• Journal of Chest Surgery
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• 제52권1호
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• pp.47-50
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• 2019

Thoracic splenosis is a rare disease that develops as a result of autotransplantation of splenic tissue into the thoracic cavity following splenic and diaphragmatic injury. We report the case of a 53-year-old man with a chief complaint of heartburn and cough. He had a history of traumatic diaphragmatic rupture treated with surgical repair and splenectomy 15 years ago. Imaging studies revealed a paraesophageal mass, and surgical resection was performed considering the possibility of Castleman disease or an esophageal submucosal tumor. Pathologic results showed findings of normal splenic tissue. The patient was discharged on postoperative day 5 without any complications.

• Journal of Chest Surgery
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• 제40권1호
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• pp.66-68
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• 2007

외상성 심장 손상은 매우 위중한 의학적인 상황이다. 흉벽의 외상이 없는 경우 심장의 손상은 간과될 수 있다. 저자들은 자동차 추돌사고를 입고 우심방 파열이 발생한 47세 여자 환자를 보고한다. 감속손상으로부터 발생하는 비틀림의 힘은 고정점에서 심장의 파열을 일으킬 수 있다. 심장의 심각한 손상을 의심할 수 있는 가장 흔한 증상은 활력증후의 변화이다. 그러므로 감속손상을 입은 환자에서 흉벽의 외상이 없더라도, 이유가 설명되지 않는 저혈압이 관찰될 때 심장의 손상을 의심하여야겠다.

• 대한기계학회논문집A
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• 제33권8호
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• pp.799-806
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• 2009

Thoracic injury from restraint loading is the principle causative factor of death, which was shown to be particularly significant for older drivers. To characterize thoracic response to belt loading of older drivers, detailed finite element models of the adult and aged thorax were developed. The geometry of the 50th percentile adult male was chosen for the adult FE model. The thoracic FE model was validated against data obtained from results of PMHS pendulum impact tests. The quantified patterns of age-related shape and well-established material changes were applied to the adult model to develop the aged model. Belt force and chest deflection were applied to the developed two types of models. Rib and clavicle fracture risk obviously increased in the aged model. This finding showed that larger rib angle and reduced material properties of the ribcage produced more higher risk of injury in the older driver.

• Journal of Trauma and Injury
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• 제25권4호
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• pp.267-270
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• 2012

A 27 year-old man, who had a penetrating cardiac injury due to a metal fragment was transferred to our hospital. At admission, his vital signs were stable, and his chest film showed a foreign-body-like finding in the heart silhouette. We evaluated the patient with chest computed tomography and echocardiography for further information. Finally, we removed the metal fragment from the left ventricle by using a cardiopulmonary bypass.

• 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).

• 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.

• Journal of Trauma and Injury
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• 제34권2호
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• pp.81-86
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• 2021

Purpose: This study investigated the clinical outcomes of trauma patients with blunt thoracic aortic injuries at a single institution. Methods: During the study period, 9,501 patients with traumatic aortic injuries presented to Trauma Center of Gil Medical Center. Among them, 1,594 patients had severe trauma, with an Injury Severity Score (ISS) of >15. Demographics, physiological data, injury mechanism, hemodynamic parameters associated with the thoracic injury according to chest computed tomography (CT) findings, the timing of the intervention, and clinical outcomes were reviewed. Results: Twenty-eight patients had blunt aortic injuries (75% male, mean age, 45.9±16.3 years). The majority (82.1%, n=23/28) of these patients were involved in traffic accidents. The median ISS was 35.0 (interquartile range 21.0-41.0). The injuries were found in the ascending aorta (n=1, 3.6%) aortic arch (n=8, 28.6%) aortic isthmus (n=18, 64.3%), and descending aorta (n=1, 3.6%). The severity of aortic injuries on chest CT was categorized as intramural hematoma (n=1, 3.6%), dissection (n=3, 10.7%), transection (n=9, 32.2%), pseudoaneurysm (n=12, 42.8%), and rupture (n=3, 10.7%). Endovascular repair was performed in 71.4% of patients (45% within 24 hours), and two patients received surgical management. The mortality rate was 25% (n=7). Conclusions: Traumatic thoracic aortic injuries are life-threatening. In our experience, however, if there is no rupture and extravasation from an aortic injury, resuscitation and stabilization of vital signs are more important than an intervention for an aortic injury in patients with multiple traumas. Further study is required to optimize the timing of the intervention and explore management strategies for blunt thoracic aortic injuries in severe trauma patients needing resuscitation.

• 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.

• Journal of Chest Surgery
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• 제32권12호
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• pp.1131-1134
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• 1999

After a penetrating thoracic injury early detection of intracardiac injury and early surgical repair when indicated are essential. A case presenting severe respiratory distress two weeks after a penetrating thoracic injury is reported. Transesophageal echocardiography showed massive pericardial effusion ventricular septal defect and mirtal regurgitation, The infundibular ventricular septal perforation was repaired using a Dacron patch the anterior mitral leaflet by interrupted sutures and the ruptured chordae of the posterior leaflet by a new chordae formation.

• 대한기관식도과학회지
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• 제14권1호
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• pp.42-45
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• 2008

Tracheal injury associated with esophageal injury due to fish bone is very rare. Also, treatment of mediastinitis due to esophageal perforation when it is diagnosed late remains controversial. We report the case that we have successfully experienced treatment of mediastinitis due to tracheal and esophageal injury by fish bone.