• Journal of Chest Surgery
• /
• 제13권1호
• /
• pp.52-59
• /
• 1980

Twelve cases of traumatic diaphragmatic injuries were treated at the Chosun University Hospital from Feb. 1977 to Inn. 1980. The following results were obtained. l. Sex ratio incidence was 5:1, which male patients were predominant. 2. The age distribution at these cases, were ranged from 16 to 43 years of age, and average age was 27 years. 3. Left sided traumatic diaphragmatic injuries were far more common than right, which approximately incidence of 5:1 diaphragmatic injuries were due to blunt trauma [7 cases-traffic accident, 1 case-fall down], and stab wound [4 cases] in etiology. 4. Surgical repairs were done through only thoracotomy incision in blunt trauma cases, and through each thoracic and abdominal incision same time in 2 cases of stab wound. 5. 2 cases {16.7%] of blunt trauma were died before operation at emergency room, and no man died during or following operation. An overall mortality was 16.7%.

• Journal of Chest Surgery
• /
• 제27권2호
• /
• pp.148-152
• /
• 1994

We have experienced 21 cases of traumatic diaphragm injury between October, 1989 and September, 1993. Of these patients, 17 cases were caused by blunt trauma and 4 by penetrating injury. Among 17 blunt traumas, 10 cases developed at left side, 6 at right and 1 at central subpericardial diaphragm, and among penetrating injuries, 3 cases developed at right side and 1 at left. Overall mortality rate was 21% and one due to blunt trauma was 29%. Initial hypotension was a predisposing factor to presume future death. When associated injuries involved 4 or more organs, mortality rate was high.

• Advances in pediatric surgery
• /
• 제2권2호
• /
• pp.94-99
• /
• 1996

The management of twenty-two children with blunt abdominal trauma was analyzed. Nineteen cases had intraabdominal injuries; involving the spleen in 7 cases, the liver in 5, the pancreas in one and the bladder in one. There were five case multiple intraabdominal organ injuries. Seventeen out of 19 patients were treated non-operatively, but one was operated upon later because of delayed bleeding. Thirteen patients required transfusion in the non operated group, the mean values of the Pediatric Trauma Score (PTS) was 11.3. The mean lowest hemoglobulin(LHb) was 9.1 g/dL. The mean value of three cases with extraabdominal injuries were 9.0 and 8.3 g/dL respectively. The average amount of transfusion was 17.3 ml/kg. In the operated group, 2 cases were transfused an average of 139.8 ml/kg and their mean PTS was 5 and LHb was 6.6 g/dL. In one out of 16 non-operated cases, intrahepatic hematoma developed and but resolved conservatively. However, two out of 3 operated cases suffer complications such as an intubation granuloma and an intraabdominal abscess with wound dehescence. In conclusion, non-operative management in child with blunt abdominal trauma was safe in Grade I and II solid organ injuries. The decision for operation should be based on the hemodynamic stability after initial resuscitation including transfusion.

• Journal of Chest Surgery
• /
• 제28권12호
• /
• pp.1167-1173
• /
• 1995

We evaluated fifty three cases of traumatic diaphragmatic injuries that we have experienced from Jan.1973 to Oct.1994. The age distribution of the pateint was ranged from 1 to 74 years. Sex ratio is 39:14 with male dominence. The traumatic diaphragmatic injuries were due to blunt trauma in 37[Left 22, Right 15 cases and penetrating trauma in 16[Left 9, Right 7 cases. In blunt trauma, Preoperative diagnosis of the diaphragmatic injuries was possible in 27 patients[72% , and in penetrating trauma, 14 patients[88% . Among 37 in blunt traumas, 22[58% cases, and among 16 in penetrating traumas, 13[88% cases were operated within 24 hours. The most common herniated abdominal organ in the thorax was stomach[14/53 . The traumatic diaphragmatic repair of 50 cases were performed by thoracic approach in 23 cases, thoracoabdominal approach in 8 cases and abdominal approach in 19 cases, and in 3 cases, not operated. Hospital mortality [including not operated patients[3 was 17%[9/53 and the causes of death were intracranial hematoma[1 , hypertensive encephalopathy[1 and asphyxia[1 , and among operated patients[6 , combined head injury[2 , multiorgan failure[2 , hypovolemic shock[1 , and pulmonary edema & renal failure[1 . All deaths had related to the severity of associated injuries.

• Journal of Trauma and Injury
• /
• 제25권4호
• /
• pp.296-299
• /
• 2012

The aorta is the most common major thoracic artery injured by blunt chest trauma. Injuries to major aortic arch branch arteries can also occur but are much less common than aortic injuries in the setting of blunt trauma. Although internal mammary artery (IMA) injury is uncommon and rarely diagnosed in cases of blunt chest trauma, it is one of the important sources of bleeding in chest trauma. IMA bleeding can cause ongoing blood loss and may lead to serious conditions such as extensive hemothorax, anterior mediastinal hematoma or its catastrophic complication, cardiac tamponade. However such arotic and branch artery injuries are not easily detected by plain radiograph, and are detected indirectly because of associated mediastinal hematoma. Herein, we report a case of IMA injury caused by blunt chest trauma secondary to pedestrian traffic accident. The injured patient was successfully treated by transcatheter arterial embolization (TAE).

