• Title/Summary/Keyword: Neck-penetrating injury

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Clinical Analysis of the Patients with Isolated Low-Velocity Penetrating Neck Injury

  • Seok, Junepill;Cho, Hyun Min
    • Journal of Trauma and Injury
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    • 제31권1호
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    • pp.1-5
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    • 2018
  • Purpose: Although there has been substantial progress for the treatment of thoracic trauma, the mortality of the penetrating neck injury is still high, has been reported about 10-15%. However, there has not been a report which is reflecting Korean medical present. We retrospectively analyzed the penetrating neck injury patients based on the Korean Trauma Data Base. Methods: Between December 2013 and June 2017 at the trauma center of the Pusan National University Hospital, Busan, Korea, total of 36 patients with isolated low-velocity penetrating neck injuries were included. We analyzed the patients' age, gender, injury mechanism and causes by medical chart review. Results: Among total of 36 patients, 26 (72.2%) were male and 10 (27.8%) were female. Homicidal neck injuries were most common, followed by accidental and suicidal injuries (47% vs. 33% vs. 19%, respectively). All penetrating injuries in our study were low-velocity trauma such as following: knife (n=16, 44.4%); glass or glass bottle (n=11, 30.6%); scissors (n=4, 11.1%); grinder (n=2, 5.6%); and three (8.3%) of miscellaneous injuries. Twenty-seven (75.0%) patients underwent emergency surgery, and only one (2.8%) patient underwent elective surgery. Eleven (30.6) patients were diagnosed with superficial injuries, including six patients who had conservative treatment. Twelve (33.3%) patients had arterial injuries and 10 (27.8%) patients had venous injuries. The patients who had deep injuries showed significant difference against the patient with superficial injury (98.0 vs. 129.1, p=0.008). Conclusions: Low velocity penetrating injury confined to the neck is able to be successfully treated with prompt surgical management. Regardless of the conditions which are evaluated at emergency department, all penetrating neck injury patients should be regarded as urgent surgical candidates.

관통성 경부 손상에 관한 임상적 고찰 (Clinical Analysis of Penetrating Neck Injury: Review of 42 Operated Cases)

  • 최환;홍석진;김연수;조재구;백승국;우정수;정광윤;권순영
    • 대한기관식도과학회지
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    • 제16권2호
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    • pp.121-125
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    • 2010
  • Background: Penetrating neck injuries are potentially dangerous and require emergency management because of the presence of vital structures in the neck. The risk of airway, vascular, neurological, and pharyngoesophageal injuries leads to many difficult diagnostic decisions. The purpose of this retrospective study is to evaluate our experience with management of penetrating neck injuries, and to assess treatment outcome. Material and Method: Forty-two consecutive patients were identified (26 patients from Korea university Ansan hospital, 16 patients from Guro hospital) as having penetrating neck injuries from 2003 to 2009. With review of medical records, variables were collected and evaluated including the location of injury, mechanism of injury, number of significant injuries, diagnostic modalities, duration of hospital stay and outcome. Results: The location of injury was zone I (lower neck) in 13 cases (31%), zone II (midportion of the neck) in 22 (52%), and zone III (upper neck) in 7 (17%). Injuries were caused by stab wounds in 23 patients, penetrating foreign bodies in 12. Among 35 patients who had deep injuries that violated the platysma, significant injuries, including major vascular (20), trachea (5) Pharyngoesophageal injuries (5) were identified in 24 patients. The mean hospital stay was 9.5 days. Conclusion: The penetrating trauma in the neck may show various degrees of severity. However, Cervical penetrating injury should not be underestimated in spite of the minimal width of the lesion.

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추골동맥 손상을 동반한 안면과 경부의 관통성 외상 치험예 (PENETRATING INJURY OF FACE AND NECK WITH THE VERTEBRAL ARTERY INJURY;A CASE REPORT)

  • 송우식;김인권;이상현;황윤정;안정용
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제23권5호
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    • pp.447-451
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    • 2001
  • With the exception of gun shot wound, the incidence of penetrating injury of face and neck areas nonorganic foreign bodies is relative low. But the diagnostic evaluation and therapeutic management of penetrating facial wounds need careful decision, when the anatomic proximity of the major vessels and nerve is considered. Penetrating facial trauma with concomitant vascular injury present challenging problems, the immediate complication of this vascular injury are severe bleeding, hematoma formation, shock, obstruction of airway. The vascular injury is conformed by angiography. In this report, a industrial tool(long tack) fired by explosive air is penetrated into face and to neck. In angiograms penetrating injury of the vertebral artery is detected. We performed the embolization of the vertebral artery with coils and manual removal of the foreign body without any complication was followed.

