• Journal of Yeungnam Medical Science
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• 제27권2호
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• pp.122-126
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• 2010

It is common m childhood that children suffer intracavity or head injury, falling down backward, having chopsticks in their mouth. But most of them have paralysis of upper and lower extremity because of secondary damage by penetrating injury of brainstem and spine. We could not find this case which have shown infaction of medulla oblangata on MRI and paralysis by impact only without clear penetrating evidence. So the authors report this case with study of literature because we experience one case that have high signal density in brainstem on MRI, Loss of consciousness, and left hemiplegia without clear penetrating evidence after falling down backward, having chopsticks in her mouth and regard it rare case.

• Journal of Chest Surgery
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• 제17권1호
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• pp.110-117
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• 1984

A clinical evaluation was performed on 76 cases of chest injury experienced at department of Chest Surgery, Capital Armed Forces General Hospital during the past 3 years period from January 1981 to August 1983. 1.The most common cause of the chest trauma was gun shot by which 26 cases were injured among 44 cases [57.9%] of penetrating injury. Remaining 32 cases [42.1%] were injured by non-penetrating blunt trauma. 2.Hemopneumothorax was observed in 60 cases [78.9%], those were caused by both penetrating [65%] and non-penetrating [35%] injuries. 3.Rib fracture was found in 58.7% of total cases and with rib fracture, clavicle fracture was combined at 19.6% and sternal fracture, at 8.7%. 4.Most common symptoms were chest pain and dyspnea, and most common signs were breath sound diminution and subcutaneous emphysema. 5.Common site of rib fracture was from 4th rib to 8th rib [69.4%]. 6.In 58 cases [76.3%], patients were treated with operation including open thoracotomy [25 cases]. 7.Overall mortality was 5.3%[4 cases] and causes of death were septic shock and respiratory failure.

• Journal of Trauma and Injury
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• 제30권4호
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• pp.166-172
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• 2017

Purpose: Thoracic traumas represent 10-15% of all traumas and are responsible for 25% of all trauma mortalities. Traumatic cardiac injury (TCI) is one of the major causes of death in trauma patients, rarely present in living patients who are transferred to the hospital. TCI is a challenge for trauma surgeons as it provides a short therapeutic window and the management is often dictated by the underlying mechanism and hemodynamic status. This study is to describe our experiences about emergency cardiac surgery in TCI. Methods: This is a retrospective clinical analysis of patients who had undergone emergency cardiac surgery in our trauma center from January 2014 to December 2016. Demographics, physiologic data, mechanism of injuries, the timing of surgical interventions, surgical approaches and outcomes were reviewed. Results: The number of trauma patients who arrived at our hospital during the study period was 9,501. Among them, 884 had chest injuries, 434 patients were evaluated to have over 3 abbreviated injury scale (AIS) about the chest. Cardiac surgeries were performed in 18 patients, and 13 (72.2%) of them were male. The median age was 47.0 years (quartiles 35.0, 55.3). Eleven patients (61.1%) had penetrating traumas. Prehospital cardiopulmonary resuscitations (CPR) were performed in 4 patients (22.2%). All of them had undergone emergency department thoracotomy (EDT), and they were transferred to the operating room for definitive repair of the cardiac injury, but all of them expired in the intensive care unit. Most commonly performed surgical incision was median sternotomy (n=13, 72.2%). The majority site of injury was right ventricle (n=11, 61.1%). The mortality rate was 22.2% (n=4). Conclusions: This study suggests that penetrating cardiac injuries are more often than blunt cardiac injury in TCI, and the majority site of injury is right ventricle. Also, it suggests prehospital CPR and EDT are significantly responsible for high mortality in TCI.

• Journal of Chest Surgery
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• 제14권4호
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• pp.311-318
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• 1981

A clinical evaluation was performed on 402 cases of chest trauma those were admitted and treated at the department of chest surgery, Chonnam National University Hospital, during the past 13 years and 7 months from Jan. 1968 to July 1980. 1. The ratio of male to female was 5.5:1 in 1968 and 3.4:1 in 1980 with progressive increase of female patient and age from 20 to 59 years is 81.0%. 2. The most common cause of chest trauma was stab wound in penetrating trauma and traffic accidents in nonpenetrating trauma. 3. The most common injury from chest trauma was hemothorax in penetrating trauma and rib fracture in nonpenetrating trauma. 4. Hemothorax was observed in 76 cases [18.9%] of total cases and rib fracture was observed in 163 cases [40.5%] of total cases. 5. Rib fracture was prevalent from 4th to 8th rib, and 1st and 2nd rib fractures were associated with major thoracic injuries and with other organ injuries. 6. Open thoracotomy was performed in 72 cases [17.9%] and others were treated with conservative nonoperative treatment. 7. Overall mortality was 4.5% [19 cases], and common causes of the death were shock and respiratory insufficiency.

