• 제목/요약/키워드: 관통손상

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Hemothorax Without Injury of the Pleural Cavity due to Diaphragmatic and Liver Laceration Caused by a Right Upper Anterior Chest Stab Wound (우상 전흉부 자상에서 흉막강 관통 없는 간손상 및 횡격막 손상에 의한 혈흉 치험 1례)

  • Cho, Kyu-Seok;Youn, Hyo-Chul;Kim, Jung-Heon;Lee, Sang-Mok
    • Journal of Trauma and Injury
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    • v.23 no.1
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    • pp.49-52
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    • 2010
  • A hemothorax usually occur, due to injuries to the intercostal and great vessels, pulmonary damage, and sometimes fractured ribs. We report a case in which the hemothorax that occurred, neither intrathoracic injury nor injury to internal thoracic vessels and organs, via lacerated diaphragmatic and liver laceration due to a right upper part of anterior chest stab injury caused by a sharp object. The patient's general conditions gradually worsened, so chest and abdominal computed tomogram were taken. The abdominal computed tomogram revealed diaphragmatic injuries and bleeding from the lacerated liver. We performed an exploratory laparotomy to control the bleeding from the lacerated liver with simple primary sutures. In addition exploration was performed in the right pleural space through the lacerated diaphragm with a thoracoscopic instrument. There were no bleeding foci in the right pleural space, the vessels, or the lung on the thoracoscopic video. Closure of the lacerated diaphragm was achieved with simple, primary sutures. The postoperative course of the patient was uneventful, and the patient was discharged.

The Prognostic Factors of Traumatic Diaphragmatic Rupture (외상성 횡격막 파열에서 예후에 영향을 미치는 인자)

  • Cho, Sukki;Lee, Eung-Bae;Seok, Yang-Ki
    • Journal of Chest Surgery
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    • v.43 no.1
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    • pp.47-52
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    • 2010
  • Background: Traumatic diaphragmatic rupture is not common, but it requires swiftly performing an emergency operation. This study was conducted to evaluate the prognostic factors for mortality after surgically treating traumatic diaphragmatic rupture. Material and Method: From Jan 2001 to Dec. 2008, we experienced 37 cases of multiple traumas with diaphragmatic injuries that were confirmed by surgical procedures. We evaluated various factors, including the type of injury, the associated injuries, the preoperative vital signs, the ISS, the time until surgery and the rupture size. Result: There were 30 patients with blunt trauma and 7 patients with penetrating trauma. Thirty-four patients had associated injuries and the mean ISS was 20.8. Postoperative complications occurred in 11 patients and hospital mortalities occurred in 6 patients. The prognostic factors that had an influence on the postoperative mortalities were the preoperative intubation state, the patient who exhibited hypotension and a high ISS. Conclusion: Traumatic diaphragmatic rupture is just one part of multiple traumas. The postoperative mortalities might depend on not only on the diaphragmatic rupture itself, but also on the severity of the associated injuries.

Penetrating Orbitocranial Injury of a Pencil in a Pediatric Patient (소아에서 발생한 연필에 의한 관통 뇌손상)

  • Hwang, Sun-Chul
    • Journal of Trauma and Injury
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    • v.25 no.1
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    • pp.28-31
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    • 2012
  • Pencils are common instruments for children to use and play with. This report describes an unusual penetrating orbitocranial injury in a 5-year-old girl who was struck in her facewith a pencil. She was holding it at a desk, and her friend pushed her back. The pencil penetrated the left lower eyelid and went deep into the right frontal lobe through the base of the skull. It was removed at the emergency room, after which brain CT was performed to detect the development of an intracranial hematoma. No complications occurred after conservative management with antibiotics and an antiepileptic drug. Pencils can be hazardous to children, and a penetrating head injury with a pencil may be managed without cranial surgery.

