• Title/Summary/Keyword: 혈종제거술

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Comparison of Pain, Sense, Bleeding and Hematoma Depending on the Process of Air Elimination of Pressure Band after Percutaneous Coronary Intervention through Radial Artery (요골동맥을 통한 경피적 관상동맥 중재술 후 압박밴드의 공기제거 방법에 따른 통증 강도, 통증 감각, 출혈 및 혈종 비교)

  • Kim, Mi Seok;Oh, Ji Seon;Cho, Hye Young
    • Journal of Korean Clinical Nursing Research
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    • v.18 no.2
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    • pp.275-283
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    • 2012
  • Purpose: This study was conducted to compare pain, sense, bleeding, and hematoma that patients feel depending on the process of eliminating air of pressure band that was applied to patients after percutaneous coronary intervention (PCI) through radial artery. Methods: It was a nonequivalent control group pretestposttest design to compare pain, sense, bleeding, and hematoma by amount and time of eliminating air of pressure band after PCI through radial artery. Results: On arrival at Coronary Care Unit, meaningful difference didn't exist between pain and sense, however, after two hours of starting eliminating air, the points of pain and sense were meaningfully low (p<.001). Also, there was meaningful difference in reciprocal action between group and time (p<.001). Conclusion: After PCI, the conclusion showed there is positive effect in decreasing wrist pain and sense without any influence of bleeding by eliminating air from patients' pressure bands.

Analysis of Medical Decisions related to Epidural Hematoma after Spinal Surgery -Focusing on the Lumbar MRI- (척추 수술 후 발생한 경막외 혈종 관련 의료 판결 분석 -요추 MRI 시행 여부를 중심으로-)

  • Lee Dongjin
    • The Korean Society of Law and Medicine
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    • v.25 no.1
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    • pp.61-86
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    • 2024
  • The purpose of this study was to investigate the importance of continuous and detailed follow-up of patients after spinal surgery by reviewing the literature on epidural hematoma and the lower court ruling on lumbar MRI during the judgment on the negligence of postoperative follow-up. In the case of neglecting MRI examination or cooperation after surgery, delaying MRI examination after pain and symptom appeal after surgery, and returning home immediately after neurological symptom development after surgery, negligence in progress observation was recognized. In the case of the case where the negligence was not recognized even after the occurrence of the aftereffects by taking measures against the symptoms, and the case where the scope of the doctor's discretion for the execution of the test was recognized, It is hoped that this study will help prevent medical accidents and disputes related to follow-up after spinal surgery by increasing awareness of the importance of prompt MRI examination, diagnosis, surgical treatment, and power, especially in the case of new neurological symptoms.

Multiple External Carotid Artery Aneurysms with Neurofibromatosis - Case Report - (신경섬유종을 동반한 다발성 외경동맥 동맥류 - 증 례 보 고 -)

  • Pyo, Sae Yeong;Kim, Moo Seong;Sim, Hong Bo;Lee, Sun Il;Jung, Yong Tae;Kim, Soo Chun;Sim, Jae Hong
    • Journal of Korean Neurosurgical Society
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    • v.29 no.9
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    • pp.1248-1254
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    • 2000
  • Multiple external carotid artery aneurysms with neurofibromatosis are rare. Trauma is the primary cause in the development of aneurysms of the external carotid artery. A 39-year-old female patient was referred to the emergency room because of a headache and a huge lump over the left temporo-parieto-occipital region. The physical examination revealed a huge round mass, $5{\times}15{\times}18cm$, in the left temporo-parieto-occipital region and low set left ear and multiple caf au lait spots in trunk and extremities. The external carotid artery angiography demonstrated multiple aneurysms arising from the superficial temporal artery and occipital artery. A MRI showed a huge hematoma on temporo-parieto-occipital region and postauricular mass suggested of subcutaneous neurofibroma. Embolization followed by surgical resections of those aneurysms and neighboring mass were performed and good result was obtained. We report our case with review of literature.

