• 제목/요약/키워드: Thoracic wall

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흉부 총상견에서 CT 촬영을 통한 흉부외상의 진단 및 치료 증례 (Case Study of Diagnosis and Treatment of Thoracic Gunshot Trauma in a Dog by Computed Tomography)

  • 심경미;김세은;유경훈;박현정;배춘식;최석화;강성수
    • 한국임상수의학회지
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    • 제24권1호
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    • pp.46-50
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    • 2007
  • A 7-year-old female, Jindo dog was referred to the Veterinary Teaching Hospital with mild dyspnea and anorexia due to a gunshot trauma. The dog was wounded in the thoracic region 3 days ago. Plain radiographs showed the left 8th rib fracture, interstitial pattern in the left caudal lung field and pleural effusion. Abdominal radiographs showed the lead bullet. Computed tomographs(CT) showed the size of pulmonary contusion, laceration, lung parenchymal injuries, hemothorax and perforation of abdominal wall. The therapeutic plan was based on abnormalities seen on CT scans but not clearly seen in survey radiographs. Thoracic CT significantly provides even more informations compared with the corresponding radiographs in thoracic gunshot trauma. Although thoracic survey radiographs are useful as a screening tool, CT is highly sensitive in detecting thoracic injuries after thoracic trauma and is superior to routine thoracic survey radiographs in visualizing lung contusion, pneumothorax and hemothorax. Therefore, we recommend CT in the initial diagnostic work-up of patients with thoracic injuries and with suspected chest trauma because early and exact diagnosis of all thoracic injuries along with sufficient therapeutic consequences may reduce complications.

흉강입구를 침범한 종양의 근골보존 경흉골병 접근술을 이용한 치유 -1예 보고- (Treatment of Tumor Involving Thoracic Inlet by Using Transmanubrial Osteomuscular Sparing Approach - One case report-)

  • 최찬영;김욱성;류지윤;장우익;김민경;조성준;김연수
    • Journal of Chest Surgery
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    • 제38권2호
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    • pp.175-179
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    • 2005
  • 흉강입구를 침범한 종양을 근골보존 경흉골병 접근술을 이용하여 수술한 증례를 보고하고자 한다. 우측 상지의 근력 약화를 주소로 69세의 남자 환자가 내원하였다. 단순 흉부 방사선 사진에서 우측 폐 상엽에 기관지 확장증, 만성 결핵과 진균덩이가 관찰되었다. 전산화단층촬영에서 종양이 제 6, 7번 경추와 제 1번 흉추의 척추강내 경막외에 위치하며 우측 흉곽 첨부에까지 연장되어 있었다 신경외과에서 먼저 후궁절제술을 시행하여 척추강 안의 종양을 절제한 후, 흉부외과에서 근골보존 경흉골병 접근술을 통하여 흉강입구를 침범한 종양을 제거하였다. 종양은 혈관외피세포종으로 진단되었으며, 환자는 수술 후 합병증 없이 회복되었다.

이강 우심실: 1례 보고 (Surgical Treatment of Double Chambered Right Ventricle: A Case Report)

  • 안광필
    • Journal of Chest Surgery
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    • 제11권1호
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    • pp.65-68
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    • 1978
  • The unusual congenital anomaly, double chambered right ventricle due to aberrant muscle band with intact ventricular septum in 10 years old female patient is presented. The pressure gradient is 70mmHg between inflow tract and outflow tract of right ventricle and the aberrant muscle band is 2X4.5cm arising below the infundibulum and traverses the right ventricular cavity, extending from its anterior wall to the crista supraventricularis forming broad triangular base in parietal anterior wall. By resecting out this muscle band clearly, the outflow tract obstruction is completely relieved.

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신생아에서 발생한 심장 섬유종;1례 보고 (Cardiac Fibroma in Neonate - A Case Report -)

  • 정성규
    • Journal of Chest Surgery
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    • 제25권11호
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    • pp.1261-1263
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    • 1992
  • Primary cardiac fibroma of the left ventricular myocardium is a rare tumor of the heart which is usually located within the anterior wall and /or septum of the left ventricle and is the second most common cardiac tumor in infant and children. Although the tumor is benign histologically, it may cause severe cardiac dysfunction and sudden death. A 30-day-old neonate with a huge intramural fibroma involving the posterolateral wall of the left ventricle underwent it`s partial resection under extracorporeal circulation on April 1992.

