• 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.

• Journal of Chest Surgery
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• v.28 no.1
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• pp.47-52
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• 1995

We have experienced 30 cases of traumatic diaphragm injury between January,1988 and August,1993. 30 cases were reviewed and following results were obtained. 1.Sex ratio is 22:8 with male dominance. 2.The 27 cases were due to blunt trauma and other 3 cases were due to penetrating injury. 3.Left side injury was more common than right[24:6 . 4.The most common herniated abdominal organ was the stomach 5.Mortality rate was 27% and its causes were not diaphragmatic injury itself,but other associated multiple organ injury.

• Journal of Chest Surgery
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• v.17 no.4
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• pp.715-722
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• 1984

From 1978 to April 30 84 thirteen cases of cardiac injured patients were operated under general anesthesia at Department of Thoracic and Cardiovascular Surgery in Chonnam National University. These patients were divided Into two groups according to their cause of trauma: Group 1, penetrating cardiac injury and Group II, blunt cardiac injury. 1.In 7 cases of Group 1, 6 cases were stab wound and one case was gunshot wound, and among 6 cases of Group II, 3 cases traffic accident, 2 cases pedestrian, 1 case agrimotor accident. 2.The sites of cardiac injury in penetrating trauma were right ventricle mainly and the next left ventricle and in blunt trauma right ventricle, myocardial contusion, right atrium, and inferior vena cava in order. 3.In most of cases central venous pressure was elevated above 15 cmH2O and in 5 of 13 cases revealed cardiomegaly in simple chest X-ray. 4.The relationship between the condition on arrival and the time to operation is not significant. 5.Associated injuries in penetrating cardiac trauma were hemothorax, pneumothorax, laceration of lung and in blunt trauma hemothorax, sternal fracture, rib fracture and pneumothorax in order. 6.One case of gunshot injury died after operation.

• Journal of Trauma and Injury
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• v.25 no.4
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• pp.267-270
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• 2012

A 27 year-old man, who had a penetrating cardiac injury due to a metal fragment was transferred to our hospital. At admission, his vital signs were stable, and his chest film showed a foreign-body-like finding in the heart silhouette. We evaluated the patient with chest computed tomography and echocardiography for further information. Finally, we removed the metal fragment from the left ventricle by using a cardiopulmonary bypass.

• Journal of Trauma and Injury
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• v.31 no.3
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• pp.174-176
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• 2018

Most of aortic injuries after blunt chest trauma usually occur at the aortic isthmus and are identified in the emergency department soon after arrival. Delayed aortic injures by fractured posterior ribs, however, are relatively rare and have been reported only a few times. We recently experienced an iatrogenic descending aortic injury sustained as a result of a direct puncture by a sharp rib end after surgical stabilization of rib fractures.

• Journal of Chest Surgery
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• v.23 no.4
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• pp.736-744
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• 1990

From Jan. 1985 to Sep. 1989, four hundred and ten patients were admitted to the department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine with a diagnosis of nonpenetrating chest trauma. The most common cause of injury were motor vehicle accidents(75.1%) with the prevalent age group being their forties. The four most common findings were rib fracture(83.4%), hemothorax(50.7%), pneumothorax(24.6%) and clavicle fracture(12.0%), Fifty piratory insufficiency and the ventilation time was correlated with 6 fators : 1) shock 2) endotracheal intubation or tracheostomy 3) hemothorax 4) clavicle fracture 5) flail chest 6) more than three combined injuries or combined head injury. Ventilatory care was also related with mortality and complications such as pneumonia sepsis and empyema thoracis(p<0.05). The most common organism of post-traumatic infection were Pseudomonas and Staphylococcus.

