• Journal of Trauma and Injury
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• v.34 no.4
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• pp.288-293
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• 2021

In South Korea, most patients who visit trauma centers with abdominal injuries have blunt trauma, and penetrating injuries are relatively rare. In extremely rare cases, some patients are admitted with a long object penetrating their abdomen, and these injuries are referred to as abdominal impalement injuries. Most cases of impalement injuries lead to fatal bleeding, and patients often die at the scene of the accident. However, patients who survive until reaching the hospital can have a good prognosis with optimal treatment. A 68-year-old female patient was admitted to the trauma center with a 4-cm-thick tree branch impaling her abdomen. The patient was transported by a medical helicopter and had stable vital signs at admission. The branch sticking out of the abdomen was quite long; thus, we carefully cut the branch with an electric saw to perform computed tomography (CT). CT revealed no signs of major blood vessel injury, but intestinal perforation was observed. During laparotomy, the tree branch was removed after confirming that there were no vascular injuries, and enterostomy was performed because of extensive intestinal injury. After treating other injuries, the patient was discharged without any complications except colostomy. Abdominal impalement injuries are treated using various approaches depending on the injury mechanism and injured region. However, the most important consideration is that the impaled object should not be removed during transportation and resuscitation. Instead, it should only be removed after checking for injuries to blood vessels during laparotomy in an environment where injury control is possible.

• Journal of Trauma and Injury
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• v.21 no.1
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• pp.53-58
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• 2008

Purpose: Skiing and snowboarding are becoming increasingly popular. Accordingly, the incidences of injuries among skiers and snowboarders are also increasing. The purpose of this study was to investigate the injury patterns of and the contributing factors to head injuries of skiers and snowboarders and to evaluate the differences in characteristics between skiing and snowboarding head injuries. Methods: One-hundred patients who visited the emergency department of Wonju Christian Hospital between January 2005 and March 2007 due to head injuries from skiing and snowboarding were enrolled. The mechanisms and the histories of the injuries were investigated by surveying the patients, and the degrees of head injuries were estimated by using brain CT and the Glasgow Coma Scale. The degrees and the characteristics of brain injuries were also analyzed and compared between skiers and snowboarders. Results: Out of 100 patients, 39 were injured by skiing, and 61 were injured by snowboarding. The mean age of the skiers was $26.7{\pm}10.0$, and that of the snowboarders was $26.7{\pm}6.2$. The percentage of male skiers was 43.6%, and that of snowboarders was 63.9%. The most frequent initial chief complaints of head-injured skiers and snowboarders were headache and mental change. The most common mechanism of injuries was a slip down. The mean Abbreviated Injury Scale Score (AIS score) of the skier group was $4.5{\pm}2.1$ and that of the snowboarder group was $5.9{\pm}5.0$ (p=0.222). The percentage of helmet users was 7.1% among skiers and 20.8% among snowboarders (p=0.346). Head injuries were composed of cerebral concussion (92.0%) and intracranial hemorrhage (8.0%). Intracranial hemorrhage was most frequently caused by falling down (62.5%). Conclusion: The most common type of head injury to skiers and snowboarders was cerebral concussion, and severe damage was usually caused by jumping and falling down. No differences in the characteristics of the head injuries existed between skiing and snowboarding injuries.

• Journal of Chest Surgery
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• v.21 no.6
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• pp.990-995
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• 1988

Seventeen cases of vascular injuries treated in Chungnam National University Hospital during the period from Apr. 1980 to Sep. 1988 were reviewed. Common causes of injuries were stab wound, automobile accidents and iatrogenic injuries. Of the 11 arterial injuries, 3 were femoral artery which was the commonest in frequency, the next was 2 cases of subclavian, common carotid, iliac artery. Of the 10 venous injuries, the subclavian vein and internal jugular vein were common in frequency. The most frequent type of injuries was laceration[13 cases in 21]. Vascular reconstruction was done by lateral suture repair in 8 cases, autogenous vein graft in 2, prosthetic vascular graft in 5, direct anastomosis in 1 case. Simple ligation was done in 5 cases. There was 1 case of visual field defect as a sequelae in right common carotid artery transaction and 1 case of mortality.