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Soft Tissue Sarcomas Presented with Hematoma (혈종을 동반한 연부 조직 육종)

  • Chung, Yang-Guk;Kang, Yong-Koo;Bahk, Won-Jong;Rhee, Seung-Koo;Lee, An-Hi;Park, Jeong-Mi;Cho, Hyun-Min
    • The Journal of the Korean bone and joint tumor society
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    • v.14 no.2
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    • pp.163-171
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    • 2008
  • Purpose: We analyze the characteristics of soft tissue sarcomas presented with hematoma, which were misdiagnosed as simple hematoma initially and the proper management were delayed. Materials and Methods: The 7 patients with histologically proven soft tissue sarcoma with hematoma presented since February 1997 were evaluated retrospectively. Neither patient had a medical history of bleeding tendency nor anticoagulant therapy. Two of them had minor traumas. There were 2 men and 5 women. Average follow up period was 58 months. MRI findings, provided treatments and oncologic outcome were reviewed with the reference of related articles. Results: Retrospective review of initial MR images revealed deep seated intramuscular masses with focal solid enhanced nodules at the peripheral margin. The diagnoses were delayed at least 1 month in 3 of them which included 2 cases of simple hematoma evacuation without biopsy initially. After histologic diagnosis of soft tissue sarcoma, wide resections were performed in 4 cases. one patient underwent above knee amputation and the remained 2 patients were managed with wide resection followed by amputation due to local recurrence. At last follow up there were CDF and NED in 2 cases, respectively and AWD in 3 cases. Conclusion: To avoid the delay of diagnosis and treatment of soft tissue sarcomas presented with hematoma, high degree of clinical suspicion, careful analysis of MR images and early biopsy were important.

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The Utility of Fibrin Sealant and Safety of Thyroid Surgery without Drainage (배액관을 삽입하지 않은 갑상선수술의 안전성과 섬유소응고제의 유용성)

  • Lee, Kyeng-Suk;Youn, Jin;Kim, Mun-Jun;Yang, Yun-Su;Hong, Ki-Hwan
    • Korean Journal of Head & Neck Oncology
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    • v.28 no.1
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    • pp.8-11
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    • 2012
  • 배경 및 목적 : 섬유소 응고제(fibrin sealants)는 다양한 두경부수술에서 지혈목적으로 사용되고 있다. 본 연구의 목적은 배액관을 삽입하지 않는 갑상선 수술에서 섬유소 응고제의 효용성과 안정성을 알아보고자 하였다. 재료 및 방법 : 최근 1년간 108명의 갑상선 수술환자 중에서 수술 후 배액관의 삽입없이 수술을 받은 103명의 환자를 대상으로 하여 임상적인 특징을 분석하였다. 결과 : 103명의 대상환자 중에서 남성은 16예, 여성은 87예였다. 대상환자의 평균연령은 $46.7{\pm}13.0$세였고, 연령분포는 17세에서 72세였다. 갑상선 종물의 평균크기는 $2.08{\pm}1.61cm$였고, 종물의 크기는 최소 0.2cm에서 최대 10.0cm까지의 분포를 보였다. 수술에는 갑상선 엽절제술이 5예, 갑상선반절제술이 41예, 아갑상선 절제술이 8예, 갑상선 전절제술이 6예, 갑상선 전절제술과 중심경부림프절 절제술이 37예, 갑상선 전절제술과 선택적경부림프절 절제술이 6예가 있었다. 수술 후 합병증은 11예(10.6%)에서 발생하였고, 발생한 합병증으로는 장액성종창이 3예, 혈종이 1예, 일측성 성대마비가 3예, 저칼슘혈증이 4예 있었다. 성대마비는 수술 후 3개월 이내에 모두 호전되었고, 장액성 종창은 반복적인 세침흡인으로 호전되었다. 1예의 혈종은 지연성으로 발생하였고, 수술 후 5일째에 수술을 통해 제거하였다. 결론 : 이러한 결과에 근거하여 갑상선 수술에서 섬유소 응고제의 사용은 다양한 갑상선 수술에서 효과적인 지혈과 함께 안전하게 사용될 수 있으며, 배액관의 삽입을 감소시켜 줄 수 있을 것으로 생각된다.

