• Journal of Korean Neurosurgical Society
• /
• v.30 no.1
• /
• pp.81-84
• /
• 2001

Pneumocephalus is exceedingly rare in the absence of trauma or recent surgery. It is most commonly seen after severe head injury, with disruption of the dura and subsequent cerebrospinal fluid leakage. Intracranial air has also been reported as a complication of shunting. This may be secondary to intermittent shunt failure or a persistent communication between the extracranial and intracranial space that permits the entrance of air. In the present case, air appeared to enter the ventricular system through the fistula that connected the frontal sinus. This air replaced the CSF being drained into the peritoneal cavity by the shunt. The decrease of intracranial pressure after a shunt might play a role in causing pneumocephalus. We report a case of tension pneumocephalus after shunting for hydrocephalus as a life-threatning complication.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.19 no.2
• /
• pp.181-189
• /
• 1997

The mandible plays a crucial role in the vital human functions of breathing, eating, and speaking. No other bone in the body has such a distinctive shape and function. Because of its prominence in the facial structure, the mandible is highly prone to fracture. A clinical study on 122 patients with mandibular fracture who visited Kangnam General Hospital during 4 year(1992-1995) was done by analysing sex, age, cause, fracture site, teeth involvement, treatment method, complication and involvement of other body part. The results obtained were as follows : 1. The occurrence was more frequent in male than in female with the ratio of 5.4 : 1 and most frequently in twenties. 2. Violence was the most common cause of facial mandibular fracture. 3. In mandibular fracure, fracture site was average 1.5 sites, most frequently in symphysis and simple fracture was 86.1%. 4. As treatment methods, open reduction(78.6%) was used more frequently than closed reduction(21.4%). 5. Post-operational complication occurred in 27.0% of the cases. 6. Other injuries that were related to maxillofacial fracture occurred in 25.4%.

• Archives of Plastic Surgery
• /
• v.49 no.5
• /
• pp.683-688
• /
• 2022

Background Reconstruction of large soft tissue defects of the lower extremity often requires the use of free flaps. The main limiting factor and potential for complications lie in the selection of proper donor and recipient vessels for microvascular anastomosis. While the superficial veins of the lower leg are easier to dissect, they are thought to be more vulnerable to trauma and lead to a higher complication rate when using them instead of the deep accompanying veins as recipient vessels. No clear evidence exists that proves this concept. Methods We retrospectively studied the outcomes of 97 patients who underwent free flap plasty to reconstruct predominantly traumatic defects of the lower extremity at our institute. The most used flap was the gracilis muscle flap. We divided the population into three groups based on the recipient veins that were used for microvascular anastomosis and compared their outcomes. The primary outcome was the major complication rate. Results Overall flap survivability was 93.81%. The complication rates were not higher when using the great saphenous vein as a recipient vessel when comparing to utilizing the deep concomitant veins alone or the great saphenous vein in combination to the concomitant veins. Conclusions In free flap surgery of the lower extremity, the selection of the recipient veins should not be restricted to the deep accompanying veins of the main vessels. The superficial veins, especially the great saphenous vein, offer an underrated option when performing free flap reconstruction.

• Journal of Korean Neurosurgical Society
• /
• v.52 no.6
• /
• pp.547-550
• /
• 2012

Tracheoinnominate artery fistula is a critical complication of tracheostomy. The most important factors influencing patient outcome are prompt diagnosis, immediate control of bleeding with a patent airway, and emergency operation with or without interruption of the innominate artery. Here, we report a case of tracheoinnominate artery fistula in a 40-year-old woman with cerebrovascular accident who was successfully managed with an aorta-axillary artery bypass.

• Clinical Endoscopy
• /
• v.55 no.1
• /
• pp.58-66
• /
• 2022

Background/Aims: Anastomotic leakage after esophageal surgery remains a feared complication. During the last decade, management of this complication changed from surgical revision to a more conservative and endoscopic approach. However, the treatment remains controversial as the indications for conservative, endoscopic, and surgical approaches remain non-standardized. Methods: Between 2010 and 2020, all patients who underwent Ivor Lewis esophagectomy for underlying malignancy were included in this study. The data of 28 patients diagnosed with anastomotic leak were further analyzed. Results: Among 141 patients who underwent resection, 28 (19.9%) developed an anastomotic leak, eight (28.6%) of whom died. Thirteen patients were treated with endoluminal vacuum therapy (EVT), seven patients with self-expanding metal stents (SEMS) four patients with primary surgery, one patient with a hemoclip, and three patients were treated conservatively. EVT achieved closure in 92.3% of the patients with a large defect and no EVT-related complications. SEMS therapy was successful in clinically stable patients with small defect sizes. Conclusions: EVT can be successfully applied in the treatment of anastomotic leakage in critically ill patients, while SEMS should be limited to clinically stable patients with a small defect size. Surgery is only warranted in patients with sepsis with graft necrosis.