• Journal of Chest Surgery
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• v.28 no.10
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• pp.924-927
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• 1995

Main bronchial injury after blunt trauma is very rare in all bronchial injuries and the pathogenesis is variable and not well known in everycases. We report a case of complete transsection of right main bronchus by blunt trauma. This 24-year old patient was transferred from a local hospital with a chest tube. Because of the severe subcutaneous emphysema and tension pneumothorax, we inserted one more chest tube resulting no obvious interval change. With the impression of bronchial injury, we performed an exploratory thoracotomy. We couldn't proceed bronchoscopy in the operation room because of his unstable vital sign. After opening of the chest wall, we could identify completely transsected right main bronchus. We anastomosed the bronchus with 4~0 Vicryl interruptedly. After operation, the patient was recovered without any complication.

• Journal of Chest Surgery
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• v.24 no.5
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• pp.505-509
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• 1991

Rupture or laceration of the aorta is a more common result of nonpenetrating traumatic injury than is generally appreciated. If the lesion is promptly diagnosed, a appropriate surgical treatment may be life-saving. Diagnosis may be difficult and at times the rupture may remain clinically silent for variable period.< A 34 - year old male patient had sustained steering wheel injury to his chest during automobile accident 8 weeks prior to admission. The diagnosis of traumatic aneurysm of the aorta was delayed as he was asymptomatic. Surgical repair of false aneurysm of the descending aorta was successfully performed by partial cardiopulmonary bypass through the femoral artery and vein.

• Journal of Trauma and Injury
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• v.26 no.3
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• pp.170-174
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• 2013

Purpose: A flail chest is one of most challenging problems for trauma surgeons. It is usually accompanied by significant underlying pulmonary parenchymal injuries and mayled to a life-threatening thoracic injury. In this study, we evaluated the treatment result for a flail chest to determine the effect of trauma localization on morbidity and mortality. Methods: Between 2004 and 2011, 46 patients(29 males/17 females) were treated for a flail chest. The patients were divided into two group based on the location of the trauma in the chest wall; Group I contained patients with an anterior flail chest due to a bilateral costochondral separation (n=27) and Group II contained patients with a single-side posterolateral flail chest due to a segmental rib fracture (n=19). The location of the trauma in the chest wall, other injuries, mechanical ventilation support, prognosis and ISS (injury severity score) were retrospectively examined in the two groups. Results: Mechanical ventilation support was given in 38 patients(82.6%), and 7 of these 38 patients required a subsequent tracheostomy. The mean ISS for all 46 patients was $19.08{\pm}10.57$. Between the two groups, there was a significant difference in mean ventilator time (p<0.048), but no significant difference in either trauma-related morbidity (p=0.369) or mortality (p=0.189). Conclusion: An anterior flail chest frequently affects the two underlying lung parenchyma and can cause a bilateral lung contusion, a hemopneumothorax and lung hemorrhage. Thus, it needs longer ventilator care than a lateral flail chest does and is more frequently associated with pulmonary complications with poor outcome than a lateral flail chest is. In a severe trauma patient with a flail chest, especially an anterior flail chest, we must pay more attention to the pulmonary care strategy and the bronchial toilet.

• Journal of Korean Critical Care Nursing
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• v.12 no.3
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• pp.61-73
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• 2019

Purpose : The purpose of this study was to examine the effects of two single chest physiotherapies mechanically ventilated patients with acute lung injury. Method : Participants were 30 ICU patients depending entirely on ventilators without self-respiration. Each patients received two single chest physiotherapiesvibration palm cup percussion at hour intervals. Data were analyzed one-way ANOVA and Wilcoxon signed-rank test. Statistical significance was accepted at a p value less than .05. Results : ibration therapy, dynamic compliance and statics compliance demonstrated a significant increase immediately and remained increased until 30 minutes after chest physiotherapy. palm cum percussion therapy saturation showed a significant increase immediately chest physiotherapyut there were no significant differences in tidal volume, dynamic compliance and statics compliance. Conclusion : In this study, we analyzed the effects of oscillation method and palm cup percussion method separately for each type of chest physiotherapy. Nursing interventions that actively utilize vibration methods should be provided to patients with respiratory diseases.