• Title/Summary/Keyword: 흉부 손상

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Surgical Treatment of Acute Type A Aortic Dissection in Ehlers-Danlos Syndrome (Ehlers-Danlos 증후군에서 발생한 Type A 대동맥박리의 수술적 치료)

  • Jeong, Dong-Seop;Kim, Kyung-Hwan;Ahn, Hyuk
    • Journal of Chest Surgery
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    • v.33 no.11
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    • pp.910-914
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    • 2000
  • Ehlers-Danlos 증후군 중 제4형은 다른 형들과 마찬가지로 피부 손상이 쉽게 오고, 쉽게 멍이 들고, 관절이 잘 휘어지는 등의 신체적인 특징을 가기지만 대혈관을 침범하여 때로는 치명적인 출혈을 일으키기도 한다. 아주 작은 충격이나 힘에도 혈관들이 쉽게 찢어지거나 때로는 심각한 손상을 임기 때문에 수술 적인 치료를 하는데 많은 위험이 있을 수 있고 심지어는 이득을 얻지 못하는 경우도 있다. 저자들은 Ehlers-Danlos 증후군을 동반한 급성 대동맥박리의 성공적인 수술적 치료를 보고하는 바이다.

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Esophageal Perforation Due to Pneumatic Pressure of Carbonated Beverage - Report of two cases - (탄산 가스의 팽창 압력에 의한 식도의 천공 -2례 보고-)

  • 장인석;김종우;이정은;최준영;김성호;이상호
    • Journal of Chest Surgery
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    • v.32 no.2
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    • pp.198-200
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    • 1999
  • Esophageal perforation due to the air pressure generated by forcefully evaporating gas is seldomly reported. If the diagnosis is confined to the injury of the oral cavity and the pharynx, missing the injury of the esophagus, the result may be fatal. Cases like this must be managed by early diagnosis and appropriate surgical intervention. The most important thing for early diagnosis is suspicion of esophageal injury from history and physical examination. We report two cases of esophageal pneumatic perforation caused by an explosive gas from the carbonated beverage bottle.

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Surgical Treatment for Acute Caustic Injury of the Hypopharynx, Esophagus, and Stomach -Two Cases- (하인두 및 위의 손상을 동반한 급성 부식성 식도손상의 외과적 치료)

  • Kim, Hyeong-Gon;Lee, Sam-Yun;Choe, Jong-Beom
    • Journal of Chest Surgery
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    • v.28 no.10
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    • pp.935-938
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    • 1995
  • Two cases of severe caustic injury of the hypopharynx, esophagus, and stomach are presented. Restoration of digestive continuity was accomplished by retrosternal isoperistaltic interposition of the transverse and left colon on the post-injury 73rd and 66th day respectively. The upper oro-colon continuity was made by a cervical approach, a vertical incision at the posterior hypopharyngeal wall, and interrupted one-layer sutures using 3-0 Dacron suture materials. The distal continuity was made by colojejunostomy between the transposed colon and proximal jejunum. There was no event after the operation in both cases. The posterior vertical hypopharyngotomy and hypopharyngocolostomy at the early post-injury period may be the preferred procedure to obtain normal deglutition in patients with esophageal stricture associated with hypopharyngeal injury.

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Trachea, Esophagus, and Spinal Cord Injury Caused by Stab Wound - A case report- (기관, 식도, 척수를 관통한 자상 치험 - 1예 보고 -)

  • Kim, Jong-In;Cho, Sung-Rae;Park, Eok-Sung;Kim, Hyung-Chul
    • Journal of Chest Surgery
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    • v.43 no.6
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    • pp.808-811
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    • 2010
  • Simultaneous occurrence of the trachea, esophagus, and spinal cord injuries due to stabbing is rare. The incidence is decreasing, but early diagnosis and surgical treatment is important because it can be life-threatening. We present one case of simultaneous trachea, esophagus, and spinal cord injury caused by self-stabbing complicated with paraplegia.

Surgical Treatment of Tracheobronchial Injury due to 81un1 Trauma (둔상에 의한 외상성 기도손상의 외과적 치료)

  • Lee, Seon-Hui;Gwon, Jong-Beom;Choe, Seung-Ho
    • Journal of Chest Surgery
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    • v.29 no.2
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    • pp.208-212
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    • 1996
  • From 1990 to 1994, 10 patients were treated for tracheobronchial injury due to blunt trauma. 7 injuries resulted from motor vehicle accident. Common presenting signs included subcutaneous emphysema, dyspnea and hemoptysis. The most common radiologic findings were pneumothorax, pneumomediastinum and hemothorax. The fiberoptic bronchoscopy was highly accurate method for the diagnosis. The operation method is simple closure except one patien underwent right pneumonectomy. One patient died because of respiratory distress and 9 patients recovered uneventfully and returned to normal activity. Early recognition and proper treatment of tracheobronchial injury is important.

