• Title/Summary/Keyword: trauma

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Gastric necrosis after gastric artery embolization in a patient with blunt abdominal trauma: a case report

  • Gil Hwan, Kim;Sung Jin, Park;Chan Ik, Park
    • Journal of Trauma and Injury
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    • v.35 no.4
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    • pp.287-290
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    • 2022
  • Gastric artery bleeding after blunt trauma is rare. In such cases, if vital signs are stable, angiographic embolization may be performed. Although gastric artery embolization is known to be safe due to its anatomical properties, complications may occur. We report a case of gastric necrosis after gastric artery embolization in a patient with blunt abdominal trauma. The 55-year-old male patient was found with gastric arterial bleeding after a traffic accident. His vital signs were stable, and gastric artery embolization was performed. Gastric necrosis was subsequently found, which was treated surgically.

Role of Interventional Radiologists in Trauma Centers (외상센터에서의 인터벤션 영상의학 의사의 역할)

  • Jeong Ho Kim
    • Journal of the Korean Society of Radiology
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    • v.84 no.4
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    • pp.784-791
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    • 2023
  • Based on statistics available in Korea, trauma centers play a critical role in treatment of patients with trauma. Interventional radiologists in trauma centers perform various procedures, including embolization, which constitutes the basic treatment for control of hemorrhage, although interventions such as stent graft insertion may also be used. Although emergency interventional procedures have been used conventionally, rapid and effective hemorrhage control is important in patients with trauma. Therefore, it is important to accurately understand and implement the concept of damage control interventional radiology, which has gained attention in recent times, to reduce preventable trauma-induced mortality rates.

Pneumoperitoneum from vaginal cuff dehiscence following blunt trauma in a patient with a history of robotic hysterectomy in Korea: a case report

  • Byung Hee Kang;Donghwan Choi
    • Journal of Trauma and Injury
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    • v.37 no.1
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    • pp.83-85
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    • 2024
  • Pneumoperitoneum usually presents as a surgical emergency, especially in patients with a history of trauma. However, we recently encountered an atypical case of pneumoperitoneum at a hysterectomy site following blunt trauma, indicating that immediate laparotomy may not always be necessary. In this report, we present the case of a 45-year-old woman who was transferred to our trauma center from a local hospital after being involved in a traffic accident the day before. Although she underwent an emergency laparotomy, no bowel perforation was detected. Instead, a rupture was found at the site of a hysterectomy that had been performed 8 months earlier. After repairing the hysterectomy site, the pneumoperitoneum resolved, and the patient was subsequently discharged without further complications.

Cervical Esophageal Perforation after Blunt Trauma (둔상에 의한 경부 식도 파열)

  • Cho, Hyun-Min;Kim, Young-Jin
    • Journal of Trauma and Injury
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    • v.24 no.1
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    • pp.45-47
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    • 2011
  • Esophageal perforation due to blunt trauma is rare. A 67-year-old male presented to Konyang University Hospital with painful neck swelling. His neck was injured by blunt trauma at work. Esophageal perforation was detected by neck CT and esophagography. We performed primary repair of cervical esophagus through the Lt. neck approach. The postoperative course was uneventful and the patient was discharged at postoperative day 15.

Hepatic Hemangioma Rupture Caused by Blunt Trauma

  • Kim, Gil Hwan;Kim, Jae Hun;Lee, Sang Bong
    • Journal of Trauma and Injury
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    • v.30 no.4
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    • pp.235-237
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    • 2017
  • Hepatic hemangioma is the most frequently occurring benign tumor of the liver. Hepatic hemangioma rupture is a rare phenomenon, which can lead to life-threatening conditions. Here, we report a case of hepatic hemangioma rupture caused by blunt trauma. Explorative laparotomy was performed due to unstable vital signs and abdominal massive hemoperitoneum revealed on computed tomography. We detected arterial bleeding from a hepatic hemangioma and performed primary suture of the liver and postoperative angiographic embolization.

Incidental traumatic right diaphragmatic rupture: a missed case after trauma

  • Fatima Alharmoodi;Shadin Ghabra;Salem Alharthi
    • Journal of Trauma and Injury
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    • v.36 no.1
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    • pp.56-59
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    • 2023
  • Traumatic diaphragmatic hernia is among the most uncommon conditions after severe trauma, and it is associated with high morbidity and mortality. The diagnosis is difficult and might be missed, but a multimodal investigation might help in terms of diagnostic yield. In this case report, we present a missed right diaphragmatic rupture 14 years after the trauma.

Conservative Management of a Duodenal Perforation after Trauma (외상 후 발생한 십이지장 천공 보존적 치료 사례 1례)

  • Yoon, Jeung-seuk
    • Journal of Trauma and Injury
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    • v.25 no.4
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    • pp.271-274
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    • 2012
  • Duodenal perforation has a high incidence of complications and mortality if not detected and treated early. Delayed diagnosis of duodenal perforation is frequent because patients rarely complain of any symptoms. We report a case of duodenal perforation that appeared after trauma and was cured by using conservative treatment.

The Management of Arteriovenous Malformation Diagnosed after Extremity Trauma (하지 외상 후 진단된 Arteriovenous Malformation의 치료)

  • Kim, Seong Yup;Jin, Sung Chan
    • Journal of Trauma and Injury
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    • v.26 no.4
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    • pp.308-311
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    • 2013
  • Congenital arteriovenous malformation is rare disease. Endovascular treatment is one of the important modality in the treatment of arteriovenous malformation. We report a successful treatment case of arteriovenous malformation with endovascular treatment.

