• 제목/요약/키워드: Fistula formation

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대동맥-기관지루를 동반한 결핵성 대동맥염 (Tuberculous Aortitis with Aorto-bronchial Fistula)

  • 위진홍;한일용;윤영철;이양행;황윤호;조광현
    • Journal of Chest Surgery
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    • 제41권2호
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    • pp.277-280
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    • 2008
  • 결핵성 대동맥염은 그 빈도가 드문 질환이다. 이 결핵성 대동맥염으로 인한 합병증인 동맥류의 발생이나 대동맥-기관지루의 형성은 더욱 희귀하며, 만일 대동맥의 파열이 동반된다면 그 사망률은 치명적으로 매우 높다. 객혈을 주소로 내원한 환자가 있다면, 결핵의 병력이 없더라도 즉시 흉부 컴퓨터 단층촬영을 시행해야 신속하고 정확하게 이 질환을 진단할 수 있다. 환자는 46세 남자로, 내원 하루 전부터 시작된 객혈과 흉부 불편감을 주소로 내원하였다. 시행한 흉부 컴퓨터 단층촬영상 하행성 흉부 대동맥의 동맥류 소견이 관찰되었으며, 대동맥-기관지루를 통해 좌측 폐하엽과 연결되어 있었다. 본원에서는 하행성 흉부 대동맥의 인조혈관 치환술 및 좌측폐하엽 절제술을 시행함으로써 좋은 결과를 얻을 수 있었다. 조직학적 검사 결과 결핵으로 확진되어 항결핵제 치료를 시작하였으며, 향후 장기간의 항결핵제 복용이 추천된다.

누두흉의 교정술: Modified Sternal Turnover 수술 치험 2례 (The Surgical Correction for Pectus Excavatum - Report of two cases perfomed Modified Sternal Turnover -)

  • 송우철
    • Journal of Chest Surgery
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    • 제24권7호
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    • pp.712-718
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    • 1991
  • The pectus excavatum or funnel shaped thorax is a relatively frequent malformation of the chest wall which composed of depressed sternum and costal cartilage. The so-called sternal turnover operation for pectus excavatum has been disappointing due to postoperative complication such as fistula formation with necrosis of bone and muscle. Thus, the need of preserved vascular pedicle to sternum was stressed in this type of operation, keeping the bilateral internal mammary vessels preserved. We have experienced two cases of modified sternal turnover in children and obtained satisfactory postoperative results.

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흉막국균증 2례 (Two Cases of Pleural Aspergillosis)

  • 심혁;박정현;양세훈;정은택
    • Tuberculosis and Respiratory Diseases
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    • 제51권1호
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    • pp.70-75
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    • 2001
  • 저자들은 폐결핵의 병력이 있던 2명의 환자에서 기침과 객담을 주소로 내원하여 단순 흉부 방사선과 흉부 전산화 단층 촬영 결과 흉막비후와 기관지흉막루를 의심할 수 있는 공동형성을 보이고 흉막 천자액 배양과 수술후 조직배양검사결과 Aspergillus fumi-gatus가 확인되어 수술 및 항진균제를 사용하여 치료한 2례를 경험하였기에 이를 보고하는 바이다.

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Surgical Treatment for Occlusion of Graft Arteriovenous Fistula in Patients Undergoing Hemodialysis

  • Noh, Tae Ook;Chang, Sung-Wook;Ryu, Kyoung Min;Ryu, Jae Wook
    • Journal of Chest Surgery
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    • 제48권1호
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    • pp.46-51
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    • 2015
  • Background: Maintenance of adequate vascular access for hemodialysis is important in patients with end-stage renal disease. Once arteriovenous fistula (AVF) occlusion occurs, the patient should be treated with rescue therapy. This study was performed to evaluate the results of a rescue therapy for AVF occlusion. Methods: From January 2008 to December 2012, 47 patients who underwent surgical rescue therapy for AVF occlusion after graft AVF formation, were enrolled in this study. The patients were divided into two groups, namely the graft repair group (group A, n=19) and the thrombectomy group (group B, n=28). Postoperative results of both groups were analyzed retrospectively. Results: There were no statistically significant differences in the clinical characteristics between the two groups. In terms of the duration of AVF patency after the first rescue therapy, group A showed a longer AVF patency duration than group B ($24.5{\pm}21.9$ months versus $17.7{\pm}13.6$ months), but there was no statistically significant difference (p=0.310). In terms of the annual frequency of AVF occlusion after the rescue therapy of group A was lower than that of group B (0.59 versus 0.71), but there was no statistically significant difference (p=0.540). The AVF patency rates at 1, 2, 3, and 5 years after the first rescue therapy in group A were 52.6%, 31.5%, 21.0%, and 15.7%, respectively, and those in group B, they were 32.1%, 25.0%, 17.8%, and 7.14%, respectively. There was no statistically significant difference (p=0.402). Conclusion: Graft repair revealed comparable results. Although there was no statistically significant difference, the patent duration and annual frequency of AVF occlusion of group A were better than those of group B. Therefore, graft repair is considered as a safe and useful procedure for maintaining graft AVF.

