• Title/Summary/Keyword: iatrogenic injury

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End-to-End Anastomosis of an Unanticipated Vertebral Artery Injury during C2 Pedicle Screwing

  • Nam, Kyung-Hun;Sung, Joo-Kyung;Park, Jae-Chan;Cho, Dae-Chul
    • Journal of Korean Neurosurgical Society
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    • v.48 no.4
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    • pp.363-366
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    • 2010
  • Vertebral artery (VA) injury is a rare and serious complication of cervical spine surgery; this is due to difficulty in controlling hemorrhage, which can result in severe hypotension and cardiac arrest, and uncertain neurologic consequences. The authors report an extremely rare case of a 56-year-old woman who underwent direct surgical repair by end-to-end anatomosis of an unanticipated VA injury during C2 pedicle screwing. Postoperatively, the patient showed no neurological deterioration and computed tomography angiography of the VA demonstrated normal blood flow. Although direct occlusion of an injured VA by surgical ligation or endovascular embolization has been used for management of an unanticipated VA injury during surgery, these methods may be associated with significant morbidity and mortality. However, despite its technical demand, microvascular primary repair can restore normal blood flow and minimizes the risk of immediate or delayed ischemic complications. Here we report an iatrogenic VA injury during C2 pedicle screwing, which was successfully treated by end-to-end anastomosis.

clinical analysis of vascular trauma (혈관손상의 임상적 고찰)

  • 성숙환
    • Journal of Chest Surgery
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    • v.19 no.2
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    • pp.288-294
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    • 1986
  • During the period from Mar. 1983 to Feb. 1986, 22 patients with vascular trauma were treated at Capital Armed General Hospital. 1] 11 patients had arterial injury alone, 6 patients had venous injury alone, and 5 patients had both arterial and venous injuries. 2] The mechanism of injury in these 22 patients was 7 penetrating non-gun shot wounds, 5 blast fragments injuries, 4 iatrogenic injuries, 4 blunt injuries, 2 gun shot wounds. 3] The method of 16 arterial repair was 5 autogenous saphenous vein graft, 8 synthetic vascular graft, 1 end to end anastomosis, 2 lateral suture. Midterm patency of 16 repairs was 100% within 1 months. 4] The method of 11 venous repair was 1 autogenous saphenous vein graft, 2 onlay vein patch, 2 ligation, 1 lateral suture. The thrombotic obstructions occurred in 4 repairs [36.4%], but they were resolved somewhat with heparinization. 5] Uncommon cases of false aneurysm of internal carotid artery and laceration of retrohepatic inferior vena cava were summarized.

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Iatrogenic Tracheal Posterior Wall Perforation Repaired with Bronchoscope-Guided Knotless Sutures Through Tracheostomy

  • Jung, Yong Chae;Sung, Kiick;Cho, Jong Ho
    • Journal of Chest Surgery
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    • v.51 no.4
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    • pp.277-279
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    • 2018
  • A 68-year-old man presented with a posterior tracheal wall injury caused by percutaneous dilatational tracheostomy. The wound was immediately covered with an absorbable polyglycolic acid sheet. Ten days after the injury, the perforation was closed with knotless sutures using a Castroviejo needle-holder through the tracheostomy. The successful repair in this case indicates the feasibility of the knotless suture technique for perforations. The technique is described in detail in this report. The patient was weaned from the mechanical ventilator on postoperative day 25. In cases of posterior tracheal posterior wall perforation, every effort should be made to repair the perforation through an existing opening.

Extraction of Impacted Supernumerary Teeth with Navigation System

  • Kim, Ji-Hyoung;Yoo, Byung-Woo;Moon, Seong-Yong
    • Journal of International Society for Simulation Surgery
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    • v.3 no.2
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    • pp.74-76
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    • 2016
  • Computer-aided navigation system is helpful in maxillofacial surgery with real time instrument positioning and clear anatomic identification. Generally, completely impacted tooth extraction surgery have e high risk by iatrogenic injury such as, adjacent tooth injury, normal anatomical structure injury. This case report describes performing extraction of impacted supernumerary teeth on anterior maxilla by using the navigation system in a 15 years old male patient.

Sural nerve grafts in subacute facial nerve injuries: a report of two cases

  • Jiwon Jeong;Yongjoon Chang;Kuylhee Kim;Chul Hoon Chung;Soyeon Jung
    • Archives of Craniofacial Surgery
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    • v.25 no.2
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    • pp.99-103
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    • 2024
  • Because facial nerve injuries affect the quality of life, leaving them untreated can have devastating effects. The number of patients with traumatic and iatrogenic facial nerve paralysis is considerably high. Early detection and prompt treatment during the acute injury phase are crucial, and immediate surgical treatment should be considered when complete facial nerve injury is suspected. Symptom underestimation by patients and clinical misdiagnosis may delay surgical intervention, which may negatively affect outcomes and in some cases, impair the recovery of the injured facial nerve. Here, we report two cases of facial nerve injury that were treated with nerve grafts during the subacute phase. In both cases, subacute facial nerve grafting achieved significant improvements. These cases highlight surgical intervention in the subacute phase using nerve grafts as an appropriate treatment for facial nerve injuries.

