• Title/Summary/Keyword: Thoracic wall

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A Treatment Case of Delayed Aortic Injury: The Patient with Posterior Rib Fracture

  • Park, Hyun-Seok;Ryu, Se-Min;Cho, Seong-Joon;Park, Sung-Min;Lim, Sun-Hye
    • Journal of Chest Surgery
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    • v.47 no.4
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    • pp.406-408
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    • 2014
  • A 66-year-old male patient arrived at the emergency room with a crush injury to his chest. Multiple rib fractures, hemothorax on both sides, left scapular fracture, liver laceration, and retroperitoneal hematoma were found upon the radiologic examination. After closed thoracostomy, the patient had been initially admitted to the intensive care unit, but he was transferred to the general ward on the next day. On the 4th post-trauma day, the patient complained of severe pain and there was bloody drainage through the chest tube. This case is an exploration with the consideration of the possibility of major bleeding and the subsequent repair of the descending thoracic aorta. This case is regarded as a case in which the aorta wall was damaged as the sharp margin of the fractured ribs caused continuous irritation.

Pectus excavatum and operative treatment: 14 cases report (누두흉의 수술적 교정: 14례 보고)

  • Sun, Kyung;Chae, Seong-Soo;Lee, Chul-Sae;Baek, Kwang-Jei;Kim, Hark-Jei;Kim, Hyong-Mook
    • Journal of Chest Surgery
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    • v.16 no.1
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    • pp.183-190
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    • 1983
  • Pectus Excavatum is a congenital anomaly of the anterior chest wall with a sharp concave curvature of the body of the sternum, from above downward and from side to side, especially just before the junction of gladiolo-xiphoid. We have experienced 14 cases of Pectus Excavatum with several operative procedures, i.e., Ravitch operation in 1 case, Wada operation [Sternal turn-over} in 3 cases, Wada operation and K-wire splint in 5 cases, Modified Wada operation [Rectus Abdominis muscle pedicle attached sternal turn-over] in 5 cases. Nearly all patients developed flail chest treated with internal fixation, and necrotic chondritis was developed postoperatively and treated with excision and curettage in one case with Wada operation. Follow-up Vertebral Index showed 48% preoperatively and 33% postoperatively, average decrement of 15%. We report 14 cases of Pectus Excavatum and their operative treatments.

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Atypical Coarctation in the Descending Thoracic Aorta: Treated by Bypass Graft (만성 비특이성 동맥염에 의한 비전형적 하행 흉대동맥 협착증: Bypass graft 를 시행한 1예)

  • Jang, Un-Ha;Yu, Hoe-Seong
    • Journal of Chest Surgery
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    • v.11 no.1
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    • pp.81-84
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    • 1978
  • A 15 years Old girl was admitted with chief complaints of intermittent claudication of lower extremity, dizziness, and headache for 5 years. On admission, malignant hypertension was noted in the upper part of body [190-150/120-110] but femoral & dorsalis pedis pulse could not palpate. Once she had experienced C. V. A. due to hypertension of upper part, about years ago. On auscultation, systolic murmur was audible along the left sternal border. E.C.G. Showed left ventricular hypertrophy pattern, and others within normal limit. Retrograde aortography demonstrated diffuse narrowing of entire thoracic aorta with underdeveloped lower abdominal aorta [below the renal artery] & both common lilac artery, and rich collaterals, but normally visualized greater arteries in the aortic arch. On left posterolasteral thoracotomy, entire descending thoracic aorta revealed marked narrowing with mild perivascular adhesion, but no mediastinal pleura adhesion. These findings suggest as congenital type of atypical coarctation in the entire thoracic aorta with mild secondary change. But histopathology was showed the findings of chronic non-specific aortitis, later. Dacron by pass graft was performed with end to side anastomosis between graft and aortic wall. After operation, all her preoperative symptoms & signs were disappeared, and discharged with good general condition.

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Elastofibroma Dorsi in the Right Chest Wall (우측 흉벽에 발생한 탄력섬유종)

  • Ryu, Sang-Woo;Song, Sang-Yun;Oh, Sang-Gi;Na, Kook-Ju;Ahn, Byoung-Hee;Choi, Yoo-Duk
    • Journal of Chest Surgery
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    • v.41 no.4
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    • pp.532-535
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    • 2008
  • A 71-year-old woman visited our hospital with the chief complain of a mass in her infrascapular region. We performed tumor excision and we diagnosed it as elastofibroma dorsi. Elastofibromas are benign soft tissue tumors that mostly arise in the infrascapular lesion; it is a slowly growing lesion that's characterized by the proliferation of fibrous tissue with elastin. Its incidence is very low and its pathogenesis remains unclear. We report here on this case, and we include a review of the relevant literature.