Assessment of Fatigue Strength Characteristics of Tendon Porch in Offshore Platforms for API 2W Gr. 50 Steel (API 2W Gr.50 강재를 이용한 해양구조물 Tendon Porch의 피로성능 평가)

  • Im, Sung-Woo;Lee, Joo-Sung
    • Journal of Ocean Engineering and Technology
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    • v.20 no.5 s.72
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    • pp.82-88
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    • 2006
  • This assessment is concerned with the fatigue strength of the tendon porch found in TLP. Lorge-scale fatigue tests with models constructed at 30% the size of the real structures have been carried out to investigate the fatigue behavior of the API 2W Grade 50 steel recently produced by POSCO. The fatigue life for the present test models was obtained based on the concept of nominal stress. A comparison of the present test results with those obtained by a numerical approach based on the structural analysis results has showngood agreement. The present results were also compared with the design curves in DnV RP-C203.

Penetrating Injuries of the Chest- Analysis of 176 Cases - (관통성 흉부손상 176례에 대한 임상적 고찰)

  • Hur, Y.;Yu, H.S.
    • Journal of Chest Surgery
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    • v.15 no.1
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    • pp.3-12
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    • 1982
  • Although most patients with penetrating injuries can be managed successfully with early tube thoracotomy, blood volume replacement & close observation, the remainder can be saved only by an aggressive operative intervention. From January 1959, to August 1980, 176 cases with penetrating injuries had been treated at the Department of Cardiothoracic Surgery, National Medical Center. The ratio of male to female patient of penetrating chest wounds was 4.3:1 in male predominance and age from 10 to 40 occupied 76.7% of the total cases. Stab wounds was the most common penetrating injuries and followed by gunshot & glass wounds. To prevent early complications of penetrating chest injuries, thoracentesis were done in 29 cases [16%], and closed thoractomy in 40 cases [22.7%]. Open thoractomy, however, had to be done in 37 cases [21%] because of massive bleeding, hemopericardium, foreign body.

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건강 도우미 I 귀 - 고막까지 뚫으시게요? 올바른 귓속 관리

  • 사단법인 한국당뇨협회
    • The Monthly Diabetes
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    • s.212
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    • pp.30-31
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    • 2007
  • 대학원생 김모씨(28세 여)는 귀에 갑작스런 통증을 느끼기 시작했다. 또 급격하게 저하된 청력으로 친구들의 말귀를 잘 못 알아들어 '사오정'이라는 별명도 얻게 되었다. 통증이 심해 병원을 찾아간 결과 외상성 고막천공이라는 진단을 받게 되었다. 이는 귀이개가 고막을 관통해 발생한 질병으로 귀이개로 귀를 후비던 중 실수고 너무 깊이 파 통증이 나타나게 된 것이다. 다행이 다른 부위는 손상이 없어 외래에서 간단한 수술 및 통원치료 후 증상은 좋아졌다. 또 직장인 박모씨(34세 남)는 어느 날부터 갑자기 귀에서 고름이 나오고, 고약한 냄새를 풍겨 병원을 찾았는데, 만성 외이도염이라는 진단을 받았다. 원인은 하루가 멀다 하고 귀지를 파내는 오래된 습관 때문이라는 것이다. 습관을 바꾸지 않으면 앞으로 청력도 떨어질 수 있다는 의사의 말에 귀이개부터 멀리하기 시작했다. 고려대 안산병원 이비인후과 조승현 교수는 "종종 속을 썩이는 것이 귀지"라며 "무리하게 후비다가는 고막까지 버릴 수 있으므로 함부로 파서는 안된다"고 지적한다.