Percutaneous Lateral Release and Medial Reefing for Recurrent Patellar Dislocation (재발성 슬개골 탈구의 경피적 외측부 유리술 및 내측부 중첩술)

  • Choi, Chong-Hyuk;Oh, Kyung-Soo;Kim, Hyoung-Sik
    • Journal of the Korean Arthroscopy Society
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    • v.10 no.1
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    • pp.33-38
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    • 2006
  • Purpose: This study seeks to address the results of percutaneous lateral release and medial reefing for patients with recurrent patellar dislocation. Materials and Methods: This paper focuses on 27 cases from 25 patients who had a surgical operation at our hospital in a span of eight years and six months from the time of December 1996 to May 2005. The subjects consist of 11 males and 14 females, and their average age was 22.2 years old. All the patients had their trauma history, and the average frequency of dislocation before surgery was 11.5 times. Results: The congruence angle before operation was 23.3 degree on the average, while the lateral patellofemoral angle was -5.7 degree on average. However, the congruence angle after surgery came to -2.4 degree, while the lateral patellofemoral angle recovered to the normal range of within 11.5 degrees. Four cases showed the recurrent dislocation, and two out of those four cases had -35, -12 degrees of their lateral patellofemoral angle respectively and 59, 14 degrees of their congruence angle respectively. Conclusion: Using percutaneous lateral release with medial reefing can be considered as an effective treatment for recurrent patellar dislocation

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Ascending Aortic Dissection Late After Aortic Valve Replacement (대동맥 판막 치환술 후 만기에 발생한 상행 대동맥 박리증)

  • 오정훈;이동협;이정철;정태은;이장훈;한승세
    • Journal of Chest Surgery
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    • v.34 no.8
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    • pp.630-633
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    • 2001
  • Central anticholinergic syndrome is defined as an absolute or relative reduction in cholinergic activity in the central nervous system and has a wide variety of manifestations. It is associated with almost any drug given during anesthesia, except neuromuscular relaxants, and treated with the cholinesterase inhibitor physostigmine. The diagnosis of central anticholinergic syndrome is often made when symptoms resolve promptly after the administration of physostigmine. We present a case of a central anticholinergic syndrome diagnosed by treatment with physostigmine, in a patient who received closure of patent foramen ovale associated with stroke.

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A Choledochal Cyst Associated with Hemorrhagic Tendency and a Cerebral Hematoma -Report of a case and review of literature- (두강내 출혈 및 출혈성 경향을 동반한 선천성 담관 낭종 -1예 보고와 문헌보고-)

  • Park, Young-Bok;Lee, Myung-Wo;Kim, Hong-Jin;Kwun, Koing-Bo
    • Journal of Yeungnam Medical Science
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    • v.2 no.1
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    • pp.299-306
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    • 1985
  • Congenital dilatation of the common bile duct is relatively rare anomaly. Its pathogenesis has not been completely understood. Complications of the choledochal cyst are mainly suppurative cholangitis, liver cirrhosis, stone formation, malignant change, bile peritonitis due to spontaneous and traumatic rupture. We experienced one case of choledochal cyst associated with hemorrhagic tendency and a cerebral hematoma, which is extremely rare complication. The 3 monthes old male patient reported here was treated with complete excision of cyst and Roux-en-Y choledochojejunostomy after correction of bleeding tendency and removal of crebral hematoma. Postoperative course was relatively uneventful, 11 days after operation, the patient was discharged with full improvement.

