• Title/Summary/Keyword: rib fractures

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Accluired Herniation of Lung a report of two cases (후천성 폐탈출증 -2례 보고-)

  • Han, Il-Yong;Lee, Yang-Haeng;Hwang, Yun-Ho
    • Journal of Chest Surgery
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    • v.30 no.11
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    • pp.1145-1148
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    • 1997
  • Lung hernia is defined as a protrusion of lung parenchyma beyond the confines of the musculoskeletal thorax. To date, less than 300 cases have been reported in the literature. The patients were 37 & 57-year-old men who had traumatic rib fractures in the past, whose chief complaint was a painless soft bulging mass increased in size during expiration or coughing and diminished during inspiration or quiet breathing. The primary repair was performed without any p stoperative recurrance. We report two cases of acquired herniation of lung first time in Korea with a brief review of literature.

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A Study of Pathogenesis and Treatment of Spontaneous Pneumothorax (자연성 기흉의 성인과 치료에 대한 고찰)

  • 홍완일;김진식
    • Journal of Chest Surgery
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    • v.1 no.1
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    • pp.11-18
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    • 1968
  • Author studied the possible pathogenesis of spontaneous pneumothorax and its effective treatment in 33 cases, and the results obtained as follows:1) Of the 33 cases, 15 cases were originated from pulmonary tuberculosis, 11 cases were non-tuberculous natures and 7 cases were followed by traumatic chest injuries which were not associated with a laceration of the lung or rib fractures.2) So called "Idiopathic spontaneous pneumothorax" seemed mostly to be caused by rupture of the emphy- sematous blebs.3) Spontaneous pneumothorax, in process of the pulmonary tuberculosis, seemed to be caused by the rupture of blebs which was formed with a pathological process of chronic pulmonary tuberculosis.4) Author experienced interesting cases of giant blebs which had been fully occupied the right thoracic cavity. At first, it was misdiagnosed as extensive spontaneous pneumothorax on X-ray which was revealed extensive pleural air shadow with total atelectasis of the right lung. A pneumonectomy was performed together with the giant multiple blebs.5] Generally, closed thoracotomy with water-sealed drainage is the treatment of choice in spontaneous pneumothorax. However, open thoracotomy and adequate surgical procedures should be undertaken in patients with continuous air leakage or recurrent attack of spontaneous pneumothorax.aneous pneumothorax.

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Penetrating Chest Injuries Caused by the Sideview Mirror of the Patient's Car - Report of 2 cases - (자동차의 사이드미러가 흉강에 박힌 채로 내원한 흉부관통상 - 2례 보고 -)

  • Kim, Soo Sung
    • Journal of Trauma and Injury
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    • v.20 no.1
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    • pp.47-51
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    • 2007
  • Penetrating chest trauma caused by the components of one's own car is rare in motor vehicle accidents. We experienced two cases of penetrating chest injury caused by the sideview mirror of the patient's vehicle. One was a 25-year-old man. The sideview mirror penetrated the left chest, went through the diaphragm, and ruptured the spleen. He was in shock upon arrival at the emergency room. An emergency thoracotomy and laparotomy were done. The ruptured spleen was resected, the lung and the diaphragm were debrided and repaired, and the chest wall was reconstructed. The other patient was a 57-year-old male, who was transported to our emergency room with the sideview mirror of his truck stuck into his right chest wall as the result of an accident. He also had a right Bennet's fracture and an open fracture of the right tibia. Air had been sucked into the right pleural cavity through the wound. Multiple rib fractures and lung lacerations had also occurred. Removal of the sideview mirror, repair of the lacerated lung, and reconstruction of chest wall were done immediately. Both patients recovered without complication and were discharged.

Effect of Complex Traditional Korean Medicine Treatment and Rehabilitation on Acetabular Fracture: A Case Report

  • Young Han Nam;Choong Hyun Han;Young Kyung Kim;Youn Young Choi;Eun Sol Won;Hwa Yeon Ryu;Hyun Lee;Jae Hui Kang
    • Journal of Acupuncture Research
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    • v.40 no.3
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    • pp.272-280
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    • 2023
  • This report presents the clinical progress of a 50-year-old male diagnosed with a left acetabular fracture and left rib fracture after falling from a height of 3 m. The patient was treated nonsurgically and underwent complex traditional Korean medicine (TKM) treatment and rehabilitation, including acupuncture, electroacupuncture, pharmacopuncture, bee venom, herbal medicine, physiotherapy, and moxibustion. Patient progress was assessed using the numerical rating scale (NRS), manual muscle test (MMT), and modified Harris Hip Score (mHHS). During 113 days of hospitalization, the NRS score decreased from 7 to 3, and the MMT grade increased to normal in the hip, knee, and ankle joints. The mHHS score increased from 26 to 99 points. Radiographs and computed tomography scans of the left acetabulum were obtained periodically, and fracture union was successfully achieved. To our knowledge, this is the first case report of complex TKM treatment and rehabilitation of acetabular fractures.

