• Journal of Chest Surgery
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• 제20권4호
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• pp.683-687
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• 1987

Bleeding from bone marrow after sternotomy for open cardiac surgery can be sometimes difficult to control and even lead to reoperation for hemostasis. A clinical comparative study was carried out to demonstrate the hemostatic effect of fibrin glue [Beriplast] for sternal marrow bleeding after sternotomy for open heart surgery. Postoperative blood loss was measured in two patient groups, group A included 19 patients operated upon from June to October 1987 and the fibrin glue was applied to the sternal marrow together with collagen fleece and group B consisted of 22 patients from January to May 1987 and only collagen fleece was applied without fibrin glue. There was no difference between two groups in age and sex distributions, coagulation state, method of extracorporeal circulation and operative management. The blood loss one hour after operation was 2.04 ml/hr/kg in group A and 3.55 ml/hr/kg in group B [P<0.001]. The most significant difference was observed during the first 4 hours after surgery with 1.34 ml/hr/kg versus 2.05 ml/hr/kg. over the following 20 hours the amount of drainage from the chest tubes was identical in both groups. Fibrin glue reduces blood loss after open heart surgery by local hemostasis at sternum. Our study has shown that local application of fibrin glue to sternal marrow is an effective method of controlling the sternal bleedings. No side effect or complication of fibrin glue was noted.

• 대한기관식도과학회지
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• 제18권2호
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• pp.56-59
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• 2012

Tracheo-innominate artery fistula (TIF) is a rare but catastrophic and almost always fatal complication of tracheostomy. TIF can occur anytime but is commonly present 3 to 24 days after tracheostomy. It can first manifest as massive bleeding around and through the tracheostomy tube, but it can also manifest as a small amount of blood with temporary spontaneous resolution. If TIF is suspicious, airway management and prompt surgical intervention are needed. In an 83-year-old man with CVA history 20 years earlier and who had recurrent aspiration pneumonia, tracheostomy was performed for respiratory management and ventilator support. On day 7 post-tracheostomy, the patient had bleeding from the tracheostoma. Immediate surgical exploration was performed to control the bleeding. A defect was seen at the post wall of the innominate artery. The erosive portion of the artery was sutured, but the patient died three weeks after the surgery due to rebleeding and respiratory failure. We present a patient who developed TIF after tracheostomy, with literature review.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제39권5호
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• pp.251-253
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• 2013

Inferior alveolar nerve block obtained maximum anesthetic effect using a small dose of local anesthetic agent, which also has low a complication incidence. Complications of an inferior alveolar nerve block include direct nerve damage, bleeding, trismus, temporary facial nerve palsy, and etc. Among them, the major iatrogenic complication is dental needle fracture. A fragment that disappears into the soft tissue would be hard to remove, giving rise to a legal problem. A 31-year-old woman was referred for the removal of a broken needle, following an inferior alveolar nerve block. Management involved the removal of the needle under local anesthesia with pre- and peri-operative computed tomography scans.

• Advances in pediatric surgery
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• 제3권2호
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• pp.126-132
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• 1997

Reduction of intussusception using air or oxygen has wide acceptance as an alternative to conventional hydrostatic reduction. This study was undertaken to evaluate the results and complications of air pressure enema in 948 pediatric intussusception. One hundred and twenty nine cases were operated on at the Department of Surgery, Masan Samsung Hospital from 1985 to 1996 because of air reduction failure. The success rate was 86.4 %. Twenty-one patients(2.2 %) showed perforation during air reduction. Risk prone factors of perforation were; age less than 3 months(42.9 % vs 11.1 %), duration of symptoms greater than 48 hours (66.7 % vs 33.3 %), and presence of pathologic leading point(28.6 % vs 3.7 %). Vomitting and spontaneous rectal bleeding revealed higher prediction to the complication. In nineteen cases, bowel infarction, coagulated necrosis and hemorrhage suggested that the cause of perforation was due to the preexisting strangulation. In conclusion, when doing an air pressure enema reduction, care must be taken if the patient is of a young age or the symptoms are of long duration.

• Journal of Korean Neurosurgical Society
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• 제52권6호
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• pp.547-550
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• 2012

Tracheoinnominate artery fistula is a critical complication of tracheostomy. The most important factors influencing patient outcome are prompt diagnosis, immediate control of bleeding with a patent airway, and emergency operation with or without interruption of the innominate artery. Here, we report a case of tracheoinnominate artery fistula in a 40-year-old woman with cerebrovascular accident who was successfully managed with an aorta-axillary artery bypass.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제22권1호
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• pp.86-89
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• 2019

Buried bumper syndrome is a rare but potentially severe complication of percutaneous endoscopic gastrostomy tube insertion. Though this complication is uncommon, it may lead to pressure necrosis, bleeding, perforation, peritonitis, sepsis, or death. Each case of buried bumper syndrome is unique in terms of patient comorbidities and anatomic positioning of the buried bumper. For this reason, many approaches have been described in the management of buried bumper syndrome. In this case report, we describe the case of an adolescent Caucasian female who developed buried bumper syndrome three years after undergoing percutaneous endoscopic gastrostomy insertion. We review diagnosis and management of buried bumper syndrome and describe a novel technique for bumper removal in which we use a guide wire in combination with external traction to maintain a patent gastrostomy lumen while removing the internal percutaneous endoscopic gastrostomy bumper.

