Esophageal leiomyoma is a benign tumor that accounts for two-thirds of esophageal benign tumors. In general, patients with esophageal leiomyoma are asymptomatic; however, as the tumor grows in size, symptoms such as dysphagia, chest discomfort, obstruction, or bleeding can appear. A 65-year-old man visited our clinic to receive treatment for a subepithelial tumor in the lower esophagus, which was incidentally found during endoscopy for work-up of chest discomfort and indigestion. On endoscopic ultrasonography (EUS), the tumor was 2.6×1.9 cm in size, with a cystic lesion located in the submucosal and proper muscle layers and thick cystic wall. Therefore, it was highly likely to be a duplication cyst. As the patient had symptoms such as chest discomfort, surgical resection was performed. The tumor was finally diagnosed as a leiomyoma with cystic degeneration. Leiomyoma with cystic change that has similar EUS features to duplication cyst is rare. Thus, we report the case with a literature review.

Esophageal leiomyoma is a benign tumor that accounts for two-thirds of esophageal benign tumors. In general, patients with esophageal leiomyoma are asymptomatic; however, as the tumor grows in size, symptoms such as dysphagia, chest discomfort, obstruction, or bleeding can appear. A 65-year-old man visited our clinic to receive treatment for a subepithelial tumor in the lower esophagus, which was incidentally found during endoscopy for work-up of chest discomfort and indigestion. On endoscopic ultrasonography (EUS), the tumor was 2.6×1.9 cm in size, with a cystic lesion located in the submucosal and proper muscle layers and thick cystic wall. Therefore, it was highly likely to be a duplication cyst. As the patient had symptoms such as chest discomfort, surgical resection was performed. The tumor was finally diagnosed as a leiomyoma with cystic degeneration. Leiomyoma with cystic change that has similar EUS features to duplication cyst is rare. Thus, we report the case with a literature review.

Esophageal duplication cyst is a rare congenital gastrointestinal malformation. It is the second most common duplication cyst following small bowel duplication cyst in the gastrointestinal tract. Patients with an esophageal duplication cyst are generally asymptomatic; however, some patients may present the following symptoms: dysphagia, chest pain, stridor, unproductive cough, and epigastric discomfort by compression of the surrounding structures. Surgical removal is the treatment of choice in symptomatic cases and can be considered in asymptomatic cases if they are at risk for developing complications, such as ulceration or perforation. Herein, we report a case of hemorrhage of an esophageal duplication cyst, which was improved by endoscopic drainage.
Chest Pain ; Cough ; Deglutition Disorders ; Drainage* ; Endosonography ; Esophagus ; Gastrointestinal Tract ; Hemorrhage* ; Humans ; Respiratory Sounds ; Ulcer

PURPOSE: Perigraft seroma and excessive fluid leaks are well known complications after the use of expanded polytetrafluoroethylene(ePTFE, Gore-Tex(R)) graft. The purpose of this study is to evaluate the effectiveness of precoating the grafts with fibrin glue in the patients underwent a modified Blalock-Taussig shunt. METHODS: Among 51 consecutive infants underwent modified Blalock-Taussig shunt between June 2000 and August 2003, 49 patients underwent 53 shunt procedures through thoracotomy were included for analysis. Their median age was 0.9 months(2 days-5.9 months), median body weight was 3.5(2.2-7.9) kg. The ePTFE grafts precoated with fibrin glue were used in 20 procedures. Perioperative variables of the precoated group were compared with those of a control group(n=33) using t-test and Fisher's exact test. RESULTS: There was no operative mortality in the both groups. No significant difference between the groups could be found in the preoperative variables, postoperative morbidity, and the incidence of perigraft seroma, which developed only in 1 case in the control group. The size of the grafts was significantly smaller in the precoated group(P<0.01). The total amount of pleural drainage per body weight of the precoated group was significantly less than that of the control group(19.7+/-25.2 versus 5.5+/-4.9 mL/kg; P<0.01). CONCLUSION: Precoating an ePTFE graft with fibrin glue may reduce perigraft leak after a modified Blalock-Taussig shunt, although the impact of the size of the graft used and the native pulmonary artery requires further investigation.
Blalock-Taussig Procedure ; Blood Vessel Prosthesis ; Body Weight ; Drainage ; Endoleak* ; Fibrin Tissue Adhesive ; Humans ; Incidence ; Infant ; Mortality ; Polytetrafluoroethylene* ; Postoperative Complications ; Pulmonary Artery ; Seroma ; Thoracotomy ; Tissue Adhesives ; Transplants

The development of Morgagni hernias is related to malformations of the embryologic septum transversum after failure of the sternal and costal fibrotendinous elements of the diaphragm to fuse. The overall incidence of Morgagni hernias among all congenital diaphragmatic defects is 3% to 4%. Inguinal hernias are the most common hernias in males and females (25% and 2%, respectively). An inguinal hernia is defined as a protrusion of the abdominal cavity contents through the inguinal canal. The combination of Morgagni and inguinal hernias is rare, and treatment using laparoscopic surgery has not been previously reported. This case presents a one-stage laparoscopic repair of Morgagni and inguinal hernias in a 2-month-old male.
Abdominal Cavity ; Diaphragm ; Female ; Hernia ; Hernia, Inguinal ; Humans ; Incidence ; Infant ; Inguinal Canal ; Laparoscopy ; Male

We reviewed our experience with resection of recurrent lung cancer to evaluate the benefit and risk of the procedure. From December 1994 to December 2003, 29 consecutive patients underwent pulmonary resections for recurrent lung cancer. The mean duration from the first resection to second surgery was 25.4+/-15.1 months for the definite 2nd primary lung cancer (n=20) and 8.9+/-5.7 months for metastatic lung cancer (n=9). The procedures at the second operations were completion-pneumonectomy in 11 patients, lobectomy in 5 patients, wedge resection in 12 patients and resection and anastomosis of trachea in 1 patient. Morbidity was observed in 6 (21%) of the patients and the in-hospital mortality was two patients (7%) after the repeated lung resection. Tumor recurrence after reoperation was observed in 14 patients (48%). The actuarial 5-yr survival rate was 69% and the 5-yr disease free rate following reoperation was 44%. No significant difference was found in overall survival and disease free survival between the 2nd primary lung cancer group and the metastatic lung cancer group. The recurrence rate following reoperation was significantly different between the wedge resection group and lobectomy/completion pneumonectomy group (p=0.008), but the survival rate was not significantly different (p=0.41). Surgical intervention for recurrent lung cancers can be performed with acceptable mortality and morbidity. If tolerable, completion pneumonectomy or lobectomy is recommended for resection of recurrent lung cancer.
Time Factors ; Survival Rate ; Retrospective Studies ; Prognosis ; Neoplasm Recurrence, Local/mortality/*surgery ; Middle Aged ; Male ; Lung Neoplasms/mortality/*surgery ; Korea/epidemiology ; Humans ; Female ; Disease-Free Survival ; Aged