• 제목/요약/키워드: Diaphragm, trauma

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Laparoscopy in Blunt Abdominal Trauma: Diaphragmatic and Bladder Lacerations Repair

  • Martins, Ruben;dos Santos, Martins;Revez, Tatiana
    • Journal of Trauma and Injury
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    • 제32권3호
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    • pp.176-180
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    • 2019
  • The growing use of laparoscopy in elective surgery has led to its increase utilization in emergency surgery. However, the employment of laparoscopy in abdominal trauma is still unusual. Here in we report a case of a patient with blunt abdominal trauma that resulted in a combination of exceptional traumatic lesions, diaphragmatic and bladder lacerations. Both injuries were diagnosed and successfully resolved by laparoscopy. The report of this type of lesions and resolution is extremely rare, being this the second case described in the international literature. This article intends to show that laparoscopy may not only be used as a diagnostic tool, but also as a therapeutic instrument in selected cases of blunt abdominal trauma.

자동차의 사이드미러가 흉강에 박힌 채로 내원한 흉부관통상 - 2례 보고 - (Penetrating Chest Injuries Caused by the Sideview Mirror of the Patient's Car - Report of 2 cases -)

  • 김수성
    • Journal of Trauma and Injury
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    • 제20권1호
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    • pp.47-51
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    • 2007
  • Penetrating chest trauma caused by the components of one's own car is rare in motor vehicle accidents. We experienced two cases of penetrating chest injury caused by the sideview mirror of the patient's vehicle. One was a 25-year-old man. The sideview mirror penetrated the left chest, went through the diaphragm, and ruptured the spleen. He was in shock upon arrival at the emergency room. An emergency thoracotomy and laparotomy were done. The ruptured spleen was resected, the lung and the diaphragm were debrided and repaired, and the chest wall was reconstructed. The other patient was a 57-year-old male, who was transported to our emergency room with the sideview mirror of his truck stuck into his right chest wall as the result of an accident. He also had a right Bennet's fracture and an open fracture of the right tibia. Air had been sucked into the right pleural cavity through the wound. Multiple rib fractures and lung lacerations had also occurred. Removal of the sideview mirror, repair of the lacerated lung, and reconstruction of chest wall were done immediately. Both patients recovered without complication and were discharged.

좌신 절제후 발생한 지연성 횡격막 탈장 2례 (Delayed Diaphragmatic Hernia after Left Nephrectomy -2 cases report-)

  • 김광휴
    • Journal of Chest Surgery
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    • 제28권12호
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    • pp.1197-1200
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    • 1995
  • Since diaphragmatic injuries are difficult to diagnose, those that missed may present with latent symptoms.Delayed diaphragmatic hernia is very rare and occurs commonly after penetrating or blunt trauma. Recently we had experience with two cases of delayed diaphragmatic hernia after left nephrectomy.They were operated by herniolysis and closure of diaphragm using prosthetic patch[Dura, Dacron through the left thoracotomy. Postoperative courses were uneventful.

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Experiences of Video-assisted Thoracic Surgery in Trauma

  • Noh, Dongsub;Lee, Chan-kyu;Hwang, Jung Joo;Cho, Hyun Min
    • Journal of Trauma and Injury
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    • 제30권3호
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    • pp.87-90
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    • 2017
  • Purpose: Nowadays, Video-Assisted Thoracic Surgery (VATS) is widely used for its benefits, low post-operative pain, excellent anesthetic result and complete visualization of intrathoracic organs. Despite of these advantages, VATS has not yet been widely used in trauma patients. In this study, we aimed to investigate the usefulness of VATS in the chest trauma area. Methods: From January 2016 to December 2016, 203 patients underwent surgical treatment for chest trauma. Their medical records were analyzed retrospectively. Results: Eleven patients underwent thoracic surgery by VATS. Six patients were unstable vital sign in the emergency room. Two patients underwent emergency surgery and the rest patients underwent planned surgery. The common surgeries were VATS hematoma evacuation and wedge resection. There was no conversion to thoracotomy. The surgery proceeded without any problems for all patients. Conclusions: VATS would be an effective diagnostic and therapeutic modality in chest trauma patients. It can be applied to retained hemothorax, persistent pneumothorax, suspicious diaphragm injury and even coagulation of bleeder.

Traumatic tension enterothorax in New Zealand: a case report

  • Monique Mahadik;Ashok Gunawardene;Aleisha Sutherland;Damien Ah Yen
    • Journal of Trauma and Injury
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    • 제36권3호
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    • pp.258-260
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    • 2023
  • Traumatic rupture of the right hemidiaphragm occurred following a high-velocity motor vehicle collision in the case presented herein. The resulting herniation of small bowel loops into the thorax resulted in hemodynamic and respiratory compromise due to pressure effects on the right heart and major vessels. The patient's hemodynamic status improved with reduction of enterothorax, and the diaphragmatic defect was repaired. We discuss the available literature and learning points from this rare case.

