• 제목/요약/키워드: emergency repair

검색결과 162건 처리시간 0.02초

흉총창에 의한 심방파열 치험 2례

  • 이두연;곽상룡
    • Journal of Chest Surgery
    • /
    • 제13권1호
    • /
    • pp.60-65
    • /
    • 1980
  • We have experienced 2 cases of the hunshot wound sof the chest involving cardiac injuries at department of the thoracic surgery, Capital Armed Forces General Hospital during I year from April I 1979 to Jan. 1980. In one case of two patients , he was a 22 years old man who was transported to this emergency room 4 hour 10 minutes after having gunshot wound of the left chest by helicopter. Physical examination showed small inlet in left 3rd ICS and left parasternal border, large outlet in left 8th ICS and left scapular line, no breath sound on left side and distant heart sound. chest roentgenography demonstrated marked pleural effusion in left side and mediastinum shifted to right. As soon as chest X-ray was taken, the bleeding through penetrating wound became profuse and cardiac arrest ensued. Closed chest cardiac massage was started and vigorous transfusion continued, but no effective cardiac activity could not be obtained. The patient was pronounced dead due to exsanguinating hemorrhage from wuwpected cardiac wounds. In this critically injured patient with evidence of intrathoracic hemorrhage and suspected cardiac penetration, only emergency thoracic exploration and immediate surgical control of bleeding points might offer the maximum possibility of survival. The other case was a 23 years old man who was transferred to the emergency room 4 hours 50 minutes after having kmultiple communicated fractures of sternum and linear fracture of right mandible by a missile. Examination revealed about 30% skin loss of the anterior chest wall, weak pulse of 96 beats/min., distant heart sound and decreased breath sounds bilaterally. finding on the chest X-ray films showed multiple sternal fractures, marked pericardial effusion indicating hemopericardium. So, the patient was moved immediately to the operation room where, after endotracheal tube inserted, a median sternotomy was performced. A hemorrhagic congestion of the right upper lobe and marked bulging pericardium were disclosed. The pericardium was opened anterior to right phrenic nerve and exsanguinating hemorrhage ensued from the 0.5cm lacerated wound in the auricle of right atrium. The rupture site of right atrium was occluded with non-crushing vascular clamps and then was over sewn with interrupted sutures. It was thought to be highly possible that he was alive long enough to have cardiorrhaphy because of cardiac tamponade, which prevented exsanguinating hemorrhage. He was taken closed reduction for linear fracture of right mandible 2 weeks after repair of ruptured right auricle in dental clinic. This patient's post-operative course was not eventful.

  • PDF

A Treatment Case of Delayed Aortic Injury: The Patient with Posterior Rib Fracture

  • Park, Hyun-Seok;Ryu, Se-Min;Cho, Seong-Joon;Park, Sung-Min;Lim, Sun-Hye
    • Journal of Chest Surgery
    • /
    • 제47권4호
    • /
    • pp.406-408
    • /
    • 2014
  • A 66-year-old male patient arrived at the emergency room with a crush injury to his chest. Multiple rib fractures, hemothorax on both sides, left scapular fracture, liver laceration, and retroperitoneal hematoma were found upon the radiologic examination. After closed thoracostomy, the patient had been initially admitted to the intensive care unit, but he was transferred to the general ward on the next day. On the 4th post-trauma day, the patient complained of severe pain and there was bloody drainage through the chest tube. This case is an exploration with the consideration of the possibility of major bleeding and the subsequent repair of the descending thoracic aorta. This case is regarded as a case in which the aorta wall was damaged as the sharp margin of the fractured ribs caused continuous irritation.

Hybrid Technique to Correct Cerebral Malperfusion Following Repair of a Type A Aortic Dissection

  • Kim, Seon Hee;Song, Seunghwan;Kim, Sang-Pil;Lee, Jonggeun;Lee, Han Cheol;Kim, Eun Soo
    • Journal of Chest Surgery
    • /
    • 제47권2호
    • /
    • pp.163-166
    • /
    • 2014
  • A 49-year-old man with drowsy mentality was diagnosed with acute type A aortic dissection; he underwent an emergency operation. When selective antegrade cerebral perfusion was initiated, the right regional cerebral oxygen saturation ($rSO_2$) decreased as compared to the left one. Adequate blood flow was perfused through the branch of the artificial graft, after distal anastomosis, but the right $rSO_2$ did not recover. Angiography revealed another intimal tear on the right common carotid artery. A stent was then inserted. The right $rSO_2$ promptly increased to the same level as that of the left one. The patient was discharged without any neurologic complications.

