• Title/Summary/Keyword: pleural cavity

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A Case of Meigs' Syndrome (Meigs 증후군)

  • Jung, Jong Hoon;Kim, Hak Ryul;Yang, Sei Hoon;Moon, Hyung Bae;Jeong, Eun Taik
    • Tuberculosis and Respiratory Diseases
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    • v.56 no.4
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    • pp.415-419
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    • 2004
  • Meigs' syndrome is defined as presence of pleural effusion, with ovarian tumor associated ascites, which spontaneously resolve soon after the removal of the tumor. The pathogenesis of the pleural effusion, in patients with Meigs' syndrome, is thought to be the passage of fluid from the peritoneal cavity into the pleural cavity, through small holes in the diaphragm. A case of Meigs' syndrome, in a 63-year-old woman, who had been referred for control of pleural effusion is reported.

Intrathoracic Desmoid Tumor Mimicking Pleural Mass: A Case Report

  • Kim, Na Rae;Chung, Dong-Hae;Lee, Jae-Ik;Jeong, Sung Hwan;Ha, Seung-Yeon
    • Tuberculosis and Respiratory Diseases
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    • v.67 no.5
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    • pp.449-453
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    • 2009
  • Desmoid tumor (fibromatosis) is a histologically benign fibrous neoplasm showing locally infiltrating growth. This type of tumor commonly occurs in the abdomen, but intrathoracic desmoid tumor is uncommon. To date, 12 cases of intrathoracic desmoid tumor protruding into the pleural cavity, radiologically mimicking pleural masses, have been reported. Here, we report on a case of intrathoracic desmoid tumor protruding into the pleural cavity, and partially covered by parietal pleura. The main preoperative differential diagnoses included pleural solitary fibrous tumor, inflammatory pseudotumor or malignant mesothelioma. A near-total mass excision was performed. Pathologically, the tumor was composed of a paucicellular arrangement of spindle-shaped cells with fibromyxoid stroma. The resection margin was partially involved with spindle cells present. On histochemical staining, the spindle cells were strongly positive for vimentin and negative for CD34, consistent with a desmoid tumor. The patient was stable without further adjuvant treatment during 6-years of follow-up.

Transsternal Approach for BPF closure -A Case Report (정중흉골절개를 통한 기관늑막루의 폐쇄술 -1례 보고-)

  • 정원상;양수호;전순호;신성호;김영학;서정국;김경헌;이준영
    • Journal of Chest Surgery
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    • v.31 no.5
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    • pp.540-543
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    • 1998
  • A patient with post-pneumonectomy empyema was treated sucessfully by modification of Clagett's operation after closure of bronchopleural fistula using a transsternal, transpericardial approach. His primary disease was pulmonary tuberculosis, and he had a past history of left upper lobe lobectomy 34 year ago. Recently recurred pulmonary tuberculosis with aspergilloma in the remaining left lung, empyema with bronchopleural fistula had developed on the post-operative 4th day after completion pneumonectomy. Closed thoracostomy was done at the lowest point of the left pleural cavity immediately. The pleural cavity was irrigated with small amount of normal saline through pigtail catheter. The 2nd operation was done by closure of bronchopleural fistula using a stapler through transsternal, transpericardial approach, and then the pleural space was irrigated with normal saline with Tobramycin which shows sensitivity to isolated organism from pleural cavity. After negative conversion of pleural fluid culture, we performed modified Clagett's operation under local anesthesia. The patient had no evidence of recurrence of empyema and discharged from hospital after 10 days of the 3rd procedure.

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Factors Affecting Postoperative Complication in Pneumonectomy for Chronic Complicated Inflammatory Lung Disease (만성 염증성 폐질환의 전폐적축술 후 합병증에 영향을 미치는 요인)

