A Case Report of Tension Pneumopericardium Following Blunt Chest Trauma / 대한흉부외과학회지

A 49-year-old man visited our hospital via the emergency room. He had suffered chest trauma by falling down. His chest X-Ray showed pneumomediastinum with pneumopericardium. We checked the Chest CT, and it showed pneumopericardium without any injury to the other organs, the compressed heart and a minimal pneumothorax on the left hemithorax. Closed thoracostomy was then done under local anesthesia. We then performed open pericardiostomy under general anesthesia. We got a good result and so we report on this case.

Simultaneous Bilateral Spontaneous Pneumothorax / 대한흉부외과학회지

BACKGROUND: The simultaneous bilateral spontaneous pneumothorax is a rare clinical event. Contrary to the unilateral pneumothorax, the patients with simultaneous bilateral spontaneous pneumothorax sometimes complains of severe respiratory distress, cyanosis and chest pain without tention pneumothorax. It is often dangerous; therefore, the chest drain should be inserted immediately. MATERIAL AND METHOD: Between March 1994 and February 2004, 802 patients were treated in our department for spontaneous pneumothorax. Among these, the simultaneous bilateral spontaneous pneumothorax developed in 14 patients (1.7%). RESULT: Out of fourteen patients, two females and twelve males presented with simultaneous bilateral spontaneous pneumothorax. The patient age ranged between 0 and 79 years with mean age of 31.2 years. In eleven patients, this was the first episode of pneumothorax. One patient had combined hemopneumothorax and two patients had combined pyopneumothorax. Six patients had smoking history (42.8%, average 17.3 p-y). Five patients had pulmonary tuberculosis history and among these, two patients had active pulmonary tuberculosis. Three patients were died due to meconium-aspiration pneumonia (1 patient) and ARDS (Acute Respiratory Distress Syndrome) with pneumonia (2 patients). We treated these patients with nasal oxygen inhalation, chest drain insertion, thoracotomy, VATS (Video-Assisted Thoracoscopic Surgery) and chemical pleurodesis. CONCLUSION: The simultaneous bilateral spontaneous pneumothorax developed in 14 patients (1.7%) among 802 patients. Prompt insertion of chest drain is needed for a relief of severe symptoms, and to reduce the risk of recurrence, early thoracotomy or VATS should be performed rather than chest drain insertion only.

Review of Primary Chest wall Tumors / 대한흉부외과학회지

BACKGROUND: Chest wall tumors can classified into soft tissue tumors and bone tissue tumors and can be subclassified into benign and malignant tumors. MATERIALS AND METHODS: We report an analysis of 68 patients with primary chest wall tumors treated at the department of thoracic and cardiovascular surgery at Hanyang University Hospital from January, 1973 to September 1997. RESULTS: Among a total of 68 patients 33 (48.5%) were males and 35 (51.5%) were females. The ages of the patients ranged from 10 to 79 years with a mean age of 39.3 years. According to the age distribution, 23 patients (33.8%) were from the 4th decade, 12 patients (17.6%) were from the 6th decade, and 10 patients (14.7%) were from the 5th decade. Among the primary chest wall tumors, 53 cases were benign and 15 cases were malignant. Among the benign tumors, 17 cases (32.1%) were in the 4th decade and among the malignant tumors, 6 cases (40%) were in the 4th decade. In both malignant and benign tumors the most common ages were in the 4th decade. The most common tumors were fibrous dysplasia and chondroma, each with a total of 14 cases (26.4%). Osteochondroma and lipoma each had 8 cases (15.1%). Among malignant tumors, osteosarcoma was most common with 8 cases (53.3%). According to location, 49 cases occured in both bone and cartilage tissue, 19 cases occurred in cartilage. Among the presenting symptoms, palpable mass was present in all cases. Fifty-one patients complained of tenderness and among cases with involvement of the lung, 3 patients had complained of respiratory distress. Among the malignant tumors 6 cases underwent a radical operation and 4 cases of benign tumors underwent a radical operation. Postoperativly, there was one case with recurrence from a desmoid tumor. There were no deaths postoperativly and no deaths due to complications (and their postoperative courses were uneventful). CONCLUSIONS: Most patients with primary chest wall tumors initially present with mass at admission. Resection is sufficient treatment for benign tumors but in malignant tumors wide resection of the chest wall is needed and mchest wall reconstruction.

Papillary Adenoma of the Lung with Pulmonary Sequestration: A Case Report / 대한흉부외과학회지

Papillary adenoma of the lung is a very rare tumor in humans. Papillary adenoma is benign, and morphologically distinctive neoplasm.Since Fanton et al. firstly described a bronchial tumor showing Clara cell features,only a few cases having features of both Clara cells and type II pneumocytes have been reported.The immunohistochemical and ultrastructural findings hint at an origin from type II pneumocytes or Clara cells.Noguchi et al. demonstrated the presence of surfactant apoprotein in cytoplasm of tumor cells in a case of papillary adenoma indicating type II pneumocyte-like differenciation of the tumor cells. The tumor was encounted in a asymptomatic patient in a mass-survey chest X-ray examination. The chest X-ray films showed the tumor as well dermacated small lesion. We reports a case of papillary adenoma of the lung with pulmomary sequestration with review of articles.

Intractable Hemoptysis due to Valvular Heart Disease Treated by Emergency Redo DVR: 1 case report / 대한흉부외과학회지

Hemoptysis occurs quite frequently as a consequence of mitral stenosis, but massive, lirE threatening pulmonary hemorrhage is distinctly unusual. We report a 30 year old female who underwent cmcrgcncy rcdo double valve replacement for intractable pulmonary hemorrhage. she underwent mitral valve replacement (lonescu Shirley 27 mm) due to rheumatic valvular heart disease in 1984 and tricuspid valve annuloplasty (Carpentier's ring 30mm) two years later She was admitted for massive hcmoptysis and dyspnea on the 26th of December, 1995. Medical treatment including transarterial embolization was given but was not satisfactory. Emergency valve replacement (Mitral valve, St. Judc 29mm and tricuspid valve ; St. Jude 33mm) was performed and hemoptysis was controlled dramatically 24 hours after surgery.

Primary Malignant Pericardial Mesothelioma (PMPM): A case Report / 대한흉부외과학회지

Primary malignant pericardial mesothelioma(PMPM) is more rare than heart tumor, and the term of mcsothelioma was first used by Adami in 1910, although the lesion was Hrst descripted by Wagner in 1870. Most of 1:le reported 40 cascs have becn diagnosed on autopsy. Antemortem diagnosis are rarely reported with only 40 cases in the world. According to Cohen, its incidence in 500,000 autopsies were 2.2. An analysis of the recent review shows that an antemortem diagnosis was made in only 19~25% of total cases. This report co sist of a case of our experience of PMPM.