• Journal of Trauma and Injury
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• 제34권1호
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• pp.44-49
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• 2021

Purpose: The aim of this study was to elucidate the prognosis, and other clinical features, such as time to surgery and the amount of transfusion, of small bowel injury (SBI) accompanied by liver injury (LI). Methods: We investigated 221 patients with SBI who visited an emergency center from October 2000 to March 2019. We excluded patients with injuries that directly led to mortality, and the remaining 149 patients were divided into the SBI alone (SBI-A) group and the SBI accompanied by LI (SBI-LI) group. Data were collected for preoperative and surgical outcome variables, and the treatment results were compared between groups. Results: The SBI-LI group had a higher mortality rate than the SBI-A group (22.4% vs. 14.3%), but this difference was not statistically significant (p=0.061). There were no significant differences between the SBI-A and SBI-LI groups, except for the amount of red blood cell (RBC) transfusion (SBI-A: 3.53±0.1 vs. SBI-LI: 8.38±0.7 packs, p=0.035) and the length of intensive care unit (ICU) stay (SBI-A: 6.7±0.2 vs. SBI-LI: 11.1±0.5 days, p=0.047). Conclusions: The SBI-LI group required more RBC transfusions and longer ICU stays than the SBI-A group. SBI accompanied by LI may show higher mortality than SBI alone; however, since the difference was not statistically significant in the present study, larger-scale follow-up research is needed.

• Journal of Trauma and Injury
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• 제34권2호
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• pp.141-145
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• 2021

Splenic injury is a common result of blunt trauma, and bleeding occurs mainly inside the splenic capsule and may leak into the peritoneal space. Herein, we report a case where active bleeding occurred in the splenic artery and only leaked into the extraperitoneal space. This is the first case of this phenomenon in a trauma patient in the English-language literature. Bleeding passed through the peritoneum, leaked into the anterior pararenal space, and continued along the extraperitoneal space to the prevesical space of the pelvis. Therefore, on the initial computed tomography (CT) scan, the bleeding appeared to be in the left paracolic gutter, so we suspected mesenteric bleeding. However, after the CT series was fully reconstructed, we accurately read the scans and confirmed splenic injury with active bleeding. If there had been a suspicion of bowel or mesenteric injury, surgery would have been required, but fortunately surgery could be avoided in this case. The patient was successfully treated with angioembolization.

• Journal of Trauma and Injury
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• 제34권3호
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• pp.187-190
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• 2021

A 91-year-old female presented to Chonnam National University Hospital Regional Trauma Center with a lateral compression type III fracture of the pelvis. She was managed non-operatively for a week in the intensive care unit under close observation and had an emergency operation due to delayed onset of an acute obstructed direct inguinal hernia. Traumatic abdominal wall hernias are rare. However, trauma surgeons should always be aware of the possibility of such injuries because of their critical consequences.

• 대한한방내과학회지
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• 제22권1호
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• pp.113-118
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• 2001

In July, 2000, A 71-year-old man complained of these symptoms: frequent defecation, urgent need to defecate, fecal leakage, anal pain, flatus, and diarrhea after surgery for colorectal cancer. The symptoms are caused specifically by injury to the bowel and sphincter function. The patient suffered physically and psychologically; but, there was no special treatment in western medicine. Therefore, we treated him with electrical acupuncture for the management of sphincter tone and the alleviation of anal pain. We also treated him with herbal medicine for the recovery of strength and gastro-colic function. As a consequence of these treatments, the bowel disorders improved immediately and successfully, even though there were some limitations. So, We report this case with a brief review of related literatures.

• Advances in pediatric surgery
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• 제3권2호
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• pp.98-107
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• 1997

To determine whether bile juice exclusion can prevent the mucosal damage, and Insulin-like growth factor-I can promote mucosal regeneration in ischemia-reperfusion injury of the bowel, 39 weanling rats with 10 cm of Thiry-Vella loop were studied. Animal groups were; Control, BL(common bile duct ligation), IGF{insulin-like growth factor-I(IGF-I) infusion} and IGF-BL(combined treatment). IGF-I(1.5 mg/kg/day) was continuously delivered through a subcutaneously implanted miniosmotic pump. After 15 minutes of superior mesenteric artery clamping, a tissue specimen(P) was taken after 30 minutes of reperfusion. Intestinal continuity was restored to allow oral feeding. A specimen of main tract(M) and another of the Thiry-Vella loop(T) were collected for histomorphometry after 48 hours of reperfusion and free feeding. Villus size ratio(VSR), crypt depth(CD), crypt-depth/villus-height ratio(CVR) and injury score(IS) were measured in 15 consecutive villi. The postoperative mortalities of bile duct ligation groups(BL and IGF-BL) were higher than those of other groups. In control group, VSR of M was lower(P<0.05) than P or T, but not in the other groups. VSR of M in control was lower than those in other groups. CD of T in control, IGF and IGF-BL group were higher than those of M. CD of M and T showed gradual increments from control, IGF and IGF-BL group, respectively. CVR of M and T in IGF group were higher than those in control. CVR in IGF-BL group, T was higher than M, and M was higher than P. About IS, M of BL($20.1{\pm}2.5$) and IGF-BL($20.9{\pm}3.3$) groups were significantly lower than that of control($32.4{\pm}2.5$). These results suggest that the exclusion of bile juice reduces the severity of the reperfusion injury of the mucosa, by inability to activate pancreatic enzymes and IGF-I stimulates mucosal regeneration in injured bowel, and the effect is potentiated by bile juice exclusion.