Watch Out for the Early Killers: Imaging Diagnosis of Thoracic Trauma

  • Yon-Cheong Wong;Li-Jen Wang;Rathachai Kaewlai;Cheng-Hsien Wu
    • Korean Journal of Radiology
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    • v.24 no.8
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    • pp.752-760
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    • 2023
  • Radiologists and trauma surgeons should monitor for early killers among patients with thoracic trauma, such as tension pneumothorax, tracheobronchial injuries, flail chest, aortic injury, mediastinal hematomas, and severe pulmonary parenchymal injury. With the advent of cutting-edge technology, rapid volumetric computed tomography of the chest has become the most definitive diagnostic tool for establishing or excluding thoracic trauma. With the notion of "time is life" at emergency settings, radiologists must find ways to shorten the turnaround time of reports. One way to interpret chest findings is to use a systemic approach, as advocated in this study. Our interpretation of chest findings for thoracic trauma follows the acronym "ABC-Please" in which "A" stands for abnormal air, "B" stands for abnormal bones, "C" stands for abnormal cardiovascular system, and "P" in "Please" stands for abnormal pulmonary parenchyma and vessels. In the future, utilizing an artificial intelligence software can be an alternative, which can highlight significant findings as "warm zones" on the heatmap and can re-prioritize important examinations at the top of the reading list for radiologists to expedite the final reports.

Evaluation of the Structural Performance of Tetragonal Lattice Girders (사각 격자지보의 구조 성능 평가)

  • Kim, Seung-Jun;Han, Keum-Ho;Won, Deok-Hee;Baek, Jung-Sik;Kang, Young-Jong
    • Journal of Korean Society of Steel Construction
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    • v.24 no.3
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    • pp.267-278
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    • 2012
  • In general, the H-shaped steel ribs or triangular lattice girders have been mostly used in constructing tunnels through the NATM construction method. The H-shaped steel rib has higher flexural and axial strength than the triangular lattice girder, but many unexpected gaps can occur in the concrete lining system after shotcreting if the H-shaped steel rib is used as the support system. To achieve better shotcreting quality, the triangular lattice girder was developed. However, in general, the triangle lattice girder has low flexural and axial strength. Likewise, the triangular lattice girder, which has circular sectional members, has so many fractures from welded points at the joints between the members. Finally, the new type of tetragonal lattice girder was developed to overcome those problems. In this study, the structural performance of the tetragonal lattice girders was evaluated through analytical and experimental studies. In the analytical studies, the four-point bending analysis, the traditional evaluation method to determine the flexural strength of the lattice girder, was performed. Moreover, the linear-elastic analysis and stability analysis of the arch structure made by the lattice girders were performed to measure structural performance. Experiments were likewise performed to compare the structural performances of the tetragonal girder with traditional triangular lattice girders.

Diagnostic Usefulness of Computed Tomography Compared to Conventional Chest X-Ray for Chest Trauma Patients (흉부 외상 환자에서 일반흉부촬영과 비교한 흉부단층촬영의 진단적 유용성)

  • Choi, Kyu Ill;Seo, Kang Suk;Ryoo, Hyun Wook;Park, Jung Bae;Chung, Jae Myung;Ahn, Jae Yoon;Kang, Seong Won;Yi, Jae Hyuck
    • Journal of Trauma and Injury
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    • v.22 no.2
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    • pp.142-147
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    • 2009
  • Purpose: Early diagnosis and management of therapeutic interventions are very important in chest trauma. Conventional chest X-rays (CXR) and computed tomography (CT) are the diagnostic tools that can be quickly implemented for chest trauma patients in the emergency department. In this study, the usefulness of the CT as a diagnostic measurement was examined by analyzing the ability to detect thoracic injuries in trauma patients who had visited the emergency department and undergone CXR and CT. Methods: This study involved 84 patients who had visited the emergency department due to chest trauma and who had undergone both CXR and CT during their diagnostic process. The patients' characteristics and early vital signs were examined through a retrospective analysis of their medical records, and the CXR and the CT saved in the Picture Archiving Communication System (PACS) were examined by a radiologist and an emergency physician to verify whether or not a lesion was present. Results: Pneumothoraxes, hemothoraxes, pneumomediastina, pulmonary lacerations, rib fractures, vertebral fractures, chest wall contusions, and subcutaneous emphysema were prevalently found in a statistically meaningful way (p<0.05) on the CT. Even though their statistical significance couldn' be verified, other disorders, including aortic injury, were more prevalently found by CT than by CXR. Conclusion: CT implemented for chest trauma patients visiting the emergency department allowed disorders that couldn' be found on CXR to be verified, which helped us to could accurately evaluate patients.