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악성 늑막 림프종이 합병된 만성 농흉 1례 (A Case of Lymphoma Developing From the Wall of Chronic Empyema)

  • 김길동
    • Journal of Chest Surgery
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    • 제26권7호
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    • pp.571-574
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    • 1993
  • We present a rare case of malignant lymphoma developing from the wall of chronic empyema thoracis. A 54-year old man with a 35 year history of tuberculosis empyema was admitted due to right chest pain and general weakness for 2 months. Under the impression of chronic empyema thoracis with destroyed right lung and tumor on posterior costophrenic sulcus, pleuropneumonectomy including tumor was performed as a single procedure through a right thoracotomy. The tumor arose from the thickened pleura, and it was histologically and immunologically diffuse large cell[non-cleaved] B-cell non-Hodgkin`s lymphoma [NHL]

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흉벽에 발생한 배아성 횡문근육종 2례 보고 (Two Cases of Embryonal Rhabdomyosarcoma Originating from Chest Wall)

  • 장병철
    • Journal of Chest Surgery
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    • 제11권4호
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    • pp.451-455
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    • 1978
  • Rhabdomyosarcoma is relatively rare in general pediatric population. Furthermore, the primary site in the thorax is one of the least sites. Because most patient, when first seen, are extensively advanced and bad in prognosis, an adequate work-up prior to any definitive therapy must be undertaken. Author experienced 2 cases of embryonal rhabdomyosarcoma originating from chest wall. Both 2 cases are included in Group III [Rhabdomyosarcoma-Intergroup Protocol Grouping], one case is treated with radical surgery and radiation therapy, and the other case is treated with radiation therapy and chemotherapy. So author present 2 cases of embryonal rhabdomyosarcoma with reference.

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종격동내 섬유종증;1례 보고 (Mediastinal Fibromatosis - One Case Report -)

  • 김기출;김기봉;김주현
    • Journal of Chest Surgery
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    • 제25권7호
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    • pp.727-731
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    • 1992
  • Fibromatoses, a broad group of fibrous proliferations of similiar microscopic appearance, show intermediate biological behavior between benign fibrous lesion and fibrosarcoma. they are characterized by the infiltrative growth and the tendency toward recurrence, but they never metastasize. The mediastinal fibromatosis has been extremely rarely reported. We experienced a case of anterior mediastinal fibromatosis ingrowing onto the anterior chest wall in 2-year-old female. A radical surgical resection and anterior chest wall reconstruction was performed successfully.

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흉벽에 발생한 특발성 괴사성 근막염 -1례 보고- (Idiopathic Necrotizing Fasciitis in the Chest Wall -A case report-)

  • 김병호;허동명
    • Journal of Chest Surgery
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    • 제33권12호
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    • pp.991-994
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    • 2000
  • 괴사성 근막염은 흔하지 않은 질환으로서 때로 전격적인 진행을 보이며 흉벽에 생기는 경우에는 매우 드물다. 신체의 어느 부위나 생길 수 있으나 주로 복벽이나 서혜부, 사지 등에 가장 많이 발생한다. 이 질환의 특징은 근막의 괴사가 광범위하게 진행되지만 피부나 근육은 비교적 잘 보존되어 있다. 따라서 조기에 진단하기가 어려우므로 진찰당시 이 질환을 염두에 두어야 진단할 수 있다. 조기진단 후 즉각적인 외과적 치료가 가장 중요하다. 본 병원 흉부외과에서 흉벽에 발생한 특발성 괴사성 근막염을 한 례 경험하여 치료하였기에 문헌 고찰과 함께 보고하는 바이다.

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흉부외과 진료통계( II ) -1992년- (Annual report of thoracic and cardiovascular surgery in Korea [II])

