• Title/Summary/Keyword: emergency repair

Search Result 162, Processing Time 0.023 seconds

Early Experiences with the Endovascular Repair of Ruptured Descending Thoracic Aortic Aneurysm

  • Choi, Jae-Sung;Oh, Se Jin;Sung, Yong Won;Moon, Hyun Jong;Lee, Jung Sang
    • Journal of Chest Surgery
    • /
    • v.49 no.2
    • /
    • pp.73-79
    • /
    • 2016
  • Background: The aim of this study was to report our early experiences with the endovascular repair of ruptured descending thoracic aortic aneurysms (rDTAAs), which are a rare and life-threatening condition. Methods: Among 42 patients who underwent thoracic endovascular aortic repair (TEVAR) between October 2010 and September 2015, five patients (11.9%) suffered an rDTAA. Results: The mean age was $72.4{\pm}5.1years$, and all patients were male. Hemoptysis and hemothorax were present in three (60%) and two (40%) patients, respectively. Hypovolemic shock was noted in three patients who underwent emergency operations. A hybrid operation was performed in three patients. The mean operative time was $269.8{\pm}72.3minutes$. The mean total length of aortic coverage was $186.0{\pm}49.2mm$. No 30-day mortality occurred. Stroke, delirium, and atrial fibrillation were observed in one patient each. Paraplegia did not occur. Endoleak was found in two patients (40%), one of whom underwent an early and successful reintervention. During the mean follow-up period of $16.8{\pm}14.8months$, two patients died; one cause of death was a persistent type 1 endoleak and the other cause was unknown. Conclusion: TEVAR for rDTAA was associated with favorable early mortality and morbidity outcomes. However, early reintervention should be considered if persistent endoleak occurs.

Repair of Posttraumatic Tricuspid Regurgitation Using Artificial Chordae and an Annuloplasty Ring (인공 건삭과 판막륜 성형술을 이용한 외상 후 삼첨판 부전증의 치료)

  • Son, Kuk-Hui;Son, Ho-Sung;Chung, Jae-Ho;Chung, Won-Jae;Sun, Kyung;Lee, Sung-Ho
    • Journal of Chest Surgery
    • /
    • v.41 no.4
    • /
    • pp.489-491
    • /
    • 2008
  • A 52-year-old man was taken to the emergency room following a motor vehicle accident. An echocardiogram showed moderate to severe tricuspid regurgitation due to rupture of the anterior chordae. An operation to repair the tarumatic tricuspid regurgitation was recommended; however, the patient refused because he was asymptomatic. Two years later, he developed mild generalized edema and dyspnea. The echocardiogram revealed progressive severe tricuspid regurgitation and annular dilatation. We treated the tricuspid regurgitation successfully using artificial chordae and ring annuloplasty.

A Literary Study on the Management of the JeongJaGak(丁字閣, T shaped building) of the Joseon Royal Tombs in the Late Joseon Dynasty - Focusing on the JeongJaGak damage record of Gakneung Suri Deungnok(Records relating to the repair of royal tombs, 1675-1713) - (조선 후기 왕릉 정자각 관리에 대한 문헌적 고찰 -『각릉수리등록(各陵修理謄錄, 1675-1713년)』의 정자각 훼손기록을 중심으로-)

  • Hong, Eun-Ki;Hwang, Jong-Kook;Chang, Hun-Duck
    • Journal of architectural history
    • /
    • v.32 no.2
    • /
    • pp.37-48
    • /
    • 2023
  • A literature study was conducted on the management of the pavilion of the royal tomb in the late Joseon Dynasty, focusing on "Gakneung Suri Deungnok(Records relating to the repair of royal tombs)". This study analyzed the royal tomb management system, organized the types of damage identified in the building, and examined how the damage status was recorded by type. In the above, the records related to the 1675~1713 repair of three JeongJaGak(Geonwonneung, Sungneung, and Mokneung), which are registered as state-designated cultural properties, are summarized in three aspects: management system, damage status, and expression words. The results of the study are as follows. First, the royal tomb pavilion was regularly inspected by Observator(觀察使) in spring and autumn, and Surunggwan(守陵官) every 5th, and Servant(守僕) regularly inspected every day and night, and also inspected and reported emergency cases of natural disasters or unexpected damage. Second, the damage status of each building was continuously observed and reported for the continuous maintenance of the buildings in the royal tomb. A total of 75 records of damage to the three royal tombs' pavilion were found to have been most frequently inspected, including 19 cases (25.3%), 14 cases (18.7%), 23 cases (30.7%) of the roof, and 19 cases (25.3%) of the roof. Third, the expression of the damage status is confirmed in various ways, such as separation, separation, burst, damage, excitation, moisture, leakage, and exfoliation. Among them, the main damage records were confirmed due to the separation of the base from the peeling, the furniture, cracks, leaks, leaks in the roof, and the collapse of the roof was able to check the damage records.

