• 제목/요약/키워드: Spleen injury

검색결과 85건 처리시간 0.028초

안정된 복부 둔상 환자에서 복강경하 비장 절제술 (Laparoscopic Splenectomy in a Case of Stable Blunt Abdominal Trauma)

  • 조항주;경연영;오주석;오영민;최세민;최경호
    • Journal of Trauma and Injury
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    • 제23권2호
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    • pp.192-195
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    • 2010
  • Splenic rupture is a frequent surgical emergency in blunt abdominal trauma patients. There are several treatment options, including conservative treatment, a partial splenectomy, splenorrhaphy, and a splenectomy for splenic injury. Although reports on the safety and the efficacy of an elective laparoscopic splenectomy are abundant in the literature, a laparoscopic splenectomy for a ruptured spleen has only been reported in a few cases. We report a case of a laparoscopic splenectomy in the patient with Grade III traumatic splenic injury. To our knowledge, this is the first report in which a laparoscopic splenectomy was performed in Korea for the treatment of a traumatic splenic injury.

한국에서 외상성 췌장 손상의 치료에 대한 문헌 고찰 (Management of Traumatic Pancreas Injury in Korea: Literature Review)

  • 이승환;장지영;심홍진;이재길
    • Journal of Trauma and Injury
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    • 제26권3호
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    • pp.207-213
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    • 2013
  • Purpose: Traumatic pancreas injuries are rare conditions that result in high morbidity and mortality. Thus, early diagnosis and intervention are very important to manage pancreatic injuries. The purpose of this study is to review the management and outcomes of the pancreatic injuries in the Korean population. Methods: Original articles published from January 2001 to December 2012 and addressing the Korean population were selected by using indices such as 'pancreas injury', 'traumatic pancreas injury', and 'pancreatic trauma' to search KoreaMed and PubMed. Nine reports were selected to review the management options for surgery or endoscopic retrograde cholangio-pancreatography. We assessed the injury mechanisms, injury severities, associated injuries, types of operation, and outcomes. Results: Two hundred fifty of the 332 patients included in the 9 selected reports were men, and the mean age of all patients was 36.4 years. The main injury mechanism was traffic accidents(65.6%). Most patients had grade II or III injuries(68.9%). The most common extra-pancreatic injury site was the liver, followed by the chest and spleen. Operative management, including distal pancreatectomies(129), drainage procedures(64), pancreaticoduodenectomies(23), and others(60), was used for 276 patients. The reported mortality rate was 10.2%, and the morbidity rate ranged from 38% to 76.9%. The average length of hospital stay was 39.5 days. Risk factors for mortality were amount of transfusion, injury severity, base deficit, age, and presence of shock. Conclusion: In this study, we found neither significant data nor a consensus. If national guidelines are to be developed and established, a national data bank or registry, and nationwide data collection are required.

갱년기(更年期) 장애(障碍)에 대(對)한 문헌적(文獻的) 고찰(考察) (Literary Study on the Climacteric Syndrome)

  • 김경수;유동열
    • 혜화의학회지
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    • 제13권1호
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    • pp.107-128
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    • 2004
  • This thesis is focused to get treatment on climacteric syndrome through literary study. The results are followed as below. 1. The climacteric syndrome is beginning with lowering of secretion of female hormone. It's not understood as abnormal disease but as normal phenomenon. 2. The causes of climacteric syndrome are defined as deficiency of the Kidney, stagnation of Liver, disharmony between Heart and Kidney, insufficiency of both the Heart and the Spleen, blood stagnation. 3. The causes of climacteric bleeding are continuous with overstrain, injury of the five emotions, blood heat, deteriorating blood. 4. The treatment of climacteric syndrome are mainly nutrition of Kidney and Liver, that of Kidney heat, descending Yang of Liver, nutrition of blood of heart, having a comunication with Kidney and Heart, nutrition of Spleen and Stomarch. 5. For the prescriptions on climacteric syndrome, the treatments such as Jaguium(左歸飮), Wooguium(右歸飮), Soyosan(逍遙散加減), Jibakjihwangtang(知柏地黃湯加減), Esuntang(二仙湯), Ejihwan(二至丸加味), Sihogayonggolmoryutang(柴胡加龍骨牡蠣湯加減) are used. And the acupuncture points such as Conception Channel, the Spleen Channel, the Urinary Bladder Channel, the Kidney Channel which are related to the lower belly of woman.

