A rare case of spontaneous esophageal rupture (Boerhaave's syndrome) associated with pulmonary rupture.

Spontaneous esophageal rupture (Boerhaave's Syndrome) is a life-threatening condition that requires early diagnosis and effective treatment. The authors describe a rare case of spontaneous rupture of the esophagus associated with pulmonary rupture in a 54-year-old man. The anatomical basis for the occurrence of a spontaneous esophageal rupture associated with pulmonary rupture is discussed.

[An experience with omentopexy for the repair of postoperative bronchopleural fistula].

Postoperative bronchopleural fistula has been the most troublesome complications in the thoracic surgery. In this report, we presented a case of bronchopleural fistula successfully closed by omentopexy. A 51-year-old man had undergone left upper lobectomy and S6 segmentectomy for primary lung cancer. Bronchopleural fistula due to postoperative pneumonia was developed and completion pneumonectomy with the intercostal-musclo-pexy was performed. Post-re-operative course was unsuccessful, bronchopleural fistula remained, so we tried re-closure of the bronchial stump by omentopexy without thoracoplasty or muscle flap plombage. About a half year after 3rd operation, he relapsed into bronchopleural fistula. Then fibrin gluing was performed via a flexible fiberoptic bronchoscope without hospitalization, and the omental flap was fixed completely to the bronchial stump. We believe the omentopexy a useful procedure for treating postoperative bronchopleural fistula which can't make any chest-wall deformation.

[CT of hypersensitivity pneumonitis].

High resolution computed tomography (CT) was applied to seven patients with hypersensitivity pneumonitis clinically confirmed. The CT findings include; (1) granular pattern with acino-centric distribution, (2) increase in density of haziness in the lung fields, (3) multiform high density areas, and (4) "subpleural curvilinear shadow" localized posteriorly. Of these findings, which severally varied degree during clinical course, the haziness showed the most remarkable fluctuation. It was especially of interest that the relapsed haziness distributed quite in the same regions. High resolution CT may be an effective adjuvant tool for hypersensitivity pneumonitis when applied to the opportune evaluation through the clinical course.

[DS-bronchial arteriography; demonstration of metastasized lymphnodes of lung cancer--with special reference to the primary effect in BAI].

We analysed the 44 DS-Bronchial arteriograms (DSBAG) of lung cancer with an attention to the demonstration of metastasized mediastinal lymphnodes. The stain of lymphnode is well demonstrated in the pericarinal region, such as station #7, #R4 along the course of bronchial arteries. The swollen nodes with stains on DSBAG show the good reduction rates (37.5%) after BAI that is analogous to the primary lesion (38.9%), in contrast to the nodes without stains (24.5%). DSBAG with excellent contrast resolution contributes to the BAI as verifying the infused area.