• Journal of Medicine and Life Science
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• 제16권1호
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• pp.13-16
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• 2019

In a patient with blunt abdominal trauma with small bowel injury, early diagnosis is clinically challenging due to unclear clinical symptoms and signs in the early stage of an injury. On the other hand, a delay of diagnosis of bowel disruption may lead to increased complication and mortality. The diagnostic laparoscopy is very useful for the evaluation of the small bowel injury. Laparoscopy can reduce unnecessary open surgery in a patient with blunt abdominal trauma with subtle symptoms and imprecise findings on abdominal computed tomography. Also it can prevent delay of treatment and be converted immediately to open surgery as soon as bowel damage is revealed. Furthermore, extracorporeal repair of small bowel via mini-laparotomy after a single incision diagnostic laparoscopy in a patient with traumatic small bowel perforation was a feasible and safe alternative to conventional laparoscopy. We are pleased to introduce successfully treated cases by extracorporeal repair of small bowel via mini-laparotomy after a single incision diagnostic laparoscopy in a patient with small bowel perforation after blunt trauma.

• Journal of Korean Neurosurgical Society
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• 제47권3호
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• pp.224-227
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• 2010

Small bowel injury resulting from unforeseen penetration of the anterior annulus fibrosus and longitudinal ligament is a rare complication of lumbar microdiscectomy. The patient complained of abdominal tenderness and distention immediately after microdiscectomy for L4-5 and L5-S1 disc herniation. Using abdominal computed tomography, we found several foci of air overlying the anterior aspect of the vertebral body at the L5-S1 level. Segmental resection of the small bowel including small tears and primary anastomosis of the jejunum were performed. Here, we present a case of intestinal perforation after lumbar microdiscectomy and discuss technical methods to prevent this complication with a review of literature.

• Journal of Trauma and Injury
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• 제24권2호
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• pp.125-128
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• 2011

Purpose: Blunt small bowel injury (SBI) is frequently combined other organ injury. So, clinical outcome and characteristics of SBI are influenced by other combined injuries. Thus, we analyzed isolated SBI patients and studied clinical outcome and characteristics. Methods: Between 2005 and 2010, 36 consecutive patients undergoing laparotomy due to isolated SBI were identified in a retrospectively collected. Database. Clinical outcome and characteristics were analyzed. Results: Laparotomy was performed in 36 patients. Primary repair was performed 17 patients. Segmental resection of small bowel was performed 19 patients. Median time gap from trauma to operation was 9 hours. In 24 hours from trauma, operation was performed 31 patients. Post operative death was 5 patients. Mean hospital stay was 18 days and median hospital stay was 12 days. There were significant differences between operation type and minor complication and hospital stay. And there were significant differences between time gap in 24 hours and minor complication. But, there were no significant between time gap and mortality. Conclusion: Although this study had many limitations, some valuable information was produced. When operation above 24 hours was delayed in SBI, minor complications were significantly increased. Segmental resection of small bowel in SBI were significantly increased minor complications and hospital stay. So, preventive measures for surgical site infection was important to reduce wound complication and hospital stay. Further continuous study and multi-center study were should be performed to improve clinical outcome in SBI.

• Journal of Trauma and Injury
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• 제24권2호
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• pp.82-88
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• 2011

Background: The incidence of abdominal trauma with intra-abdominal organ injury or bowel rupture is increasing. Articles on the diagnosis, symptoms and treatment of small bowel perforation due to blunt trauma have been reported, but reports on the relationship of mortality and morbidity to clinical factors for prognosis are minimal. The purposes of this study are to evaluate the morbidity and mortality of patients with small bowel perforation after blunt abdominal trauma on the basis of clinical examination and to analyze factors associated with the prognosis for blunt abdominal trauma with small bowel perforation. Methods: The clinical data on patients with small bowel perforation due to blunt trauma who underwent emergency surgery from January 1994 to December 2009 were retrospectively analyzed. The correlation of each prognostic factor to morbidity and mortality, and the relationship among prognostic factors were analyzed. Results: A total of 83 patients met the inclusion criteria: The male was 81.9%. The mean age was 45.6 years. The mean APACHE II score was 5.75. The mean time interval between injury and surgery was 395.9 minutes. The mean surgery time was 111.1 minutes. Forty seven patients had surgery for ileal perforations, and primary closure was done for 51patients. The mean admission period was 15.3 days, and the mean fasting time was 4.5 days. There were 6 deaths (7.2%), and 25 patients suffered from complications. Conclusion: The patient's age and the APACHE II score on admission were important prognostic factors that effected a patient's progress. Especially, this study shows that the APACHE II score had effect on the operation time, admission period, the treatment period, the fasting time, the mortality rate, and the complication rate.