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소양인체질병증 임상진료지침: 소양상풍병 (Clinical Practice Guideline for Soyangin Disease of Sasang Constitutional Medicine: Lessor-Yang Wind-Injury (Soyang-sangpung) Symptomatology)

  • 전수형;최애련;이의주
    • 사상체질의학회지
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    • 제26권3호
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    • pp.241-250
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    • 2014
  • Objectives This research was proposed to present Clinical Practice Guideline(CPG) for Soyangin Disease of Sasang Constitutional Medicine(SCM): Lessor-Yang Wind-Injury (Soyang-sangpung) Symptomatology. This CPG was developed by the national-wide experts committee consisting of SCM professors. Methods First, it was performed that search and collection of literature related SCM such as "Dongeuisusebowon", Textbook of SCM, Clinical Guidebook of SCM and Fundamental research to standardize diagnosis of Sasang Constitutional Medicine. And journal search related to clinical trial or Human complementary medicine of SCM was performed domestic and overseas. Finally, 1 articles were selected and included in CPG for Lessor-Yang Wind-Injury (Soyang-sangpung) Symptomatology of Spleen Cold-based Exterior Cold (Bisuhan-pyohan) disease in Soyangin Disease. Results & Conclusions The CPG of Lessor-Yang Wind-Injury (Soyang-sangpung) Symptomatology in Soyangin Disease include classification, definition and standard symptoms of each pattern. Lessor-Yang Wind-Injury (Soyang-sangpung) Symptomatology is classified into mild and moderate pattern by severity. Lessor-Yang Wind-Injury (Soyang-sangpung) Symptomatology mild pattern is classified into initial pattern and advanced pattern. Lesser-Yang Wind-Injury (Soyang-sangpung) symptomatology moderate pattern is classified into Chest-binding (Gyeolhyoong) pattern and Chest-binding (Gyeolhyoong) advanced pattern.

간경화증 환자에서 경도 외상 후 발생한 지연 비장 파열 (Delayed Splenic Rupture Following Minor Trauma in a Patient with Underlying Liver Cirrhosis)

  • 정경운;이병국;류현호
    • Journal of Trauma and Injury
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    • 제24권1호
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    • pp.52-55
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    • 2011
  • The spleen is the most frequently injured organ following blunt abdominal trauma. However, delayed splenic rupture is rare. As the technical improvement of computed tomography has proceeded, the diagnosis of splenic injury has become easier than before. However, the diagnosis of delayed splenic rupture could be challenging if the trauma is minor and remote. We present a case of delayed splenic rupture in a patient with underlying liver cirrhosis. A 42-year-old male visited our emergency department with pain in the lower left chest following minor blunt trauma. Initial physical exam and abdominal sonography revealed only liver cirrhosis without traumatic injury. On the sixth day after trauma, he complained of abdominal pain and diarrhea after eating snacks. The patient was misdiagnosed as having acute gastroenteritis until he presented with symptoms of shock. Abdominal sonography and computed tomography revealed the splenic rupture. The patient underwent a splenectomy and then underwent a second operation due to postoperative bleeding 20 hours after the first operation. The patient was discharged uneventfully 30 days after trauma. In the present case, the thrombocytopenia and splenomegaly due to liver cirrhosis are suspected of being risk factors for the development of delayed splenic rupture. The physician should keep in mind the possibility of delayed splenic rupture following blunt abdominal or chest trauma.

황제내경(黃帝內經)이 동원(東垣)의 의학사상(醫學思想)에 미친 영향에 관한 연구 (A Study on the Effect of Naegyeong on Lee Dong-yuan's Medical Thought)

  • 남무길;정창현
    • 대한한의학원전학회지
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    • 제18권2호통권29호
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    • pp.85-101
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    • 2005
  • The purpose of this study is to explain the effect of Naegyeong on Lee Dong-yuan's medical thought. Lee is famous physician who studied the theory of spleen and stomach. His general idea of spleen and stomach could be thought as an result of study on Naegyeong. He distinguished between Eum disease and Yang disease and classified into internal injury and external affection. In the contents of Naegyeong, he took note of the four seasons' changes that are continued by the ascending and descending between heaven and earth, also he took note of the fact that movement of human body's organs is represent of ascending and descending. Human body is a site that a singular ascending and descending of Gi of the stomach.