  • 최필조;우종수
    • Journal of Chest Surgery
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    • v.33 no.1
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    • pp.73-78
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    • 2000
  • Background: this study was designed to estimate whether specific risk factors could increase the postoperative complication rate of pneumonectomy for chronic complicated inf-lammatory lung disease. Material and Method: Eighty-five patients underwent pneumon-ectomy for chronic complicated inflammatory lung disease(tuberculosis, 67 ; bronchiecasis 11; aspergio- losis, 4; others, 3) between January 1991 and August 1998. We performed a univariated statistical analysis to identify preoperative and intraoperative risk factors associated with postoperative complications, Result: There was no operative mortality. There were a total of 18 postoperative complications(22.2%) Bronchopleural fistula(BPF) and empyema occurred in 5(5.9%) and 2(2.4%) respectively. General complication rate was significantly higher in patients with right-sided pneumonectomy(p=.029) extrapleural pneu-monectomy(p=.009) and intraoperative pleural spillage due to cavity or lesion perforation (p=.004). The prevalence of BPF and empyema was higher in patients with right sided pneumonectomy(p=.007) extrapleural pneumonectomy(p=.015) and intraoperative pl- eural spillage due to cavity or lesion perforation(p=.003) which is as the same results as gen-eral complication rate. Conclusion: The postoperative complication rate of pneumone-ctomy for chronic complicated lung disease is accptably low. But it is increase in patients with right sided pneumonectomy extrapleural pneumonectomy and intraoperative pleural spillage due to cavity or lesion perforation. therefore more careful and meticulous intra-operatve management are needed in right sided extrapleural pneumonectomy without intra- pleural spillage.

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A Case of Mediastinal Teratoma Complicated by Spontaneous Rupture into Pleural Cavity (종격동 기형종의 흉막강내로의 자연 파열 1예)

  • Lee, Tae-Hoon;Lee, Seung-Eun;Baik, Jae-Joong;Chung, Yeon-Tae
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.2
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    • pp.265-271
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    • 1999
  • Patients with mediastinal teratoma are usually asymptomatic, but may develop symptoms by rupture into adjacent structures which result in pneumonia, hemoptysis, pleural effusion, pericardial effusion, or pneumothorax. Rarely, life-threatening acute respiratory distress require a emergency surgery. Rupture into pleural cavity may result in pleuritis and pleural effusion with severe anterior chest or back pain. The symptom must be differentiated from other common intrathoracic distress diseases. Clinical, cytologic and radiologic examinations of pleural effusion, and moreover, measurement of enzymes such as amylase or insulin, which is secreted from pancreatic tissues, in pleural effusion and cystic fluid enabled us to make the diagnosis of rupture of mediastinal teratoma preoperatively.

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Traumatic Diaphragmatic Hernia: A Report of Two Cases (외상성 횡경막 Hernia: 2례 보고)

  • 김영태
    • Journal of Chest Surgery
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    • v.6 no.2
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    • pp.237-242
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    • 1973
  • Two cases of traumatic diaphragmatic hernia are reported, who were operated on in this department during the last 12 months` period. The first case, a 34 year old male, fell from 6 meters` height while he was working on electric pole. He sustained rib fractures, left 8th, 9th and 10th rib, left diaphragmatic rupture and ileal perforation. In the pleural cavity, there were stomach, omentum, left lobe of liver, transverse colon and ileum, which were reduced into the peritoneal cavity, and the diaphragmatic aperture was closed through anterolateral thoracotomy. After closure of the thoracic incision, median abdominal incision was made and closed the ileal perforation by primary suture. The second case was a 19 year old tyre repairman, who felt abrupt severe abdominal pain during lifting a heavy lyre. A barium study revealed a marked displacement of the stomach into the left pleural cavity. Immediately, thoracotomy was performed and closed the ruptured diaphragm after reduction of the herniated stomach, omentum, transverse colon, spleen and small intestine. The size of the diaphragmatic aperture were measured 17cm. in first case and 12cm. in the other respectively. Both cases discharged after uneventful recovery.

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Intracavitary Carboplatin Chemotherapy in a Malignant Mesothelioma Dog (개의 악성중피종의 흉강내 Carboplatin 투여 증례)

  • 홍성혁
    • Journal of Veterinary Clinics
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    • v.18 no.2
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    • pp.167-169
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    • 2001
  • A 10-year-old castrated male Siba dog was presented for signs referable to pleural effusion associated with neoplasm of the thoracic cavity. The pleural effusion fluid consisted of blood and tumor cells by thoracocentesis. Histopathological examination of the sedimentary tumor cells revealed malignant mesothelioma. Intracavitary carboplatin was administered at 300 mg/$m^2$ every 5 weeks for 3 treatment and pleural effusion was disappeared after 3 treatments. The dog had recurrence of pleural effusion at 515 days but intracavitary carboplatin chemotherapy had no effect. It would be thought that the intracavitary carboplatin treatment was quite a useful method to control a canine malignant mesothelioma with minimal toxicity.