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Reverse Superficial Sural Artery Flap for the Reconstruction of Soft Tissue Defect Accompanied by Fracture of the Lower Extremity (하지 골절과 동반된 연부조직 결손 재건을 위한 역행성 비복동맥 피판술)

  • Han, Soo-Hong;Hong, In-Tae;Choi, SeongJu;Kim, Minwook
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.3
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    • pp.253-260
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    • 2020
  • Purpose: Soft tissue defects of the distal lower extremity are commonly accompanied by a fracture of the lower extremities. Theses defects are caused by the injury itself or by complications associated with surgical treatment of the fracture, which poses challenging problem. The reverse superficial sural artery flap (RSSAF) is a popular option for these difficult wounds. This paper reviews these cases and reports the clinical results. Materials and Methods: Between August 2003 and April 2018, patients who were treated with RSSAF for soft tissue defects of the lower third of the leg and ankle related to a fracture were reviewed. A total of 16 patients were involved and the mean follow-up period was 18 months. Eight cases (50.0%) of the defects were due to an open fracture, whereas the other eight cases (50.0%) were postoperative complication after closed fracture. The largest flap measured 10×15 cm2 and the mean size of the donor sites was 51.9 cm2. The flap survival and postoperative complications were evaluated. Results: All flaps survived without complete necrosis or failure. One case with partial necrosis of the flap was encountered, but the wound healed after debridement and repair. One case had a hematoma with a pseudoaneurysmal rupture of the distal tibial artery. On the other hand, the flap was intact and the wound healed after arterial ligation and flap advancement. A debulking operation was performed on three cases for cosmetic reasons and implant removal through the flap was performed in three cases. No flap necrosis was encountered after these additional operations. Conclusion: RSSAF is a relatively simple and safe procedure for reconstructing soft tissue defects following a fracture of the lower extremity that does not require microsurgical anastomosis. This can be a useful treatment option for soft tissue defects on the distal leg, ankle, and foot.

The Role of Endoscopy for Tumorous Conditions of the Upper Gastrointestinal Tract in Children (내시경으로 진단된 소아 상부 위장관의 종양성 질환에 대한 고찰)

  • Kim, Hye Young;Park, Jae Hong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.8 no.1
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    • pp.31-40
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    • 2005
  • Purpose: This study aimed to provide, as a basic material, the experiences of endoscopy in diagnosis and treatment of tumorous conditions in the upper gastrointestinal tract in children. Methods: The objects were 26 patients diagnosed as having tumorous conditions in the upper gastrointestinal tract among 1,283 patients who underwent upper gastrointestinal endoscopic examination at the Department of Pediatrics, Pusan National University Hospital, from January 1994 to July 2004 retrospectively. The characteristics of patients, the chief complaints for endoscopic examination, the sorts of tumors diagnosed, the endoscopic findings of tumors, and the treatment of tumors were analysed. Results: 1) Eleven male and fifteen female were included, whose mean age was $6.93{\pm}4.02years$. 2) The chief complaints for endoscopic examination were abdominal pain (80.7%), vomiting or nausea (30.8%), and gastrointestinal beeding (30.7%) in order. 3) Six cases of ectopic pancreas, five cases of sentinel polyp, three cases of papilloma and vallecular cyst, two cases of Brunner's gland hyperplasia and gastric submucosal tumor, one case of gastrointestinal stromal tumor, duodenal intramural hematoma, T cell lymphoma, lipoma, and Peutz-Jeghers syndrome were diagnosed by endoscopy with or without biopsy. 4) The location of tumors was in the pharynx (19.2%), esophagus (7.7%), gastro-esophageal junction (23.0%), stomach (30.7%) and duodeneum (26.9%). 5) The size of tumors was less than 10 mm in 53.8%, 10~20 mm in 26.9%, more than 20 mm 19.2%. 6) Treatments for tumors included resection by laser, surgical resection, endoscopic polypectomy with a forcep or snare, and observation 7) There was no significant complication. Conclusion: Various and not a few tumors were found in the upper gastrointestinal tract. The endoscopy was accurate, effective, and safe means for diagnosis and treatment of those lesions in children.

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