• Journal of Chest Surgery
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• v.27 no.6
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• pp.481-482
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• 1994

Blunt cardiac trauma is typified by the injury caused by the steering wheel in automobile collision. We experienced a case of IVC rupture due to in-car TA. The operation was performed under deep hypothermia with circulatory arrest to close the ruptured site by continuous over and over suture method with 3-0 prolene.

• Journal of Chest Surgery
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• v.24 no.6
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• pp.579-584
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• 1991

The records of 25 patients with traumatic diaphragmatic injuries seen at Chosun University Hospital from February 1977 to May 1991 were reviewed. We treated 20 male and 5 female patients ranging in age from 6 to 72 years. The diaphragmatic injuries were due to blunt trauma in 19 cases[traffic accident 13, fall down 4, compression injury 2] and penetrating trauma in 6 cases[stab wound 5, gun shot 1]. Most common symptoms were dyspnea[72%], chest pain[56%] and abdominal pain [40%], Chest X-ray were normal in 7 cases[28%] and 22 cases[88%] were diagnosed or suspected as diaphragmatic injuries preoperatively. The repair of 25 cases were performed with thoracic approach in 16 cases, thoracoabdominal approach in 6 cases and abdominal approach in 3 cases. Postoperative complications included atelectasis, wound infection and empyema. there was no postoperative death.

• Journal of Trauma and Injury
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• v.28 no.3
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• pp.219-221
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• 2015

Subclavian injuries in blunt trauma are reported in less than 1% of all arterial injuries or chest related injuries. We report a female 68 yr-old patient whom has visited our emergency center due to a motorcycle traffic accident with complaints of right chest wall and shoulder pain. Her injury severity score was 22 and she was found with a comminuted clavicle fracture and subclavian artery injury. She developed delayed symptoms of pallor, pain and motor weakness with loss of pulse in her right arm. Attempts at intervention failed and thus, she underwent emergency artificial graft bypass from her subclavian artery to her brachial artery. Her postoperative course was uneventful and she is happy with the results. Although rare, a high index of suspicion for the injury must be noted and the inevitable surgical option must always be considered.

• Journal of Chest Surgery
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• v.30 no.5
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• pp.533-536
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• 1997

We report a successful repair of severe traumatic tricuspid regurgitation by PTFE chordal replacement and ring annuloplasty. A 64-year-old man with multiple trauma was referred to our department because of cardiomegaly on chest roentgenogram. Echocardiography showed moderate amount of pericardial effusion and severe tricuspid regurgitation with rupture of anterior papillary muscle. But he experienced progressive dyspnea, and chest roentgenogram showed pro ressive cardiomegaly. He underwent operation 4 months after trauma. The nterior papillary muscle was reinserted, and the valve was repaired by PTFE chordal replacements and ring annuloplasty. Postoperatively, the patient's functional status was improved, and there was trivial tricuspid regurgitation on echocardiographic examination.

• Journal of Chest Surgery
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• v.54 no.1
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• pp.68-71
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• 2021

A 37-year-old man was transferred to our level I trauma center after a road traffic accident, presenting with right acetabular fracture, multiple rib fractures, epidural hemorrhage, and liver contusion. Severe traumatic tricuspid regurgitation was also discovered during the work-up for surgery. Our initial attempt at acetabular surgery failed when the patient experienced near cardiac arrest during anesthetic induction. It was hence decided that tricuspid valve repair should precede orthopedic surgery. Minimally invasive tricuspid valve repair using the double orifice technique was successfully performed. Subsequently, acetabular surgery was performed and he was discharged 35 days post-trauma without any complications.

• Journal of Chest Surgery
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• v.28 no.9
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• pp.837-841
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• 1995

Between June 1981 and April 1994, 15 patients underwent surgical repair of diaphragmatic hernia. The ages ranged from 1 day to 60 years, with a mean age of 34. There were 5 cases of congenital diaphragmatic hernia; Bochdalek hernia in 4 cases and Morgagni hernia in 1 case. There were 10 cases of traumatic diaphragmatic hernia;blunt trauma in 8 cases and stab wounds in 2 cases. The chest X-ray findings were abnormal in 10 cases. Operations were performed in all patients and there was only one death, who was a newborn with left Bochdalek hernia and pulmonary hypoplasia.

• Journal of Trauma and Injury
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• v.30 no.4
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• pp.202-205
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• 2017

After blunt chest injuries, extrapleural hematoma may result in a collection of blood between the parietal pleura and the endothoracic fascia. Extrapleural hematoma is frequently misdiagnosed as hemothorax. Extrapleural fat sign, the inward displacement of strip of extrapleural fat on computed tomography, is typical radiological findings of extrapleural hematoma. We encountered a case of extrapleural hematoma with a presentation similar to hemothorax after blunt chest injury.

