• Journal of Chest Surgery
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• v.43 no.2
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• pp.188-190
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• 2010

Sternal fracture is relatively common after blunt chest trauma, and this usually resolves without complication. But acute extrapericardial tamponade caused by sternal fracture and injury to the internal mammary artery secondary to blunt chest trauma is very rare. We report here on two cases of acute extrapericardial tamponade that were caused by blunt chest trauma.

• Journal of Chest Surgery
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• v.39 no.5 s.262
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• pp.411-414
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• 2006

Innominate artery injury by blunt chest trauma is rarely reported. This report describes a 40-year-old male who had innominate artery dissection and pseudoaneurysm caused by blunt chest trauma and was treated successfully by ascending aorta to innominate artery bypass graft. The patient recovered without any complications and was discharged one week after the operation.

• Journal of Chest Surgery
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• v.34 no.3
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• pp.264-269
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• 2001

흉부 둔상에 의한 기도와 식도의 동시적 파열상은 매우 드물게 발생되고 있다. 그러나 최그들어 고속 교통사고의 증가와 환자에 대한 응급체계의 발전으로 점차 치험 보고례가 증가되고 있다. 저자들은 흉부의 둔상에 의하여 기도와 식도에 종적으로 긴 파열상을 입은 환자 2례의 치험을 보고한다. 1례는 이전 병원에서 시행한 기관식도 재건술이 실패한 상태에서 전원되어와 2차적으로 식도절제 및 기관재건술을 실시하였으나 사망하였고. 다른 1례는 식도절제 및 기도재건술로 합병증이 없이 생존하였다.

• Journal of Chest Surgery
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• v.40 no.3 s.272
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• pp.228-231
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• 2007

Chest trauma can lead to various cardiac complications ranging from arrythmia to myocardial rupture. Coronary artery injury in patients with blunt chest trauma is rare, and traumatic aneurysm of the left coronary artery is even more unusual than right coronary artery. Injury to the coronary arteries, including intimal aneurysm, dissection, laceration, arteriovenous fistula and thrombosis, are sequelae that rarely occur after a blunt trauma. Occlusion of the coronary artery results is a serious complication for the patient via acute myocardial infarction, We report here on a case of acute myocardial infarction with coronary artery aneurysm that arose from blunt chest trauma in a 33-year-old male, and he was successfully managed by a coronary bypass graft without performing cardiopulmonary bypass.

• Journal of Chest Surgery
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• v.36 no.8
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• pp.627-629
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• 2003

The pneumopericardium following blunt chest trauma is exceedingly unusual. A patient was admitted to the emergency room after a motorcycle accident. Pneumopericardium and left pneumothorax were not detected on initial chest AP, but they were detected on chest computed tomograpy and resolved completely after chest tube insertion into the left pleural space.

• Journal of Chest Surgery
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• v.43 no.6
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• pp.804-807
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• 2010

Blunt bronchial injuries rarely occur in children. This can be a life threatening condition and respiratory management is important for successful treatment. We present here a pediatric patient who had traumatic bronchial transection with difficult airway management. Surgical treatment was carried out under ventilatory support using extracorporeal membrane oxygenation (ECMO) in the emergency room. During the application of ECMO, systemic heparization was unnecessary and. there were no thrormbotic complications. In conclusion， ventilatory SUpport using ECMO is useful for treating selected patients with blunt trauma regardless of using heparin.

• Journal of Chest Surgery
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• v.42 no.2
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• pp.226-232
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• 2009

