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Surgical Treatment of Intralobar Pulmonary Sequestration (폐엽내형 폐격리증 수술치험 1례)

  • 안광수
    • Journal of Chest Surgery
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    • v.27 no.11
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    • pp.961-964
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    • 1994
  • The pulmonary sequestration is an uncommon congenital anomaly characterized by the presence of nonfunctioning lung tissue supplied by aberrant artery from the aorta or its branches and usually has no communication with the normal bronchial tree. The patient was 35 year old female and had no specific complaints. The lung mass was found incidentally and was continned to be intralobar pulmonary sequestration by aotography whitch showed aberrant blood supply from thoracic aorta at the T. vertebra level. The right lower lobectomy was done.

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Surgical Resection of Intralobal Pulmonary Sequestration - A Case Report - (폐엽내형 폐격리증 수술치험 1례)

  • 박형주
    • Journal of Chest Surgery
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    • v.23 no.2
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    • pp.357-361
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    • 1990
  • The pulmonary sequestration is rare congenital pulmonary disease with nonfunctioning lung tissue supplied by aberrant arteries arising from systemic arteries-thoracic aorta, subclavian artery, innominate artery, internal mammary artery, etc. In our country, only 23 cases were reported previously and the majority was intralobar pulmonary sequestration except 2 cases. The patient was 17 year-old man and admitted due to intermittent cough, productive sputum and fever for 8 years. On simple chest P \ulcornerA view, multiple cysts with air-fluid levels were located at left lower lobe area. Aortogram revealed two aberrant arteries arising from thoracic aorta just above the diaphragm. On the operative field, the arteries were 0.7 and 0.3 cm in diameter. Left lower lobectomy was done with ligation of aberrant arteries. The patient was recovered and discharged uneventfully.

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Surgical treatment of bilateral pulmonary sequestraion; -report of A case- (양축에 발생한 엽내형 폐격리증의 외과적 치료 -1례 보고-)

  • 손재문
    • Journal of Chest Surgery
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    • v.28 no.8
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    • pp.792-796
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    • 1995
  • The pulmonary sequestration is a rare congenital malformation of the lung, concerning about the abnormal feeding systemic artery, may happen a serious complication of bleeding during operation if not recognized before operation. We experienced a case of bilateral intralobar pulmonary sequestration preoperatively confirmed by aortogram. An Aortogram demonstrated a anomalous systemic artery arising from thoracic aorta just above the diaphragm. The artery bifurcated and supplied areas of both right and left lower lobes. On the operative field, left lower lobectomy was done with devision and ligation of left branch of anomalous artery and triple ligation of remained branch of anomalous artery was done. Postoperative course was uneventful. She was discharged on postoperative seventeenth day.

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Intralobar Pulmonary Sequestration with Hemoptysis and Hemothorax (혈흉과 각혈을 동반한 내엽성 폐분리증)

  • Park, Jeong-Min;Oh, Bong-Suk
    • Journal of Chest Surgery
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    • v.40 no.10
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    • pp.708-710
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    • 2007
  • A 60-year-old female entered the emergency unit with a chief complaint of hemoptysis. Based on the computer tomographic image analysis of the chest, the patient was diagnosed as having an intralobar pulmonary sequestration that accompanied a hemothorax, and the hemothorax was do to the rupture of a pseudocyst. Pulmonary lobectomy of the left lower lobe and primary closure of an aberrant artery were both performed as an emergency operation. After one week following the operation, the patient was discharged without any postoperative complications.

