• Title/Summary/Keyword: Thoracic wall

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Surgical Treatment of Postinfarct Ventricular Double Rupture - A case report - (심근경색 후 발생한 심실이중파열의 외과 치료)

  • Kim Young Sam;Yoon Young Han;Kim Joung Taek;Kim Kwang Ho;Lim Hyun Kyoung;Kwan Jun;Baek Wan Ki
    • Journal of Chest Surgery
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    • v.38 no.10 s.255
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    • pp.717-720
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    • 2005
  • Here we report a case of posterior left ventricular (LV) free wall rupture following postinfarct ventricular septal rupture (VSR). A 58-year-old man was transferred to the hospital under the impression of acute myocardial infarction. Posterior VSR was seen on echocardiographic examination. The intraaortic balloon pump catheter was introduced percutaneously and the emergent operation was proposed. Sudden circulatory collapse was developed shortly after the anesthetic induction and the patient's chest was hurriedly opened while on cardiopulmonary resuscitation. The acute cardiac tamponade was seen and the blood was seen pumping from the longitudinal tear at the mid-level of LV posterior wall, measuring 2 cm in length. The cardiopulmonary bypass was set and LV reconstruction was done. The postoperative recovery was delayed due to the brain injury presumably caused by preoperative cardiac arrest.

Myxofibrosarcoma Originating from Chest Wall (흉벽에서 발생한 점액성섬유육종)

  • Cha, Byung-Ki;Lee, Mi-Kyung;Lee, Sam-Youn;Choi, Chong-Bum;Choi, Soon-Ho
    • Journal of Chest Surgery
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    • v.39 no.2 s.259
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    • pp.166-170
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    • 2006
  • Myxofibrosarcoma represents one of the most common soft tissue sarcomas of the extremities in adult and elderly patients. However, it only rarely occurs in the chest wall. A 58 years old woman presented with a huge painless lump (8 ${\times}$ 6.5 cm) in the right lower parasternal area which recurred a few months following excision from General surgery of our hospital. Histology showed an infiltrative deep seated dermal and subcutaneous tumor. It had a distinctive lobular growth pattern with prominent myxoid change and moderate cellularity. Tumor cells were spindleshaped with varying degrees of pleomorphism and frequent mitotic figures. Numerous blood vessels with curvilinear growth pattern were also seen. Immunostains for S-100, CD68, Mac 387, and FX IIIa were all negative, but positive for Vimentin. The histologic feature was of an intermediate grade myxofibrosarcoma. Wide excision was performed and recovered in good condition without any physical disabilities and was discharged at one month later. Currently she is waiting for the skin graft without chemotherapy and radiotherapy.

Traumatic Extrapleural Hematoma Mimicking a Hemothorax (혈흉으로 오인된 흉막외혈종)

  • Park, Young-Woo;Lee, Jae-Wook;Lee, Dong-Gi
    • Journal of Chest Surgery
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    • v.43 no.3
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    • pp.328-331
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    • 2010
  • Extrapleural hematoma results from blood accumulating between the parietal pleura and the endothoracic fascia, whereas hemothorax shows pooling in the pleural space. Extrapleural hematoma results from an intact parietal pleura that blocks blood from escaping the pleural cavity. Extrapleural fat, a fat layer outside the pleura in the chest wall between the parietal pleura and the endothoracic fascia, is pathognomonic on computed tomography. We diagnosed traumatic extrapleural hematoma and treated it with video-assisted thoracic surgery. We report here on this case along with a review of the literature.

Penetrating Injury to the Left Ventricle from a Fractured Rib Following Blunt Chest Trauma (흉부 둔상으로 골절된 늑골로 인해 발생한 좌심실 천공)

  • Oh, Tak-Hyuk;Lee, Sang Cjeol;Lee, Deok Heon;Cho, Joon Yong
    • Journal of Trauma and Injury
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    • v.27 no.4
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    • pp.192-195
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    • 2014
  • The perforation of a cardiac chamber by a fractured rib after blunt trauma is a rare event. Here, we report the case of patient who was referred for multiple rib fractures after a fall from a height. The patient was found to have a penetrating cardiac injury which was detected on a computed tomography chest scan. Computed tomography is a useful screening tool for victims of blunt chest trauma. Once cardiac perforation has been confirmed or is highly suspected, it is important to preserve the patient's vital signs until reaching the operating room by minimally manuplating the chest wall and permitting hypotension, which also prevents exsanguinating hemorrhage. For the same reasons, early cardiac tamponade may also improve the patient's survival.

