신주위공간의 혈관근지방종: 증례 보고

신호섭,윤성국,이진화,김찬성,오종영,신태범,이기남,남경진,김대철 대한영상의학회 2002 대한영상의학회지 Vol.47 No.6

Angiomyolipomas commonly originate from renal parenchyma but extremely rarely from perinephric space. We report a case of angiomyolipoma of the perinephric space confirmed by radical nephrectomy. A 13-year-old boy presented with left flank pain and abdominal distension, first experienced five months earlier. Ultrasonography and CT indicated that in the space surrounding the left kidney, a huge fat-containing mass with linear strands was present. 신실질과 달리 신주위공간에서 발생하는 혈관근지방종은 매우 드물다. 이에 저자들은 근치적 신절제술로 확진된 신주위공간에서 발생한 혈관근지방종 1예를 보고한다. 13세 남자 환아가 5개월간의 좌측 옆구리 통증과 복부팽만을 호소하였다. 초음파검사와 전산화단층촬영 소견상 좌신을 둘러싸는 신주위공간에서 선상 선음영을 동반한 거대 지방 함유종괴를 보였다.

Retroperitoneal Synovial Sarcoma Manifested by Obstructive Jaundice in an Elderly Woman: Case Report

Dae Ho Kim,주광로,차재명,신현필,이정일,Jae Jun Park,Hyun Soo Kim,Dal Mo Yang 대한소화기내시경학회 2012 Clinical Endoscopy Vol.45 No.4

Synovial sarcoma is a rare type of soft tissue sarcoma that arises in tissues containing synovial fluid, usually in the extremities. It has only rare occurrence in the retroperitoneal space. Early detection of retroperitoneal synovial sarcoma is difficult, since the retroperitoneal space is highly expandable and deeply hidden. Furthermore, the presenting symptoms are often vague and nonspecific, and are related to the pressure on adjacent structures. In this study, we present an unusual case of retroperitoneal synovial sarcoma with obstructive jaundice due to intrabiliary blood clots caused by invasion of bile duct by tumor. The obstructive jaundice was relieved through endoscopic removal of the blood clots and insertion of a biliary stent.

Retroperitoneal Bronchogenic Cyst Located in the Presacral Space: A Case Report

김아연,민선정,김현철,최정아 대한영상의학회 2021 대한영상의학회지 Vol.82 No.1

Bronchogenic cysts are rare congenital anomalies that are most frequently found in the mediastinum along the tracheobronchial tree, especially in the posterior aspect of the superior mediastinum. Bronchogenic cysts have also been reported in intrapulmonary, intrapericardial, abdominal, and retroperitoneal locations. Herein, we report a case of a retroperitoneal bronchogenic cyst in the presacral space. The patient was diagnosed based on a post-operative histopathological examination.

신장주위공간 모세혈관종의 역동적 조영증강 전산화단층촬영 소견

이정민,김상원,김현철,양달모,류정규,임성직 대한영상의학회 2016 대한영상의학회지 Vol.74 No.5

Hemangiomas are benign mesenchymal neoplasms that rarely occur in the kidney and perirenal space. Perirenal hemangiomas can mimic the appearance of exophytic renal cell carcinoma or various retroperitoneal tumors. We report a case of perirenal hemangioma detected by dynamic enhanced computed tomography in a 43-year-old female. 혈관종은 양성의 간엽성 종양이며 신장과 신장주위공간에서 드물게 발생한다. 신장주위공간에서 혈관종이 발견되는 경우는 극히 드물며 외장성 신세포암이나 다양한 후복막강 종양들과 유사하게 보일 수 있다. 저자들은 43세 여자 환자의 역동적 조영증강 전산화단층촬영에서 발견된 신장주위공간 혈관종의 증례를 경험하였기에 이를 보고하고자 한다.

