ABSTRACT
A 70-year-old man with aphasia due to ischemic cerebral events by thromboemboli was admitted. The cause of thromboemboli was investigated, and transesophageal echocardiography and chest MRI revealed an encapsulated cystic mass in the right atrium, not circulating. It was a homogeneous cystic mass suggesting a tumor (Myxoma) rather than thrombus. Right atrial mass was resected together with partial atrial septum under the normothermic cardiopulmonary bypass. Histologically it was an atrial septal aneurysm, closed on itself, filled with blood. We report this rarely seen case with a review of the literatures.
Subject(s)
Aged , Humans , Aneurysm , Aphasia , Atrial Septum , Cardiopulmonary Bypass , Echocardiography, Transesophageal , Heart Atria , Heart Neoplasms , Heart Septum , Magnetic Resonance Imaging , Thorax , ThrombosisABSTRACT
Bilateral diaphragmatic paralysis is a rare disease. It is caused by trauma, cardiothoracic surgery, neuromuscular disorders, cervical spondylosis, and infection. A 60 year-old male patient developed bilateral diaphragmatic paralysis after an en-bloc resection of thymic carcinoma which invaded the right upper lobe, pericardium, superior vena cava and innominate vein. Severe respiratory difficulty developed and ventilator weaning was impossible. We performed bilateral diaphragmatic plication. After the operation, satisfactorily ventilator weaning and sleeping in supine position were possible; therefore, we report this case.
Subject(s)
Humans , Male , Middle Aged , Brachiocephalic Veins , Diaphragm , Pericardium , Rare Diseases , Respiratory Paralysis , Spondylosis , Supine Position , Thymoma , Thymus Neoplasms , Vena Cava, Superior , Ventilator WeaningABSTRACT
Hamartoma is rare but the most common benign neoplasm in the lung. However endobronchial lipomatous hamartoma has been rarely reported. A 73-year-old male patient was admitted to our hospital due to hemoptysis 1 month prior to admission. On bronchoscopic examination, a large pedunculated endobronchial mass right upper lobar bronchus. The endobronchial mass was enucleated by bronchotomy that is no evidence of malignancy in frozen specimens. We report a case of endobronchial lipomartous hamartoma which was resected by bronchotomy.
Subject(s)
Aged , Humans , Male , Bronchi , Bronchial Neoplasms , Hamartoma , Hemoptysis , LungABSTRACT
A case of endobronchial tuberculosis with left main bronchial stenosis and atelectasis of left lower lobe in a 26-year-old female is reported. She had taken antituberculous agents for 9 months, but she complained of chest pain and coughing. Bronchoscopy revealed patency of left upper bronchus and bronchiectasis of left lower lobe. She underwent left lower lobectomy with bronchoplasty. After the operation she had significant improvement of pulmonary function. Although surgical treatment of endobronchial tuberculosis is controversial, bronchoplastic surgery can be an effective treatment of tuberculous bronchial stenosis because it relieves patients from symptoms by preserving lung functions.
Subject(s)
Adult , Female , Humans , Bronchi , Bronchiectasis , Bronchoscopy , Chest Pain , Constriction, Pathologic , Cough , Lung , Pulmonary Atelectasis , TuberculosisABSTRACT
Pedicled omentoplasty is effective in thoracic surgery, but it is associated with several postoperative complications. A case of diaphragmatic hernia as a complication of pedicled omentoplasty in a 65-year-old male is reported. Because aortoesophageal fistula occurred three months after the patch aortoplasty for mycotic aneurysm of descending thoracic aorta, he underwent ascending thoracic aorta to abdominal aorta bypass surgery with resection of thoracic aortic aneurysm and esophagorrhaphy with wrapping of the esophageal suture line and the stumps of aorta with pedicled omental flap. Three years after the operation, herniation of the stomach developed. The pedicled omental flap was ligated and divided, and the diaphragm defect was repaired.
Subject(s)
Aged , Humans , Male , Aneurysm, Infected , Aorta , Aorta, Abdominal , Aorta, Thoracic , Aortic Aneurysm, Thoracic , Diaphragm , Fistula , Hernia, Diaphragmatic , Postoperative Complications , Stomach , Surgical Flaps , Sutures , Thoracic SurgeryABSTRACT
Pulmonary sequestration is an abnormal lung tissue that does not communicate with tracheobronchial tree, and that receives blood supply from anomalous arteries. Pulmonary sequestration is divided into two anatomical forms, intralobar and extralobar. Extralobar pulmonary sequestration is usually located between the diaphragm and the lower lobe and has systemic arterial supply and venous drainage, and most patients are diagnosed in their infancy. We report an extralobar pulmonary sequestration located between the right upper lobe and the lower lobe in a 48-year-old female adult, which has anomalous blood supply from the right pulmonary artery and venous drainage directly into the left atrium.
Subject(s)
Adult , Female , Humans , Middle Aged , Arteries , Bronchopulmonary Sequestration , Diaphragm , Drainage , Heart Atria , Lung , Pulmonary ArteryABSTRACT
Endoscopic symphathicotomy is an effective treatment for hyperhidrosis. Chylothorax is a rare but life-threatening complication. We recently encountered a case of chylothorax after endoscopic symphathicotomy at T2-T4 symphathetic nerve. We successfully treated chylothorax by electric cauterization with thoracic endoscopy.
Subject(s)
Cautery , Chylothorax , Endoscopy , HyperhidrosisABSTRACT
Aortoesophageal fistula is an uncommon and fatal complication after surgery of aortic aneurysm. A case of aortoesophageal fistula as a complication of synthetis patch aortoplasty for mycotic aneurysm of descending thoracic aorta is described. After 3 months since patch aortoplasty for mycotic aneurysm of descending thoracic aorta this patient visited the emergency room due to melena and hematemesis. After gastrofiberoscopy and computed tomography the patient was taken ot the operating room. The surgical intervention was performed in two steps. Median sternotomy and midline laparotomy were made. Hemashield's Dacron(16mm) bypass between ascending thoracic aorta and infra-renal abdominal aorta was established first. Through the posterolateral thoracotomy false aneurysm and previous Hemashield's Dacron patch of descending aorta were resected. The two ends of the aorta were sutured and esophageal fistula was repaired. The esophageal suture line and the stumps were covered with omental graft. Thirty months later the patient has had no difficulty referable to the aortic surgery.
Subject(s)
Humans , Aneurysm, False , Aneurysm, Infected , Aorta , Aorta, Abdominal , Aorta, Thoracic , Aortic Aneurysm , Emergency Service, Hospital , Esophageal Fistula , Fistula , Hematemesis , Laparotomy , Melena , Operating Rooms , Polyethylene Terephthalates , Sternotomy , Sutures , Thoracotomy , TransplantsABSTRACT
BACKGROUND: Because the development of medicine, the survival of ESRD(end stage renal disease) patients were improved and the chance of secondary arteriovenous fistula formation was increased. The purpose of this study is to evaluate the patency rate of one of the secondary arteriovenous fistula formation. MATERIAL AND METHOD: From January 1995 to September 1998, arteriovenous fistulae were made in 365 patients with ESRD. Among them, 62 patients underwent revisional arteriovenous fistula. RESULT: The patency rate for revisional arteriovenous fistula was 78.8% at 6 months, 72% at 12 months, 63% at 24 months, 56.9% at 36 months. CONCLUSION: Revision is a reliable procedure for salvaging a failed and inadequate fistula, which yields an acceptable patency rate.