실감미디어 동영상정보를 이용한 실내 공간 정보 제공 시스템 구현 (The Implementation of Information Providing Method System for Indoor Area by using the Immersive Media's Video Information)

  • 이상윤;안희학
    • 디지털산업정보학회논문지
    • /
    • 제12권3호
    • /
    • pp.157-166
    • /
    • 2016
  • This paper presents the interior space information using 6D-360 degree immersive media video information. And we implement the augmented reality, which includes a variety of information such as position information, movement information of the specific location in the interior space GPS signal does not reach the position information. Augmented reality containing the 6D-360 degree immersive media video information provides the position information and the three dimensional space image information to identify the exact location of a user in an interior space of a moving object as well as a fixed interior space. This paper constitutes a three dimensional image database based on the 6D-360 degree immersive media video information and provides augmented reality service. Therefore, to map the various information to 6D-360 degree immersive media video information, the user can check the plant in the same environment as the actual. It suggests the augmented reality service for the emergency escape and repair to the passengers and employees.

자석 이물에 의한 위-십이지장 누공 1예 (A Case of Gastroduodenal Fistula Caused by Ingested Magnetic Foreign Bodies)

  • 이원희;민영돈;문경래
    • Pediatric Gastroenterology, Hepatology & Nutrition
    • /
    • 제11권1호
    • /
    • pp.84-88
    • /
    • 2008
  • 여러 개의 자석을 삼킨 경우 자석들이 서로 잡아당겨 압력 괴사로 인한 장폐쇄, 장천공, 누공 형성 등의 합병증을 일으킬 수 있다. 따라서 영 유아나 정신과적인 문제가 있는 큰 아이의 경우 자석이나 자석이 포함된 장난감과 같은 물건들을 멀리하고, 자석을 삼킨 경우에는 즉시 확인해 보아야 한다. 저자들은 1년 전부터 주기성 구토를 호소했던 중등도 정신지체를 가진 12세 남아에서 삼킨 장난감 자석 4개로 인해 위-십이지장 누공을 형성하였고 수술 후 호전된 1예를 치험하였기에 보고하는 바이다.

  • PDF

외상성 기도 손상의 임상적 고찰 (Clinical Aanalysis of Airway Trauma)

  • 조현민;김영진;류한영;황정주
    • Journal of Trauma and Injury
    • /
    • 제24권1호
    • /
    • pp.7-11
    • /
    • 2011
  • Purpose: Traumatic airway injuries have high rates of mortality and morbidity. Thus, we evaluated the clinical results of trauma-related airway-injury patients. Methods: A clinical analysis was performed for patients with airway trauma who were admitted and treated at the Department of Thoracic and Cardiovascular Surgery, Konyang University Hospital from Dec. 2002 to Dec. 2009. Results: Sixteen patients were admitted and treated. Fourteen patients were male, and the ages of the patients ranged from 16 to 75 years. Six cases were penetrating injuries, 4 were traffic-accident injuries. 3 were fall injuries, and. 3 were other blunt trauma injuries. Anato- mic injuries included 14 trachea cases (87.5%), 1 Rt. main bronchus (6.25%), and 1 Lt. main bronchus cases (6.25%). Diagnosis was made by using computed tomography and bronchoscopy. Five patients were treated with an explothoracotomy, and 7 underwent neck exploration with primary repair. Three patients simply needed conservative management, and 1 patient was treated with a closed thoracostomy. The post-operative mortality rate was 6.25 % (1 patient). Conclusion: Airway trauma is dangerous and should be treated as an emergency, so a high index of suspicion is essential for rapid diagnosis and successful surgical intervention in patients with airway injuries.