Robot-assisted Resection of Paraspinal Schwannoma

양문술,김긍년,윤도흠,William Pennant,하윤 대한의학회 2011 Journal of Korean medical science Vol.26 No.1

Resection of retroperitoneal tumors is usually perfomed using the anterior retroperitoneal approach. Our report presents an innovative method utilizing a robotic surgical system. A 50-yr-old male patient visited our hospital due to a known paravertebral mass. Magnetic resonance imaging showed a well-encapsulated mass slightly abutting the abdominal aorta and left psoas muscle at the L4-L5 level. The tumor seemed to be originated from the prevertebral sympathetic plexus or lumbosacral trunk and contained traversing vessels around the tumor capsule. A full-time robotic transperitoneal tumor resection was performed. Three trocars were used for the robotic camera and working arms. The da Vinci Surgical System® provided delicate dissection in the small space and the tumor was completely removed without damage to the surrounding organs and great vessels. This case demonstrates the feasibility of robotic resection in retroperitoneal space. Robotic surgery offered less invasiveness in contrast to conventional open surgery.

The Differential Imaging Features of Fat-Containing Tumors in the Peritoneal Cavity and Retroperitoneum: the Radiologic-Pathologic Correlation

Shin, Na-young,Kim, Myeong-Jin,Chung, Jae-Joon,Chung, Yong-Eun,Choi, Jin-Young,Park, Young-Nyun The Korean Society of Radiology 2010 KOREAN JOURNAL OF RADIOLOGY Vol.11 No.3

<P>There are a variety of fat-containing lesions that can arise in the intraperitoneal cavity and retroperitoneal space. Some of these fat-containing lesions, such as liposarcoma and retroperitoneal teratoma, have to be resected, although resection can be deferred for others, such as adrenal adenoma, myelolipoma, angiomyolipoma, ovarian teratoma, and lipoma, until the lesions become large or symptomatic. The third group tumors (i.e., mesenteric panniculitis and pseudolipoma of Glisson's capsule) require medical treatment or no treatment at all. Identifying factors such as whether the fat is macroscopic or microscopic within the lesion, the origin of the lesions, and the presence of combined calcification is important for narrowing the differential diagnosis. The development and wide-spread use of modern imaging modalities make identification of these factors easier so narrowing the differential diagnosis is possible. At the same time, lesions that do not require immediate treatment are being incidentally found at an increasing rate with these same imaging techniques. Thus, the questions about the treatment methods have become increasingly important. Classifying lesions in terms of the necessity of performing surgical treatment can provide important information to clinicians, and this is the one of a radiologist's key responsibilities.</P>

The Differential Imaging Features of Fat-Containing Tumors in the Peritoneal Cavity and Retroperitoneum: the Radiologic-Pathologic Correlation

신나영,김명진,정재준,정용은,최진영,박영년 대한영상의학회 2010 Korean Journal of Radiology Vol.11 No.3

There are a variety of fat-containing lesions that can arise in the intraperitoneal cavity and retroperitoneal space. Some of these fat-containing lesions, such as liposarcoma and retroperitoneal teratoma, have to be resected, although resection can be deferred for others, such as adrenal adenoma, myelolipoma, angiomyolipoma, ovarian teratoma, and lipoma, until the lesions become large or symptomatic. The third group tumors (i.e., mesenteric panniculitis and pseudolipoma of Glisson’s capsule) require medical treatment or no treatment at all. Identifying factors such as whether the fat is macroscopic or microscopic within the lesion, the origin of the lesions, and the presence of combined calcification is important for narrowing the differential diagnosis. The development and widespread use of modern imaging modalities make identification of these factors easier so narrowing the differential diagnosis is possible. At the same time, lesions that do not require immediate treatment are being incidentally found at an increasing rate with these same imaging techniques. Thus, the questions about the treatment methods have become increasingly important. Classifying lesions in terms of the necessity of performing surgical treatment can provide important information to clinicians, and this is the one of a radiologist’s key responsibilities.

Mortality risk factor analysis in colonic perforation

Ri Na Yoo,Bong-Hyeon Kye,Gun Kim,Hyung Jin Kim,Hyeon-Min Cho 대한외과학회 2017 Annals of Surgical Treatment and Research Vol.93 No.4