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Effects of lipopolysaccharide and CpG-DNA on burn-induced skin injury

  • Park, Byoung-Kwon;Kim, Dong-Bum;Cho, Sun-Hee;Seo, Jae-Nam;Park, Jae-Bong;Kim, Yong-Sun;Choi, Ihn-Geun;Kwon, Hyeok-Yil;Lee, Young-Hee;Kwon, Hyung-Joo
    • BMB Reports
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    • 제44권4호
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    • pp.273-278
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    • 2011
  • Destruction of the skin barrier by thermal injury induces microbial invasion, which can lead to the development of systemic infection and septic shock. Microbial pathogens possess pathogen-associated molecular patterns (PAMPs), which are recognized by conserved receptors. To understand the role of PAMPs in thermal injury-induced mice, LPS or CpG-DNA were topically applied to dorsal skin after thermal injury. We observed an increase in the number of inflammatory cell infiltrates as well as thickening in the dermis upon treatment with LPS or CpG-DNA. We also found that expression of IL-$1{\beta}$, MIP-2, and RANTES induced by thermal injury was enhanced by LPS or CpG-DNA. In addition, the proportions of $CD4^+$ and $CD^8+$ T cells in the spleen and lymph nodes were altered by LPS or CpG-DNA. These results provide important information concerning PAMPs-induced inflammation upon thermal injury and provide a basis for studying the role of PAMPs in thermal injury-induced complications.

복부 손상을 동반한 흉부손상 환자의 외과적 치료 (Surgical Treatment of Thoracic Injuries Combined with Abdominal Injuries)

  • 정성운;김병준;이성광
    • 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.

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Could the Injury Severity Score be a new indicator for surgical treatment in patients with traumatic splenic injury?

  • Jeong, HyeJeong;Jung, SungWon;Heo, Tae Gil;Choi, Pyong Wha;Kim, Jae Il;Jung, Sung Min;Jun, Heungman;Shin, Yong Chan;Um, Eunhae
    • Journal of Trauma and Injury
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    • 제35권3호
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    • pp.189-194
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    • 2022
  • Purpose: The purpose of this study was to determine whether a higher Injury Severity Score (ISS) could serve as an indicator of splenectomy in patients with traumatic splenic lacerations. Methods: A total of 256 cases of splenic laceration were collected from January 1, 2005 to December 31, 2018. After the application of exclusion criteria, 105 were eligible for this study. Charts were reviewed for demographic characteristics, initial vital signs upon presentation to the emergency room, Glasgow Coma Scale, computed tomography findings, ISS, and treatment strategies. The cases were then divided into nonsplenectomy and splenectomy groups for analysis. Results: When analyzed with the chi-square test and t-test, splenectomy was associated with a systolic blood pressure lower than 90 mmHg, a Glasgow Coma Scale score lower than 13, active bleeding found on computed tomography, a splenic laceration grade greater than or equal to 4, and an ISS greater than 15 at presentation. However, in multivariate logistic regression analysis, only active bleeding on computed tomography showed a statistically significant relationship (P=0.014). Conclusions: Although ISS failed to show a statistically significant independent relationship with splenectomy, it may still play a supplementary role in traumatic splenic injury management.

Polysaccharides from Panax ginseng promote intestinal epithelial cell migration through affecting the Ca2+ related regulators

  • Huibin Zhu;Jianhong Cao;Xinyi Liang;Meng Luo;Anrong Wang;Ling Hu;Ruliu Li
    • Journal of Ginseng Research
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    • 제47권1호
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    • pp.89-96
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    • 2023
  • Background and aim: Panax ginseng, a key herbal medicine of replenishing Qi and tonifying Spleen, is widely used in the treatment of gastrointestinal diseases in East Asia. In this study, we aim to investigate the potential effects and mechanisms of polysaccharides from P. ginseng (PGP) on intestinal mucosal restitution which is one of the crucial repair modalities during the recovery of mucosal injury controlled by the Ca2+ signaling. Methods: Rat model of intestinal mucosal injury was induced by indomethacin. The fractional cell migration was carried out by immunohistochemistry staining with BrdU. The morphological observations on intestinal mucosal injury were also performed. Intestinal epithelial cell (IEC-6) migration in vitro was conducted by scratch method. Western-blot was adopted to determine the expressions of PLC-𝛾1, Rac1, TRPC1, RhoA and Cav-1. Immunoprecipitation was used to evaluate the levels of Rac1/PLC-𝛾1, RhoA/TRPC1 and Cav-1/TRPC1. Results: The results showed that PGP effectively reduced the assessment of intestinal mucosal injury, reversed the inhibition of epithelial cell migration induced by Indomethacin, and increased the level of Ca2+ in intestinal mucosa in vivo. Moreover, PGP dramatically promoted IEC-6 cell migration, the expression of Ca2+ regulators (PLC-𝛾1, Rac1, TRPC1, Cav-1 and RhoA) as well as protein complexes (Rac1/PLC-𝛾1, Cav-1/TRPC1 and RhoA/TRPC1) in vitro. Conclusion: PGP increases the Ca2+ content in intestinal mucosa partly through controlling the regulators of Ca2+ mobilization, subsequently promotes intestinal epithelial cell migration, and then prevents intestinal mucosal injury induced by indomethacin.