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Pleural Effusion and Pancreatico-Pleural Fistula Associated with Asymptomatic Pancreatic Disease (췌장염 증상없이 췌장-흉막루를 통해 발생한 흉막저류)

  • Park, Sang-Myun;Lee, Sang-Hwa;Lee, Jin-Goo;Cho, Jae-Youn;Shim, Jae-Jeong;In, Kwang-Ho;Kang, Kyung-Ho;Yoo, Se-Hwa
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.2
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    • pp.226-230
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    • 1995
  • Effusions arising from acute pancreatitis are usually small, left sided and self limiting. The incidence of pleural effusions in acute pancreatitis is reported between 3% and 17%. In chronic pancreatitis, as a consequence of fistula and pancreatitic pseudocyst formation or by spontaneous rupture of a pancreatic psudocyst directly into thoracic cavity, extremely large effusions may be seen. When the underlying pacreatic disease is asymptomatic, the diagnosis is made by measuring the amylase content of the pleural fluid. We experience a case of left sided pleural effusions caused by pancreatico-pleural fistula associated with pancreatic pseudocyst. The diagnosis was made by measuring of pleural fluid amylase level(80000U/L). Abdominal CT scan revealed pancreatic pseudocyct and pancreatitis with extension to left pleural space through esophageal hiatus and extension to left subdiaphragmatic space. Left pleural effusions were decreased after fasting, total parenteral nutrition and percutaneous pleural fluid catheter drainage. We reported a case of pleural effusions and pacreatico-pleural fistula asssociated with asymptomatic pancreatic disease with review of literatures.

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Non-surgical Treatment for Secondary Spontaneous Pneumothorax Associated with Bacterial Pneumonia in a Beagle Dog (비글견에서 세균성 폐렴으로 인한 속발성 자발 기흉의 비외과적 치료)

  • Han, Hyun-Jung;Yoon, Hun-Young;Kim, Jun-Young;Jang, Ha-Young;Choi, Seok-Hwa;Jeong, Soon-Wuk
    • Journal of Veterinary Clinics
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    • v.25 no.1
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    • pp.31-36
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    • 2008
  • One year old, male beagle dog was presented with acute onset of severe dyspnea, cyanosis, and anorexia. He had no trauma history. Five days earlier, the dog had been diagnosed as bacterial pneumonia caused by Pseudomonas aeruginora and E. coli. He exhibited a restrictive respiratory pattern and at admission, immediately oxygen supplementation given. On a ventrodorsal(VD) radiographic view, right lung was collapsed and contrasted with the air-filled pleural space. The mediastinum, heart, and great vessels were shifted to the left. On a right-lateral radioraphic view, the heart appeared to be elevated from the sternum. The dog was diagnosed as secondary spontaneous pneumothorax resulting from bacterial pneumonia. The chest tubes were placed on the right and left pleural cavity under general anesthesia. At 3 days after treatment, on a VD radiograph, air of right pleural cavity disappeared while left pleural cavity showed radiolucent area filled with air, and the heart was shift to the right. Therefore, the left tube thoracostomy was performed too. The right chest tube was maintained for 5 days and the left chest tube was maintained for 45 days. During the period, antibiotics and vitamin I were used for managing of bacterial pneumothorax and preventing of retroinfection through the tubes. As the result, bacterial pneumonia was well managed by medicines and secondary SP was completely treated that air in bilateral pleural cavity disappeared on radiographs. During the follow-up for 2 years, patient showed normal condition without recurrence.

Clinical evaluation of thoracic empyema: review of 59 cases (농흉의 임상적 고찰: 59례 보)

  • 김현순
    • Journal of Chest Surgery
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    • v.15 no.3
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    • pp.274-277
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    • 1982
  • A Clinical analysis of 59 patients of thoracic empyema was done who were received surgical intervention at dept. of thoracic surgery of the C.A.F.G.H. in the period of 2.5 years from January 1979 to June 1982. Occurrence ratio of Left and Right side pleural cavity of empyema was 1: 1.4. The predisposing factors of empyema were pulmonary Tbc. [49%], Chest pain [25%], Cough [8%], in order. B.P.F. was associated with empyema in 5 cases. The pleural cavity empyema was treated with several surgical procedures and conservative measures. Among of the 59 cases, the 30 cases [50%] were treated with decortication, 12 cases [20%] with closed thoractomy drainage, 9 cases with frequent thoracenteses, 5 cases with partial decortication and thoracoplasty and 3 cases with open thoracostomy tube drainage. Among of the 59 cases thoracic empyema, the full recovery were in 32 cases [54%], partial recovery in 20 cases [34%], not improved in 3 cases [5%] and 3 cases were died. The mortality rate was 5% and the recovery rate was 89%.

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