• Title/Summary/Keyword: 다발성 외상

Search Result 88, Processing Time 0.029 seconds

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
    • /
    • v.31 no.8
    • /
    • pp.804-810
    • /
    • 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).

  • PDF

Treatment of Traumatic Vascular Injury (외상성 혈관 손상의 치료)

  • 장인석;최준영;김종우;이정은;이상호
    • Journal of Chest Surgery
    • /
    • v.36 no.8
    • /
    • pp.590-594
    • /
    • 2003
  • Vascular injury has been increased with popular outside activities. However there are only a few studies for vascular trauma. We intended to find out the relationships between the vascular trauma and its prognosis. Material and Method: Forty-four patients were diagnosed and operated on for vascular injury in the Gyeongsang National University Hospital from 1992. to 1999. We reviewed their chart and analysed their data retrospectively. We studied to causes, treatments, and prognoses of traumatic vascular injury. Result: The transfer time between accident place and emergency department was mean 3,5 hour, and the operation preparing time was 8.8 hours. Five cases required amputation of extremity. All amputation cases were combined with communited bony fractures. Thirty-eight cases had combined other injuries, and almost combined injuries were muscular and neurological damages, Conclusion: The optimal treatment plan for vascular trauma was prompt diagnosis and quick management. It may decrease amputation rate and post-traumatic complications. Therefore we must be carefully evaluated the multiple traumatic patients for early diagnosis of vascular injury and operate quickly in emergency status.

Delayed Diagnosis of a Traumatic Diaphragmatic Injury (지연 진단된 외상성 횡격막 손상 1예)

  • Park, Seon-Wook;Kim, Cheol-Hong;Kim, Ji-Youn;Lee, Seung-Hwa;Kim, Young-Wook;Hyun, In-Gyu;Shin, Ho-Seung
    • Tuberculosis and Respiratory Diseases
    • /
    • v.66 no.3
    • /
    • pp.241-245
    • /
    • 2009
  • Traumatic diaphragmatic rupture is uncommon, but requires a prompt diagnosis and repair. Diaphragmatic injury is most commonly associated with automobile accidents. The diagnosis is difficult and may be delayed because there are no specific symptoms, signs, or radiographic studies that are pathognomic for diaphragmatic injury. The most important factor in the diagnosis is a high suspicion and the use of proper diagnostic studies. We report a case involving the delayed presentation of diaphragmatic rupture in a 54 year old man, requiring surgical repair 12 days following multiple blunt trauma. It should be noted that early recognition for diaphragmatic injury is important in patients with multiple trauma to avoid the potential fatal complications.

The Usefullness of Percutaneous Transarterial Embolization in Patients with Severe Multiple Traumas (다발성 손상에 의한 중증외상환자의 경피적 동맥색전술의 유용성)

  • You, In-Gyu;Lim, Cheong-Hwan
    • Journal of the Korean Society of Radiology
    • /
    • v.6 no.2
    • /
    • pp.107-114
    • /
    • 2012
  • The study was conducted in patients who had undergone angiography and arterial embolization after being diagnosed with arterial bleeding among those registered with severe trauma at the admission to the department of emergency due to accidents. In the study, comparison was done between the survived group and the nonsurvived group to investigate the usefulness and the optimal performance timing of angiography and embolization as the survival-affecting factors and treatment methods for patients. The study was performed as a retrospective analysis in 45 patients who had undergone angiography and arterial embolization among those categorized as severe trauma patients from the emergency department of H hospital located in Gyeonggi-do from July, 2006 until December, 2010. The Injury Severity Score (ISS), the Revised Trauma Score (RTS), the hematocrit were the main outcome measurements. Arterial embolization was technically successful in all cases, transcatheter arterial embolization of arterial bleeding is a useful procedure in lowering the mortality and complication in severe trauma patients. and RTS, ISS, Hematocrit were the predictable early mortality factors. So bad vital sign patients must be progressed rapidly.