외상성 횡격막 손상에 대한 임상적 고찰 (Clinical Evaluation of Traumatic Diappragmatic Injuries)

  • 이성주;구원모
    • Journal of Chest Surgery
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    • 제30권10호
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    • pp.1005-1009
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    • 1997
  • 흉부와 복부장기 두 곳에 손상을 심하게 받으면 쇼크와 급성 호흡곤란이 동시에 발생하여 치명적일 수 있 다. 둔상이나 관통상으로 인해 발생되는 외상성 횡격막 손상은 대부분 홉부와 복부에 퐁반 손상이 유발 됨 으로 이에 대한 요인 및 평가는 중요하다 본 연구는 1993턴 3월 부터 1997년 2월 까지 5년간 서을 위생병원 흉부외과에서 치료받은 17명의 횡격막 손상 환자를 대상으로 이루어졌다. 환자의 평균 나이는 36.2세였고 남 녀 성별 비율은 3.2 1이었다. 들상에 의한 손상(N=5, 우측=4, 좌측긱)은 29.5%, 관통상에 의한 손상(N=12, 우측f5, 좌측:7)은 70.5%이었다. 호흡곤란이 가장 흔한 증상(76%)이었고, 손상의 크기(mean$\pm$ SD)는 둔상(9.8 $\pm$3.7 Cm)이 관통상의 경우(3.2$\pm$1.3 Cm) 보다 컸으며(P<0.05) 모든 환자에서 동반 손상이 있었고 치료는 수 술적 방법으로 개흉술 11례(64%), 개복술 3례(18%)그리고 개흉복술 3례(18%)였다. 다른 장기의 손상으로 수 술 중 발견된 횡격막 손상은 관통상의 경우 5례(41%)였다 흉부나 복부에 둔상이나 관통상을 입은 환자에 일 단 횡격막 손상을 의심해 보고 평가하여 뒤늦게 나타날 수 있는 합병증을 예방하는 것이 필요하다고 사료된다.

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반대측 외상성 횡격막 마비가 합병된 횡격막성 내장전위 치험 1례 (A Case of Diaphragmatic Eventration Complicated with Contralateral Traumatic Diaphragmatic Paralysis)

  • 허진필;이정철;정태은;이동협;한승세
    • Journal of Chest Surgery
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    • 제32권2호
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    • pp.201-205
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    • 1999
  • 횡격막성 내장전위는 드문 질환이며 선천적인 원인에 의한다. 저자들은 기존에 좌측 횡격막성 내장전위가 있던 상태에서 교통사고로 인한 우측 횡격막 마비가 동반되어 호흡부전에 빠진 환자에 대한 수술을 시행하였다. 본 례는 국내외 문헌에 아직 보고된 례가 없는 매우 희귀한 경우로서 횡격막 주름성형술을 시행하여 좋은 결과를 얻었기에 보고하는 바이다.

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둔상에 의한 우측 횡격막 손상 (Right Diaphragmatic Rupture after Blunt Trauma - Case Report-)

  • 김기훈;김진수;박성진;김운원;강도균;민호기;김용한;오철규
    • Journal of Trauma and Injury
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    • 제25권3호
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    • pp.87-90
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    • 2012
  • Blunt diaphragmatic rupture (BDR) is a relatively rare injury and occurs in 0.8% to 7% of all thorocoabdominal blunt trauma. Especially right diaphragmatic rupture after blunt abdominal trauma is a rarer than left. The diagnosis of BDR can be missed while evaluating the multiple trauma patient. Other severe injuries may mask BDR during the primary resuscitation and survey. We experienced two cases of traumatic rupture of right diaphragm, one diagnosed immediately and the other diagnosed delayed. In this paper we present two cases of traumatic diaphragmatic rupture.

Intraoperative Diagnosis of a Pericardial Injury Associated with Multiple Diaphragmatic Ruptures in a Patient with Abdominal Blunt Trauma

  • Kim, Do Wan;Jeong, In Seok;Na, Kook Joo;Song, Sang Yun;Lee, Kyo Seon;Kang, Seung Ku
    • Journal of Trauma and Injury
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    • 제29권4호
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    • pp.180-183
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    • 2016
  • A diaphragmatic injury is uncommon, but occurs more frequently with injury to other organs. Particularly, a diaphragmatic accompanied by a pericardial injury is very rare. The authors report a case of incidentally detecting a pericardial injury during surgery for a diaphragmatic injury due to abdominal blunt trauma.

하부늑골 골절에 의한 지연성 대량혈흉을 동반한 횡격막 손상 (Delayed Diaphragmatic Injury with Massive Hemothorax Due to Lower Rib Fracture)

  • 김우식;김중석
    • Journal of Trauma and Injury
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    • 제28권2호
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    • pp.79-82
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    • 2015
  • Simple rib fracture is one of most common injury after blunt thoracic trauma found in approximately 7% to 40% of cases. Delayed traumatic diaphragmatic injury with massive hemothorax after rib fracture is rare but a potentially life-threatening condition. We present a rare case of a 79-year-old male with delayed diaphragmatic injury with massive hemothorax due to fracture of the lower ribs. Under thoracoscopy, hemothorax was evacuated, diaphragmatic rupture was identified and repaired, and the lower ribs were fixed with metal plate (s). Although simple lower rib fractures may be the only clinical finding, close observation and monitoring are required because of the possibility of diaphragmatic and/or intraabdominal organ injury.

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