• Title/Summary/Keyword: Chest injury

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Primary Survey of Cardiac Troponin I Elevated Groups in Trauma Patients (외상 환자에서의 cardiac troponin I 상승군에서의 기초 조사)

  • Sohn, You Dong;Lim, Kyoung Soo;Ahn, Ji Yun;Park, Jung Keun;Cho, Gyu Chong;Oh, Bum Jin;Kim, Won
    • Journal of Trauma and Injury
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    • v.18 no.2
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    • pp.81-86
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    • 2005
  • Background: Cardiac troponin I (cTnI) is a sensitive cardiac marker of myocardial injury. In normal coronary angiogram, positive cTnI values may be detected in various events such as sepsis, stroke, trauma and so on. To investigate characteristics of cTnI positive group in trauma patients, we designed this study between cTnI positive group and cTnI negative group. Method: Trauma patients who visited emergency room within 24 hours after accidents were included. Patients who had renal failure, acute coronary syndrome, sepsis, spontaneous SAH were excluded. Retrospective study of 97 trauma patients was done. We investgated ISS (injury severity score), positive cTnI, EKG abnormality, shock class, ICU admission rate and mortality. Result: In comparing with non chest trauma group, chest trauma group, whose chest AIS (Abbreviated Injury Score) is more than 3 point, had significant values in ISS, positive cTnI, EKG abnormality, shock class and ICU admission rate. Also, in non chest trauma group, we found several patients whose cTnI level was positive. When non chest trauma group was divided into two subgroups, the mortality and shock class of positive cTnI group were higher than that of negative cTnI group. When all trauma patients were divided into two groups, a positive cTnI group had higher values in ISS, shock class, ICU admission rate and mortality than that in a negative cTnI group. Conclusion: We found that cTnI were positive in patients of cardiac contusion but also in various trauma cases. In non chest trauma patients, we assumed that hypotension caused cTnI elevating. The cTnI could play a role in predicting prognosis in trauma patients.

Surgical Repair of a Traumatic Tracheobronchial Injury in a Pediatric Patient Assisted with Venoarterial Extracorporeal Membrane Oxygenation

  • Suh, Jee Won;Shin, Hong Ju;Lee, Chang Young;Song, Seung Hwan;Narm, Kyoung Sik;Lee, Jin Gu
    • Journal of Chest Surgery
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    • v.50 no.5
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    • pp.403-406
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    • 2017
  • Tracheobronchial rupture due to blunt chest trauma is a rare but life-threatening injury in the pediatric population. Computed tomography (CT) is not always reliable in the management of these patients. An additional concern is that ventilation may be disrupted during surgical repair of these injuries. This report presents the case of a 4 -year-old boy with an injury to the lower trachea and carina due to blunt force trauma that was missed on the initial CT scan. During surgery, he was administered venoarterial extracorporeal membrane oxygenation (ECMO). Although ECMO is not generally used in children, this case demonstrated that the short-term use of ECMO during pediatric surgery is safe and can prevent intraoperative desaturation.

Delayed Splenic Rupture Following Minor Trauma in a Patient with Underlying Liver Cirrhosis (간경화증 환자에서 경도 외상 후 발생한 지연 비장 파열)