• Journal of Chest Surgery
• /
• 제50권5호
• /
• pp.407-410
• /
• 2017

Traumatic chylothorax after blunt chest trauma alone is considered rare. Our patient was a 27-year-old female who was in a motorcycle accident and sustained blunt thoracic and traumatic thoracic aortic injuries with T1-T2 vertebral subluxation. She underwent thoracic endovascular aortic repair from T4 to T9 without any thoracic or spinal surgery. On postoperative day 7, the drainage from her left chest turned into a milky-white fluid indicative of chyle leakage. The patient was treated conservatively for 2 weeks and then the chest drain was safely removed. The results show that traumatic chylothorax can be successfully managed with conservative treatment.

• Journal of Chest Surgery
• /
• 제27권8호
• /
• pp.643-649
• /
• 1994

We evaluated sixteen patients of traumatic diaphragmatic injuries that we have experienced from Jan. 1987 to Aug 1993. Age was ranged from 6 to 71 years, predominantly in the fourth and fifth decades. 13 were male and 3 were female, a ratio of 4.3: 1. Blunt trauma was develped in 11 [Lt 7, Rt 4], penetrating trauma in 5 [Lt 2, Rt 3]. Preoperative diagnosis of diaphragmatic injury was possible in 8 patients [72.2 %] in blunt trauma, and 1 patient [20 %] in penetrating trauma. 8 cases[54.5%] in blunt trauma, and 4 cases in penetrating trauma were treated within 24 hours,meanwhile, patients treated after 10 days were 3, all by blunt trauma.The repair of 16 cases were performed with thoracic approach in 4 cases, thoracoabdominal approach in 3 cases, and abdominal approach in 9 cases. The herniated organs in thorax were stomach [5], colon [3], liver [2], and pancreas [1]. Postoperative complication were developed in 9cases[56.3%] significantly related with delayed operation time [p < 0.01 ]. Hospital mortality was 12.5 % [2/16], and the causes of death were hypovolemic shock in one and hepatic failure due to portal vein rupture in another.

• Journal of Chest Surgery
• /
• 제48권3호
• /
• pp.214-216
• /
• 2015

Blunt abdominal trauma may cause peripheral vascular injuries. However, blunt abdominal trauma rarely results in injuries to the external iliac and common femoral arteries, which often stem from regional bone fractures. Here, we present the case of a patient who had experienced trauma in the lower abdominal and groin area three months before presenting to the hospital, but these injuries did not involve bone fractures and had been managed conservatively. The patient came to the hospital because of left lower leg claudication that gradually became severe. Computed tomography angiography confirmed total occlusion of the external iliac and common femoral arteries. The patient underwent femorofemoral bypass grafting and was discharged uneventfully.

• Advances in pediatric surgery
• /
• 제3권1호
• /
• pp.32-40
• /
• 1997

A clinical review was done of 31 children with blunt liver injury who were admitted to the Department of Surgery, Kyungpook National University Hospital between 1981 and 1990. Seventeen of the 31 children required laparotomy(11 primary repairs, 4 lobectomies, 2 segmentectomies). There were two deaths after laparotomy, one due to associated severe head injury and another due to multiorgan failure. The remaining 14 children, who were hemodynamically stable after initial resuscitation and who did not have signs of other associated intraabdominal injuries, were managed by nonoperative treatment. Patients were observed in a pediatric intensive care unit for at least 48 hours with repeated abdominal clinical evaluations, laboratory studies, and monitoring of vital signs. The hospital courses in all cases were uneventful and there were no late complication. A follow-up computed tomography of 7 patients showed resolution of the injury in all. The authors believe that, for children with blunt liver injuries, nonoperative management is safe and appropriate if carried out under careful continuous surgical observation in a pediatric intensive care unit.

• Journal of Trauma and Injury
• /
• 제25권3호
• /
• pp.105-108
• /
• 2012

Chyloperitoneum or chylous ascite after trauma is a rare condition. It can develop after direct injuries of lymphatic vessels or cisterna chyli. Though isolated chyle duct injury has sometimes been reported, chyloperitoneum is generally accompanied by various kinds of damage to other intraabdominal organs. There's still no established therapeutic protocol regarding the treatment of chyloperitoneum when it is accompanied by the serious injuries of intraabdominal organs. We describe a 66-year-old male with serious intraabdominal organ injuries after blunt trauma. In our case, chyloperitoneum developed due to the injuries to the mesenteric lymph vessels and compression of cisterna chyli by hematoma around aorta.