• Journal of Chest Surgery
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• v.28 no.3
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• pp.308-312
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• 1995

A 5-year retrospective study of 14 patients with diaphragmatic injuries revealed 9 blunt and 5 penetrating injuries. In the blunt trauma group, 7 were left and 2 were right side. The penetrating diaphragmatic wound consist of 3 left and 2 right sided. Sex ratio was 11: 3, with male predominanace. Preoperative diagnosis was possible in 9 cases and delayed diagnosis [greater than 24 hours occured in 5 cases.Simple chest X-ray was diagnostic or highly suggestive in 7 cases. 7 cases were diagnosed diaphragmatic injuries by computed tomography, fiuroscopy or by explorative operation. All of the cases had association injury. 11 cases of diaphragmatic ruptures were corrected through thoracotomy and 3 cases needed exploratory laparotomy. One death occured after operation due to associated injuries and respiratory failure. Blunt and penetrating diaphragmatic injuries remain a diagnostic challenge and associated injuries, delayed diagnosis determine the outcome.

• Journal of Chest Surgery
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• v.25 no.3
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• pp.283-288
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• 1992

From january 1970 through december 1990, 130 cases of patients with chest penetrating injury were admitted to department of thoracic and cardiovascular surgery in Chosun University Hospital. We analyzed above patients and obtained results were as follows: 1. The ratio of male to female was 7.1:1 in male predominance, and the majority[69.6%] was distributed from 2nd to 3rd decade. 2. The most common cause of chest penetrating injuries was stab wound. 3. 110 cases[84.5%] were arrived to our emergency room within six hours after trauma. 4. The most common injuring mode was hemo, pneumothorax. 5. The frequently injured site of the penetrating chest trauma was left side of the chest [64.65%]. 6. The common associated injuries of penetrating chest injuries were extremities injuries, abdominal injuries, head & facial injuries. 7. The common method of surgical treatment were closed thoracostomy[78 cases], open thoracotomy[20 cases], laparatomy[12 cases]. 8. The overall motality was 3.07%[4/130], and the causes were hypovolemic shock, sepsis and asphyxia.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.26 no.6
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• pp.677-680
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• 2000

Orbital injuries are common with facial trauma. Direct injuries to the globe are not rare but it can result in complications such as chemosis, subconjunctival hemorrhage and hyphema. Periorbital trauma or injuries to the extraocular muscles and blow-out fracture may result in lid edema, ecchymosis & ptosis and diplopia or limitation of ocular motion respectively. Indirect injuries to the optic nerve come up without any injuries but its complication is irreversible and severe such as loss of vision. The aim of this study is to review the literature on blindness or ptosis following facial trauma and present the cases of blindness after facial trauma and ptosis after mandibular fracture without specific clinical findings.

• Journal of Trauma and Injury
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• v.35 no.3
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• pp.219-222
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• 2022

Muscle injuries caused by indirect trauma during exercise are common. Most of these injuries can be managed conservatively; however, further treatment is required in extreme cases. Although transcatheter arterial embolization is a possible treatment modality, its role in traumatic muscle injuries remains unclear. In this case series, we present three cases of exercise-induced muscle hemorrhage treated by transcatheter arterial embolization with successful outcomes. The damaged muscles were the rectus abdominis, adductor longus, and iliopsoas, and the vascular injuries were accessed via the femoral artery during the procedures.

• Journal of Trauma and Injury
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• v.35 no.3
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• pp.168-172
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• 2022

Purpose: The neck is a particularly critical region for penetrating injuries due to the close proximity of the trachea, esophagus, blood vessels, and the spinal cord. An open neck injury has the potential for serious morbidity and mortality. The purpose of this study is to evaluate the assessment and management of open neck injuries. Methods: In this retrospective study, open neck injury patients who were admitted to the Trauma Center of Daejeon Eulji Medical Center, Eulji University between December 2015 and December 2017 were analyzed for epidemiology, the mechanism of trauma, the injured organ, complications, and mortality. Results: Thirty-two patients presented with open neck injuries. All patients underwent computed tomographic angiography to evaluate their injuries once their vital signs stabilized. Among these patients, 27 required surgical treatment. The most commonly injured organ was the airway. There were five deaths, and the main cause of death was bleeding. Mortality was associated with the initial systolic blood pressure at the hospital and Glasgow Coma Scale. Conclusions: Mortality from open neck injuries was associated with initial systolic blood pressure at the hospital and Glasgow Coma Scale.

