위늑막루에 의한 농흉의 치험 −1예 보고− = Management of Empyema Caused by a Gastropleural Fistula -A case report-

다국어 초록 (Multilingual Abstract)

Gastropleural fistula is a rare complication of prior lung surgery, gastric ulcer, trauma and malignancy. A 62 year old female patient who had received surgical repair of a perforated gastric wall 10 years prior, underwent open pleural decortication. At 4 days after surgery, food residuums were noticed at the chest bottles. Hence, an emergency esophagogram was done. The esophagogram revealed a gastropleural fistula. The patient received a total gastrectomy, intra-abdominal diaphragmatic repair and massive thoracic saline irrigation through a previous thoracic wound. The patient was discharged 11 days after surgery without other morbidity.

국문 초록 (Abstract)

위늑막루는 이전의 폐수술 병력, 위궤양의 합병증, 외상, 악성종양 등에 의해 일어날 수 있는 흔하지 않은 합병증이다. 10년전에 위장천공의 외과적 봉합술을 받았던 62세 여자 환자로 좌측 농흉이 발생하여 개흉하에 흉막 박피술을 시행하였다. 수술 후 4일째, 음식물이 흉관을 통해서 배액 되어서 응급 위식도 조영술을 시행하였다. 위식도 조영술상 위늑막루를 발견하였다. 환자는 위전절제술 및 횡경막 봉합을 시행하고, 이전의 흉부창상을 통해 흉강을 세척하였다. 특별한 문제 없이 수술 후 11일째 퇴원하였다.

참고문헌 (Reference)

1 Odell JA, "Management of empyema thoracis" 87 : 466-470, 1994

2 Mehran A, "Laparoscopic partial gastrectomy for the treatment of gastropleural fistula" 9 : 213-215, 2005

3 Warburton CJ, "Gastropleural fistula due to gastric lymphoma presenting as tension pneumothorax and empyema" 10 : 1678-1679, 1997

4 Arun S, "Gastropleural fistula as a complication of empyema thoracis" 74 : 301-303, 2007

5 Garrett KA, "Gastro-broncho-pleural fistula after laparoscopic gastric band placement" 19 : 941-943, 2009

6 Molnar TF, "Current surgical treatment of thoracic empyema in adults" 32 : 422-430, 2007

7 Ozol D, "Complicated parapneumonic effusion and empyema thoracis:microbiologic and therapeutic aspects" 100 : 286-291, 2006

8 Bilgin M, "Benefits of early aggressive management of empyema thoracis" 76 : 120-122, 2006