Pancreatic Fistula after D1+/D2 Radical Gastrectomy according to the Updated International Study Group of Pancreatic Surgery Criteria: Risk Factors and Clinical Consequences. Experience of Surgeons with High Caseloads in a Single Surgical Center in Eastern Europe

  • Martiniuc, Alexandru;Dumitrascu, Traian;Ionescu, Mihnea;Tudor, Stefan;Lacatus, Monica;Herlea, Vlad;Vasilescu, Catalin
    • Journal of Gastric Cancer
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    • 제21권1호
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    • pp.16-29
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    • 2021
  • Purpose: Incidence, risk factors, and clinical consequences of pancreatic fistula (POPF) after D1+/D2 radical gastrectomy have not been well investigated in Western patients, particularly those from Eastern Europe. Materials and Methods: A total of 358 D1+/D2 radical gastrectomies were performed by surgeons with high caseloads in a single surgical center from 2002 to 2017. A retrospective analysis of data that were prospectively gathered in an electronic database was performed. POPF was defined and graded according to the International Study Group for Pancreatic Surgery (ISGPS) criteria. Uni- and multivariate analyses were performed to identify potential predictors of POPF. Additionally, the impact of POPF on early complications and long-term outcomes were investigated. Results: POPF was observed in 20 patients (5.6%), according to the updated ISGPS grading system. Cardiovascular comorbidities emerged as the single independent predictor of POPF formation (risk ratio, 3.051; 95% confidence interval, 1.161-8.019; P=0.024). POPF occurrence was associated with statistically significant increased rates of postoperative hemorrhage requiring re-laparotomy (P=0.029), anastomotic leak (P=0.002), 90-day mortality (P=0.036), and prolonged hospital stay (P<0.001). The long-term survival of patients with gastric adenocarcinoma was not affected by POPF (P=0.661). Conclusions: In this large series of Eastern European patients, the clinically relevant rate of POPF after D1+/D2 radical gastrectomy was low. The presence of co-existing cardiovascular disease favored the occurrence of POPF and was associated with an increased risk of postoperative bleeding, anastomotic leak, 90-day mortality, and prolonged hospital stay. POPF was not found to affect the long-term survival of patients with gastric adenocarcinoma.

Early management of parotid gland injury with oral nortriptyline and closed drain

  • Chung, Chan Min;Wee, Sung Jae;Lim, Hyoseob;Cho, Sang Hun;Lee, Jong Wook
    • 대한두개안면성형외과학회지
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    • 제21권4호
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    • pp.253-256
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    • 2020
  • Parotid gland plays the most critical role in saliva secretion in the oral cavity. Parotid gland injuries due to facial trauma can cause various complications such as formation of a fistula or sialocele. Thus, such saliva-related complications can interfere with wound healing and increase the risk of infection. Several previous studies have discussed the treatment of fistula or sialocele. Nonetheless, prevention of such complications is of utmost importance. We present a case of parotid gland injury due to trauma to the cheeks that was surgically treated, with early postoperative management involving oral administration of nortriptyline and closed drainage, without complications.

