• Journal of Chest Surgery
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• 제28권8호
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• pp.801-806
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• 1995

Tracheal rupture by a blunt trauma is an uncommon injury, and its clinical presentations are variable. It is a kind of the modern hazard. Herewith, we report a successful management of the tracheal rupture. A 22 year-old female was transferred from other hospital 4 hours after a car crash. Physical examination, simple chest X-ray, Chest CT and fiberoptic bronchoscopy revealed rupture of the membranous portion of the trachea about 5cm in length extending to the right main bronchus. Ruptured membraous portion of the trachea was sutured directly with absorbable suture. Her postoperative course was uneventful, and follow-up fiberoptic bronchoscopy revealed intact membranous portion of the trachea.

• Journal of Trauma and Injury
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• 제26권4호
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• pp.297-299
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• 2013

Traumatic asphyxia, also called 'Perthes syndrome', is characterized by subconjunctival hemorrhage, cervicofacialpetechiae and cyanosis resulting from venous hypertension caused by an abrupt, severe, compressive force to the thoracoabdominal region. A 37-year-old male patient who was transferred to the emergency room due to chest trauma by overturning of a forkcrane. His head, neck, and shoulders showed severe ecchymosis, and his upper chest was cyanotic. There was bilateral subconjunctival hemorrhage and bilateral ear bleeding without tympanic rupture. Perthes syndrome is a rare condition and we treated a patient with typical and atypical symptoms; thus we report this case of Perthes syndrome.

• Journal of Chest Surgery
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• 제30권10호
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• pp.1028-1031
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• 1997

무명동맥은 길이가 짧고 흉곽에 의해 잘 보호되기 때문에 흉부둔상에 의한 무명동맥의 손상은 매우 드물다. 본 증례는 흉부둔상을 수상한 37세의 남자에서 발생한 무명동맥 파열로 흉부W와 대동맥 조영술로 진단되었다. 정중흉골절개를 통한 응급 수술을 시행한 바 무명동맥의 근위부에 길이와 폭이 각각 3 cm의 가성동맥류를 형성하고 있었고 혈관 내피의 완전파열을 관찰할 수 있었다 무명동맥의 근위부를 대동맥궁 쪽에서 폐쇄시키고 손상된 부위를 절제한 후 10 m Gore-tex를 이용하여 대동맥-무명동맥 우회술을 실시하였다. 수술후 환자는 20일째에 신경학적 합병증없이 퇴원하였고 양측상지의 혈압도 동일하게 측정되었다.

• Journal of Trauma and Injury
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• 제18권2호
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• pp.119-126
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• 2005

Background: Blunt thoracic trauma in children has a high morbidity and mortality. In this study, we assessed the significance of the injury pattern, mechanism and initial status in emergency department on severity and prognosis in pediatric blunt thoracic trauma patients. Method: We retrospectively reviewed medical records and chest X-ray and CT images of 111 pediatric blunt thoracic trauma patients from October 2000 to June 2005. Data recorded age, gender, season, injury mechanism, injury pattern, associated injury, length of hospital stay and cause of death. Result: Of all 111 patients, 68 patients were injured by motor vehicle accidents, 30 were falls, 5 were motorcycle accidents, 3 were sports accidents and 5 were miscellaneous. In thoracic trauma, single injury of lung contusion were 35 patients and 32 patients had multiple thoracic injuries. Hospital stay in school age group were longer than preschool age group. The causes of death were brain injury in 9, respiratory distress in 4, and hypovolemic shock in 2 patients. Emergently transfused and mechanically ventilated patients had higher mortality rates than other patients. Patients required emergency operation and patients with multiple thoracic injuries had higher mortality rates. Conclusion: In this study, patients with combined injury, emergency transfusion, mechanical ventilation, emergency operation, multiple injuries in chest X-ray had higher mortality rates. Therefore in these pediatric blunt thoracic trauma patients, accurate initial diagnosis and proper management is required.

• Journal of Chest Surgery
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• 제27권2호
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• pp.161-165
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• 1994

We have experienced a case of ventricular septal defect due to blunt chest trauma. A 22 year old male patient was admitted due to chest pain after Motor cycle accident on July 1st,1993. On 5th hospital day, sudden onset of dyspnea was noted and auscultation represented newly developed systolic murmur. A cardiac catheterization and Left ventriculogram revealed ruptured septum at the apical portion. Because there was open wound on anterior chest wall and congestive heart failure was medically controlled, the patient was discharged for elective operation. He was readmitted on August 14th, 1993.At operation, ventricular septal defect was found in apico-posterior muscular septal area, about 2.0 x 1.5 cm in size. The defect was repaired by double velour patch with interrupted suture and ventriculotomy was closed with Teflon felt. The patient`s postoperative course was uneventful and discharged 10 days postoperatively without complication. The patient have been followed up~ for 2 months. He is on functional class I with small amount of residual shunt at the ventricular septum.

• 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.

