• Title/Summary/Keyword: 개흉술, 다발성 외상

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Clinical Analysis of Patients with Multiple Organ Injuries Who Required Open thoracotomy (개흉술이 필요했던 다발성 외상환자에 대한 임상적 고찰)

  • 이성광;정성운;김병준
    • Journal of Chest Surgery
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    • v.31 no.8
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    • pp.804-810
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    • 1998
  • Background: Multiple trauma patients have rapidly increased due to traffic accidents, industrial disasters, incidental accidents, and violence. Multiple trauma can involve injuries to the heart, lung, and great vessels and influence the lives, necessitate prompt diagnosis and treatment. Most of the thoracic injuries can be managed with conservative method and simple surgical procedures, such as closed thoracostomy, but in certain cases open thoracotomy is necessary. Materials and methods: The author analyzed the surgical result of 70 cases of open thoracotomy after multiple organ injury including thoracic organ. Results: The most common type of thoracic lesion was hemothorax with or without pneumothorax and diaphragmatic rupture was the second. Sixty percent of the patients were associated with bone fractures, 42.9% with abdominal injuries, and 37.1% with head injuries. The modes of operation were ligations of torn vessels for bleeding control(48.6%), repair of diaphragm(35.7%), and repair of lung laceration(25.7%) in this order of frequency and additional procedures were splenectomy(14.3%), hepatic lobectomy (8.6%) and repair of liver lacerations(5.7%). Postoperative complications were atelectasis (8.6%), wound infection (8.6%), and pneumonia(4.3%). Postoperatively six patients died(The mortality rate was 8.6%) and the causes of death were respiratory failure(2), acute renal failure(2), sepsis(1), and hypovolemic shock(1).

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Clinical Analysis of Traumatic Diaphragmatic injuries Report of 28 cases (외상성 횡경막 손상 28례 분석보고)

  • 장진우;이연재
    • Journal of Chest Surgery
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    • v.30 no.4
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    • pp.402-407
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    • 1997
  • The records of 28 patients with traumatic diaphragmatic injuries seen at Masan Samsung Hospital from march 1986 o March 1995 were reviewed. We treated 21 male and 7 female patients ranging in ages from 5 to 68 years. Thc diaphragimatic injuries were due to blunt trauma in'20 cases(Trawc accident 18, compression injury 1, Human trauma 1) and penetrating injuries 8 cases (all stab wound). Most common symptoms were dyspnea 27 (96%), chest pain 26 (93%), abdomianl pain 8 (29%), comatose mentality 36 (11 %). Chest X-ray were elevated diaphragm in 20 cases(71%) find hemothorax in 18 cases (64%) and 25 cascs (89%) were diagnosed or suspected as diaphragmatic inju,rims prcopcrativcly. The repair of 28 cases were performed with thoracic approach in 20 cases, abdominal approach 7, thoracoabdominal approach in 1 cases. There were 5 death (18%) and all death related to the severity of associated injury. (hypovolcmic shock 3, combined head injury 1, renal failure 1).

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Stent-graft Treatment for a Traumatic Pseudoaneurysm of the Descending Thoracic Aorta -A case report- (외상성 하행 흉부 가성대동맥류에 대한 스텐트-그라프트 치료 - 1예 보고 -)

  • Kim, Dae-Hyun;Kim, Bum-Shik;Kim, Jung-Heon
    • Journal of Chest Surgery
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    • v.41 no.3
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    • pp.373-376
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    • 2008
  • Surgery is the general treatment modality for thoracic aortic pseudoaneurysm combined with traumatic aortic rupture. However, we should select other treatment modalities for patients who can't tolerate surgery due to severe multiple injuries. Herein we report on a case of successful stent-graft treatment for a traumatic descending thoracic aortic pseudoaneurysm combined with severe multiple trauma, and we include a review of the relevant literature.