Surgical Resection of Intralobar Pulmonary Sequestration Misconceived of the Lung Abscess -1 Case Report- (폐농양으로 오인한 폐엽내형 폐격리증 수술 치험 1례)

  • Kim, Jae-Ryeon;Im, Jin-Su;Choe, Hyeong-Ho
    • Journal of Chest Surgery
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    • v.28 no.8
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    • pp.797-800
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    • 1995
  • Pulmonary sequestration is an uncommon congenital pulmonary malformation characterized by presence of nonfunctioning lung tissue which receives its blood supply mostly from the anomalous systemic arteries - descending thoracic aorta or abdominal aorta, subclavian artery, innominated artery and internal mammary artery, etc. In our country, 39 cases were reported previously. The patient was a 40 years old woman and admitted due to productive cough for 1 year. The chest X-ray and chest C-T showed a dense mass containing a large cavity with air-fluid level and multiple radiolucent cysts in the right lower lung field. On the operative field, we could identify an aberrant large artery [ $\phi$7mm which arose directly from the descending thoracic aorta at eighth thoracic spinal level and fed the sequestrated portion of the right lower lobe. The aberrant artery was double ligation after division. Only sequestrated lobe on the superolateral lesion of the right lower lobe was resected because of nonseparated lobes in all the right lobes. An abnormal vein and bronchiole were ligated with black silk. The patient`s postoperative course was unevenful.

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Simple Congenital Cystic Adenomatoid Malformation with a Feeding Artery (영양동맥을 동반한 단순 선천성 낭종성 선종양 기형)

  • Kim, Jae-Jun;Wang, Young-Pil;Park, Jae-Kil
    • Journal of Chest Surgery
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    • v.43 no.4
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    • pp.450-453
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    • 2010
  • CCAM with no other anomalies such as sequestration receives its blood supply from the pulmonary artery. Our case presented with a simple CCAM and no other anomalies but with a feeding artery. Although preoperative evaluation may not show feeding arteries, they may exist in congenital cystic lung diseases.

Accessory auricle: Classification according to location, protrusion pattern and body shape

  • Hwang, Jungil;Cho, Jaeyoung;Burm, Jin Sik
    • Archives of Plastic Surgery
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    • v.45 no.5
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    • pp.411-417
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    • 2018
  • Background Accessory auricles (AAs) are common congenital anomalies. We present a new classification according to location and shape, and propose a system for coding the classifications. Methods This study was conducted by reviewing the records of 502 patients who underwent surgery for AA. AAs were classified into three anatomical types: intraauricular, preauricular, and buccal. Intraauricular AAs were divided into three subtypes: intracrural, intratragal, and intralobal. Preauricular AAs were divided into five subtypes: precrural, superior pretragal, middle pretragal, inferior pretragal, and prelobal. Buccal AAs were divided into two subtypes: anterior buccal and posterior buccal. AAs were also classified according to their protrusion pattern above the surrounding surface: pedunculated, sessile, areolar, remnant, and depressed. Pedunculated and sessile AAs were subclassified as spherical, ovoid, lobed, and nodular, according to their body shape. Cartilage root presence and family history of AA were reviewed. A coding system for these classifications was also proposed. Results The total number of AAs in the 502 patients was 1,003. Among the locations, the superior pretragal subtype (27.6%) was the most common. Among the protrusion patterns and shapes, pedunculated ovoid AAs were the most common in the preauricular (27.8%) and buccal areas (28.0%), and sessile lobed AAs were the most common in the intraauricular area (48.7%). The proportion of AAs with a cartilage root was 78.4%, and 11% of patients had a family history. The most common type of preauricular AA was the superior pretragal pedunculated ovoid AA (13.2%) with a cartilage root. Conclusions This new system will serve as a guideline for classifying and coding AAs.

Surgical Treatment of Congenital Cystic Lung Disease (선천성 낭성 폐질환의 수술적 치료)