  • Sun, Kyung;Kwak, Young-Tae;Kim, Hyoung-Mook
    • Journal of Chest Surgery
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    • 제26권3호
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    • pp.163-169
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    • 1993
  • This is the result of the annual statistic analysis of thoracic and cardiovascular surgical cases in 1992 Korea. Overall 17, 520 cases of surgery [11, 732 cases of thoracic surgery by 54 institutes / 5, 788 cases of cardiovascular surgery by 48 institutes] were done. 1. Tumor [N=2, 532] : Lung was the most frequently involved organ by tumor [54.9%],and the remainders were mediastinum [16.2%] / esophagus [14.8%] / chest wall [11.7%] / tracheobronchus [1.3%] / pleura [1.1%] in order. Of 1, 082 cases of primary lung cancer surgery,the frequency of cell type was squamous [62.6%] / adeno [21.6%] / small cell [7.1%] / large cell [2.7%]. Of 411 cases of mediastinal tumor surgery,the frequency of cell type was neurogenic [28.8%] / thymoma [27.6%] / teratoma [17.7%] / congenital cystic [17.2%]. Of 376 cases of esophageal tumor surgery,primary cancer were the most [85.4%]. 2. Infection [N=3, 157] : Pleura was the most frequently involved organ [59.0%],and the remainders were lung [31.3%] / chest wall [8.6%] / mediastinum [1.1%] in order. 3. Miscellaneous [N=6, 043] : Lung and pleural disease esp. pneumothorax [85.1%] was the most frequent surgical indication. The remainders were chest wall anomaly [3.4%] / benign esophageal disease [3.4%] / diaphragmatic pathology [2.4%] / myasthenia [1.4%] in order. Of 85 cases of thymectomy for myasthenia gravis,thymoma was noted in 58.8%. 1. Congenital heart disease [N=3, 363] : The ratio of noncyanotic to cyanotic heart disease was 3:1. Of 2, 516 cases of noncyanotic heart disease,the frequency of disease entity was VSD [44.1%] / ASD [26.0%] / PDA [19.4%] / PS [3.3%],and that of 847 cases of cyanotic heart disease was TOF [29.4%] / ECD [15.6%] / TGA [9.7%] / DORV [7.6%]. Overall mortalities were 2.1% in noncyanotic and 12.2% in cyanotic heart surgery. 2. Acquired heart disease [N=1, 929] : Of 1, 422 cases of valvular surgery,single mitral pathology was the most frequent candidate [48.0%],and total 1, 574 prosthetic valves which were mainly mechanical [95.6%] were used. Of 376 cases of coronary surgery,triple vessel was the most [35.9%],and the frequency of bypassing grafts was great saphenous vein [52.9%] / internal mammary artery [44.7%] / artificial vessel [2.4%]. Overall mortalities were 3.4% in valvular and 4.5% in coronary surgery. 3. Pericardium,Cardiac tumor,Arrhythmia,Aortic aneurysm,Assist device,and Pacemaker : There were no specific changes compared to previous survey1]. This nation-wide inquiry will be continued and reported annually by KTCS Society.

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선천성 심실중격결손증 교정술 후 발생한 가성 상행대동맥류 수술 치험 -1례 보고- (Surgical Treatment of the Pseudoaneurysm of the Ascending Aorta Following the Repair of Congenital VSD -1 case report-)

  • 안병희;김광휴;나국주;김상형
    • Journal of Chest Surgery
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    • 제29권5호
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    • pp.564-568
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    • 1996
  • 개심술후 발생하는 가성 상행대동맥류의 빈도는 매우 낮으나 점진적으로 진행하여 크기가 커지면 커 질수록 수술사망률이 높기 때문에 정기적인 검진으로 조기에 발견하여 주위 조직을 압박 변위시키기 전 에 외과적으로 교정하는 것이 바람직하다. 본 교실에서는 선천성 심실중격결손증 교정술 후 50개월이 경과하여 발견된 가성 상행대동맥류 1례 를 성공적으로 치료하였기 에 문헌고찰과 합께 보고하는 바이다. 환아는 14세 여아로9세때 선천성 심실중격결손증으로타병원에서 팻취봉합술에 의한근치술을받고 합병증으로 창상감염이 발생하였으나 완치된 후 정상적인 생활을 하여오다 1 개월전에 발생한 운동성 호흡곤란과 전신피로감을 주소로 내원하여 검진중 가성 상행대동맥류로 진단되어 상행대동맥성형술을 받았다. 수술소견상 대동맥 및 심정 지액 관류를 위 해 삽관하였던 부위로 추정되는 상행대동맥에 각각 장 경 1.5cm정도의 개구부가 있었으며 가성대동맥류의 크기는 10$\times$7cm로 주폐동맥, 상대정맥, 우심방, 우심실 등을 심하게 변위시키고 있었다. 2개의 개구부 사이에 위치한 대동맥 벽을 제거하여 하나의 개구부 로 만든 후 Dacron graft를 재단\ulcorner여 만든 팻취를 이용하여 대동맥성형술을 시행하였다. 수술합병증은발생하지 않았으며 술후 12일째에 건강하게 퇴원하였다.

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