Background: Blunt chest trauma accounts for 90% of all chest traumas in Europe and the United States and this causes 20% of all trauma-related deaths. The major cause of morbidity and mortality after blunt chest trauma is undetected injuries. For this reason, chest computerized tomography has gained popularity for the evaluation of trauma, but it is expensive and it exposes patients to radiation. This study identified the clinical features associated with the diagnosic information obtained on a CT chest scan, as compared with a standard chest X-ray, for patients who sustained blunt trauma to the chest. This study also evaluated the role of a routine computed tomographic (CT) scan for these patients. The patients who had chest computed tomography done after the initial chest x-ray were analyzed separately for the presence of occult injuries. Material and Method: We studied 100 consecutive patients from November 2006 to July 2007: 74 patients after motor vehicle crashes and 26 patients after a fall from a height >2m. Simultaneous with the initial clinical evaluation, an anteroposterior chest radiograph and a helical chest CT scan were obtained for all the patients. The data extracted from the medical record included the vital signs, the interventions and the type and severity of injury (RTS). Result: Among the 100 cases, 79 patients showed at least more than one pathologic sign on their chest radiograph, and 21 patients had a normal chest radiograph. For 17 of the patients who had a normal chest X ray, the CT scan showed multiple injuries, which were pneumothorax, hemothorax, lung contusion, sternal fracture etc. This represents that a CT scan is statistically superior to a chest radiograph to diagnose the pathologic signs. But on the other hand, as for treatment, only 31 patients were diagnosed by CT scan and they were treated with chest tube insertion ect. 42 patients needed ony conservative management without invasive thoracosurgical treatment such as chest tube insertion or open thoracotomy. 27 patients were treated based on the diagnosis made by the chest radiograph and physical examination. Conclusion: Chest computerized tomography was significantly more effective than routine chest X-ray for detecting lung contusion, pneumothorax and mediastinal hematoma, as well as fractured ribs, scapula and, sternum. Although the occult findings increased, the number of patients who needed treatment was small. Therefore, we suggest making selective use of a CT scan to avoid its overuse in ERs.

• Journal of Chest Surgery
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• v.34 no.2
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• pp.173-175
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• 2001

흉부둔상에 의한 심장파열은 50% 이상의 치사율을 갖는 질환으로 응급실에 도착하기 전에 사망하는 경우가 대부분이다. 일반적으로 전형적인 심장압전을 동반하기 때문에 이학적 소견이나 심장초음파 또는 흉부전산화 단층촬영으로 진단이 가능하다. 그러나 저자의 경우와 같이 심장압전의 징후가 없이 중증 우측혈흉만 있는 경우 심장파열을 진단하는 것은 어렵다. 만약 고속의 자동차사고로 인한 흉부둔상을 받은 환자에서 늑골골절이 없이 우측에 중증의 혈흉이 있어 응급개흉술을 받아야 한다면 심장파열의 가능성을 염두에두고 수술을 계획하는 것이 필요하다고 생각한다. 본 인하대학교 흉부외과학 교실에서는 흉부둔상에 의한 중증우측 혈흉과 심낭파열을 동반한 심장파열 2례를 심패바이패스와 자가수혈 장치를 이용하여 효과적으로 치료하였기에 보고하는 바이다.

• Journal of Chest Surgery
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• v.31 no.3
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• pp.255-261
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• 1998

A clinical evaluation was performed on 11 cases of the cardiac rupture by blunt chest trauma at the department of thoracic and cardiovascular surgery, Yeungnam University Hospital during the period from July, 1993 to May, 1995. The results were as follows ; The sex distribution was 8 mem and one women, and mean age was 41 years old. The causes of accident was traffic accident in most cases. And then one case was cultivator accident and another one was fall down. The average times from trauma to admission was 139 minutes and the patients that transferred via other hospitals have relatively long average times to 227 minutes. The average times from admission to operation was 117 minutes and we consumed 25 minutes for the preoperative preparation. The sites of injury were 7 cases in the right heart and 3 cases in the left heart. There were symptoms and signs of the cardiac tamponade(dyspnea, chest pain, nausea/vomitus, neck vein distention & hypovolemic shock) at admission and in most of them typical symptoms and signs of a tamponade appeared. Surgical approach was performed with median sternotomy in 10 cases. Subxiphoid pericardial window was created in one case. Another case which was very difficult in surgical procedure was operated under cardiopulmonary bypass and the result was good.

• Journal of Chest Surgery
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• v.41 no.5
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• pp.633-635
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• 2008

Cardiac rupture after blunt chest trauma is a relatively uncommon diagnosis, and it is associated with a very high mortality rate. A 41-years-old man crashed his car into a guardrail and he was then transported to hospital. Although unstable vital signs are the most common symptoms of cardiac injury, this patient had stable vital signs. The chest CT scan showed pericardial effusion, and echocardiography did not clearly reveal cardiac tamponade, but the right atrium was slightly collapsed. Cardiac injury was suspected, and surgery was commenced for obtaining the diagnosis and treatment. A 2cm laceration at the junction of the left atrium and the lefl inferior pulmonary vein was discovered and this was repaired with $4{\sim}0$ Polypropylne monofilament sutures. We report here on the successful management of a patient with left atrial rupture following blunt chest trauma.