• 제목/요약/키워드: chylothorax

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영아에서 발생한 특발성 유미흉 (Surgical Treatment of Idiopathic Chylothorax in Infant -1 case report-)

  • 강두영;이창영;김도형;임승균;이두연
    • Journal of Chest Surgery
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    • 제37권5호
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    • pp.456-459
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    • 2004
  • 16개월 된 남자 유아가 목욕탕에서 쓰러진 상태로 발견되었으나 신체 모든 부위에 타박흔적은 없었다. 점진적인 호흡곤란이 지속되어 타 병원에 내원하여 흉부 X-선 촬영상 오른쪽 가슴에 심한 수흉으로 확인되어 흉강 천자와 폐쇄식 흉관 삽입술을 시행하여 배액하였으나 하루 200 ㏄ 이상의 유미액이 배액되어 2003년 7월 17일 본원으로 전원되었다. 삽관 후 21일 이상 금식 등으로 치료하였으나 증상이 호전되지 않아 우측 소개흉으로 절개하여 흉관 결찰 수술을 시행하였다. 수술 후 우측농흉이 발생하였으나 항생제 투여로 수술 후 30일째 경과 양호하여 흉관을 제거하게 되었으며 수술 3개월 후 현재 경과 양호하여 보고하는 바이다.

Popliteal Lymphography in a Dog with Chylothorax

  • Bang, Sohyun;Lee, Hanbin;Park, Daehwan;An, Taegeon;Kim, Hyunryung;Yu, Jin;Yoon, Hyunglok;An, Gayeon;Oh, Hyehong;Chang, Jinhwa;Kim, Gonhyung;Chang, Dongwoo
    • 한국임상수의학회지
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    • 제35권6호
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    • pp.290-293
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    • 2018
  • Signalment: A dog which had been hit by car a month prior and had been experiencing recurrent pleural chyle effusion was referred to Chung-buk National University Animal Medical Center. The clinical signs included tachypnea and salivation. Results: Ultrasound-guided popliteal lymphography was performed. The computed tomography imaging revealed that the thoracic duct was ruptured and the lymph was leaking into the cranial mediastinal region. After this discovery, thoracic duct ligation was performed. The ultrasound-guided popliteal lymphography was repeated after the surgery. The second computed tomography imaging revealed that the thoracic duct rupture was resolved. Clinical relevance: We identified the etiology of chylothorax through the computed tomographic lymphography and imaged specific leakage areas. After surgery, the computed tomography imgaing confirmed the lymphatic flow modification and the treatment was successful.

옥트레오타이드를 이용한 유육종증과 동반된 유미흉의 보존적 치료 1예 (A Case of Successful Management of Sarcoidosis with Chylothorax Using Octreotide)

  • 정경수;문지애;윤설희;변민광;정우영;정재희;최상봉;김대준;표주연;김영삼;김세규;장준;김성규;박무석
    • Tuberculosis and Respiratory Diseases
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    • 제62권2호
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    • pp.119-124
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    • 2007
  • Sarcoidosis is a multi-system granulomatous disorder of an unknown etiology and affects individuals worldwide. It is characterized pathologically by the presence of non-caseating granulomas in more than one involved organ. However, pleural involvement of sarcoidosis is rare and there are no reported cases in Korea. Traditionally, sarcoidosis has often been treated with systemic corticosteroids or cytotoxic agents. In particular, chylothorax with sarcoidosis is usually treated with corticosteroid for approximately 3~6 months, followed by repeated therapeutic thoracentesis, talc pleurodesis, dietary treatment, or thoracic duct ligation where needed. We encountered a 46 years old female patient presenting with cough, dyspnea and both hilar lymphadenopathy (stage I) on chest radiograph. The patient was diagnosed with a non-caseating granuloma, sarcoidosis by a mediastinoscopic biopsy. For one month, she had suffered from dyspnea due to right side pleural effusion, which was clearly identified as a chylothorax on thoracentesis. Corticosteroid therapy with dietary adjustment was ineffective. She was treated successfully with a subcutaneous injection of octreotide for 3 weeks and oral corticosteroid. We report a case of successful and rapid treatment of chylothorax associated with sarcoidosis using octreotide and oral corticosteroid.