Multivariate Analysis of Predictive Factors for the Severity in Stable Patients with Severe Injury Mechanism (중증 손상 기전의 안정된 환자에서 중증도 예측 인자들에 대한 다변량 분석)

  • Lee, Jae Young;Lee, Chang Jae;Lee, Hyoung Ju;Chung, Tae Nyoung;Kim, Eui Chung;Choi, Sung Wook;Kim, Ok Jun;Cho, Yun Kyung
    • Journal of Trauma and Injury
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    • v.25 no.2
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    • pp.49-56
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    • 2012
  • Purpose: For determining the prognosis of critically injured patients, transporting patients to medical facilities capable of providing proper assessment and management, running rapid assessment and making rapid decisions, and providing aggressive resuscitation is vital. Considering the high mortality and morbidity rates in critically injured patients, various studies have been conducted in efforts to reduce those rates. However, studies related to diagnostic factors for predicting severity in critically injured patients are still lacking. Furthermore, patients showing stable vital signs and alert mental status, who are injured via a severe trauma mechanism, may be at a risk of not receiving rapid assessment and management. Thus, this study investigates diagnostic factors, including physical examination and laboratory results, that may help predict severity in trauma patients injured via a severe trauma mechanism, but showing stable vital signs. Methods: From March 2010 to December 2011, all trauma patients who fit into a diagnostic category that activated a major trauma team in CHA Bundang Medical Center were analyzed retrospectively. The retrospective analysis was based on prospective medical records completed at the time of arrival in the emergency department and on sequential laboratory test results. PASW statistics 18(SPSS Inc., Chicago, IL, USA) was used for the statistical analysis. Patients with relatively stable vital signs and alert mental status were selected based on a revised trauma score of more than 7 points. The final diagnosis of major trauma was made based on an injury severity score of greater than 16 points. Diagnostic variables include systolic blood pressure and respiratory rate, glasgow coma scale, initial result from focused abdominal sonography for trauma, and laboratory results from blood tests and urine analyses. To confirm the true significance of the measured values, we applied the Kolmogorov-Smirnov one sample test and the Shapiro-Wilk test. When significance was confirmed, the Student's t-test was used for comparison; when significance was not confirmed, the Mann-Whitney u-test was used. The results of focused abdominal sonography for trauma (FAST) and factors of urine analysis were analyzed using the Chi-square test or Fisher's exact test. Variables with statistical significance were selected as prognostics factors, and they were analyzed using a multivariate logistics regression model. Results: A total of 269 patients activated the major trauma team. Excluding 91 patients who scored a revised trauma score of less than 7 points, 178 patients were subdivided by injury severity score to determine the final major trauma patients. Twenty-one(21) patients from 106 major trauma patients and 9 patients from 72 minor trauma patients were also excluded due to missing medical records or untested blood and urine analysis. The investigated variables with p-values less than 0.05 include the glasgow coma scale, respiratory rate, white blood cell count (WBC), serum AST and ALT, serum creatinine, blood in spot urine, and protein in spot urine. These variables could, thus, be prognostic factors in major trauma patients. A multivariate logistics regression analysis on those 8 variables showed the respiratory rate (p=0.034), WBC (p=0.005) and blood in spot urine (p=0.041) to be independent prognostic factors for predicting the clinical course of major trauma patients. Conclusion: In trauma patients injured via a severe trauma mechanism, but showing stable vital signs and alert mental status, the respiratory rate, WBC count and blood in the urine can be used as predictable factors for severity. Using those laboratory results, rapid assessment of major trauma patients may shorten the time to diagnosis and the time for management.

Problems with Transferring Major Trauma Patients to Emergency Medical Center of a University Hospital from Another Medical Center (대학병원 응급의료센터로 전원되는 중증 외상환자의 현황 및 문제점)

  • Han, Sang-Soo;Jung, Kyoung-Won;Kwon, Jun-Sik;Kim, Ji-Young;Choi, Sang-Cheon;Lee, Kug-Jong
    • Journal of Trauma and Injury
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    • v.24 no.2
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    • pp.118-124
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    • 2011
  • Purpose: The incidence of multiple trauma is increasing nowadays and is the leading cause of death among young adults. Initial treatment is well known to be crucial in multiple trauma victims. However, many indiscriminate transfers occur due to the lack of a well-organized trauma system in Korea. The objective of this study is to demonstrate the current serious state in which major trauma patients are transferred to the Emergency Medical Center of a university hospital from another medical center. Methods: From November 2009 to October 2010, we performed a retrospective study to analyze the characteristics of patients who visited the Ajou University Medical Center located in Gyeonggi-do. We evaluated the ISS (injury severity score), and a score over 15 point was identified as major trauma. The major trauma patients were separated into two groups according to the visit route, and the characteristics of each group were analyzed. Results: Among the 88,862 patients who visited to the Emergency Medical Center, trauma patients accounted for 19,950, and 343 of them were evaluated as major trauma patients. Among the 343 patients, 170 patients had been transferred from other medical centers. The proportion of males to females was 3.3:1, and the mean ISS was 22.7. The leading cause of trauma was motor vehicle accidents. Of the total 170 patients, 77.6% were admitted to the Intensive care unit and 36.3% underwent surgery. The 170 patients that had been transferred to our medical center, 78.8% were transferred from Gyeonggi-do, 15.3% were transferred from other regions, and 5.9% were miscellaneous. Conclusion: Almost half of the major trauma victims treat at our medical center had been transferred from other medical centers. Establishing a traumatic system, supported by well-organized trauma centers and emergency medical services, that can reduce inappropriate transfers among medical facilities is essential.