Primary Left Atrial Myxofibrosarcoma -A case report- (좌심방에 발생한 악성 원발성 점액섬유성육종 -1예 보고-)

  • Yoon, Yoo-Sang;Lee, Cheol-Joo;Kang, Joon-Kyu;Kim, Hyung-Tai;Choi, Ho;Lee, Kyi-Beom
    • Journal of Chest Surgery
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    • v.36 no.6
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    • pp.422-426
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    • 2003
  • Primary cardiac tumor has very low incidence, especially in cases of malignancy. A 29 year old male patient visited our cardiologic clinic for recent aggrevation of dyspnea on exertion and palpitation. Echocardiography showed a large tumor in the left atrium, which suggested the left atrial myxoma. Urgent open heart surgery was taken. The operative finding was fossa ovalis based a large tumor (35$\times$90$\times$50 mm) that invaded the posterior wall of LA and right superior pulmonary vein directly. The tumor was excised well by simple dissection, and the final pathologic report was malignant myxofibrosarcoma. His postoperative course was smooth and he was discharged in good health. Postoperative radiation and chemotherapy had taken with satisfactory clinical outcome.

The Thoracic Radiculopathy in SAPHO Syndrome - A Case Report - (SAPHO 증후근에서의 신경근병증 - 증 례 보 고 -)

  • Han, Seok;Cho, Tai Hyoung;Kim, Se Hoon;Lim, Dong Jun;Park, Jung Yul;Chung, Yong Gu;Suh, Jung Keun
    • Journal of Korean Neurosurgical Society
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    • v.30 no.11
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    • pp.1320-1323
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    • 2001
  • SAPHO syndrome is an acronym for an increasingly recognized syndrome of synovitis, acne, pustulosis, hyperostosis, and osteitis. Most of the previously reported case are from Japan and Europe. The authors report a case of SAPHO syndrome in Korean female who presented with extrasternal neurologic symptoms. A 60-year-old female with thoracic and right chest wall pain presented with the sternocostoclavicular hyperostosis, and recurrent aseptic osteitis. Previously, she had hystrectomy and thyroidectomy due to uterine malignancy 25 years ago. Also, she started to take medications for palm and sole pustulosis 7 days prior to admission. Through evaluation of clinical, radiological, serological studies, studies was done along with bone needle biopsy for the biological reassessment. The hyperostosis was found in the pedicles of thoracic 8, 9, 10 vertebrae and sternoclavicular joint. Radio-isotope bone scan showed an accumulation of tracer in thoracic vertebra. The bone biopsy from these site showed increased osseous turnover, thickening of trabeculae accompanied by mild acculuation of granulation tissue and round cell infiltration, compatible with mild chronic inflammation with marrow fibrosis. The patient showed good response to conservative management. The authors report a case of SAPHO syndrome with thoracic radiculopathy. It is considered that SAPHO syndrome is related to spondyloarthropathy, and appears to have benign disease process with good prognosis.

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May-Thurner Syndrome Treated with Endovascular Wall Stent - Report of two cases - (May-Thurner 증후군의 혈관 내 스텐트를 이용한 치료 - 치험 2예 -)

  • Yoon, You-Sang;Won, Je-Hwan;Choi, Ho;Soh, Dong-Mun;Lee, Cheol-Joo;Kim, Hyung-Tae
    • Journal of Chest Surgery
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    • v.36 no.3
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    • pp.202-205
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    • 2003
  • Deep vein thrombosis (DVT) is a common disease. However, May-Thurner syndrome, which is the cause of DVT, is an uncommon processes in which there is an impaired venous return due to compression of the left iliac vein by the overlying right common artery. This condition results in a left iliofemoral deep thrombosis and severe leg edema. It is, therefore, called iliac compression syndrome. Catheter-directed thrombolytic therapy of acute extensive iliofemoral DVT and balloon angioplasty with venous stenting are recommended. Two cases with history of left leg swelling are diagnosed as May-Thurner syndrome, which was demonstrated by venography. We successfully treated the patients with thrombolysis, balloon angioplasty, and stent insertion at the site of common iliac vein compression. Therefore, we report the cases with overall review of the literature.

