Bilateral intrathoracic kidneys and adrenal glands associated with posterior congenital diaphragmatic hernias

We present a case of bilateral intrathoracic kidneys and adrenal glands associated with bilateral posterior diaphragmatic defects in a symptomatic 18-month-old baby boy. The diaphragmatic defect did not appear to be the typical posterolateral diaphragmatic hernia of Bochdalek. The patient underwent primary surgical correction through an abdominal approach. Postoperatively, the patient enjoyed an uneventful course and was discharged home without any further events. We discuss this report of bilateral intrathoracic kidneys associated with bilateral diaphragmatic hernias, we describe the operative management, and we analyze the possible embryological development of this defect.     

Optimal treatment of intrathoracic extramedullary hematopoiesis resembling posterior mediastinal tumor; report of a case

Intrathoracic extramedullary hematopoiesis is a rare condition accompanying chronic hematologic disease. We present a case of chronic gastric ulcer in which a posterior mediastinal mass was diagnosed as extramedullary hematopoiesis. We underwent video-assisted thoracoscopic resection safely and successfully. This procedure is relevant and safety procedure for differential diagnosis of patients who have chronic anemia with asymptomatic intrathoracic tumors.     

Acute respiratory failure and tracheal obstruction in patients with posterior giant mediastinal (intrathoracic) goiter

The extension of a thyroid goiter into the mediastinum, commonly known as a substernal goiter, is commonly located in the anterior mediastinum. Substernal enlargement of a goiter can cause compression of several mediastinal structures including the trachea. Tracheal compression may rarely lead to acute respiratory failure. We present a patient with tracheal compression and respiratory failure due to a posterior mediastinal goiter in the light of the literature.     

Goiter in surgical practice

In this series of consecutive cases of disease of the thyroid gland subjected to partial thyroidectomy there may be found what the author believes to be a fairly normal distribution of the different types of goiter. The pre- and postoperative care, the operation, the pathology and the post-operative complications have been discussed. There were no instances in the group of injury to the recurrent laryngeal nerve, nor of injury to the blood supply of the parathyroids. There were no fatalities and all patients were definitely improved on discharge from the hospital and when examined on return visits. Until a five year period has elapsed, no statement can be made concerning recurrences.     

胸内甲状腺肿的外科治疗（附20例报告）

报告１９７０年到１９９４年间通过手术切除并经病理证实为胸内甲状腺肿２０例。胸内甲状腺肿是指肿大的甲状腺部分或全部位于胸廓入口以下。绝大多数胸内甲状腺肿是由颈部甲状腺肿大延伸而来，真正起源于胸腔的迷走性甲状腺肿极少。本病多发生在４０岁以上的病人，以女性居多。主要症状是气管受压引起的呼吸困难、喘鸣等。Ｘ线胸片、ＣＴ、同位素扫描是常用的诊断手段。手术切除为首选治疗方法，三种主要手术入路为颈部领式切口、纵劈胸骨法和开胸法。     

复发性结节性甲状腺肿诊治分析

目的探讨复发性结节性甲状腺肿的诊断与治疗。方法回顾性分析再次手术治疗的复发性结节性甲状腺肿60例,首次手术行单侧腺叶手术的39例(65%),再手术时29例行对侧腺叶部分切除,5例行患侧腺叶全切加对侧腺叶部分切除,5例行双侧腺叶大部分切除。首次手术行双侧腺叶手术21例,再手术时16例行一侧腺叶全切加对侧腺叶部分切除,5例行双侧腺叶大部分切除。结果60例患者中,再手术后发现甲状腺癌10例(16.7%),15例(25%)出现术后并发症,其中永久性喉返神经损伤2例,永久性低钙血症2例,甲状腺功能减退症5例。再次手术并发症发生率为25%,高于首次手术(6%)(P<0.05)。结论甲状腺良性疾病再手术是安全可行的;但手术者应遵循手术原则与手术方式,小心细致,尽量防止并发症的发生。     

Goiter and deaf mutism.

The occurrence of deaf-mutism and goiter unassocaited with creatinism or mental retardation in euthyroid patients is known as Pendred's Syndrome. It is considered due to a single mutant recessive gene responsible for both the goiter and deafness. The penetrance is high, the intenseness of expressivity may vary within the same family and only one generation is affected. The extremely atypical hyperplasia seen in such goiters has been considered malignant. In 1956 the author reported a family in which 4 of 6 sibilings demonstrated Pendred's Syndrome. Three of the 4 had undergone thyroidectomy, two were considered to have carcinoma. Nineteen years later the family is again reported. The fourth sibling has recently undergone thyroidectomy. This thyroid demonstrated the same atypical hyperplasia as seen in the elder two siblings. The 19 year followup of this family has shown no evidence of recurrence or metastases, indicating that the atypical hyperplasia is probably not malignant. Pendred's Syndrome is described and certain suggestions are made for the counseling of the parents and the treatment and counseling of those children so afflicted.