• Journal of Chest Surgery
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• v.49 no.6
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• pp.435-442
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• 2016

Background: Blunt traumatic cardiac rupture is rare. However, such cardiac ruptures carry a high mortality rate. This study reviews our experience treating blunt traumatic cardiac rupture. Methods: This retrospective study included 21 patients who experienced blunt traumatic cardiac rupture from 1999 to 2015. Every patient underwent surgery. Several variables were compared between survivors and fatalities. Results: Sixteen of the 21 patients survived, and 5 (24%) died. No instances of intraoperative mortality occurred. The most common cause of injury was a traffic accident (81%). The right atrium was the most common location of injury (43%). Ten of the 21 patients were suspected to have cardiac tamponade. Significant differences were found in preoperative creatine kinase-myocardial band (CK-MB) levels (p=0.042) and platelet counts (p=0.004) between the survivors and fatalities. The patients who died had higher preoperative Glasgow Coma Scale scores (p=0.007), worse Trauma and Injury Severity Scores (p=0.007), and higher Injury Severity Scores (p=0.004) than those who survived. Conclusion: We found that elevated CK-MB levels, a low platelet count, and multi-organ traumatic injury were prognostic factors predicting poor outcomes of blunt cardiac rupture. If a patient with blunt traumatic cardiac rupture has these factors, clinicians should be especially attentive and respond promptly in order to save the patient's life.

• Journal of Chest Surgery
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• v.21 no.3
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• pp.471-478
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• 1988

We evaluated forty cases of traumatic diaphragmatic injuries that we have experienced from Jan. 1972 to Dec. 1987. 28 patients were male and 12 were female[M:F=2.3:1]. The age distribution was ranged from 4 to 71 years with mean age of 26. The diaphragmatic injuries were due to blunt trauma in 27 cases[traffic accident 22, fall down 3, others 2] and penetrating trauma in 13 cases[stab wound 11, gun shot 1, other 1]. In the blunt injury,14 cases of 17 were diagnosed and treated within 24 hours in the left diaphragmatic injury but only 3 cases of 7 cases in the right diaphragmatic injury were diagnosed and treated within 24 hours. All cases except one in penetrating injury were diagnosed and treated within 12 hours. In the blunt injury, the rupture site was located in the left in \ulcorner7 cases and in the right in 7 cases. In the penetrating injury, the rupture site was located in the left in 11 cases and in the right in 2 cases. The repair of 37 cases were performed with thoracic approach in 20 cases, thoracoabdominal approach in 12 cases and abdominal approach in 5 cases. Over all mortality was 17.5%[7/40] and postoperative mortality was 11%[4/37]. The causes of death were hypovolemic shock[3], combined head injury[2], acute renal failure[1] and septic shock with ARDS[1].

• Journal of Chest Surgery
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• v.23 no.1
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• pp.95-106
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• 1990

Between May 1979 and April 1989, 213 patients with esophageal injuries visited the Department of the Thoracic and cardiovascular surgery Department, Yonsei University College of Medicine. There were 159 non perforated esophageal injuries accompanied by hematemesis, and 54 perforated esophageal injuries. The causes of non perforated esophageal injuries were Mallory-Weise Syndrome [%], corrosive esophagitis [54], esophageal carcinoma [4], foreign bodies [2], sclerotherapy due to esophageal varices [3]. The causes of perforated esophageal injuries were esophageal anastomosis[13], malignancies[17], esophagoscopy or bougienage[5], chest trauma[5], foreign bodies[5], paraesophageal surgery[3], others[6] In esophageal perforation due to foreign bodies, esophagoscopy or bougienage, there were 6 cervical esophageal perforations and 9 thoracic esophageal perforations. There were no mortalities in the treatment of the cervical esophageal perforations and 5 deaths resulted in the treatment of 9 thoracic esophageal perforations. And four of six patients with thoracic esophageal perforations died in the initiation of treatment over 24 hours, after trauma. There were another 12 deaths in the patients with chest trauma, malignancies or chronic inflammation except esophageal injuries due to foreign bodies or instruments during the hospital stay or less than 30 days after esophageal injuries. One patient with esophageal carcinoma died due to bleeding and respiratory failure after irradiation. Another patient with esophago gastrostomy due to esophageal carcinoma died of sepsis due to EG site leakage. One patient with a mastectomy due to breast cancer followed by irradiation died of sepsis due to an esophagopleural fistula. Two patients with Mallory-Weiss syndrome died; of hemorrhagic shock in one and of respiratory failure due to massive transfusion in the other. One patient with TEF died of respiratory failure and another died of pneumonia and respiratory failure. One patient with esophageal perforation due to blunt chest trauma died of brain damage accompanied with chest trauma.