Evaluation of Zone 2 Thoracic Endovascular Aortic Repair Performed with and without Prophylactic Embolization of the Left Subclavian Artery in Patients with Traumatic Aortic Injury

  • Miju Bae;Chang Ho Jeon;Hoon Kwon;Jin Hyeok Kim;Seon Uoo Choi;Seunghwan Song
    • Korean Journal of Radiology
    • /
    • v.22 no.4
    • /
    • pp.577-583
    • /
    • 2021
  • Objective: To report the authors' experience in performing thoracic endovascular aortic repair (TEVAR) for zone 2 lesions after traumatic aortic injury (TAI). Materials and Methods: This retrospective review included 10 patients who underwent zone 2 TEVAR after identification of aortic isthmus injury by CT angiography (CTA) upon arrival at the emergency room of a regional trauma center from 2016 to 2019. Patients were classified into two groups: those who underwent left subclavian artery (LSA) embolization concurrently with the main TEVAR procedure, and those in whom LSA embolization was not performed during the main procedure, but was planned as a bailout treatment if type II endoleak was noted on follow-up CTA images. Pre-procedural and procedure-related factors and post-procedure prognosis were compared between the groups. Results: There were no differences in pre-procedural factors, occurrence of endoleaks, and post-procedure prognosis (including mortality) between patients in the two groups. The duration of the procedure was shorter in the non-LSA embolization group (61 minutes vs. 27 minutes, p = 0.012). During follow-up, type II endoleak did not occur in either group. Conclusion: Delaying preventative LSA embolization until stabilization of the patient would be desirable when performing zone 2 TEVAR for TAI, in the absence of endoleak on the completion aortography image taken after complete deployment of the stent graft.

Verification of Applicability of Emergency Recovery Scenario Applying Field Recovery Case (현장복구사례를 이용한 긴급복구 시나리오의 적용성 검증)

  • Yoon, Hyuk-Jin;Jung, Jae-Hyun
    • Journal of the Korea Academia-Industrial cooperation Society
    • /
    • v.19 no.2
    • /
    • pp.632-638
    • /
    • 2018
  • Recently, damage to waterside structures, such as bridges or retaining walls, is increasing due to typhoons, flooding, aging, etc. In such cases, the damage is not limited to the structures themselves, but can include effects on a wider scale, such as the suspension of and restriction of access to the facilities, human injury, economic loss, etc. To preclude such damage, recovery methods suitable for the particular field circumstances should be applied when damage occurs. By enforcing prompt repairs, the material and human damage and losses that can occur can be minimized. Since the impact of losses caused by damage and disaster increases with the elapse of time, emergency recovery is even more important. In the emergency recovery process, appropriate repair and reinforcement is crucial. In the present study, the derivation scenarios of the emergency recovery method were applied to some field recovery cases, and their applicability was verified by comparison with the recovery methods actually used. It is expected that the results of this study will be useful for practical application, by suggesting more appropriate recovery methods.

Spontaneous Closure of Delayed Esophageal Perforation: By temporary cervical fistulation with dual drainages (식도천공의 자연폐쇄치료[경부식도루 조성술과 이중배액법에 의한]:1예 보고)

  • Oh, Bong-Seok;Choi, Jong-Beom;Lee, Dong-Jun
    • Journal of Chest Surgery
    • /
    • v.14 no.1
    • /
    • pp.77-82
    • /
    • 1981
  • The esophageal perforation is the most rapidly fatal and most serious perforation of the gastrointestinal tract. The 53 year old male patient was admitted because of substernal and epigastric pain altar esophageal bougienage for the indigestion and the difficult swallowing before about 18 hours. On esophagogram, there was the extravasation of contrast media at the right side of the lower esophagus [retrocardiac segment]. The emergency thoractotomy, debridement and suture closure with drainage were performed. But after 7 days the esophageal leakage was complicated again with pus discharge, although primary repair was done. On the 13th hospital day, the temporary cervical esophageal fistulation with dual drainages was made under general anesthesia. On the 38th day after this procedure, the esophageal leakage was closed spontaneously. On the 63rd hospital day the cervical fistulation was repaired and ever since the esophageal passage was good without leakage or swallowing difficulty.