  • Wi, Jin-Hong;Lee, Yang-Haeng;Han, Il-Yong;Yoon, Young-Chul;Hwang, Youn-Ho;Cho, Kwang-Hyun
    • Journal of Chest Surgery
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    • v.41 no.3
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    • pp.335-342
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    • 2008
  • Background: Congenital cystic diseases of the lung are uncommon, and they share similar embryogenic and clinical characteristics. But they are sometimes vary widely in their presentation and severity. Therefore they are often difficult to make different diagnosis each other, and all require surgical treatment. Material and Method: From 1993 to 2006, 38 patients underwent surgical procedures under these diagnostic categories in the Depart. of Thoracic and. Cardiovascular Surgery, Busan-Paik Hospital, College of Medicine, Inje University. And we retrospectively reviewed these patients' charts for clinical presentations, surgical procedures, pathologic findings and postoperative morbidity and mortality. Result: There were 22 males and 16 females, ages ranged from 1 month after birth to 51 years and mean age was 20.8 years. The main symptoms were 19 fever, cough, sputum production due to recurrent infection, 7 dyspnea, 8 chest discomfort, 4 hemoptysis, but eight patients were asymptomatic. Computed tomography was chosen as diagnostic modalities and available for operation plan for all of patients. For all the cases, surgical resection were performed. Lobectomy was performed in 28 patients, simple excision (resection) in 8 patients, segmentectomy or wedge resection in 2 patients. There were 10 pulmonary sequestrations, 15 congenital cystic adenomatoid malformations (CCAM), 11 bronchogenic cysts, and 2 congenital lobar emphysemas. They all were confirmed by pathologic exams. The complications were 6 wound disruption or infection, 2 chylothorax, 1 ulnar neuropathy, but all of them were resolved uneventful. There was no persistent air leakage, respiratory failure, operative mortality and recurrence. Conclusion: We performed immediate surgical removal of congenital cystic lung lesions after diagnosis and obtained good results, so reported them with literature review.

Clinicopathological Correlation of Intralobar Pulmonary Sequestration (내엽성 폐격리증의 임상적 특성과 조직병리학적 소견의 연관성)

  • Cho, Hyun-Min;Shin, Dong-Hwan;Kim, Kil-Dong;Lee, Sak;Chung, Kyung-Young
    • Journal of Chest Surgery
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    • v.36 no.5
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    • pp.356-362
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    • 2003
  • Background: Intralobar and extralobar pulmonary sequestrations have been considered as congenital lesions that occur at different stages of embryonic life. However, most cases of intralobar pulmonary sequestration (IPS) seem to have an acquired origin, as they are absent in infants and associated anomalies are relatively, uncommon among them. Material and Method: The cases of 25 patients who were diagnosed as IPS after surgical resection from December, 1985 to July, 2002 were included in this study. The medical records wire retrospectively reviewed and the clinical characteristics were age at operation; gender; symptoms at presentation; presence of congenital anomalies; combined diseases; preoperative studies and diagnosis; location of the lesion; method of surgical resection; origin, size and numbers of aberrant artery; histopathological findings; and postoperative complications. Result: There were 17 (68%) female patients and 8 (32%) male patients, their ages ranged from 1 to 57 and mean value was 23 years old. Though 14 patients (56%) complained of respiratory symptoms such as pneumonia and recurrent respiratory infections, a large number of patients (44%) were asymptomatic or had chest pain only when the lesion was discovered. Only 8 patients (32%) were diagnosed as pulmonary sequestration preoperatively and 8 (32%) were suspected as mediastinal or lung tumor, 5 (20%) were congenital or acquired cystic lung disease, and 4 (16%) were lung abscess or bronchiectasis, respectively. The majority of aberrant arteries (86.4%) confirmed during the operation were originated from thoracic aorta and 2 were thoracic and abdominal aorta, 1 was abdominal aorta, respectively. The younger patients (less than 10 years old) had more other congenital anomalies (30% vs 6.7%) but the proportion of congenital IPS was not significantly different (10% vs 6.7%, p>0.05) compared with elder patients. Histopathologically, almost all lesions showed chronic inflammation, cystic changes and similar pleural adhesions regardless of age. Conclusion: The large portion of the patients with IPS (44%) was clinically asymptomatic or presented non-respiratory symptoms at diagnosis and likely to be diagnosed as mediastinal or lung tumor especially in elder patients. Though the younger patients had more other congenital anomalies, most cases of IPS proved to be acquired lesions in terms of the histopathlogical findings and the proportion of congenital evidences.