Surgical Resection of Thoracic Duct Lymphangioma

  • Bok, Jin San;Jun, Jae Hyun;Lee, Hyun Joo;Park, In Kyu;Kang, Chang Hyun;Kim, Young Tae
    • Journal of Chest Surgery
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    • 제47권4호
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    • pp.423-426
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    • 2014
  • A 67-year-old male patient came to the hospital due to lung cancer and mediastinal cystic mass which was suspected to be esophageal duplication cyst. Video-assisted thoracoscopic surgery (VATS) was performed and intra-operative finding suggested it as a cystic mass along the thoracic duct. Thoracic duct was ligated and the cyst was completely resected. A 48-year-old female patient visited the hospital for dysphagia. Mediastinal cystic mass was suspected to be an esophageal duplication cyst. Intraoperative finding suggest a thoracic duct lymphangioma. After thoracic duct ligation, the mass was completely resected with VATS. Postoperative chylothorax did not develop in both cases.

Aberrent Thoracic Duct Cyst in Postrior Mediastinum

  • Park, Soo Jin;Park, Seonng Yong;Choi, Ho
    • Journal of Chest Surgery
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    • 제48권3호
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    • pp.225-227
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    • 2015
  • Thoracic duct cysts in the upper portion of the diaphragm are mostly found in the neck and are rarely found in the mediastinum. Thoracic duct cysts should be differentiated from other mediastinal tumors or cysts, and surgical treatment is required to avoid the development of chylothorax if the cyst ruptures. Herein, we report the case of a patient with a thoracic cyst located just above the diaphragm that was treated with surgical resection.

유미흉과 양측성 기흉을 동반한 폐 림프관평활근종증 1예 (A Case of Lymphangioleiomyomatosis Combined with Chylothorax and Bilateral Pneumothoraces)

  • 김종화;김양기;김정현;이영목;김기업;어수택;노형준;김현조;장원호;김동원
    • Tuberculosis and Respiratory Diseases
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    • 제62권6호
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    • pp.554-559
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    • 2007
  • 본 저자들은 국내외적으로 그 발생이 드문 양측성 기흉과 유미흉을 동반한 LAM 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

개에서 림프절 전이와 유미흉을 동반한 심낭막 중피종 증례 보고 (Pericardial mesothelioma in a dog with lymph node metastasis and chylothorax)

  • 이정하;이수형;고두민;김대용
    • 대한수의학회지
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    • 제56권4호
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    • pp.273-276
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    • 2016
  • Pericardial mesothelioma is a rare neoplasm in dogs. This report describes a case of pericardial mesothelioma in a 13-year-old Shih Tzu that presented with a clinical history of dyspnea. Hemorrhagic pericardial effusion and chylous pleural effusion with reactive mesothelial cells were identified by radiograph and cytology. Necropsy revealed multiple round nodules throughout the pericardium and regional lymph nodes in addition to chylothorax. Histopathology revealed invasive neoplasm on the pericardial surface with metastasis to the lymph nodes. The neoplastic cells were immunopositive to both cytokeratin and vimentin. Diagnosis of pericardial mesothelioma with regional lymph node metastasis was made.

mTOR inhibitor와 beta-blocker 병합요법으로 성공적으로 치료된 Gorham-Stout 질환 (A Case of Gorham-Stout Disease with Life-threatening Chylothorax Successfully Treated with the Combined Therapy of mTOR Inhibitor and Beta-blocker)