Iatrogenic Vertebral Artery Injury During Anterior Cervical Spine Surgery : Report of Two Cases

  • Lee, Jae-Hyun;Lee, Jung-Kil;Joo, Sung-Pil;Kim, Soo-Han
    • Journal of Korean Neurosurgical Society
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    • v.40 no.6
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    • pp.450-454
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    • 2006
  • The incidence of vertebral artery injury during the anterior approach to the cervical spine is rare, but potentially lethal. The authors describe two cases of vertebral artery injury during anterior cervical decompression surgery. In the first case, infection was the cause of the vertebral artery injury. During aggressive irrigation and pus drainage, massive bleeding was encountered, and intraoperative direct packing with hemostatic agents provided effective control of hemorrhage. Ten days after surgery, sudden neck swelling and mental deterioration occurred because of rebleeding from a pseudoaneurysm. In the second case, the vertebral artery was injured during decompression of cervical spondylosis while drilling the neural foramen. After intraoperative control of bleeding, the patient was referred to our hospital, and a pseudoaneurysm was detected by angiography four days after surgery. Both pseudoaneurysms were successfully occluded by an endovascular technique without any neurological sequelae. Urgent vertebral angiography, following intraoperative control of bleeding by hemostatic compression in cases of vertebral artery injury during anterior cervical decompression, should be performed to avoid life-threatening complications. Prompt recognition of pseudoaneurysm is mandatory, and endovascular treatment can be life saving.

Unrecognized Bilateral Dislocation of Temporomandibular Joint during Orotracheal Intubation (진단이 늦어진 기관삽관 후 발생한 턱관절 탈구)

  • Chung, Sang-Bong;Jeon, Hyoungbae;Kim, Taikwan
    • Journal of Trauma and Injury
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    • v.28 no.2
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    • pp.75-78
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    • 2015
  • Mandible dislocation during endotracheal intubation is an unusual occurrence but easy to be overlooked for its unfamiliarity. We recently had a case of iatrogenic bilateral dislocation of a temporomandibular joint during orotracheal intubation and emphasize the importance of an early awareness of this possible complication.

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Clinical experiences of arterial disease (동백질환의 임상적 고찰)

  • Lee, J.H.;Kim, J.E.;Yu, H.S.
    • Journal of Chest Surgery
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    • v.13 no.4
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    • pp.385-393
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    • 1980
  • From 1959 to 1980, for about 21 yrs, the authors have experienced of 69 cases of arterial diseases, and analyzed the diseases. They are Aneurysm 16 Iatrogenic thrombosis after angio & cardiac Cath. 20 Coarctation 3 Primary arteritis 9 Traumatic injury 9 Occlusive disease 12 But PDA (107 cases) & Buerger's disease are excluded in this study.

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Clinical Study of Vascular Injuries (혈관 손상의 임상적 고찰)

  • Chung, Sung-Woon;Kim, Young-Kyu
    • Journal of Chest Surgery
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    • v.40 no.7 s.276
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    • pp.480-484
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    • 2007
  • Background: Major vascular injuries can jeopardize a patient's life or imperil limb survival. We performed this study to establish an optimal management plan for vascular injuries. Material and Method: We retrospectively reviewed 26 cases of vascular injury that were treated at Pusan National University Hospital from May, 1999 to September, 2004. The age and sex distribution, the locations and causes of vascular injury, the diagnostic tools, the degree of injuries, clinical manifestations, the treatment modality and complications were reviewed. Result: The mean age was 39.5 years (range: $12{\sim}86$) and the male to female ratio was 22 : 4. The injuries were in 6 descending thoracic aortas, 4 femoral arteries, 4 popliteal veins and so on. The causes of injury were iatrogenic in 8 cases, traffic accident in 7, stab injury in 6 and industrial accident in 5. The most commonly used diagnostic tools were CT and angiography. The degrees of arterial injury were pseudoaneurysm in 10 cases, partial severance in 5, complete severance in 3 and thrombosis in 3. The degrees of venous injury were partial severance in 6 cases, complete severance in 2 and arteriovenous fistula in 2. The clinical manifestations were absence of pulse in 8 cases, coldness in 7, chest pain in 6, swelling in 5, bleeding in 5 and so on. The most frequently used type of revascularization was graft interposition in 11 cases. Two arteriovenous fistulae were repaired by endovascular procedure. There was one case of mortality due to multi-organ failure after hemorrhagic shock, There were three major amputations, and two of them were due to delayed diagnosis and treatment. Conclusion: A system for the early diagnosis and treatment is essential for improving limb salvage and patient mortality. As a consequence of the widespread application of endovascular procedures, the incidence of iatrogenic injuries has recently increased. Educating physicians is important for the prevention of iatrogenic injury. Easy communication and cooperation for earlier involvement of a vascular surgeon is also an important factor.

Clinical Study on the Case of Patient with Iatrogenic Brachial Plexus Injury after Cervical Lymph Node Biopsy: A Case Report (경부림프절 생검 후 발생한 상완신경총 손상 환자의 한방치료 1례: 증례 보고)

  • Kim, Yu Ri;Noh, Seung Hee;Kim, Kun Hyung;Yang, Gi Young;Lee, Byung Ryul;Kim, Jae Kyu
    • Journal of Acupuncture Research
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    • v.30 no.5
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    • pp.219-226
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    • 2013
  • Objectives : The purpose of this study is to report the effect of Korean medicine treatment on a patient with brachial plexus injury. Methods : The patient with symptoms of pain and dysesthesia on right forearm and hand was treated with acupuncture treatment, herbal medicine, moxibustion and physical treatment. Improvement of the patient's symptoms was evaluated by Hepatic dullness sound, NRS, VAS, SF-36 bodily pain, grip strength. Results : After 42 days of treatment, NRS score significantly decreased. VAS score, SF-36 bodily pain and grip strength showed moderate improvement. Conclusions : This results suggest that Korean medicine treatment may be effective in reducing the symptoms of brachial plexus injury.