• Journal of Chest Surgery
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• 제53권5호
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• pp.291-296
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• 2020

Background: We report our 10-year experience with traumatic peripheral arterial injury repair at an urban level I trauma center. Methods: Between January 2007 and December 2016, 28 adult trauma patients presented with traumatic peripheral arterial injuries. Data were retrospectively collected on demographic characteristics, the mechanism of injury, the type of vascular injury, and physiological status on initial assessment. The analysis also included the Mangled Extremity Severity Score (MESS), Injury Severity Score, surgical procedures, and outcome variables including limb salvage, hospital stay, intensive care unit stay, and postoperative vascular complications. Results: Four (14.3%) patients required amputation due to failed revascularization. MESS significantly differed between patients with blunt and penetrating trauma (8.2±2.2 vs. 5.8±1.3, respectively; p=0.005). The amputation rate was not significantly different between patients with blunt and penetrating trauma (20% vs. 0%, respectively; p=0.295). The overall mortality rate was 3.6% (1 patient). Conclusion: Blunt trauma was associated with higher MESS than penetrating trauma, and amputation was more frequent. In particular, patients with blunt trauma had significantly higher MESS than patients with penetrating trauma (8.2±2.2 vs. 5.8±1.3, respectively; p=0.005), and amputation was performed when revascularization failed in cases of blunt trauma of the lower extremity. Therefore, particular care is needed in making treatment decisions for patients with peripheral arterial injuries caused by blunt trauma.

• Journal of Chest Surgery
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• 제22권6호
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• pp.1070-1077
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• 1989

Traumatic injuries of the diaphragm are not an infrequent occurrence with rise in violence and increasing use of automobiles, more diaphragmatic injuries may be seen. Fifty cases from Severance hospital were reviewed of these there were 27 injuries secondary to blunt trauma and 23 penetrating injuries, and occurred commonly in male. In blunt trauma, right and left diaphragmatic injuries occurred equally. Chest X * ray were normal in 18 cases [36 %], a hemo-and/or pneumothorax was present in 22 cases [44 %], and only 12 cases[24 %] were diagnosed or suspected as diaphragmatic injuries preoperatively. Seventeen cases underwent thoracotomy alone, 19 cases required laparotomy only, and 14 had combined thoracotomy and laparotomy. There were 5 deaths [10 % mortality], and all deaths related to the severity of associated injuries. It was concluded that injuries of the diaphragm should be suspected in all patients with severe blunt torso trauma or penetrating injuries near the diaphragm.

• Journal of Trauma and Injury
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• 제19권2호
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• pp.188-191
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• 2006

Tricuspid regurgitation after blunt chest trauma is rarely seen in the emergency department. A 19-year-old patient visited our emergency department with chest discomfort after collision with his brother while skiing. Recently, Skiing as a winter sports has become popular with the Korean people, so there is an increasing tendency for patients with diverse traumas associated with ski accidents to visit the emergency department. From simple abrasions or contusions to deadly injuries with unstable vital signs, we are seeing many kind of injuries in the emergency department. We present the case report of a patient with tricuspid regurgitation after a blunt chest trauma during the skiing.

• Journal of Chest Surgery
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• 제29권4호
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• pp.433-439
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• 1996

경북대 학교병원에서는 1980년 1월부터 1995년 7월까지 들상에 의한 횡격 막 손상 환자 32례와 관통상 에 의한 12례를수술 치료하였다. 평균연령은둔상의 경우)7.6세,관통상의 경우29.2세로,들상의 경우 가 평 균 8.4세가 높았다(p<0.05). 진단은 단순 흉부 X-선 사진으로 횡격막 손상을 진단한 경우가 둔상에서는 24례 (75%), 관통상에서는 4fl (33%)였다. 관통상에서는 횡격막 손상의 의심 없이 다른 장기손상으로 수술하여 횡격막 파열이 발견 된 경우가 7례 (58%)였다. 탈장은 둔상시 24례 (75%), 관통상시 5례 (42%)에서 발생 하였다. 탈장이 발생 한 29례의 횡격막 손상의 크기는 10.9 $\pm$ 4.3cm, 발생하지 않은 15례는 3.5 $\pm$ 2.9cm로 양군간의 크기 의 차 이가 있어 (p<0.05) 횡격막 손상의 크기와 탈장과는 밀접한 관계가 있었다. 수출은 진단 즉시 시 행하였으며, 수술시 절개방법은 들상의 경우 20례 (6)%)에서 개흥술, 9례 에서 개 복술, 2례 에서 개흥복술, 1례 에서 개흥술 및 개복술을 분리 시행하였으며, 관통상시에는 6례 (50%)에서 개복술, 4례에서 개흥술, 2례에서 개흥술 및 개복술을 분리 시행하였다. 수술 후 합병증은 둔상시 6례 (19%), 관통 澯\ulcorner3례 (25%)에서 발생하여 비교적 높았다. 수술 후 사망률은 들상의 경우 2례 에서 사망하 였고(6.3%), 관통상의 경우는 사망례가 없어 전체 사망률은 4.5%였다. 결론적으로흥복부 외상시 횡격막 손상의 가능성을 염두에 두어야하며, 둔상의 경우횡격막손상의 크기는 관통상에 의한 경우보다 더 크며, 탈장도 횡격막 손상의 길이 에 비례하여 더 많이 발생하였다.