• Title/Summary/Keyword: 근막 절개술

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Acute Compartment Syndrome after Anticoagulant Therapy to Misdiagnosed Deep Vein Thrombosis (오인된 심부 정맥 혈전증에 대하여 항응고제 투여 후 발생한 급성 구획 증후군)

  • Hwang, Seok-Ha;Jeon, Ho-Seung;Woo, Young-Kyun;Lim, Seong-Tae
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.2
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    • pp.177-181
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    • 2019
  • Acute compartment syndrome, which is an orthopedic emergency, induces irreversible tissue necrosis by increasing the compartment pressure. In serious cases, this event may result in functional impairment, loss of the lower limb, and death by renal failure. When the patient initially presents with pain and swelling that are similar to deep vein thrombosis, a differential diagnosis between the two diseases is very critical. The authors encountered a case of acute compartment syndrome after anticoagulant therapy in a patient presenting with painful swelling of the left leg following a massage that was initially misdiagnosed as deep vein thrombosis. A fasciotomy was performed on this case with satisfactory results. This paper reports this case with a review of the relevant literature.

Klebsiella Pneumonia-Necrotizing Fasciitis followed by Liver Abscess (폐렴 간균-괴사성 근막염에 이어 발생한 간농양)

  • Lee, Seung Hyun;Choi, Jeong Woo;Lee, Myeung Su
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.6
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    • pp.427-431
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    • 2018
  • We report a case of a patient with necrotizing fasciitis followed by liver abscess. A 51-year-old man was admitted to our hospital with a 5-day history of fever and chills with painful swelling of the right thigh. A magnetic resonance imaging (MRI) scan showed fluid collection with numerous dark signal intensities considered as air-bubbles between the posteromedial and posterolateral groups of the right thigh, resulting in presumptive diagnosis of necrotizing fasciitis. At the time of admission, an ultrasonograph of the abdomen showed increased parenchymal echogenicity of both kidneys and no liver abscess. Ten days after fasciotomy, an abdominal computed tomography (CT) scan showed intrahepatic abscess. Sonography-guided percutaneous drainage was performed. Both cultures of pus specimens from the liver abscess and right thigh yielded Klebsiella pneumoniae (K. pneumoniae). The patient was treated with fasciotomy several times and parenteral antibiotics, after which he began to improve. After 5 weeks, liver abscess size was reduced, and after 10 weeks, liver abscess disappeared. To the best of our knowledge, this is the first case of K. pneumoniae-necrotizing fasciitis followed by liver abscess.

Case of Abdominal Compartment Syndrome Treated by using a Bedside Open Linea Alba Fasciotomy (외상에 의한 후복막 출혈환자에서 발생한 복부구획증후군을 침상 옆 백선 근막 절개술로 치료한 증례)

  • Kim, Ji-Hoon T.;Han, Myung-Sik;Choi, Gun-Moo;Jang, Hyuck-Jae;Kwak, Jin-Ho;Kim, Ji-Hoon S.
    • Journal of Trauma and Injury
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    • v.24 no.1
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    • pp.56-59
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    • 2011
  • Abdominal compartment syndrome (ACS) is a life-threatening disorder caused by rapidly increasing intra-abdominal pressure. ACS can result in multiorgan failure and carries a mortality of 60~70%. The treatment of choice in ACS is surgical decompression. There are very few reports of ACS and experience in Korea. We report 12-year-old male patient who developed an abdominal compartment syndrome due to traffic-accident-induced retroperitoneal hematomas, Which was successfully treated by performing a bedside emergency surgical decompression with open linea alba fasciotomy with intact peritoneum. When patients do not respond to medical therapy, a decompressive laparotomy is the last surgical resort. In patients with severe abdominal compartment syndrome, the use of a linea alba fasciotomy is an effective intervention to lower intra-abdominal hypertension (IAH) without the morbidity of a laparotomy. Use of a linea alba fasciotomy as a first-line intervention before committing to full abdominal decompression in patients with abdominal compartment syndrome improves physiological variables without mortality. Consideration for a linea alba fasciotomy as a bridge before full abdominal decompression needs further evaluation in patients with polytrauma abdominal compartment syndrome.

INTERPOSITIONAL ARTHROPLASTY OF TEMPOROMANDIBULAR JOINT ANKYLOSIS WITH TEMPORALIS MYOFASCIAL FLAP (측두근-근막피판을 이용한 악관절 강직증의 외과적 재건)

  • Nam, Jung-Soon;Lee, Yong-Gyoo;Kwon, Tae-Geon;Kim, Jong-Bae
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.26 no.5
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    • pp.544-549
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    • 2000
  • The treatment of TMJ ankylosis poses a significant challenge because of technical difficulties and high incidence of recurrence. TMJ ankylosis has been treated by excision and total joint reconstruction with alloplastic, allogeneic, autogenous materials as interpositional materials. The temporalis myofascial flap had been considered to be a successful interpositional material, due to its anatomical, topographical, and functional properties. This study evaluated the efficacy of the temporalis myofascial flap for nine TMJs (five patients) through the preauricular approach and coronoidectomy. Radiographic and physiologic long term result was investigated in this study. The result reveals that the temporalis myofascial flap is a good autogenous tissue satisfying the criteria of an ideal interpositional material, which offers a material that fulfills the physiological function of the disc. In spite of favorable functional outcome, mild postoperative openbite tendency remains another challenge.

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