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경흉부 관통상에 대한 경부와 정중흉골절개술을 이용한 치험 1례 (Emergency Repair Using Cervico-median Sternotomy for Cervicothoracic Penetrating Injury)

  • 이현주;김현구;최영호
    • Journal of Trauma and Injury
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    • 제21권2호
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    • pp.136-139
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    • 2008
  • A great variety of penetrating injuries is happening due to the increasing population and violence today. An optimal surgical approach is the key factor for successful repair of a complicated penetrating injury. A 23-year-old woman fell down the stairs from the second floor and received cervico-thoracic penetration injury due to a metalic bar. The metalic bar ruptured the right jugular vein and penetrated the left upper and lower lung. Under cervico-median sternotomy, neck vessels were repaired and the left thorax was successfully entered to repair the damaged lung through the mediastinal pleura. With this approach, the patient's position did not need to be changed during operation, while reduced the operation time compared to the conventional approach (cervical incision and standard thoracotomy).

Outcomes of open neck injuries

  • Noh, Dongsub;Choi, Jin Ho
    • Journal of Trauma and Injury
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    • 제35권3호
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    • pp.168-172
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    • 2022
  • Purpose: The neck is a particularly critical region for penetrating injuries due to the close proximity of the trachea, esophagus, blood vessels, and the spinal cord. An open neck injury has the potential for serious morbidity and mortality. The purpose of this study is to evaluate the assessment and management of open neck injuries. Methods: In this retrospective study, open neck injury patients who were admitted to the Trauma Center of Daejeon Eulji Medical Center, Eulji University between December 2015 and December 2017 were analyzed for epidemiology, the mechanism of trauma, the injured organ, complications, and mortality. Results: Thirty-two patients presented with open neck injuries. All patients underwent computed tomographic angiography to evaluate their injuries once their vital signs stabilized. Among these patients, 27 required surgical treatment. The most commonly injured organ was the airway. There were five deaths, and the main cause of death was bleeding. Mortality was associated with the initial systolic blood pressure at the hospital and Glasgow Coma Scale. Conclusions: Mortality from open neck injuries was associated with initial systolic blood pressure at the hospital and Glasgow Coma Scale.

Stent Graft Repair of Penetrated Injury of the Common Carotid Artery

  • Kim, Soon Jin;Ryu, Sang Woo;Chekar, Jaykey;Kim, Yong Tae;Seo, Bo Ra
    • Journal of Trauma and Injury
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    • 제29권4호
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    • pp.172-175
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    • 2016
  • Penetrated injury of common carotid artery (CCA) is rare and extremely lethal. Carotid artery injury tends to bleed actively and potentially occlude the trachea. It can cause fatal neurological complications. An accurate diagnosis and adequate treatment are very needed to the successful outcome of the penetrating vascular injury in zone 1, 2, and 3 of the neck. Open surgical treatment is more invasive and complicated than endovascular treatment. We experienced a case with penetrating injury in neck zone 2. Here, we report the case successfully treated with endovascular stent graft technique.

근육 모델이 고려된 두부 및 경추 유한요소모델을 이용한 비관통 피탄 충격에 의한 인체 상해 해석 (Analysis of Human Body Injury by Non-penetrating Ballistic Impact Using a Finite Element Model of the Head and Neck)

  • 강문정;조영남;채제욱;유홍희
    • 대한기계학회논문집A
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    • 제41권1호
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    • pp.1-6
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    • 2017
  • 헬멧을 착용한 병사의 비관통 피탄 충격은 총탄이 헬멧을 관통하지 않더라도 인체에 치명적인 상해를 유발한다. 이로 인한 인체 상해 해석을 위한 연구들이 이뤄져 왔으나 주로 두부의 손상에 초점을 맞춘 해석 모델이 개발되어 왔다. 비관통 피탄 충격에 의한 경추 및 경추부 관련 근육의 손상은 인체에 치명적인 상해를 입히지 않더라도 병사의 생존성에 상당한 영향을 미친다. 따라서 경추 및 경추부 근육을 포함한 모델 개발이 필요하다. 본 연구에서는 기존에 연구된 두부 모델과 근육 모델이 적용된 경추부 모델을 활용하여 인체의 상해해석을 수행하였다. 정량적 상해예측을 위해 응력, 변형률 및 HIC를 비교하였다. 경추부가 포함된 모델의 해석결과는 두부 모델만 고려된 해석결과보다 상해 정도를 작게 예측하였다. 모델의 신뢰성 확보를 위하여 두부 상해 해석 결과를 타 문헌과 비교하였다.

척수 손상을 일으킨 경부 가위 관통상 (Penetrating Neck Trauma: A Case of Spinal Cord Injury by Embedded Scissor)

  • 김선희;최선우;박성진;여광희;김창완;이상봉;김호현;박찬용;김재훈;황정주;조현민
    • Journal of Trauma and Injury
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    • 제28권2호
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    • pp.71-74
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    • 2015
  • Penetrating neck trauma involving spinal cord injury is relatively uncommon, but can be life-threatening. We report a case of 59-year-old female who presented with hypotension after stab injury self-inflicted with a scissor to her neck. Although Open removal of the scissor and control of bleeding were successfully done, penetration of spinal cord resulted in a neurologic impairment.