  • Jeung, Kyung-Woon;Lee, Byung-Kook;Ryu, Hyun-Ho
    • Journal of Trauma and Injury
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    • v.24 no.1
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    • pp.52-55
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    • 2011
  • The spleen is the most frequently injured organ following blunt abdominal trauma. However, delayed splenic rupture is rare. As the technical improvement of computed tomography has proceeded, the diagnosis of splenic injury has become easier than before. However, the diagnosis of delayed splenic rupture could be challenging if the trauma is minor and remote. We present a case of delayed splenic rupture in a patient with underlying liver cirrhosis. A 42-year-old male visited our emergency department with pain in the lower left chest following minor blunt trauma. Initial physical exam and abdominal sonography revealed only liver cirrhosis without traumatic injury. On the sixth day after trauma, he complained of abdominal pain and diarrhea after eating snacks. The patient was misdiagnosed as having acute gastroenteritis until he presented with symptoms of shock. Abdominal sonography and computed tomography revealed the splenic rupture. The patient underwent a splenectomy and then underwent a second operation due to postoperative bleeding 20 hours after the first operation. The patient was discharged uneventfully 30 days after trauma. In the present case, the thrombocytopenia and splenomegaly due to liver cirrhosis are suspected of being risk factors for the development of delayed splenic rupture. The physician should keep in mind the possibility of delayed splenic rupture following blunt abdominal or chest trauma.

Statistical Review for USNCAP on SUV & Pick-up, Part 1: Frontal Crash Test (SUV & 트럭 차종의 USNCAP 통계분석, Part 1: 정면충돌)

  • Beom, Hyenkyun;Kim, Joseph;Cho, Kisoon;Yi, Hoki
    • Transactions of the Korean Society of Automotive Engineers
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    • v.23 no.4
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    • pp.420-427
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    • 2015
  • This paper statistically reviewed for the USNCAP frontal crash test results carried out by NHTSA. Vehicle samples were selected on total 20 vehicles which were included on 15 vehicles for MPV&SUV and 5 Pickup. The results was summarized as followings. The performance for the driver was better than the passenger's in the average sense. There exist distinctions between the driver and the passenger on the USNCAP front test procedure, for example dummy size, seating position and airbag style. Therefore these differences originated in the statistical results. Main effect was Neck injury for crash performance on both dummies on the average value. Root cause of neck injury was different for each dummy, ie, the driver caused from Nte & Ntf, but the passenger did absolutely Nte mode. Reliability evaluated from the standard deviation was highly dependent upon chest injury on the driver and neck injury on the passenger. Restraint system was also summarized.

Innominate Artery Injury by Blunt Chest Trauma -A case report - (흉부 둔상으로 인한 무명동맥 손상 -수술치험 1예-)

  • Hong Joon-Hwa;Lee Cheol-Joo;Choi Jin-Wook;Soh Dong-Moon
    • Journal of Chest Surgery
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    • v.39 no.5 s.262
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    • pp.411-414
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    • 2006
  • Innominate artery injury by blunt chest trauma is rarely reported. This report describes a 40-year-old male who had innominate artery dissection and pseudoaneurysm caused by blunt chest trauma and was treated successfully by ascending aorta to innominate artery bypass graft. The patient recovered without any complications and was discharged one week after the operation.

An Experience of Inferior Vena Caval Ligation in Traumatic Injury (하공정맥 손상의 치험 1례)

  • 이성행
    • Journal of Chest Surgery
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    • v.6 no.2
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    • pp.209-212
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    • 1973
  • Because of the. rise in the incidence of high speed automobile accident and various gun shot wound, complicated vascular injuries are becoming more frequent. Inferior vena caval injury seems to be also in high incidence, but reports in the literature were rare. because of potentially lethal. Recently we have experienced a case of inferior vena caval injury due to stab wound on the posterior aspect of the right abdomen. This was successfully treated with inferior caval ligation on the both, proximal and distal of the injured infrarenal vena cava.

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Emergency Treatment of Penetrating Cardiac Injury (관통성 심장 자상 환자의 응급수술)

  • 신윤곤
    • Journal of Chest Surgery
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    • v.27 no.6
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    • pp.483-485
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    • 1994
  • Recently, we experienced one case of penetrating cardiac injury patient by the knife.This patient was treated by emergency operation through left anterolateral thoracotomy under local anesthesia at emergency room. But, the patient was brought about the brain death inspite of normalized function of heart and lung. Now we have a conclusion that was able to recover of heart and lung functions by doctor`s exactly judgement and practice, at least.