자기공명영상을 이용하여 비침습적으로 진단된 췌장 가성낭종과 간문맥 사이의 누공: 증례 보고 (Non-invasive MR Demonstration of the Fistula between Pancreatic Pseudocyst and Portal Vein: A Case Report)

  • 김성민;이영환;강웅래
    • Investigative Magnetic Resonance Imaging
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    • 제18권2호
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    • pp.171-175
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    • 2014
  • 간문맥으로 파열된 췌장 가성낭종은 매우 드문 합병증이며, 자기공명영상으로 확진된 경우는 3예만 보고되어 있다. 저자들은 50세 남자 환자에서 가성낭종과 간문맥 사이에 형성된 누공을 자기공명영상을 이용하여 비침습적으로 확진한 증례를 보고한다. T2강조영상 및 자기공명 담체관조영술에서 간문맥, 상장간막정맥, 그리고 비장정맥 내에 액체신호가 보였으며, 가성낭종과 간문맥이 직접 연결된 소견을 보였다.

근관성형후 나타나는 동통에 관한 임상적 연구 (THE DEGREE AND INCIDENCE OF INTERAPPOINTMENT PAIN ASSOCIATED WITH CLINICAL FACTORS AFTER CANAL ENLARGEMENT)

  • 금기연;박동수;이찬영;이승종;이정석
    • Restorative Dentistry and Endodontics
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    • 제15권1호
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    • pp.175-186
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    • 1990
  • The purpose of this study was to determine whether any clinical factors or conditions are associated with an increased incidence or degree of pain occuring during endodontic treatment in patients who begin treatment with no symptoms. The 260 teeth of 256 patients were surveyed and statistical analysis was used to determine whether a significant relationship existed between pain and any recorded clinical factors or conditions. The following conclusions were drawn. 1. No significant relationship between interappointment pain and any of the analyzed clinical factors or conditions except for fistula formation could be determined. 2. The presence of a draining fistula from a periapical lesion significantly decreased the posttreatment pain. 3. The judicious use of canal irrigants and canal medicaments is not associated with an increased incidence or degree of interappointment pain.

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만성 신부전증 환자에서의 동정맥루조성술 (Clinical Analysis of Arteriovenous Fistula Formation for CRF Patiients)

  • 김응중;이영;박진석
    • Journal of Chest Surgery
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    • 제27권8호
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    • pp.669-676
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    • 1994
  • Because the number of patients who require maintenance hemodialysis is increasing in number recently, angioaccess has become important to many vascular surgeons participating in the management of such patients.The authors created 269 arteriovenous fistulas[AVF] for angioaccess in 229 patients with chronic renal failure[CRF] at the Department of Thoracic and Cardiovascular Surgery in Chungnam National University Hospital during the period from August 1990 to March 1993. We analyzed the results of 260 operations for 220 patients except 9 patients who were lost during the follow up period. We performed snuffbox AVF in 171 cases, classic radiocephalic AVF in 46 cases, direct AVF at other site in 5 cases, forearm Gore-Tex AVF in 29 cases, and upper arm Gore-Tex AVF in 9 cases. We experienced 13 cases of operative failures, 11 cases of early complications, and 60 cases of late complications including obstructions during follow-up period. The 1 year, 2 year and 3 year patency rates of snuffbox AVF[Group 1], classic radiocephalic AVF[Group 2], and Gore-Tex AVF[Group 3] are like followings; 89, 84, 76% in group 1, 84, 75, 68% in group 2, and 79, 66, 55% in group 3. It showed a statistically significant difference between group 1, 2 and group 3.

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개의 소화관점막 재생에 관한 외과적 연구 (An Experimental Study on the Mucosal Epithelization of the Digestive Tract in the Dog)

  • 장경진
    • 대한수의학회지
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    • 제14권1호
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    • pp.107-113
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    • 1974
  • This study was performed for the purpose of investigating the possibility of epithelization on the defect of digestive tract after covering it with serosal wall of the cecum in the dog. The results obtained were as fallows: 1. Each defect of the digestive tract revealed almost complete formation of the mucous membrane and the muscle. Especially it was most fast in the jejunum. 2. Fistula formation was not found in all the experimental cases. The defects of small intestine and large intestine near the cecum were healed more fastly than the other portion. 3. The stomach and the duodenum appeared intestinal adhetion more frequently than the jejunum and the colon. Therefore, it is considered that covering with serosal wall of the cecum in the lower intestine is far better than in the upper intestine.

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