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Clinical Characteristics of Patients with Traumatic Diaphragm Injury and Comparison of Scoring Systems as Predictors (외상성 횡격막 손상환자의 임상적 고찰과 예후 예측 인자의 유용성 비교)

  • Lee Sang Jin;Jung Jin Hee;Sohn Dong Suep;Cho Dai Yun
    • Journal of Chest Surgery
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    • v.38 no.1 s.246
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    • pp.56-62
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    • 2005
  • Because of high morbidity and mortality, traumatic diaphragm injury remains a diagnostic challenge. In this study, we evaluate that some factors and scores can be used as predictors. Material and Method: From May 1995 to June 2003, 23 patients with traumatic diaphragm injury were enrolled. We examined the clinical features of patients. RTS, TRISS, ISS and APACHE II scores for each patient are calculated for analyzing the relationship of mortality and ICU duration. Result: The study identified 15 men $(65.2{\%})$ and 8women $(34.8{\%})$. There are right sided diaphragmatic injury in 11 patients $(47.8{\%})$, left sided in 11 $(47.8{\%})$, and both sided in 1 ($0.4{\%}$). Plain X-ray, CT, upper GI contrast study and esophagogastroscopy were used as diagnostic tools. Age, hemodynamic status, early diagnosis are not associated with outcome. As prognostic factor, RTS and ISS are associated with mortality and there was negative relationship between RTS and ICU duration (r=0.737, p=0.026). Conclusion: An early diagnosis of traumatic diaphragm injury can frequently be missed in the acute trauma setting. So high index of suspicion and a careful examination are important in multiple trauma patients. An RTS can probably be used effectively as a predictor for the severity and prognosis in patients with traumatic diaphragm injury.

An Experience of Inferior Vena Caval Ligation in Traumatic Injury (하공정맥 손상의 치험 1례)

  • 이성행
    • Journal of Chest Surgery
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    • v.6 no.2
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    • pp.209-212
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    • 1973
  • Because of the. rise in the incidence of high speed automobile accident and various gun shot wound, complicated vascular injuries are becoming more frequent. Inferior vena caval injury seems to be also in high incidence, but reports in the literature were rare. because of potentially lethal. Recently we have experienced a case of inferior vena caval injury due to stab wound on the posterior aspect of the right abdomen. This was successfully treated with inferior caval ligation on the both, proximal and distal of the injured infrarenal vena cava.

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Closure of VSD in a Patient with Tracheostoma-A case report- (기관절개구가 있는 환아에서 심실중격결손증의 치험-1례보고-)

  • 김상익;박철현;박국양;오상준
    • Journal of Chest Surgery
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    • v.34 no.3
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    • pp.246-251
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    • 2001
  • 심장 탈장은 심낭을 열고 전폐절제술을 시행 후 드물게 발생되는 합병증으로 수술이 끝날때나 수술직후 발생된, 44세 남자환자에서 심낭을 열고 좌측 폐를 전절제술 후 심낭 결손부위를 인공조직으로 봉합하였다. 수술이 종료될 때 심장탈장이 발생되어 개흉에 의한 응급 복원을 시행하였으나 심한 저 산소성 뇌 손상이 발생되었다.

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기본인명구조술(1)-심폐소생술

  • Lee, Hui-Taek
    • 건강소식
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    • v.31 no.10 s.347
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    • pp.32-33
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    • 2007
  • 기본인명구조술은 의식이 없는 환자를 발견한 후 구조를 요청하고 기도유지, 구조호흡, 흉부압박을 시행하는 심폐 소생술의 초기단계이다. 이번 호에는 심정지가 의심되는 환자를 발견하였을 때의 행동요령과 심폐소생술에 대하여 알아보고자 한다. 심정지의 발생은 예측이 불가능하며 심정지가 발생한 후 4~6분이 경과하면 치명적인 뇌손상이 발생하므로 환자가 발생한 현장에서부터 목격자에 의한 심폐소생술을 시행함으로써 폐와 심장의 기능을 유지하고, 뇌의 생리학적 사망을 연장시켜 심정지 환자의 생명을 살릴 수 있다. 그러므로 환자발견 현장에서 빠른 시간 내에 심폐소생술을 시행하는 것이 중요하다. 응급의료 선진국에서는 현장에서의 빠른 응급처치로 인해 20%의 생명을 살릴 수 있는 반면, 우리나라는 4%에 불과하다.

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Traumatic Injuries of Diaphragm (외상성 횡격막 손상 -6례 보고-)

  • 윤양구
    • Journal of Chest Surgery
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    • v.27 no.3
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    • pp.255-258
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    • 1994
  • I have experienced with 6 cases traumatic injury of diaphragm from May 1991 to October 1993 at the Youngdong Hospital in Tonghae. This cases included 4 penetrating injuries and 2 nonpenetrating injuries. Associated injuries occurred 4 cases and 2 cases occurred stomach herniation. All cases, operative treatment were done. Result of this treatment cases were good. Complications included 1 early death and only 1 wound infection. Cause of death was related to associated injury.

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