  • PDF

Early Postoperative Retrograde Jejunojejunal Intussusception after Total Gastrectomy with Roux-en-Y Esophagojejunostomy: A Case Report

  • Lee, Se-Youl;Lee, Jong-Chan;Yang, Doo-Hyun
    • Journal of Gastric Cancer
    • /
    • v.13 no.4
    • /
    • pp.263-265
    • /
    • 2013
  • Intussusception is a rare cause of postoperative intestinal obstruction in adults. Many retrograde intussusceptions occur during the period following gastrectomy. A 77-year-old woman visited our hospital because of detected gastric adenocarcinoma. She received radical total gastrectomy with Roux-en-Y esophagojejunostomy. On the fifth postoperative day, she complained of abdominal pain, and we found leakage at the esophagojejunostomy site and dilatation of the Roux limb and the afferent limb of the jejunojejunostomy. Emergency surgery was performed. Retrograde jejunojejunal intussusception accompanied with a nasojejunal feeding tube was found at the efferent loop of the jejunojejunostomy. No ischemic change was found; therefore, manual reduction and primary repair of esophagojejunostomy was performed. She was discharged without complications on the 23rd re-postoperativeday. We suggest that the nasojejunal feeding tube acted as a trigger of intussusception because there was no definitive small bowel mass or postoperative adhesion. We present our findings here along with a brief review of the literature.

A Case of Neobladder Rupture Following Blunt Trauma (둔상으로 인한 인공방광 파열 1예)

  • Sul, Young Hoon;Lee, Moon Haeng;Lee, Sang Il;Cheon, Kwang Sik;Song, In Sang
    • Journal of Trauma and Injury
    • /
    • v.25 no.3
    • /
    • pp.101-104
    • /
    • 2012
  • Bladder rupture following blunt trauma is rare, and no neobladder rupture following blunt trauma has yet been reported. We present a case of neobladder rupture following blunt trauma. The patient was a 65-year-old male patient who had been treated for bladder cancer via a radical cystectomy with an orthotopic ileal neobladder four years prior to this admission, and who was admitted to our emergency department due to multiple trauma after a 1.5 m fall. Primary repair was performed for the neobladder rupture.

False aneurysm of right common carotid artery due to gun shot wound: report of a case (총창으로 인한 우측 총경동맥의 가성 동맥류 치험 1)

  • 남구현
    • Journal of Chest Surgery
    • /
    • v.17 no.3
    • /
    • pp.488-491
    • /
    • 1984
  • Vascular injuries from gun shot wound is rare in these days, in Korea. A Case of false aneurysm of the right common carotid artery due to penetrating injury to the neck by carbine. The confirmatory diagnosis was made by right carotid angiogram which revealed bean-sized aneurysmal sac at the mid-portion of the right common carotid artery. Despite of no symptoms, emergency false aneurysmectomy and reconstruction with on-lay vein patch graft using left greater saphenous vein for threat of rupture and embolization from mural thrombi. During repair of common carotid artery, cerebral circulation was maintained with internal shunt. The postoperative course was uneventful except limit of motion of right upper extremity due to initial injury.

  • PDF

Congenital Intercostal Lung Herniation Combined with an Unusual Morgagni's Hernia

  • Lee, Sang-Kwon;Kim, Do-Hyung
    • Journal of Chest Surgery
    • /
    • v.44 no.6
    • /
    • pp.455-457
    • /
    • 2011
  • A 70-year-old male visited urgent care due to coughing for 1 month and left chest pain. He had no history of trauma. The initial chest computed tomography (CT) showed the 7th left intercostal lung herniation. A follow-up CT showed an intercostal lung herniation combined with a bowl herniation, which had developed due to a Morgagni's hernia. An emergency operation was performed due to the incarceration of the bowl and lung. The primary repair of the diaphragm was performed and the direct approximation of the 7th intercostal space was determined. We concluded that the defect of the diaphragm and the intercostal muscle was a congenital lesion, and the recurrent coughing was the aggravating factor of herniation.