• Title/Summary/Keyword: Traffic Injury Patients

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Pneumoperitoneum from vaginal cuff dehiscence following blunt trauma in a patient with a history of robotic hysterectomy in Korea: a case report

  • Byung Hee Kang;Donghwan Choi
    • Journal of Trauma and Injury
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    • v.37 no.1
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    • pp.83-85
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    • 2024
  • Pneumoperitoneum usually presents as a surgical emergency, especially in patients with a history of trauma. However, we recently encountered an atypical case of pneumoperitoneum at a hysterectomy site following blunt trauma, indicating that immediate laparotomy may not always be necessary. In this report, we present the case of a 45-year-old woman who was transferred to our trauma center from a local hospital after being involved in a traffic accident the day before. Although she underwent an emergency laparotomy, no bowel perforation was detected. Instead, a rupture was found at the site of a hysterectomy that had been performed 8 months earlier. After repairing the hysterectomy site, the pneumoperitoneum resolved, and the patient was subsequently discharged without further complications.

Clinical Observations of the Chest Trauma (흉부 손상에 대한 임상적 고찰)

  • 최명석
    • Journal of Chest Surgery
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    • v.23 no.5
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    • pp.905-915
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    • 1990
  • A clinical evaluation was performed on 545 cases of the chest trauma those had been admitted and treated at the department of thoracic and cardiovascular surgery in Chosun University Hospital during the past 11 years 5 months period from January 1978 to may 1989. Obtained results were as follows: 1. The ratio of male to female was 3.9: 1 in male predominance, and the majority[66.6%] was distributed from 3rd to 5th decade. 2. Nonpenetrating chest trauma was more common than penetrating about 4.6 times, and the most common cause of the nonpenetrating injuries was traffic accident[241/448, 53.8%] and of the penetrating injuries was stab wound[88/97, 90.7%]. 3. Only 79 cases[14.5%] were arrived to our emergency room within one hour after trauma. 4. The most common lesion due to trauma among these admitted patients was rib fracture[390/545, 71.6%], and the others were lung contusion[217/545, 39.8%], hemothorax[35%], hemopneumothorax[19.6%], and pneumothorax[11.8%] et al in decreasing order. 5. The associated injuries those required special treatment of other departments were 223 cases and its distributions were bone fractures[178/545, 32.7%], head injury[5.3%], and abdominal injury[6.6%]. 6. The others, but interesting chest injuries were follows: sternum fracture[3.1%], diaphragm rupture[2.6%], myocardial laceration and rupture[2 cases], bronchial rupture and laceration[2 cases], and traumatic thymoma rupture[1 case]. 7. The incidence of flail chest was 5.8%a[26/448] in the nonpenetrating injury, and the causes were multiple rib fracture which was in rows more than 4 rib fracture[20 cases], and sternum fracture[6 cases]. 8. We could managed the most of the patient with conservative treatment[43.1%] or closed tube thoracostomy[52.7%], but required emergency open thoracotomy in 64 cases

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Thoracic Trauma in Children (소아에서의 흉부외상)

  • 구본원;김성완
    • Journal of Chest Surgery
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    • v.30 no.1
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    • pp.77-82
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    • 1997
  • Sixty children were admitted to he Department of Thoracic and Cardiovascular Surgery, Kyungpook National University Hospital for the treatment of thoracic injuries for about a 10year period ending in August, 1995. We reviewed the hospital records retrospectively, to see the characteristics of the scope and consequences of childhood chest injuries. Mean age was 9 years and forty-six cases(77%) were male. Fifty children(83%) were victims of a blunt trauma. Among the blunt trauma patients, more than 60% were traffic-related. All victims of penetrating trauma were male. Among the blunt trauma patients, rib fracture was the most frequently found (52%) followed by pneumothorax(42%), although significant intrathoracic injuries occurred without rib fractures in )2% of blunt trauma cases. Associated injuries were present in 42% of children reviewed. Most frequently performed surgical procedure was closed thoracostomy(45% ), and ten children required thoracotomy and fifteen needed assisted ventilation. Modified Injury Severi y Scale(MISS) score was measured in the multiple Injured group. MISS score correlated significantly with the length of stay In the intensive care unit. One child(1.7% ), involved in a traffic accident, died of sepsis.

