• Journal of Trauma and Injury
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• 제37권1호
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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.

• Journal of Chest Surgery
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• 제23권5호
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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

• Journal of Chest Surgery
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• 제30권1호
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• pp.77-82
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• 1997

경북대학교병원 흉븐외과엔서는 1995년 8월까지 약 10년간 본과에 입원하여 치료한 60명의 15세이하 소아연령의 흉부외상 환아 60울을 대상으로, 외상의 원인과 양상 및 치료결과 등을 분석하여, 국내에서 발표됐던 전체 연령군에 대한 결과와 비교하여 소아 연령층의 특수성을 파악하는데 중점을 두어 분석해 보았다. 남아가 46명으로 77%를 차지하였고, 평균연령은 9세였다. 50명의 환아가 들상에 기인하였으며, 둔상환아의 60%이상이 교통사고와 관련되어 있었다. 들상의 경우 늑골골절이 52%로 가장 흔하였고, 그 다음이 기흉, 혈흉 등의 순이었다. 특히 둔상환아의 32%가 늑골골절없이 기흉 등 흉곽내 장기 손상이 있었다. 관통상의 경우 10명 모두 남아였으며, 기흉, 혈흉이 가장 흔하였다. 42%의 환아에서 흉 부이외의 동반손상이 있었다. 치료를 위해 가장 흔히 시행한 외과적 처치는흉강삽관술이었으며(45%), 10례에서 개흉술이 필요하였다. 동반손상아 있었던 경우 MISS score와 중환자실 입실기간 사이에는 유의한 상관관계가 있었다(p<0.05). 9명의 환아에서 합병증이 있었으며 폐혈증으로 1명(1.7%)이 사망하였다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제18권3호
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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%.

• Journal of Trauma and Injury
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• 제24권2호
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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.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제11권1호
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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.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제19권4호
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• pp.367-376
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• 1997

저자등은 1992년 1월 1일부터 1996년 12월 31일까지 최근 5년간 전남대학교병원 구강악안면외과에 입원하여 치료받은 환자중 추적이 가능한 중안면골 골절 환자 234례에 대해 임상통계학적 비교 분석하여 다음과 같은 결과를 얻었다. 남녀비는 5.3 : 1로 남자에서 호발하였고, 연령별로는 20대, 30대, 10대순으로, 월별로는 8월, 5월, 9월과 10월 순으로 발생하였다. 발생원인은 자동차사고, 추락사고, 오토바이 사고의 순이었고, 골절부위로는 관골-상악골 복합골절이 86례로 가장 많았다. 연관 손상으로는 안면열상이 가장 많았으며 신경외과적 손상, 하악골 골절순이었다. 수상후 수술시 까지 경과시간은 1주일이내가 55%였다. 사용된 금속판수는 관골 또는 상악골 단독골절시에는 2개, 관골-상악골 복합 골절시에는 3개, Le Fort I, Le Fort I, II ; II, III ; I, III ; Le Fort I,II,III 골절시에는 각각 4개, 5.5개, 7개였다. 술후 합병증으로는 감염 7례, 안면비대칭 6례, 안구함몰증 5례, 부정교합 2례로 모두 20례(8%)가 발생하였다. 이상의 결과는 중안면골 골절시에 골절 부위와 환자의 전신상태 및 연관 손상에 대한 신속한 진단과 치료가 필요하고 타과와의 협동 치료가 이루어져야 함을 시사하였다.

• Journal of Chest Surgery
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• 제30권5호
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• pp.517-523
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• 1997

동국대학병원에서는 1992년 2월부터 1995년 12월까지 3년 10개월동안 외상에 의한 횡격막 파열환자 14fl를 수술치험하여 이를 분석하였다. 대상환자는 남자가 10례, 여자가 4례였고, 연령은 17세부터 73세까지로 평균연령은 41.7세였다. 손상의 원인은 둔상 12r11(85.7%), 관통상 2fBl(14.3%)였으며, 둔상에서는 교통사고 lIfTl, 압좌상 1례였고 관통상은 2례 모두 칼에 의한 자상이었다. 들상에 의한 횡격막 파열 12례 중에서는 좌측 손상이 7례(58.3%), 우측 손상이 5례(41.7%)로 우측 파열이 비교적 많은 비율을 차지굻였으며, 관통상에 의한 2례는 모두 우측 파열이었다. 단순흉부촬영, 전산화단층촬영, 초음파검사, 그리고 방사선투시검사 등을 이용하여 횡격막 파열을 진단하였으며, 14례 중 8례는 술전 진단하였고(57.1%), 술전 진단이 안된 경우는 6511(42.9%)였으며 모두 우측 파열이었다. 이들 중 5례는 횡격막 파열을 의심하여 시행한 시험적 개흉술로 진단하였으며, 1례는 동반손상에 대한 개흉술 중에 발견되었다. 우측 파열 7례는 개흉술로 수술하였으며, 좌측 파열의 경우 6례는 개복술로, 1례는 개복술 및 개흉술로 수술하였다. 술후 2례에서 사망하 \ulcorner수술사망율은 14.3%였다.

• Journal of Trauma and Injury
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• 제20권1호
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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.

• 척추신경추나의학회지
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• 제8권2호
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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.