Purpose: Colonic perforation is a lethal condition presenting high morbidity and mortality in spite of urgent surgical treatment. This study investigated the surgical outcome of patients with colonic perforation associated with retroperitoneal contamination. Methods: Retrospective analysis was performed for 30 patients diagnosed with colonic perforation caused by either inflammation or ischemia who underwent urgent surgical treatment in our facility from January 2005 to December 2014. Patient characteristics were analyzed to find risk factors correlated with increased postoperative mortality. Using the Physiological and Operative Severity Score for the Enumeration of Mortality and Morbidity (POSSUM) audit system, the mortality and morbidity rates were estimated to verify the surgical outcomes. Patients with retroperitoneal contamination, defined by the presence of retroperitoneal air in the preoperative abdominopelvic CT, were compared to those without retroperitoneal contamination. Results: Eight out of 30 patients (26.7%) with colonic perforation had died after urgent surgical treatment. Factors associated with mortality included age, American Society of Anesthesiologists (ASA) physical status classification, and the ischemic cause of colonic perforation. Three out of 6 patients (50%) who presented retroperitoneal contamination were deceased. Although the patients with retroperitoneal contamination did not show significant increase in the mortality rate, they showed significantly higher ASA physical status classification than those without retroperitoneal contamination. The mortality rate predicted from Portsmouth POSSUM was higher in the patients with retroperitoneal contamination. Conclusion: Patients presenting colonic perforation along with retroperitoneal contamination demonstrated severe comorbidity. However, retroperitoneal contamination was not found to be correlated with the mortality rate.

Mortality risk factor analysis in colonic perforation: would retroperitoneal contamination increase mortality in colonic perforation?

우리나,계봉현,김건,김형진,조현민 대한외과학회 2017 Annals of Surgical Treatment and Research(ASRT) Vol.93 No.4

Purpose: Colonic perforation is a lethal condition presenting high morbidity and mortality in spite of urgent surgical treatment. This study investigated the surgical outcome of patients with colonic perforation associated with retroperitoneal contamination. Methods: Retrospective analysis was performed for 30 patients diagnosed with colonic perforation caused by either inflammation or ischemia who underwent urgent surgical treatment in our facility from January 2005 to December 2014. Patient characteristics were analyzed to find risk factors correlated with increased postoperative mortality. Using the Physiological and Operative Severity Score for the Enumeration of Mortality and Morbidity (POSSUM) audit system, the mortality and morbidity rates were estimated to verify the surgical outcomes. Patients with retroperitoneal contamination, defined by the presence of retroperitoneal air in the preoperative abdominopelvic CT, were compared to those without retroperitoneal contamination. Results: Eight out of 30 patients (26.7%) with colonic perforation had died after urgent surgical treatment. Factors associated with mortality included age, American Society of Anesthesiologists (ASA) physical status classification, and the ischemic cause of colonic perforation. Three out of 6 patients (50%) who presented retroperitoneal contamination were deceased. Although the patients with retroperitoneal contamination did not show significant increase in the mortality rate, they showed significantly higher ASA physical status classification than those without retroperitoneal contamination. The mortality rate predicted from Portsmouth POSSUM was higher in the patients with retroperitoneal contamination. Conclusion: Patients presenting colonic perforation along with retroperitoneal contamination demonstrated severe comorbidity. However, retroperitoneal contamination was not found to be correlated with the mortality rate.

초음파상 난관수종으로 오인된 거대수뇨관 증례 1 예

김미라 ( Kim Mi La ),고윤희 ( Go Yun Hui ),조연진 ( Jo Yeon Jin ),백준길 ( Baeg Jun Gil ),우혁준 ( U Hyeog Jun ),홍준식 ( Hong Jun Sig ),조준형 ( Jo Jun Hyeong ),주관영 ( Ju Gwan Yeong ) 대한산부인과학회 2004 Obstetrics & Gynecology Science Vol.47 No.2

The retroperitoneal space of the posterior abdomen and the pelvic retroperitoneum contain the major neural, vascular and lymphatic supply to the pelvic viscera, the urinary system and colorectal system. A pain or mass in the pelvis may arise primarily from the reproductive organs, but it may just as easily arise from the retroperitoneal space, include the urinary tract and the gastrointestinal tract. Therefore, the gynecologic surgeon should be aware of the various conditions associated with retroperitoneal mass and the correct management of these disorders. Hydroureter may misdiagnose as a pelvic mass or retroperitoneal mass. The cause of hydroureter is mainly secondary obstruction such as malignancy, idiopathic retroperitoneal fibrosis and pelvic disease but primary obstructive megaureter should be considered. This report describes a case of marked hydroureter, misdiagnosed as a hydrosalpinx by ultrasound.