• Archives of Reconstructive Microsurgery
• /
• v.21 no.2
• /
• pp.86-91
• /
• 2012

Purpose: Mass can compress around tissue and cause deviation of normal anatomical structures. Often, mass grows toward neurovascular pedicle and encircles depending on the nature of mature mass. Neglecting neurovascular involvement of the mass is a serious problem not to be overlooked. Authors have performed microscopic approach regarding mass involving the neurovascular pedicle in the hand. Materials and Methods: From January 2007 through February 2012, retrospective analysis for nine cases of mass involving neurovascular pedicles was done. Patients were evaluated preoperatively by ultrasonography or MRI and checked intraoperative finding. Masses were evaluated by site, preoperative evaluation, involved neurovascular pedicle, histopathologic diagnosis, complication, and recurrence. Results: The site of mass involving neurovascular pedicles was 4 cases on the wrist, 2 cases on the palm, 2 cases on the finger, 1 case on the hand dorsum. Involved neurovascular pedicles were 3 radial arteries and nerves, 3 proper digital arteries and nerves, 1 radial artery, 1 superficial branch of radial nerve, 1 common digital artery and nerve. The histopathologic diagnosis of mass were 3 ganglions, 2 giant cell tumors, 2 epidermal cysts, 1 fibroma, and 1 benign spindle tumor. There were 2 cases of recurrence and secondary excisions were performed. Conclusion: Neurovascular pedicle injury can lead to serious complication like sensory and motor disorders, distal part ischemia, and so on. In case of mass suspected neurovascular invasion, accurate preoperative evaluation such as ultrasonography or MRI is necessary. To prevent any neurovascular related complication during mass excision, delicate surgical technique using a microscope becomes essential.

• Archives of Craniofacial Surgery
• /
• v.9 no.2
• /
• pp.62-66
• /
• 2008

Purpose: Although nasal fractures are often discussed as minor injuries but the incidence of post-traumatic nasal deformity remains high. For decrease the incidence of post-traumatic nasal deformity which require the guideline to optimize the management of acute nasal bone fracture. The aim of this study is analysis of post-traumatic nasal deformity according to Stranc classification. Method: We reviewed 310 patients with nasal bone fracture treated at our hospital from January of 2005 to December of 2006. Result: Post-traumatic complication were divided septal deviation, nasal bone deformity, temporary hyposmia and synechia. Nasal bone deformity include nasal bone deviation, hump, flat nose and minimal nasal bone irregularity. The incidence of total complication rate was 36.4%. The most common complication was nasal deformity(22.9%) followed by septal deviation(19.7%). The most common complication was septal deviation(20%) in frontal impact. The most common complication was nasal deformity(19.5%) in lateral impact. In frontal impact, the incidence of complication rate was plane II(68.8%) followed by plane I(29.9%) and plane III(16.7%). In lateral impact, the incidence of complication rate was plane II (78.8%) followed by plane III(61.5%) and plane I(42.7%). Conclusion: This result can be used to improve longterm results and to reduce the incidence of post-traumatic nasal deformity by predict complication of nasal bone fracture according to Stranc classification.

• Journal of Chest Surgery
• /
• v.44 no.2
• /
• pp.186-188
• /
• 2011

Ventricular septal rupture (VSR) is a rare but lethal complication of myocardial infarction. The event occurs 2~8 days after an infarction and often precipitates cardiogenic shock. Post myocardial infarction VSR is known for difficult to repair. Especially, Transmural myocardial infarction involved in the posterior VSD area, exposure of the affected site is difficult and postoperative mortality rate is high. We have experienced a case of a 75-year-old female patient who suffered posterior VSD due to acute myocardial infarction, and attained good result by approaching the lesion through right atrial incision and repaired the defect by using patch closure technique.

• Tuberculosis and Respiratory Diseases
• /
• v.71 no.1
• /
• pp.50-54
• /
• 2011

Pulmonary lipiodol embolism is a rare but very fatal complication of transcatheter arterial chemoembolization (TACE), Here we present the case of an unusual complication of TACE in a 67-year-old man who presented with dyspnea, hemoptysis, and a history of a third session of TACE for hepatocellular carcinoma (HCC) that had been performed 3 days prior to presenting. On the basis of chest X-ray and computed tomography (CT) scan findings, we diagnosed pulmonary lipiodol embolism. He was conservatively treated with oxygen and haemostatic agents. The patient recovered quickly without any significant sequela and was discharged.

• Korean Journal of Radiology
• /
• v.22 no.12
• /
• pp.2082-2093
• /
• 2021

Objective: We conducted a systematic review and meta-analysis of the tissue adequacy and complication rates of percutaneous transthoracic needle biopsy (PTNB) for molecular analysis in patients with non-small cell lung cancer (NSCLC). Materials and Methods: We performed a literature search of the OVID-MEDLINE and Embase databases to identify original studies on the tissue adequacy and complication rates of PTNB for molecular analysis in patients with NSCLC published between January 2005 and January 2020. Inverse variance and random-effects models were used to evaluate and acquire meta-analytic estimates of the outcomes. To explore heterogeneity across the studies, univariable and multivariable metaregression analyses were performed. Results: A total of 21 studies with 2232 biopsies (initial biopsy, 8 studies; rebiopsy after therapy, 13 studies) were included. The pooled rates of tissue adequacy and complications were 89.3% (95% confidence interval [CI]: 85.6%-92.6%; I² = 0.81) and 17.3% (95% CI: 12.1%-23.1%; I² = 0.89), respectively. These rates were 93.5% and 22.2% for the initial biopsies and 86.2% and 16.8% for the rebiopsies, respectively. Severe complications, including pneumothorax requiring chest tube placement and massive hemoptysis, occurred in 0.7% of the cases (95% CI: 0%-2.2%; I² = 0.67). Multivariable meta-regression analysis showed that the tissue adequacy rate was not significantly lower in studies on rebiopsies (p = 0.058). The complication rate was significantly higher in studies that preferentially included older adults (p = 0.001). Conclusion: PTNB demonstrated an average tissue adequacy rate of 89.3% for molecular analysis in patients with NSCLC, with a complication rate of 17.3%. PTNB is a generally safe and effective diagnostic procedure for obtaining tissue samples for molecular analysis in NSCLC. Rebiopsy may be performed actively with an acceptable risk of complications if clinically required.