• 한국응급구조학회지
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• 제9권1호
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• pp.95-99
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• 2005

Penetrating neck trauma by gunshot injury involving tracheobronchial tree is rare in Korea. Extensive tissue damage by cavitation, tissue fragmentation and shock wave transmission of high-velocity projectile along with associated organ injury renders high rate of mortality and morbidity. A 28 year old man in military service with gunshot wound in left cervical area presented initial symptoms of severe dyspnea and subcutaneous emphysema. Computed tomography of chest and cervical region as well as bronchoscopic evaluation was performed to confirm highly suspected injury to cervical trachea. Surgical exposure was established through a low collar incision; the damaged segment of 3.5 cm length including 2-4th tracheal rings was resected out and end-to-end anastomosis was performed. Bleeding from lacerated anterior jugular vein was controlled by ligation of both ends and a K2 bulllet was found upon inner border of body of first rib, medial to right carotid sheath and removed out. Cervical esophagus, carotid artery, internal jugular vein and recurrent laryngeal nerve were spared. Extubation was done on the first postoperative day and postoperative course until discharge on nineth postoperative day remained uneventful.

• Journal of Trauma and Injury
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• 제25권3호
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• pp.94-96
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• 2012

Duodenal injuries following a blunt or penetrating trauma are uncommon and account for just 3% to 5% of all abdominal injuries. About 22% of all duodenal injuries are caused by blunt trauma. An overlooked injury or delayed diagnosis of duodenal injury may lead to increased mortality and morbidity. We report two cases of a duodenal injury following blunt abdominal trauma.

• Journal of Chest Surgery
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• 제28권3호
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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.

• 한국응급구조학회지
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• 제9권1호
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• pp.89-93
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• 2005

Penetrating chest trauma by stab injury may result in massive hemothorax from damage to single or multiple intrathoracic organs such as heart, aorta, internal mammary artery, intercostal artery or pulmonary parenchyme. Prognosis of massive hemothorax necessitating emergency thoracotomy is fatal especially so if there exists concomitant underlying compromise of cardiopulmonary function. A 56 year old man with destroyed left lung due to old pulmonary tuberculosis was stabbed in right parasternal lesion through third intercostal space. Intubation with cardiopulmonary resuscitation and closed thoracostomy were performed to resuscitate from cardiac asystole from hemorrhagic shock and acute respiratory distress. Midsternotomy was made to expose active bleeding foci in right mammary artery, subclavian vein, intercostal artery and anterior segment of right upper lung showing severe bullous change and pleural adhesion. Postoperative care included ventilator support, inotropic instillation and cautious, balance fluid therapy ; successful extubation was done on third postoperative day and patient was discharged on tenth postoperative day without any complication.

• Journal of Chest Surgery
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• 제27권12호
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• pp.1023-1026
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• 1994

We reviewed 10 cases of traumatic diaphragmatic injuries at Soonchunhyang University Gumi Hospital from January 1990 through April 1993. seven patients were male and three patients were female. The age distribution was ranged from 25 to 79 years, predominant 4th decades occurred in male. The traumatic diaphragmatic injuries were due to blunt trauma in 9 cases (traffic accident 7 and crash injury 2) and penetrating wound in 1 case (stab wound). The common symptom were dyspnea (60%), chest pain and abdominal pain in order frequency. In the blunt trauma and crash injury, te rupture site was all located in the left(9 cases). In the penetrating wound, the rupture site was located in the right(1 case). The surgical repair of 10 cases were performed with transthoracic approach in 9 cases and thoracoabodominal approach in 1 case. The postoperative mortality was 10% (1/10). The cause of death was multiple organ failure with pulmonary edema.

• Journal of Trauma and Injury
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• 제34권4호
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• pp.248-256
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• 2021

Purpose: Laparoscopy has various advantages over laparotomy in terms of postoperative recovery. The number of surgeons using laparoscopy as a diagnostic and therapeutic tool in abdominal trauma patients is increasing, whereas open conversion is becoming less common. This report summarizes a single surgeon's experience of laparoscopy at a level I trauma center and evaluates the feasibility of laparoscopy as a diagnostic and therapeutic tool for abdominal trauma patients. Methods: In total, 30 abdominal trauma patients underwent laparoscopy by a single surgeon from October 2014 to May 2020. The purpose of laparoscopy was categorized as diagnostic or therapeutic. Patients were classified into three groups by type of surgery: total laparoscopic surgery (TLS), laparoscopy-assisted surgery (LAS), or open conversion (OC). Univariate analysis was performed to determine the advantages and disadvantages. Results: The mechanism of injury was blunt in 19 (63.3%) and penetrating in 11 patients (36.7%). Eleven (36.7%) and 19 patients (63.3%) underwent diagnostic and therapeutic laparoscopy, respectively. The hospital stay was shorter for patients who underwent diagnostic laparoscopy than for those who underwent therapeutic laparoscopy (5.0 days vs. 13.0 days), but no other surgical outcomes differed between the groups. TLS, LAS, and OC were performed in 12 (52.2%), eight (34.8%), and three patients (13.0%), respectively. There was no significant difference in morbidity and mortality among the three groups. Conclusions: Laparoscopic surgery for selected cases of abdominal trauma may be feasible and safe as a diagnostic and therapeutic tool in hemodynamically stable patients due to the low OC rate and the absence of fatal morbidity and mortality.