• Natural Product Sciences
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• 제17권3호
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• pp.234-238
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• 2011

We investigated the effects of fucoidan and lutein against dextran sulfate sodium (DSS)-induced mice colitis. Evaluations were made of the body weight, histological index such as crypt injury and inflammation score, biochemical factor such as serum amyloid (SAA) and MPO level data. The combination of fucoidan and lutein reduced the score of crypt injury and inflammation and markedly showed more decrease of the SAA and MPO levels than 5-ASA group. In addition, each sample of fucoidan and lutein was reduced the level of IL-6 which is stimulated by a lipopolysaccharide (LPS) in HT-29 cell line in vitro. Therefore, fucoidan and lutein may be useful as a dietary substance for preventing inflammatory bowel disease in humans.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제11권sup2호
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• pp.59-66
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• 2008

Genome-wide association studies using large case-control samples and several hundred thousand genetic markers efficiently and powerfully assay common genetic variations. The application of these studies to inflammatory bowel disease has led to the identification of susceptibility genes and affirmed the importance of innate and adaptive immunity in the pathogenesis of disease. Efforts directed towards the identification of environmental factors have implicated commensal bacteria as determinants of dysregulated immunity and inflammatory bowel disease. Host genetic polymorphisms most likely interact with functional bacterial changes to stimulate aggressive immune responses that lead to chronic tissue injury.

• Journal of Trauma and Injury
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• 제25권2호
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• pp.63-66
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• 2012

Resection of the bowel is necessary for the repair of a ventral hernia after recovery from trauma in some cases. In such instances, polyester or polypropylene meshcannot be used due to the possibility of infection; we had to use biological mesh instead. We report a case in which a traumatic hernia was repaired with Permacol (Covidien, Norwalk, CT, USA). A 42-year-old male patient had been injured by a factory machine seven months prior to admission. At that time, he had abdominal wall injury and small bowel perforation. His abdominal wall had been a defect after operation. A CT scan of the abdomen showed that the left abdominal wall, which is lateral to left rectus abdominis muscle had only one muscle layer, an external oblique muscle, and that a previous abdominal incision had a defect along the entire incision. During the exploration, 10 cm of small bowel was removed due to firm adhesion to the previous surgical scar. Permacol mesh was applied and fixed with transfascial fixations and tacks by using the intraperitoneal onlay mesh technique. There were no complications after the surgery and the patient was discharged without any problems.

• Journal of Trauma and Injury
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• 제36권4호
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• pp.435-440
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• 2023

Mesenteric injury occurs rarely in cases associated with blunt abdominal trauma. Despite its low incidence, mesenteric injury can lead to fatal outcomes such as hypovolemic shock due to hemoperitoneum or sepsis due to intestinal ischemia, or perforation-related peritonitis. For mesenteric injuries, especially those involving massive bleeding, intestinal ischemia, and perforation, the standard treatment is surgery. However, in the case of operative management, it should be borne in mind that there is a possibility of complications and mortality during and after surgery. The usefulness of transcatheter arterial embolization (TAE) is well known in solid organs but is controversial for mesenteric injury. We present a 75-year-old man with mesenteric injury due to blunt abdominal trauma. Initial abdominal computed tomography showed no hemoperitoneum, but a mesenteric contusion and pseudoaneurysm with a diameter of 17 mm were observed near the origin of the superior mesenteric artery. Since there were no findings requiring emergency surgery such as free air or intestinal ischemia, it was decided to perform nonoperative management with TAE using microcoils in hybrid emergency room system. TAE was performed successfully, and there were no complications such as bleeding, bowel ischemia, or delayed bowel perforation. He was discharged on the 23rd day after admission with percutaneous catheter drainage for drainage of mesenteric hematoma. The authors believe that treatment with TAE for highly selected elderly patients with mesenteric injuries has the positive aspect of minimally invasive management, considering the burden of general anesthesia and the various avoidable intraoperative and postoperative complications.

• Journal of Chest Surgery
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• 제28권9호
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• pp.842-846
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• 1995

Recently, the trauma patients have been markedly increasing due to the vast increase of traffic accident, industrial disaster, incidental accident and violence. The authors have analysed of 22 patients of thoracic injuries combined with abdominal injuries and summarized as follows. The ratio of male to female was 3.4:1 and their age distribution was from 5 years to 68 years and mean age was 34.4 years. The etiologies of injury were traffic accident, stab wound, fall down and violence. Associated injuries were fractures, bowel perforation, kidney rupture, head injury, liver laceration, spleen rupture and so forth. The modes of treatment were closed thoracostomy, repair of diaphragm, ruptured bowel repair, explo-thoracotomy, splenectomy, hepatic lobectomy in this order of frequency. The postoperative complications were atelectasis, wound infection, pneumonia, empyema, acute renal failure, respiratory failure and bleeding. The mortality rate was 13.6% [3/22 and the causes of death were respiratory failure 1 case, acute renal failure 1 case and hypovolemic shock 1 case.

• Journal of Trauma and Injury
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• 제33권2호
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• pp.128-133
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• 2020

Traumatic abdominal wall hernias (TAWHs) are uncommon and the incidence of this, which is rarely encountered in clinical practice, has been estimated at 1%. Furthermore, blunt transection of the entire abdominal wall musculature caused by seatbelt is a very rare complication. We report a case of adult with a complete disruption of the entire anterolateral abdominal wall muscle following the seatbelt injury. A 32-year-old male was wearing a seat belt in a high speed motor vehicle collision. Abdominal computed tomography (CT) scan revealed the complete disruption of bilateral abdominal wall musculatures including TAWH without visceral injury. However, injuries of small bowel and sigmoid colon were observed in the intra-operative field. The patient underwent the repair by primary closure of the defect with absorbable monofilament sutures. This case suggests that especially in TAWH patients, even if a CT scan is normal, clinicians should keep the possibility of bowel injury in mind, and choose a treatment based on the clinical findings.