Characterization of Venous Involvement in Vasculo-Behçet Disease

  • Lee, Na Hyeon;Bae, Miju;Jin, Moran;Chung, Sung Woon;Lee, Chung Won;Jeon, Chang Ho
    • Journal of Chest Surgery
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    • v.53 no.6
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    • pp.381-386
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    • 2020
  • Background: Behçet disease is a chronic inflammatory disorder with a varying etiology. Herein, we report the involvement of peripheral veins in Behçet disease and discuss the treatment thereof. Methods: Thirty-four patients with venous involvement in vasculo-Behçet disease were retrospectively analyzed over 15 years. We reviewed the clinical manifestations, treatment choices, and complications of these patients. Results: Deep vein thrombosis (DVT) was observed in 24 patients (70.59%) and varicose veins in 19 (52.94%). Immunosuppressive treatment was administered to all patients due to the pathological feature of vein wall inflammation. In patients with DVT, anticoagulation therapy was also used, but post-thrombotic syndrome was observed in all patients along with chronic luminal changes. Eleven patients with isolated varicose veins underwent surgery; although symptoms and lesions recurred in half of these patients, no cases of secondary DVT occurred. Conclusion: When DVT was diagnosed in patients with Behçet disease, there was no cure for the lesions. Ultrasonographic abnormalities were observed in all patients, and post-thrombotic syndrome remained to varying degrees. In cases of isolated varicose veins in patients with Behçet disease, DVT did not occur after surgical treatment. If the activity of Behçet disease is controlled, surgical correction of varicose veins is preferable.

Atherosclerotic Aneurysm of the Right Proximal Subclavian Artery - A case report - (우측 근위부 쇄골하동맥에 발생한 동맥경화성 동맥류 - 1예 보고 -)

  • Kim, Duk-Sil;Kim, Sung-Wan;Kim, Byung-Ki;Lee, Hyeon-Jae;Lee, Gun;Lim, Chang-Young
    • Journal of Chest Surgery
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    • v.42 no.5
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    • pp.649-652
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    • 2009
  • A 75-year-old man presented with worsening dyspnea and intermittent dysphagia of one month's duration. A plain chest X-ray showed severe tracheal indentation by the right superior mediastinal mass. A chest CT established the diagnosis of a saccular aneurysm arising from the right proximal subclavian artery. Resection of the aneurysm and arterial revascularization was done through a median sternotomy with supraclavicular extension. Aneurysm wall and thrombus culture results were negative and pathology showed an atherosclerotic aneurysm. After the operation, dyspnea and dysphagia were reduced, but he died of advanced stomach cancer 8 months later.

Simultaneous Nuss Operation and Mammoplasty in an Adult Patient with Pectus Excavatum - A case report - (성인 여자 오목가슴 환자에서 유방 확대술과 동시에 시행한 너스 수술 - 1예 보고 -)

  • Kim, Kyung-Soo;Cho, Deog-Gon;Cho, Kyu-Do;Jo, Min-Seop;Kang, Chul-Ung
    • Journal of Chest Surgery
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    • v.41 no.4
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    • pp.523-526
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    • 2008
  • Minimally Invasive repair of pectus excavatum using a metal bar, as advocated by Nuss, has been broadly accepted recently for its aesthetic aspect. There are and various treatment methods, as welt. Pectus excavatum may be accompaniedso many modified repair methods have been developed and performed. We report a case of a 33-year-old woman with pectus excavatum and breast hypoplasia, which were simultaneously corrected using a substernal steel bar and mammoplasty.