorta was established first. Through the posterolateral thoracotomy false aneurysm and previous Hemashield's Dacron patch of descending aorta were resected. The two ends of the aorta were sutured and esophageal fistula was repaired. The esophageal suture line and the stumps were covered with omental graft. Thirty months later the patient has had no difficulty referable to the aortic surgery.

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외상성 심막파열 치험 1례 (Traumatic Pericardial Rupture -A Case Report-)

  • 박일환;오중환;성승훈
    • Journal of Trauma and Injury
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    • 제22권1호
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    • pp.116-118
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    • 2009
  • Pericardial rupture due to blunt trauma is very rare, but can lead to serious complications. It occurs mainly on the left, is found incidentally during surgery, and is seldom discovered radiologically unless accompanied by cardiac herniation. The following case describes a 53-year-old traffic-accident victim who received emergency pericardial repair and bleeding control via an exploratory thoracotomy and an exploratory laparatomy. The patient was discharged without any complication and remained healthy at six month after injury.

선천성 횡격막 무발육증 수술치험 1례 (Congenital Agenesis of Left Diaphragm: Surgical Repair - Report of a Case -)

  • 이종락;이신영
    • Journal of Chest Surgery
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    • 제24권12호
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    • pp.1238-1241
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    • 1991
  • Agenesis of the hemidiaphragm is unusual congenital anomaly associated with a high mortality. A case of congenital agenesis of left diaphragm was experienced in 22-day old male patient who was dyspneic and cyanotic on admission. Emergency exploration through the left eight interspace thoracotomy showed complete agenesis of the left diaphragm. The stomach and transverse colon covered with peritoneal sac was partially herniated into left hemithorax. The left lung was slightly hypoplastic. This neonate had no intestinal malrotation. The defect was reconstructed using Dacron graft. Dacron patch was sutured with interrupted Ethibond to chest wall anteriorly, esophagus aorta and costomediastinal sinus medially, and the tenth rib posterolaterally. Postoperatively, Extubation was performed at 1st day, but some respiratory difficulty was noted. Severe dyspnea was occurred at postoperative 11th day and so reintubation was done. Intermittently ventilatory support and intravenous alimentation were continued for 9 days after that. Thereafter he had no respiratory problems at discharge.

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외상성 횡경막 손상치험 12예 (Traumatic Diaphragmatic Injuries -Report of 12 cases-)

  • 이종국
    • Journal of Chest Surgery
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    • 제13권1호
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    • pp.52-59
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    • 1980
  • Twelve cases of traumatic diaphragmatic injuries were treated at the Chosun University Hospital from Feb. 1977 to Inn. 1980. The following results were obtained. l. Sex ratio incidence was 5:1, which male patients were predominant. 2. The age distribution at these cases, were ranged from 16 to 43 years of age, and average age was 27 years. 3. Left sided traumatic diaphragmatic injuries were far more common than right, which approximately incidence of 5:1 diaphragmatic injuries were due to blunt trauma [7 cases-traffic accident, 1 case-fall down], and stab wound [4 cases] in etiology. 4. Surgical repairs were done through only thoracotomy incision in blunt trauma cases, and through each thoracic and abdominal incision same time in 2 cases of stab wound. 5. 2 cases {16.7%] of blunt trauma were died before operation at emergency room, and no man died during or following operation. An overall mortality was 16.7%.

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