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A CLINICAL STUDY ON THE FACIAL BONE FRACTURE (악안면골절의 임상적고찰)

  • Jang, Hyun-Seok;Jang, Myung-Jin
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.18 no.3
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    • pp.454-462
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    • 1996
  • With the increase of population, dramatic urbanization, traffic, leisure and sports, the number of maxillofacial injury has increased markedly. Subsequently the number of motor vehicle accident, sports accident and industrial accident were increased and the number of oral and maxillofacial trauma patients were also markedly increased. A clinical study on 177 patients with facial bone fracture who visited Kangnam General Hospital during 4 years(1992-1995) was done by analysing sex, cause, fracture site, 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 4.2 : 1 and most frequently in twenties. 2. Violence was the most common cause of facial bone fracture. 3. Mandible was the most frequently occurred site and there were more cases of simple fracture(81.9%) than cases of compound fracture. 4. Simple fracture was most frequently occurred(44.0%). 5. In mandible fracture, simple fracture was 86.1%, fracture site was average 1.5 sites, most frequently in symphysis. 6. As treatment methods, open reduction(78.5%) was used more frequently than closed reduction(21.5%). 7. Post-operative complication occurred in 29.4% of the cases. 8. Other injuries that were related to maxillofacial fracture occurred in 28.2%.

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Serious Bleeding Complication Due to the Use of Low-molecular-weight heparin to treat a Traumatic Patient with Acute Renal Failure (급성신부전이 발생한 중증 외상 환자에서 저분자량헤파린 투여 후 발생한 심각한 출혈 합병증)

  • Kyoung, Kyu-Hyouck;Kim, Woon-Won;Park, Sung-Jin;Kim, Ki-Hoon;Kim, Jin-Soo;Park, Jong-Kwon
    • Journal of Trauma and Injury
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    • v.24 no.2
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    • pp.164-167
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    • 2011
  • Trauma is an important risk factor for a pulmonary thromboembolism, and anticoagulation is essential to prevent deep vein thrombosis (DVT) in patients with trauma. Low-molecular-weight heparin (LMWH) is excreted in the kidney; therefore, using LMWH in patients with renal insufficiency may increase the risk of bleeding complication. The following case describes a 55-year-old traffic accident victim who had massive bleeding and underwent a laparotomy for bleeding control. The patient had acute renal failure, and enoxaparin was administered for the prophylaxis of DVT. Although the patient suffered from serious complications such as pericardial hematoma, the patient recovered without sequellae and was discharged at day 84.

A Clinical Study of Facial Bone Fractures of Koreans at Yonsei Medical Center for the last 6 years (최근 6년간 연세의료원에서 경험한 한국인 안면골 골절에 대한 임상적 연구)

  • Park, Hyung-Sik;Lee, Eui-Wung;Yoon, Jung-Ho;Lee, Choong-Kook;Kwon, Jun-Ho;Min, Woo-Seok
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.11 no.1
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    • pp.21-31
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    • 1989
  • This is a series of continuing research on facial bone fractures of Koreans worked by Dept. of Oral and Maxillofacial surgery, Dental College of Yonsei University, Seoul, Korea, since 1972. The study was based on a series of 630 patients with facial bone fractures treated as in-patient at Yonsei Medical Center, Yonsei University, during the period of Jan., 1982 through Dec., 1987. The results obtained are as follows: 1. The ratio of Men to Women was 4.3 : 1, and admissions for facial bone fractures have been increased year after 1984. 2. The age frequency was highest in the third decade(38.3%), and fourth, second, fifth decade in orders. 3. The traffic accident was the most frequent cause of facial bone fractures (51.3%). 4. The most common location of facial bone fractures was the Mandible(35.3%), and Zygoma complex(29.8%), Nasal bone(15.0%), Maxilla(11.0%) were next in order of frequency. 5. In 291 patients of Mandible fractures, 226(77.7%) had fractures only in Mandible and 65(22.3%) had another facial bone fractures. The most frequent fracture site of Mandible was the Symphysis(43.0%) and Angle(22.4%), and Simple fracture was the most frequent in type of fracture(66.9%). Intermaxillary fixatin & Open reduction was major method of treatment(36.9%). 6. In 394 patients of Midface fractures 323)82.0%) had fractures only in Midface and 71(18.0%) had another facial bone fractures. The most frequent site of Midface fractures was zygoma complex & zygomatic arch(42.7%), and Simple fracture was the most common type of fractures. Observation(Maxilla :44.2%, Zygoma :51.0%) and Open Reduction(Maxilla :20.0%. Zygoma :23.5%) were the major method of treatment. 7. The frequency of Nasal bone fracture was about 1/5 of Midface fractures, and Closed Reduction(45.2%) was the major method of treatment. 8. The complication was reported in only 16 patients, and Malunion was the major complication. 9. Head(44.4%), Lower extrimities(14.5%) and Eye(12.3%) were injured commonly with facial bone fractures. 10. The elapsed time from injury to hospital was within 24 hours in 73.8% of patients, however 15.5% of patients arrived the hospital 72 hours after injury.