• Journal of Trauma and Injury
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• v.23 no.2
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• pp.107-112
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• 2010

Purpose: Recently, the change to a more complex social structure has led to an increased frequency of traumas due to violence, accident and so on. In addition, the severity of the traumas and the frequency of penetrating injuries have also increased. Traumas to cervical and abdominal areas, what are commonly seen by general surgeons, can have mild to fatal consequences because in these areas, various organs that are vital to sustaining life are located. The exact location and characteristics of the injury are vital to treating patients with the trauma to these areas. Thus, with this background in mind, we studied, compared, and analyzed clinical manifestations of patients who were admitted to Wonju Christian hospital for penetrating injuries inflicted by themselves or others. Methods: We selected and performed a retrospective study of 64 patients who had been admitted to Wonju Christian Hospital from January 2005 to December 2009 and who had cervical or abdominal penetrating injuries clearly inflicted by themselves or others. Results: There were 51 male (79.7%) and 13 female (20.3%) patients, and the number of male patients was more dominant in this study, having a sex ratio of 3.9 to 1. The range of ages was between 20 and 86 years, and mean age was 43.2 years. There were 5 self-inflicted cervical injuries, and 19 self-inflicted abdominal injuries, making the total number of self-inflicted injury 24. Cervical and abdominal injuries caused by others were found in 11 and 29 patients, respectively. The most common area involved in self-inflicted injuries to the abdomen was the epigastric area, nine cases, and the right-side zone II was the most commonly involved area. On the other hand, in injuries inflicted by others, the left upper quadrant of the abdomen was the most common site of the injury, 14 cases. In the neck, the left-side zone II was the most injured site. In cases of self-inflicted neck injury, jugular vein damage and cervical muscle damage without deep organ injury were observed in two cases each, making them the most common. In cases with abdominal injuries, seven cases had limited abdominal wall injury, making it the most common injury. The most common deep organ injury was small bowel wounds, five cases. In patients with injuries caused by others, six had cervical muscle damage, making it the most common injury found in that area. In the abdomen, small bowel injury was found to be the most common injury, being evidenced in 13 cases. In self-inflicted injuries, a statistical analysis discovered that the total duration of admission and the number of patients admitted to the intensive care unit were significantly shorter and smaller, retrospectively, than in the patient group that had injuries caused by others. No statistically significant difference was found when the injury sequels were compared between the self-inflicted-injury and the injury-inflicted-by-others groups. Conclusion: This study revealed that, in self-inflicted abdominal injuries, injuries limited to the abdominal wall were found to be the most common, and in injuries to the cervical area inflicted by others, injuries restricted to the cervical muscle were found to be the most common. As a whole, the total duration of admission and the ICU admission time were significantly shorter in cases of self-inflicted injury. Especially, in cases of self inflicted injuries, abdominal injuries generally had a limited degree of injury. Thus, in our consideration, accurate injury assessment and an ideal treatment plan are necessary to treat these patients, and minimally invasive equipment, such as laparoscope, should be used. Also, further studies that persistently utilize aggressive surgical observations, such as abdominal ultrasound and computed tomography, for patients with penetrating injuries are needed.

• Journal of Trauma and Injury
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• v.24 no.2
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• pp.129-135
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• 2011

Purpose: During August 2010, a natural gas fuel cylinder on a bus exploded in downtown Seoul, injuring 20 citizens. This kind of blast injury has never been reported in Korea before. Thus, the goal of this study was to review the clinical features of these victims to help physicians manage similar cases and to understand the risk factors associated with blast injuries in everyday life. Methods: Twenty (20) victims who visited nearby emergency departments, and 3 peoples left hospital without care. Seventeen (17) victims were included in this study, and the following factors were investigated: age, sex, type of hospital, diagnosis of injury, injury mechanism, position of victim (in-bus/out of bus), classification of injury severity with START (simple triage and rapid treatment), and classification of injury according to the mechanism of the blast injury. Results: The victims included 8 males (47%), 9 females (53%). The mean age was $37.5{\pm}12$. Thirteen (13) victims were transferred to two tertiary hospitals, and 4 were transferred to two secondary hospitals. The types of injury were 3 fractures, 2 ligaments injuries, 6 contusions, 4 abrasions, and 3 open wounds (one of them was combined fracture). According to START classification, 17 victims were 1 immediate, 11 minor, 5 delayed, and no death. Classifications according to the mechanism of the blast injury were 1 primary injury, 6 secondary injuries (2 of them combined other mechanism), 3 tertiary injuries and 9 quaternary injuries. Conclusion: Trauma care physicians should be familiar with not only the specific types of injuries from blast accidents, but also the potential accidents that may occur in public facilities.