The Usefullness of Percutaneous Transarterial Embolization in Patients with Severe Multiple Traumas (다발성 손상의 의한 중증외상 환자의 경피적 동맥색전술의 유용성)

  • You, In-gyu;Lim, Chung-Hwan
    • Proceedings of the Korea Contents Association Conference
    • /
    • 2011.05a
    • /
    • pp.199-200
    • /
    • 2011
  • 중증외상 환자의 사망률을 높이는 출혈의 형태에는 정맥손상으로 인한 출혈과 골절 및 장기손상에 의한 동맥손상 출혈, 골수 내 출혈이 있을 수 있는데, 이중에서 동맥손상에 의한 출혈은 진단이 지연되면 다량의 출혈로 인한 생체활력 징후가 불안정하며 사망률이 높아지는 아주 중요한 질환이다. 응급실을 내원한 중증외상 환자로 등록된 환자 중 혈관조영술을 시행 받고, 동맥 파열이 진단되어 동맥색전술을 시행 받은 환자를 대상으로 생존의 영향을 미치는 인자에 대하여 알아보고자 하며 생존 군과 사망 군을 비교하여 동맥촬영 및 색전술이 적절한 치료방법으로 유용성과 적절한 시행시점을 연구하기 위함이다.

  • PDF

Treatment of Multiple Rib Fracture and Flail Chest with Judet's Strut-105 Case REport- (다발성 늑골골절 및 Flail Chest 환자에서 Judet's strut를 이용한 수술적 고정술 105례)

  • Park, Byeong-Sun;Jo, Wan-Jae;O, Jeong-U
    • Journal of Chest Surgery
    • /
    • v.30 no.8
    • /
    • pp.803-808
    • /
    • 1997
  • There were 105 patients with multiple rib fracture or flail chest who had underwent surgical rib fixation using judet's strut from Aug. 1989 to Aug. 1995. They were 86 men and 19 women, and the age distribution was from 17 to 77(mean $48\pm12).$ The most common cause of accident was a traffic accident(81%), The mean number of rib fracture was 5.5 and the distribution of patient were flail chest(72, 64.7%), severe displaced rib Fracture(18, 17.1%), traumatic chest wall deformity(10, 95%) and others(5, 4.7%). The operative mortality was 1 patient(0.96%) and the incidence of postoperative complication were 13 patients(12.3%). The duration of perioperative artificial ventilator therapy was $90.5\pm22.6$ hours. Our method allowed shorter duration of an artificial ventiatin and decreased a functional sequelae. We find this technique to be better than previously published methods, since it provides better stabilization and immobilization of he ribs and thus obviates the need for artificial ventilation and prevents post-traumatic chest deformity.

  • PDF

Traumatic Aneurysm Involving Left Ventricle and Descending Thoracic Aorta (외상에 의해 동시에 발생한 가성 좌심실류와 하행 대동맥류의 치험1례)

  • 이서원;이계선
    • Journal of Chest Surgery
    • /
    • v.30 no.6
    • /
    • pp.617-620
    • /
    • 1997
  • Traumatic aneurysm of both the thoracic aorta and the left ventricle are extremely rare in children because it is characterized by high mortality. We report a case which we experienced recently with sucessful outcome. A Five-year-old boy had a blunt trauma by bongo bus. He had pulmonary hemorrage and pericardial effusion complicated by multiorgan failure threatening his life. Aneurysm of LV and Descending aorta were showed by 2-D echocardiogram and MRI. The atient underwent successful corrective surgery 2 and half momths after trauma, the Postoperative status of this patient was uneventful, now he is being followed up the OPD.

  • PDF

An Atypical Subtrochanteric Femoral Fracture in a Patient with Multiple Myeloma Received Zoledronic Acid: A Case Report (졸레드론산을 투여한 다발성 골수종 환자에서 발생한 비전형적 대퇴골 전자하 골절: 증례 보고)

  • Jeong, Won-Ju;Na, Sang-Bong;Cho, Hwan-Seong;Kim, Joon-Woo;Park, Il-Hyung
    • The Journal of the Korean bone and joint tumor society
    • /
    • v.18 no.2
    • /
    • pp.99-103
    • /
    • 2012
  • Little literature exists about the risk of atypical femoral fracture in patients received zoledronic acid for prevention of skeletal metastasis. We report an atypical subtrochanteric femoral fracture in a patient with multiple myeloma received zoledronic acid. The patient was treated by closed reduction and internal fixation with cephalomedullary nailing.