ABSTRACT
We report a case with pericardial diverticulum in the mediastinum. A 64-year-old woman visited our hospital because of cough and dyspnea. Chest X-ray showed a smooth-bordered mass in the right superior mediastinum and computed tomography (CT) showed a homogeneous cystic mass in the paratracheal area. During right mini-thoracotomy, a thin-walled cystic lesion was found involving the trachea, the superior vena cava, and the azygos vein. The cyst extended a duct toward the pericardium. We performed total excision and pathological examination confirmed the diagnosis of a pericardial diverticulum. Mini-thoracotomy provides an effective and minimally invasive means of excising the mediastinal mass, relieving symptoms, and allowing pathological examination.
Subject(s)
Diverticulum/surgery , Pericardium , Female , Heart Diseases/diagnosis , Heart Diseases/surgery , Humans , Middle AgedABSTRACT
A 20-year-old man was admitted to our hospital with a sudden onset of dyspnea, caused by right pleural effusion. The patient was in a state of shock. Thoracentesis was revealed hemothorax. Right thoracotomy revealed pulmonary arteriovenous fistula projecting into the intrapleural space from the right upper lobe. Partial resection was performed. His postoperative course was uneventful. Intrapleural rupture of pulmonary arteriovenous fistula was reported rarely; therefore we described here our case.
Subject(s)
Arteriovenous Fistula/surgery , Hemothorax/etiology , Pulmonary Artery/abnormalities , Pulmonary Veins/abnormalities , Adult , Arteriovenous Fistula/complications , Humans , Male , Pulmonary Surgical Procedures/methodsABSTRACT
An 82-year-old man who had been undergoing hemodialysis for chronic renal failure, 3 times a week for the last 3 years, was admitted to our hospital for the treatment of lung cancer. Under careful perioperative management, we successfully performed a lobectomy. Histological examination revealed well differentiated squamous cell carcinoma and the postoperative staging was pT1N0M0. On postoperative day 1, he was commenced on hemodialysis with nafamostat mesilate instead of heparin sodium, and there was no postoperative bleeding. The patient had an uneventful postoperative course and was discharged 3 weeks after his operation.
Subject(s)
Carcinoma, Squamous Cell/surgery , Kidney Failure, Chronic/therapy , Lung Neoplasms/surgery , Pneumonectomy/methods , Renal Dialysis , Aged , Aged, 80 and over , Carcinoma, Squamous Cell/pathology , Humans , Kidney Failure, Chronic/complications , Lung Neoplasms/pathology , Male , Neoplasm StagingABSTRACT
A 64-year-old man was admitted to our hospital with multiple traumas, caused by motorcycle accident. Six months later, he revisited our hospital, because he was found to have aortic regurgitation and subsequent congestive heart failure. Therefore, the aortic valve was excised and replaced with 23 mm CarboMedics prosthesis. His postoperative course was uneventful. Aortic regurgitation due to nonpenetrating trauma of the chest is rare.
Subject(s)
Aortic Valve Insufficiency/surgery , Thoracic Injuries/complications , Wounds, Nonpenetrating/complications , Accidents, Traffic , Aortic Valve Insufficiency/etiology , Heart Valve Prosthesis Implantation , Humans , Male , Middle Aged , Multiple Trauma/complicationsABSTRACT
A 72-year-old female, who had received medication for hypertension and angina pectoris was hospitalized with complaining of an abrupt dyspnea. Roentgenogram of the chest revealed no abnormal findings except cardiac enlargement. An electrocardiogram showed overloading of the right ventricle. Arterial blood gas analysis of room air showed 55.4 mmHg of PaO2, 25.5 mmHg of PaCO2 and 7.30 of PH, respectively. Acute and massive pulmonary embolism was diagnosed by an emergent pulmonary arteriography. Despite intensive treatment such as infusion of urokinase and heparin for four days, thrombus was still detected in the left main pulmonary artery by a transesophageal echocardiography. By the result of ineffective conservative therapy, embolectomy was performed under cardiopulmonary bypass. However mechanical respiratory support was required for a long time due to the right heart failure, she is doing well for a year after the operation.