• Journal of Chest Surgery
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• 제26권8호
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• pp.613-619
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• 1993

As developing surgical techniques and postoperative cares, a pneumonectomy is a relatively popular surgical method in disease which is not treated completely with other type of pulmonary resection, but a postpneumonectomy complication is a life-threatening serious problem if it occurred. We performed one hundred twenty-five cases of pneumonectomy for treatment of various causes of pulmonary diseases in Kosin Medical College during about ten years, and we experienced 41 cases of postoperative complications in 29 patients, so we analyzed them. The most common complication is an empyema thoracis in 13 cases[10.4%], of which one case combined with bronchopleural fistula died on early postoperative day. Of them except one case, the early postoperative empyema thoracis[within 30 days] were 6 cases, and the late postoperative empyema thoracis[above 30 days] were 6 cases. The main etiologic pathogens were a staphylococcus in early postoperative empyema and a streptococcus in late postoperative empyema, but the most cases were mixed infections with pseudomonas, klebsiella, acinectobacter, and candida. The treatment of postoperative empyema thoracis were that 4 cases were treated with open drainage using chest tube, 7 cases with Clagett`s operation, and 1 case with thoracoplasty. The next common complication was a postoperative serious respiratory insufficiency in 7 cases. And the other complications were massive postoperative bleeding in 5 cases, of which 2 cases advanced to occurrence of postoperative empyema thoracis, and wound disruption in 4 cases, cardiac arrhythmia in 3 cases, contralateral pneumothorax and pneumonia in each of 2 cases, esophagopleural fistula in 1 case. The postoperative deaths were 9 cases[7.2%] of 125 cases, the causes of death were respiratory insufficiency in 6 cases, sepsis in 2 cases, and cardiac arrhythmia in 1 case.

• Journal of Trauma and Injury
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• 제27권2호
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• pp.33-37
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• 2014

Central venous catheterization through a subclavian approach is indicated for some special purposes but it may cause many complications such as infection, bleeding, pneumothorax, thrombosis, air embolization, arrhythmia, myocardial perforation, and nerve injury. A case involving a mistaken central venous catheterization into the right vertebral artery through the subclavian artery is presented. A 33-year-old man who had deteriorated mentality after head injury underwent an emergency craniotomy for acute epidural hematomas on the right frontal and temporal convexities. His mentality improved rapidly, but he complained of continuous severe pain in the right posterior neck even though he had no previous symptom or past medical history of such pain. Three-dimensional cervical spine computed tomography (3D-CT) was performed first to rule out unconfirmed cervical injuries and it revealed a linear radiopaque material intrathoracically from the level of the 1st rib up to the level of C6 in the right vertebral foramen. An additional neck CT was performed, and the subclavian catheter was indwelling in the right vertebral artery through right subclavian artery. For the purpose of proper fluid infusion and central venous pressure monitoring, the subclavian vein catheterization had been performed in the operation room after general anesthesia induction before the craniotomy. Sufficient anatomical consideration and prudence is essential because inadvertent arterial cannulation at a non-compressible site is a highly risky iatrogenic complication of central venous line placement.

• Journal of Chest Surgery
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• 제25권4호
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• pp.418-423
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• 1992

Tracheo-innominate artery fistula[TIF] is the uncommon delayed fatal complication of tracheostomy. The mortality rate of the lesion, if not treated surgically, approaches 100%. A 64-year-old man presenting with a TIF after tracheostomy was treated by lateral repair and muscle interposition between the innominate artery and trachea. Preoperatively, bleeding was controlled by gauze packing around the tude under manual compression and hyperinflation of the balloon cuff of the tracheostomy tube. No abnormality was found by angiographic evaluation. The patient failed to regain consciousness and died 4 days later from sepsis.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제13권1호
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• pp.1-6
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• 2010

The small bowel is the most difficult intestinal segment to examine. Radiologic tests are mostly insensitive and double-balloon enteroscopy is unsuitable for the younger child. Capsule endoscopy is a novel wireless method of investigation of the small bowel. The primary indications for capsule endoscopy include evaluation of obscure gastrointestinal bleeding, small bowel Crohn's disease, and polyposis syndromes. Capsule endoscopy offers an accurate and effective means of investigating the small bowel in children. Capsule retention is a potential complication of capsule endoscopy. This review provides the indications, safety, and limitations of wireless capsule endoscopy in children.