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One Stage Repair of Traumatic Ventricular Septal Defect and Mitral Regurgitation (외상성 심실중격결손 및 승모판막 역류증의 일차 완전정복)

  • 이재원;송태승;제형곤;송명근
    • Journal of Chest Surgery
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    • v.32 no.12
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    • pp.1131-1134
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    • 1999
  • After a penetrating thoracic injury early detection of intracardiac injury and early surgical repair when indicated are essential. A case presenting severe respiratory distress two weeks after a penetrating thoracic injury is reported. Transesophageal echocardiography showed massive pericardial effusion ventricular septal defect and mirtal regurgitation, The infundibular ventricular septal perforation was repaired using a Dacron patch the anterior mitral leaflet by interrupted sutures and the ruptured chordae of the posterior leaflet by a new chordae formation.

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Clinical Evaluation of Chest Trauma (흉부 손상의 임상적 고찰)

  • 김용한
    • Journal of Chest Surgery
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    • v.25 no.9
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    • pp.968-975
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    • 1992
  • A clinical analysis was performed on 404 cases of the chest trauma who were admitted and treated at department of thoracic and cardiovascular surgery, Chung Ang University, Yong San Hospital during the past 8 years from July 1984 to April 1992. The results were as follows. 1. The sex ratio was 3: 1 with male predominence. 2. The common age groups were 3rd, 4th, 5th and 6th decades. 3. The most common chief complaint was chest pain[58.2%]. 4. Of 404 cases of chest trauma, 50 cases were resulted from penetrating injuries whereas 354 cases were from non penetrating injuries. The most common cause of the non penetrating injuries was traffic accident[234/354, 66.1%] and of the penetrating injuries were stab wound[47/50, 94%]. 5. The left thorax was the preferred site of chest trauma. 6. The range of hospital stay was from less than 1 week to over 6 weeks and the average duration was about 2 weeks. 7. The common chest trauma was rib fracture[51.6%] and others were simple contusion [18.8%], hemothorax[14.6%], hemopneumothorax[14.9%] and pneumothorax[8.7i]. The rib fracture was prevalent between 4th to 9th rib laterally. 8. There were 92 cases of associated injuries which were bone fracture[66/92, 71.7%], head injury[17/92, 18.5%] and abdominal injury[9/92, 9.8%]. 9. The methods of treatment were conservative management[58.6%], closed tho-racostomy[23.3%], open thoracotomy[3.4%] and others. 10. There were 28 cases[6.9%] of complication, such as pneumonia, atelectasis, emp-yema, respiratory failure and others. 11. The overall mortality was 2.5%[10 cases] and causes of death were hypovolemic shock, acute renal failure, adult respiratory distress syndrome, sepsis and multiple organ failure.

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A Clinical Evaluation of 1,110 Chest Trauma (흉부 손상 1,110례에 대한 임상적 고찰)

  • 조용준
    • Journal of Chest Surgery
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    • v.25 no.10
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    • pp.1013-1019
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    • 1992
  • A clinical evaluation was performed on 1, 110 cases of chest trauma treated at the Department of Chest Surgery, Chonnam University Hospital, during the past 23 years from January 1968 to June 1990. The ratio of male to female was 5.5: 1. The most common causes of chest trauma was stab wounds in penetrating trauma and traffic accidents in nonpenetrating trauma. The most common injuries in chest trauma were hemothorax in penetrating trauma and rib fracture in nonpenetrating trauma. Hemothorax or pneumothorax was observed in 592 cases [53.3%] of the total cases and rib fracture was observed in 527 cases[47.5%] of the total cases. Rib fracture was prevalent from the 3th to 8th rib, and 1st and 2nd rib fractures were associated with major thoracic injuries and other organ injuries. Open thoracotomy was performed in 163 cases[14.7%] and conservative nonoperative treatment in the others. Overall mortality rate was 8.5%[94 cases], and common causes of the death were shock and respiratory insufficiency.

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