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A CLINICOSTATISTICAL STUDY ON MIDFACIAL BONE FRACTURE (중안면골 골절에 대한 임상통계학적 연구)

  • Ryu, Sun-Youl;Cho, Kyu-Seung
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.19 no.4
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    • pp.367-376
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    • 1997
  • The 234 patients who received treatment of midfacial fractures at the Department of Oral and Maxillofacial Surgery of Chonnam University Hospital from Jan. 1, 1992 to Dec. 31, 1996 were analyzed clinicostastically. Results obtained were as follows ; Male predominated over females by a ratio of 5.3 to 1. The frequently developing age groups were first 3rd (25%), 4th (21%) and the 2nd (18%) decade on succession. The peakest month was the August (16%), and May (11%), September (9%), October (9%). When it comes to the reasons for in-patients, traffic accident was predominant to 38%. In the 234 cases of midfacial fractures, zygomaticomaxillary complex fracture was the most by 37%. The most common with injury show that facial laceration marked by 49%, neurologic injury 24%, and mandibular fracture 20% each by each. About the time from injury onset to operation, 55% of cases were less than a week while the others (45%) more than a week. 3 plates were used for operation : 2 for zygoma or maxilla fracture and 3 for zygomatiomaxillary complex fracture. especially 4 for Le Fort I fracture, 5.5 for Le Fort I, II ; I, III ; II, III fracture, 7 for Le Fort I,II,III fracture were used. 20 patients (8%) appealed their complication and the most common was reported as infection. Above results suggest that early diagnosis and treatment of fracture site, systemic condition and associated injuries are necessary, and coorperative treatment with medical department should be performed.

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Clinical Analysis of Traumatic Diaphragmatic Rupture (외상성 횡격막 파열에 대한 임상적 고찰)

  • 권영무;신현종
    • Journal of Chest Surgery
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    • v.30 no.5
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    • pp.517-523
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    • 1997
  • The records of 14 patients with traumatic diaphragmatic rupture seen at Dongguk University Hospital from February 1992 through December 1995 were reviewed. Ten patients were male and four were female(M:F=2.5:1). The age distribution ranged from 17 to 73 years with the mean age of 41.7 years. The 14 patients included 12 who had blunt trauma(traffic accident 11, crushing injury 1) and 2 with penetrating diaphragmatic rupture(stab wound 2). Of those 12 blunt trauma, 7 patients(58.3%) were left sided and 5(41.7%) involved the right hemidiaphragm. The diagnosis was made preoperatively in 8 patients (57.1%) and during surgery in 6(42.9%). All right-sided injuries were repaired through a thoracotomy and left-sided defects were corrected through a laparotomy in 6, laparotomy and thoracotomy in 1. There were 2(14.3%) operative deaths that were caused by myocardial infarction and the sequelae of combined injuries.