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Thoracic Trauma in Children (소아에서의 흉부외상)

  • 구본원;김성완
    • Journal of Chest Surgery
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    • v.30 no.1
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    • pp.77-82
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    • 1997
  • Sixty children were admitted to he Department of Thoracic and Cardiovascular Surgery, Kyungpook National University Hospital for the treatment of thoracic injuries for about a 10year period ending in August, 1995. We reviewed the hospital records retrospectively, to see the characteristics of the scope and consequences of childhood chest injuries. Mean age was 9 years and forty-six cases(77%) were male. Fifty children(83%) were victims of a blunt trauma. Among the blunt trauma patients, more than 60% were traffic-related. All victims of penetrating trauma were male. Among the blunt trauma patients, rib fracture was the most frequently found (52%) followed by pneumothorax(42%), although significant intrathoracic injuries occurred without rib fractures in )2% of blunt trauma cases. Associated injuries were present in 42% of children reviewed. Most frequently performed surgical procedure was closed thoracostomy(45% ), and ten children required thoracotomy and fifteen needed assisted ventilation. Modified Injury Severi y Scale(MISS) score was measured in the multiple Injured group. MISS score correlated significantly with the length of stay In the intensive care unit. One child(1.7% ), involved in a traffic accident, died of sepsis.

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Delayed Detection of a Penetrating Tracheal Foreign Body (수상 후 10년이 지나 발견된 기관 내 이물질)

  • Jang, Woo-Sung;Kim, Young-Tae;Kim, Joo-Hyun;Kang, Chang-Hyun
    • Journal of Chest Surgery
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    • v.40 no.5 s.274
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    • pp.384-387
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    • 2007
  • The finding of a tracheal penetrating injury that's caused by a foreign body is rare in adulthood. A 42-year-old man had experienced penetrating trauma due to a glass fragment 10 years ago. He presented with blood tinged sputum and dyspnea on exertion, and this had developed 1 year previously. Chest CT scan and bronchoscopy revealed a foreign body crossing the tracheal lumen and the object arose from outside of the trachea; this was all associated with airway edema. We removed the foreign body, which was a 5cm length of glass fragment, and we repaired the tracheal defect using a simple primary suture. The postoperative course of the patient was uneventful and he is now being followed up at the outpatient department; he has had no additional symptoms.

Structural Integrity Evaluation of Reactor Pressure Vessel Bottom Head without Penetration Nozzles in Core Melting Accident (노심용융사고 시 관통노즐이 제거된 원자로용기 하부헤드의 구조 건전성 평가)

  • Lee, Yun Joo;Kim, Jong Min;Kim, Hyun Min;Lee, Dae Hee;Chung, Chang Kyu
    • Journal of the Computational Structural Engineering Institute of Korea
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    • v.27 no.3
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    • pp.191-198
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    • 2014
  • In this paper, structural integrity evaluation of reactor pressure vessel bottom head without penetration nozzles in core melting accident has been performed. Considering the analysis results of thermal load, weight of molten core debris and internal pressure, thermal load is the most significant factor in reactor vessel bottom head. The failure probability was evaluated according to the established failure criteria and the evaluation showed that the equivalent plastic strain results are lower than critical strain failure criteria. Thermal-structural coupled analyses show that the existence of elastic zone with a lower stress than yield strength is in the middle of bottom head thickness. As a result of analysis, the elastic zone became narrow and moved to the internal wall as the internal pressure increases, and it is evaluated that the structural integrity of reactor vessel is maintained under core melting accident.

Ultrasonographic Diagnosis of Extensor Tenosynovitis Caused by Dorsal Screw Prominence after Volar Plate Fixation of Distal Radius Fracture: Case Report (원위 요골 골절의 수장측 금속판 고정술 후 발생한 신전건 활막염에 대한 초음파를 이용한 진단: 증례 보고)

  • Lim, Tae Kang;Kim, Sang Yeol;Kang, Hong Je;Hah, Dae Ho
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.6 no.2
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    • pp.60-64
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    • 2013
  • After volar locking plating of distal radius fracture, complications arising from unrecognized dorsally prominent screws penetrating the extensor compartments are increasingly reported. However, standard radiography and fluoroscopy may not adequately visualize screw lengths, because of complex shape of dorsal cortex of the distal radius. We presented case of ultrasonography diagnosis of extensor tenosynovitis caused by dorsal screw prominence after volar plate fixation of distal radius fracture.

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