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총상에 의한 경부 관통상 -치험 1례- (Penetrating Neck Trauma by Gunshot Injury: 1 Case Report)

  • 홍윤주
    • 한국응급구조학회지
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    • 제9권1호
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    • pp.95-99
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    • 2005
  • Penetrating neck trauma by gunshot injury involving tracheobronchial tree is rare in Korea. Extensive tissue damage by cavitation, tissue fragmentation and shock wave transmission of high-velocity projectile along with associated organ injury renders high rate of mortality and morbidity. A 28 year old man in military service with gunshot wound in left cervical area presented initial symptoms of severe dyspnea and subcutaneous emphysema. Computed tomography of chest and cervical region as well as bronchoscopic evaluation was performed to confirm highly suspected injury to cervical trachea. Surgical exposure was established through a low collar incision; the damaged segment of 3.5 cm length including 2-4th tracheal rings was resected out and end-to-end anastomosis was performed. Bleeding from lacerated anterior jugular vein was controlled by ligation of both ends and a K2 bulllet was found upon inner border of body of first rib, medial to right carotid sheath and removed out. Cervical esophagus, carotid artery, internal jugular vein and recurrent laryngeal nerve were spared. Extubation was done on the first postoperative day and postoperative course until discharge on nineth postoperative day remained uneventful.

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복부와 경부 관통상 환자에 대한 임상적 고찰 (Clinical Analysis of Patients with Abdomen or Neck-penetrating Trauma)

  • 노하니;김광민;박준범;류훈;배금석;강성준
    • Journal of Trauma and Injury
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    • 제23권2호
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    • pp.107-112
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    • 2010
  • Purpose: Recently, the change to a more complex social structure has led to an increased frequency of traumas due to violence, accident and so on. In addition, the severity of the traumas and the frequency of penetrating injuries have also increased. Traumas to cervical and abdominal areas, what are commonly seen by general surgeons, can have mild to fatal consequences because in these areas, various organs that are vital to sustaining life are located. The exact location and characteristics of the injury are vital to treating patients with the trauma to these areas. Thus, with this background in mind, we studied, compared, and analyzed clinical manifestations of patients who were admitted to Wonju Christian hospital for penetrating injuries inflicted by themselves or others. Methods: We selected and performed a retrospective study of 64 patients who had been admitted to Wonju Christian Hospital from January 2005 to December 2009 and who had cervical or abdominal penetrating injuries clearly inflicted by themselves or others. Results: There were 51 male (79.7%) and 13 female (20.3%) patients, and the number of male patients was more dominant in this study, having a sex ratio of 3.9 to 1. The range of ages was between 20 and 86 years, and mean age was 43.2 years. There were 5 self-inflicted cervical injuries, and 19 self-inflicted abdominal injuries, making the total number of self-inflicted injury 24. Cervical and abdominal injuries caused by others were found in 11 and 29 patients, respectively. The most common area involved in self-inflicted injuries to the abdomen was the epigastric area, nine cases, and the right-side zone II was the most commonly involved area. On the other hand, in injuries inflicted by others, the left upper quadrant of the abdomen was the most common site of the injury, 14 cases. In the neck, the left-side zone II was the most injured site. In cases of self-inflicted neck injury, jugular vein damage and cervical muscle damage without deep organ injury were observed in two cases each, making them the most common. In cases with abdominal injuries, seven cases had limited abdominal wall injury, making it the most common injury. The most common deep organ injury was small bowel wounds, five cases. In patients with injuries caused by others, six had cervical muscle damage, making it the most common injury found in that area. In the abdomen, small bowel injury was found to be the most common injury, being evidenced in 13 cases. In self-inflicted injuries, a statistical analysis discovered that the total duration of admission and the number of patients admitted to the intensive care unit were significantly shorter and smaller, retrospectively, than in the patient group that had injuries caused by others. No statistically significant difference was found when the injury sequels were compared between the self-inflicted-injury and the injury-inflicted-by-others groups. Conclusion: This study revealed that, in self-inflicted abdominal injuries, injuries limited to the abdominal wall were found to be the most common, and in injuries to the cervical area inflicted by others, injuries restricted to the cervical muscle were found to be the most common. As a whole, the total duration of admission and the ICU admission time were significantly shorter in cases of self-inflicted injury. Especially, in cases of self inflicted injuries, abdominal injuries generally had a limited degree of injury. Thus, in our consideration, accurate injury assessment and an ideal treatment plan are necessary to treat these patients, and minimally invasive equipment, such as laparoscope, should be used. Also, further studies that persistently utilize aggressive surgical observations, such as abdominal ultrasound and computed tomography, for patients with penetrating injuries are needed.