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Analysis of the Prognostic Factors for Abdominal Trauma (복부외상환자의 예후에 영향을 미치는 인자들에 대한 분석)

  • Kim, Hee Joon;Kim, Hyung Soo;Seo, Kyung Won;Ju, Jae Kyun;Ryu, Seong Yeop;Kim, Jeong Cheol;Kim, Hyung Rok;Park, Young Kyu;Kim, Dong Yi;Kim, Young Jin;Kim, Shin Kon
    • Journal of Trauma and Injury
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    • v.20 no.1
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    • pp.12-18
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    • 2007
  • Purpose: Recently, trauma is more frequent due to the increases in the population, the number of traffic accident, and the incidence of violence. Especially, abdominal trauma is a leading cause of morbidity and mortality. We analyzed the clinical features and the factors associated with morbidity and mortality. Methods: We analyzed 136 patients of abdominal trauma who were admitted at the Department of Surgery, Chonnam National University Hospital, from January 2003 to June 2005. We analyzed the cause of trauma, the injured organ, combined injuries, mental status, blood pressure, laboratory findings, morbidity, and mortality. The relationships between by variable were assesed by using the independent samples test and the Kruskal?Wallis test. Results: The causes of trauma were traffic accidents (98 cases, 72%), falling accidents (9 cases, 6.6%), violence (6 cases, 4.4%), and stab injuries (6 cases, 4.4%). The injured organs were the small intestines (47 cases, 34.6%), the liver (35 cases, 25.7%), the spleen (26 cases, 19.1%), the mesentery (17 cases, 12.5%), the large intestines (15 cases, 11.0%), the pancreas (14 cases, 10.3%), etc. The most common combined injury was chest injury (53 cases, 39%). Comatose or semicomatose mental status and shock on admission (<60 mmHg in systolic) were related to high mortality (85.7%). In laboratory findings, decreased hemoglobin (<8 g/dL), and platelet count (<$50,000/mm^3$), and increased creatinine level (>1.6 mg/dL) were significant prognostic factors. The incidence of postoperative complications was 40.4%, and frequent complications were wound infection (8.1%) and re-bleeding (8.1%). The overall mortality rate was 18.4%, and most common cause was hypovolemic shock (18 cases, 13.2%), however, there was no statistical difference according to injurd organ. Conclusion: In the multivariate analysis, mental status, hemoglobin, and serum creatinine level were the most significant prognostic factors. When an abdominal trauma patient arrives at the emergency room, a rapid and accurate evaluation of the patient's status and risk factors, and resuscitation, if necessary, have to be performed to lower the morbidity and mortality.

The Study on Relation between Cervical Lateroflexion and Upper Limb Numbness of Patients without Disc Herniation after Traffic Accident (교통사고 이후 디스크 탈출이 없이 상지 저림을 호소하는 환자의 경추 측굴과 상지 저림에 관한 연구)

  • Park, Hyun-Min;Park, Ji-Yong;Kim, Dong-Sub;Kim, Eun-Soo;Kim, Mi-Riong;Cho, Nam-Hoon;Jeong, Hoon;Seong, Ik-Hyun;Kim, Min-Woo;Hong, Nam-Jung;Ha, In-Hyuk;Lee, Jin-Ho
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.8 no.2
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    • pp.21-29
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    • 2013
  • Objectives : The purpose of this study is to investigate the relation between cervical spine lateroflexion and upper limb numbness after whiplash injury by traffic accident. Methods : Outpatients who visited Jaseng korean medicine hospital after traffic accident took cervical MRI. Patients who had Normal disc and bulging disc were reviewed to measure the cervical lateroflexion by C2-C7 Cobb's angle & scalenus muscle's length through neutrality AP X-ray views. For statistics, we used SPSS version 18.0 for windows. Results : Groups classified into difference of scalenus muscle's length were showen statistical significance than into cobb's angle. Means of numbness group's length difference are $4.18{\pm}2.26mm$ and that of non-numbness group is $1.59{\pm}1.17mm$. Unilateral numbness group had greater angle and longer of length's difference than non-numbness group. Conclusions : The more severe the lateroflexion of the upper extremity numbness occurs well. Group classifed into difference of scalenus muscle's length has more tendency of occurrence of upper limb numbness than that into cobb's angle. And upper limb numbness occurs more frequently at the same direction of lateroflexion.

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