Treatment of Subclavian Artery Injury in Multiple Trauma Patients by Using an Endovascular Approach: Two Cases (다발성 외상환자에서 혈관계 접근을 통해 치료한 쇄골하동맥 손상 2례)

  • Cho, Jayun;Jung, Heekyung;Kim, Hyung-Kee;Lim, Kyoung Hoon;Park, Jinyoung;Huh, Seung
    • Journal of Trauma and Injury
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    • v.26 no.3
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    • pp.243-247
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    • 2013
  • Introduction: Surgical treatment of subclavian artery (SA) injury is challenging because approaching the lesion directly and clamping the proximal artery is difficult. This can be overcome by using an endovascular technique. Case 1: A 37-year-old male was drawn into the concrete mixer truck. He had a right SA injury with multiple traumatic injuries: an open fracture of the right leg with posterior tibial artery (PTA) injury, a right hemothorax, and fractures of the clavicle, scapula, ribs, cervical spine and nasal bone. The injury severity score (ISS) was 27. Computed tomography (CT) showed a 30-mm-length thrombotic occlusion in the right SA, which was 15 mm distal to the vertebral artery (VA). A self-expandable stent($8mm{\times}40mm$ in size) was deployed through the right femoral artery while preserving VA flow, and the radial pulse was palpable after deployment. Other operations were performed sequentially. He had a viable right arm during a 13-month follow-up period. Case 2: A 25-year-old male was admitted to our hospital due to a motorcycle accident. The ISS was 34 because of a hemothorax and open fractures of the mandible and the left hand. Intraoperative angiography was done through a right femoral artery puncture. Contrast extravasation of the SA was detected just outside the left rib cage. After balloon catheter had been inflated just proximal to the bleeding site, direct surgical exploration was performed through infraclavicular skin incision. The transected SA was identified, and an interposition graft was performed using a saphenous vein graft. Other operations were performed sequentially. He had a viable left arm during a 15-month follow-up period. Conclusion: The challenge of repairing an SA injury can be overcome by using an endovascular approach.

Neglected Type IV Acromioclavicular Joint Injury - 2 Cases Report - (간과된 제 4형 견봉-쇄골 관절 손상 - 2례 보고 -)

  • Kim, Do-Young;Shin, Sung-Ryong;Yoo, Yon-Sik;Lee, Sang-Soo;Jeong, Un-Seob;Park, Keun-Min
    • Clinics in Shoulder and Elbow
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    • v.11 no.2
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    • pp.185-188
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    • 2008
  • Acromioclavicular joint injuries usually occur as a result of direct trauma to the superolateral aspect of the shoulder. Roockwood Type IV injuries are relatively uncommon, and they are easily misdiagnosed or neglected in patients who have suffered multiple traumas. Therefore, to correctly treat a patient with type IV injury, we need to take a careful physical examination and conduct proper radiologic evaluation for the acromioclavicular joint. We report here on two cases of modified Weaver-Dunn reconstruction for neglected type IV acromioclavicular joint injuries that were associated with multiple rib fractures.

A Case of with Transient splenic Hot Uptake on $^{99m}Tc$-Methylene Diphosphonate(MDP) Bone Scan Following Blunt Abodominal Trauma with Underlying Liver Cirrhosis (간경변환자에서 복부외상후 일시적으로 관찰된 $^{99m}Tc$-MDP Bone Scan의 비장 섭취 1예)

  • Won, Jong-Hyeon;Kim, Jae-Myung;Kim, Jung-Han;Choo, Gil-Yeon;Park, Seok-Oh;Sung, Sang-Kyu;Choi, Dae-Seob;Kim, Chin-Seung
    • The Korean Journal of Nuclear Medicine
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    • v.27 no.2
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    • pp.309-314
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    • 1993
  • We report a case of 33-year-old man with a transient splenic uptake who had traumatic multiple rib fractures and hernoperitoneum combined with underlying liver cirrhosis, liver cirrhosis with liver bed laceration and splenomegaly without any other demonstrable splenic lesion due to traffic accident was found by abdominal ultrasound and surgery. Incidentally, $^{99m}Tc$-MDP Bone scan showed whole prominent splenic uptake, spleen was also visible on $^{99m}Tc$ Tin colloid liver scan. We suggest the splenic uptake of the radionuclide temporary splenic infarct to the transient total splenic infarction or unknown traumatic effect.

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