• Journal of Trauma and Injury
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• 제27권4호
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• pp.204-207
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• 2014

Non-occlusive mesenteric ischemia (NOMI) encompasses all forms of mesenteric ischemia with patent mesenteric arteries. NOMI is commonly caused by decreased cardiac output resulting in hypoperfusion of peripheral mesenteric arteries. We report a case of NOMI secondary to hemorrhagic shock and rhabdomyolysis due to trauma. A 42-year-old man presented to our trauma center following a pedestrian trauma. On arrival, he was drowsy and in a state of hemorrhagic shock. He was found to have multiple fractures, both lung contusion and urethral rupture. An initial physical examination and abdominal computed tomography (CT) scan revealed no evidence of intra-abdominal injury. High doses of catecholamine were administered for initial 3 days due to unstable vital sign. On day 25 of hospitalization, follow-up abdominal CT scan demonstrated that short segment of small bowel loop was dilated and bowel wall was not enhanced. During exploratory laparotomy, necrosis of the terminal ileum with intact mesentery was detected and ileocecectomy was performed. His postoperative course was uneventful and is under rehabilitation.

• 산업융합연구
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• 제21권2호
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• pp.25-32
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• 2023

뇌손상 환자는 초기 재활 단계에서 가장 흔한 소화장애로 변비가 발생하며 예후에 영향을 미친다. 본 연구의 목적은 경관영양하는 뇌손상 환자의 재활 치료 입원, 전동 직후부터 배변 습관을 사정하고 복부 마사지와 하지 관절 운동을 적용하여 효과를 알아보고자 한다. 연구 설계는 뇌손상 환자에게 배변 간호 중재(복부 마사지와 하지 관절 운동)를 적용하여 그 효과를 알아보기 위한 비 동등성 대조군 시차 연구이다. 연구결과, 배변 횟수는 실험군의 배변 횟수가 통계적으로 유의하게 높았으며 (p=.030), 좌약 사용은 대조군이 실험군보다 사용 횟수가 통계적으로 유의하게 높았다(p=.004). 변비 완화 시점은 실험군은 1.73일, 대조군은 4.61일로 두 군간 변비 완화 시점에 차이가 있는 것으로 나타났다(p<.001). 뇌손상 환자에게 재활 초기부터 배변을 완화시키고 변비를 예방을 위한 간호 중재는 복부 마사지와 하지관절 운동이 효과적임을 입증하였다.

• Journal of Trauma and Injury
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• 제28권1호
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• pp.51-54
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• 2015

The incidence of foreign body insertion in the anorectum is rare, however, it is increasing, especially in urban populations. Foreign objects in the anorectum can be of different sizes, shapes and materials. Frangible objects like glass or beakers, and sharp foreign bodies that may easily injure the bowel mucosa are particularly dangerous. Physicians have to consider more innovative options on how to extract these foreign bodies without inciting injury; and, if injury would occur, consider different techniques to repair it, whether transanally or transabdominally, and opt for primary repair, or resection with either anastomosis or stoma creation. Here, I introduce our cases with colorectal foreign bodies and present several literatures to help physicians decide when presented with cases like these.

• Journal of Chest Surgery
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• 제22권2호
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• pp.364-370
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• 1989

22 Cases of traumatic diaphragmatic injuries treated at the Department of Thoracic and Cardiovascular Surgery in Chon-Buk National University Hospital from Jan. 1979 to Oct. 1988 were reviewed in this study. Of the 22 cases, 18 were male and 3 were female, a ratio of 4.5:1. This ratio revealed high incidence in male patient. The age distribution ranged from 2 to 60 years and mean age was 31 years. The modes of injury were as follows: 11 stab wound, 5 traffic accident, 2 fall down, 2 fighting injury, 1 compression wound by sand bag, and 1 slip down injury. Useful diagnostic tools were chest X-ray with or without radiopaque dye swallowing, which was the most commonly diagnostic, UGI series, and thoracoscope. Operations were performed in 22 cases, and 18 cases were through thoracotomy. The herniated organs through the ruptured diaphragm were stomach, omentum, liver, spleen, colon, and small bowel. There were associated injuries, and the most commonly associated was rib fracture. There was no postoperative death.

• 동서간호학연구지
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• 제24권2호
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• pp.130-138
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• 2018

Purpose: The purpose of this study was to determine the effectiveness of hand acupressure in relieving constipation among patients with paraplegia. Methods: Data were collected from a total of 52 participants with paraplegia from a spinal cord injury. Data were analyzed by chi-square test and t-test using SPSS/WIN 21.0. Results: The numbers of bowel movements per week increased in the experimental group who have received hand acupressure increased as compared with the control. Satisfaction with defecation of the experimental group improved as compared with the control. The level of constipation in the experimental group decreased compared to the control. Conclusion: We found that hand acupressure is effective in relieving constipation among patients with paraplegia from a spinal cord injury.