Non-Tuberculous Mycobacterium Induced Pseudoaneurysm of the Common Carotid Artery

  • Lee, Hae Young;Cho, Seong Ho;Kim, Hyun Su;Moon, Jeong Min;Lee, Sangho;Kim, Jong In
    • Journal of Chest Surgery
    • /
    • 제49권6호
    • /
    • pp.468-471
    • /
    • 2016
  • An 81-year-old male patient presented with complaint of a pulsating neck mass. The patient had a previous history of cervical lymphadenopathy by non-tuberculous mycobacterium infection. Rapid growth of the mass on admission and contrast enhanced computed tomography of the neck resulted in a diagnosis of non-tuberculous mycobacterium induced pseudoaneurysm. The patient underwent emergency open repair of the pseudoaneurysm. Pseudoaneurysm of the common carotid artery is regularly reported, but here we report a rare case of non-tuberculous mycobacterium induced pseudoaneurysm of the common carotid artery.

Favorable Aortic Remodeling Following Serial False Lumen Procedures in a Case of Chronic Type IIIb Dissection

  • Eleshra, Ahmed Sameh;Heo, Woon;Lee, Kwang-Hun;Lee, Shin-Young;Lee, Ha;Song, Suk-Won
    • Journal of Chest Surgery
    • /
    • 제51권4호
    • /
    • pp.286-289
    • /
    • 2018
  • We report a case of acute type I aortic dissection in which an emergency graft replacement of the ascending aorta and innominate artery was performed. We performed false lumen thrombosis through hybrid thoracic endovascular aortic repair to seal the primary entry tear, followed by false lumen obliteration at the level of the descending thoracic aorta, abdominal aorta, and right common iliac artery. Over a period of 4.5 years, we used Amplatzer vascular plugs and coils based on our computed tomography angiography follow-up protocol.

Isolated Common Hepatic Duct Injury after Blunt Abdominal Trauma

  • Park, Yun Chul;Jo, Young Goun;Kang, Wu Seong;Park, Eun Kyu;Kim, Hee Jun;Kim, Jung Chul
    • Journal of Trauma and Injury
    • /
    • 제30권4호
    • /
    • pp.231-234
    • /
    • 2017
  • Extrahepatic bile duct injury is commonly associated with hepatic, duodenal, or pancreatic injuries, and isolated extrahepatic bile duct injury is rare. We report a patient who presented with an isolated extrahepatic bile duct injury after blunt trauma. A 50-year-old man was referred to our hospital after having suffered a fall down injury. His laboratory findings showed hyperbiliribinemia with elevated aspartate aminotransferase and alanine aminotransferase level. Initial abdominal computed tomography (CT) showed a mild degree of hemoperitoneum without evidence of abdominal solid organ injury. On the 3rd day of hospitalization, the patient complained of dyspnea and severe abdominal discomfort. Follow-up abdominal CT showed no significant interval change. Owing to the patient's condition, Emergency laparotomy revealed a large amount of bile-containing fluid collection and about 1 cm in size laceration on the left lateral side of the common hepatic duct. Primary repair of the injured bile duct with T-tube insertion was performed On postoperative day (POD) 30, endoscopic retrograde cholangiopancreatography showed minimal bile leakage and endoscopic sphincteroplasty and endoscopic retrograde biliary drainage were performed. On POD 61, the T-tube was removed and the patient was discharged.

상수도맨홀 관리를 위한 스마트 관리장치의 활용 (Leveraging the Smart device for waterworks manhole management)

  • 전해복;김영관
    • 상하수도학회지
    • /
    • 제31권2호
    • /
    • pp.141-148
    • /
    • 2017
  • The waterworks company is in charge of managing water facilities buried underground, and the management has been centered on manholes. However, since there is no standard management manual, it has been impossible to introduce and operate a systemized managing tool by water service providers and managers, and manhole management has been carried out by individual data recording personnel for each water service provider. When the management is carried out individually, the data to be shared by other waterworks managers tend to be privatized, and consequently, it may become a big obstacle to proceed with many civil works such as emergency leak repair, road excavation, replacement of old buildings. This report introduces RFID (Radio Frequency Identification) system which is based on the magnetic field capable of IOT. It also describes the necessity of leveraging the system for smart managing of pipe management record that has been done by hand writing. The RFID system includes RFID marker, data reader, portable computer operating program, and data base server operating program. In this system, the data is managed with a single communication device, and it would be possible to share the information on the underground facilities and water treatment facilities. This RFID technology is expected to provide water service providers with opportunities to develop more scientific and modernized underground facilities information systems.