Use of a Valved-Conduit for Exclusion of the Infected Portion in the Prosthetic Pulmonary Valve Endocarditis

  • Jung, Joonho;Hong, You Sun;Lee, Cheol Joo;Lim, Sang-Hyun;Choi, Ho;Park, Soo-Jin
    • Journal of Chest Surgery
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    • v.46 no.3
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    • pp.208-211
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    • 2013
  • A 51-year-old male was admitted to the hospital with complaints of fever and hemoptysis. After evaluation of the fever focus, he was diagnosed with pulmonary valve infective endocarditis. Thus pulmonary valve replacement and antibiotics therapy were performed and discharged. He was brought to the emergency unit presenting with a high fever (> $39^{\circ}C$) and general weakness 6 months after the initial operation. The echocardiography revealed prosthetic pulmonary valve endocarditis. Therefore, redo-pulmonary valve replacement using valved conduit was performed in the Rastelli fashion because of the risk of pulmonary arterial wall injury and recurrent endocarditis from the remnant inflammatory tissue. We report here on the successful surgical treatment of prosthetic pulmonary valve endocarditis with an alternative surgical method.

Surgical Treatment of Post-Infarction Ventricular Septal Defect with Left Ventricular Rupture -A Case Report- (심근 경색후 발생한 좌심실 파열을 동반한 심실중격 결손의 외과적 치료 -1례 보고-)

  • Kim, Hyun-jo;Kim, Doo-Sang;Ahn, Hyuk
    • Journal of Chest Surgery
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    • v.28 no.9
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    • pp.857-860
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    • 1995
  • In a 53-year old male with post-infarction ventricular septal defect [VSD , owing to an acute exacerbation of pulmonary edema, respiratory failure developed, and the ventilatory support and intraaortic balloon counterpulsation [IABP were applied. At the following day, operation was performed with the aid of IABP. Under the cardioplumonary bypass, he underwent infarctectomy, trimming of VSD margin, patch closure of VSD and infarctectomy site. Left ventricular free wall rupture was detected during operation, which was confined with pericardial adhesion. Post-operative course was uneventful, and he could be discharged with minimal degree of dyspnea [NYHA class II .

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Coarctation of the Aorta Associated with Thoracic Aortic Aneurysm (대동맥 축착증에 동반된 대동맥류 치험 1례)

  • 유홍석
    • Journal of Chest Surgery
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    • v.24 no.2
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    • pp.202-205
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    • 1991
  • Development of an aneurysm in the thoracic aorta, intercostal arteries, or cerebral vessels is not an uncommon occurrence in patients with coarctation of the aorta. The mechanism whereby coarctation predisposes to aneurysm formation is incompletely understood and we suggest that in this case, an intrinsic factor in the wall of the aorta underlies the formation of aneurysms. Recently we experienced one case of COA associated with the thoracic aortic aneurysm and operation was done successfully. PDA was simply ligated and the aorta was cross-clamped proximally and distally and the area of constriction or aneurysmal site were excised. Postoperative course was uneventful and the patient was discharged 2 weeks after operation. Hypertension at upper extremities was controlled without any antihypertensive drugs after operation and the degree of regurgitation of mitral valve was improved postoperatively but long-term follow-up should be necessary.

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A Case of Severe Thoracoabdominal Impalement by a Steel Bar

  • Kim, Ki Tae;Seo, Pil Won
    • Journal of Chest Surgery
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    • v.49 no.6
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    • pp.481-484
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    • 2016
  • A 53-year-old man arrived at the trauma center with a steel bar penetrating from the epigastrium to the right scapula. He was hypotensive and hypoxic, and immediate resuscitation and basic evaluation were performed. An emergency operation was performed due to an unstable hemodynamic state. Multiple injuries were confirmed in the right lower lobe, posterior chest wall, diaphragm, and liver lateral segment. Right lower lobectomy and liver lateral sectionectomy were performed following removal of the bar. The patient recovered without additional hemorrhage after the surgery, and was transferred to a rehabilitation institution with periodic follow-up.