  • 류경국;서고훈;김윤명;최진호;유한욱;이범희
    • 대한유전성대사질환학회지
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    • 제17권1호
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    • pp.24-30
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    • 2017
  • Gorham-Stout disease (GSD)는 골용해와 함께 혈관 및 림프조직의 비정상적인 증식으로 골조직 파괴가 유발되는 매우 드문 질환이다. 아직까지 GSD의 정확한 병인 및 기전은 밝혀지지 않았다. 악성종양이나 신경병증, 감염과의 연관성은 불명확하며, 골조직이 있는 신체 어디에서든 기형적 혈관-림프관 증식이 발생할 수 있다. GSD 중 약 20%에서 유미흉을 동반하는데, 림프관 형성이상이나 가슴 림프관 손상에 의해 이차적으로 발생한다. 급격한 호흡부전으로 이어질 수 있어 불량한 예후인자로 알려져 있지만, 질환 자체의 희귀성 때문에 현재까지 확립된 표준치료법은 없다. 본 증례는 유미흉을 동반한 생명을 위협하는 GSD 환자에서 적극적인 외과적 중재술 후 mTOR inhibitor 및 beat-blocker 복합요법을 적용하여 치료에 성공한 보고이다. 환자는 가슴림프관 결찰술 및 흉막유착술을 시행 받았으나, 일시적 증상호전 이후로 유미흉 및 호흡곤란의 재악화 반복되었다. 양측 흉막유착제거 및 폐쇄 흉강삽관술과 함께, beta-blocker와 mTOR inbititor 경구투약을 시작했다. 약물투약 1개월 후 유미흉 재발없이 호흡 안정적으로 유지되어 산소 보조치료 없이 퇴원하였다. 현재 11개월째 지속적으로 약물 투약 중으로, 약물 부작용 및 추가적인 입원치료 없이 정상적인 일상생활을 유지하고 있다. 추후 유미흉을 동반한 GSD 환자의 치료에서, 적극적인 외과적 중재술과 함께 경구 mTOR inhibitor 및 beta-blocker 복합요법을 고려해 볼 수 있겠다.

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폐절제술후 발생한 합병증 및 사망률에 대한 후향적 고찰 (Retrospective Study for Morbidity and Mortality after Major Lung Resection)

  • 문광덕;이철주;김영진;최호;김정태;강준규;홍준화
    • Journal of Chest Surgery
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    • 제33권4호
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    • pp.310-315
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    • 2000
  • Background: A retrospectiye study was done for understanding morbidity and mortality after major lung resection. Material and Method: From June 1994 to August 1998, 203 patients received major lung resections for various causes. There were 142 males and 62 females with a mean age of 47.5 years. Initial complains were cough in 47.8%, sputum in 33.0%, hemoptysis or blood-tinged sputum in 23.2%, dyspnea in 18.2%, chest pain in 15.3%, weight loss in 10.8%, fever and chill in 4.9%. There were no complaints in 5.9% of the total patients. The underlying diseases were lung tumor(102 cases/50.2%), bronchectasis(28 cases/13.8%), aspergillosis(24 cases/1.8%), tuberculosis(20 cases/9.9%) and others (29 cases/66.5%) and pneumonectomy(68 cases/33.5%). The postoperative complications were classified as : empyema, BPF, respiratory problem, persistent air leakage over 7 days, arrhythmia, ventilator applied over 24 hours, bleeding, wound infection and chylothorax. The postlobectomy complications were revealed as follow: empyema(3.7%), BPF(2.2%), respiratory problem(5.2%), persistent air leakage over 7days(8.9%), arrhythmia(2.2%), ventilator applied over 24 hours(2.2%), bleeding(1.5%), wound infection(2.9%), chylothorax(0.7%). The postpneumonectomy complications were revealed as follow : empyema(5.9%), BPF (5.9%), respiratory problem(17.6%), persistent air leakage over 7days(0%), arrhythmia(5.4%), ventialtor apply over 24 hours(7.4%), bleeding (7.4%), wound infection(2.9%) and chylothorax(1.5%). Reoperation was done in 8 cases (4.0%). There were 5.8% operative mortalities in pneumonectomy and 0.7% in lobectomy.

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식도 평활근종;2례 보고 (Leiomyoma of The Esophagus - Report of two cases -)

  • 임승현
    • Journal of Chest Surgery
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    • 제25권9호
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    • pp.943-947
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    • 1992
  • Intramural leiomyoma is the most common benign esophageal tumor, but it is rare compared with carcinoma. Although the most common symptom is dysphagia, this tumor may not cause symptoms before attaining large size. Radiographic and endoscopic findings allow an accurate diagnosis to be made before operation in most patients. The treatment of choice is enucleation without mucosal encroachment. Recently, we experienced two cases of esophageal leiomyoma on the mid portion of esophagus and enucleation of tumors were done by blunt dissection with caution. In one case, postoperative chylothorax was complicated, but cured with conservative treatment. The tissue diagnosis was confirmed with pathological finding.

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