• Title/Summary/Keyword: Iatrogenic complication

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Iatrogenic Delayed Aortic Injury Following a Surgical Stabilization of Flail Chest

  • Seok, Junepill;Cho, Hyun Min;Kim, Seon Hee;Kim, Ho Hyun
    • 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.

Unrecognized Bilateral Dislocation of Temporomandibular Joint during Orotracheal Intubation (진단이 늦어진 기관삽관 후 발생한 턱관절 탈구)

  • Chung, Sang-Bong;Jeon, Hyoungbae;Kim, Taikwan
    • Journal of Trauma and Injury
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    • v.28 no.2
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    • pp.75-78
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    • 2015
  • Mandible dislocation during endotracheal intubation is an unusual occurrence but easy to be overlooked for its unfamiliarity. We recently had a case of iatrogenic bilateral dislocation of a temporomandibular joint during orotracheal intubation and emphasize the importance of an early awareness of this possible complication.

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Traumatic Disc Injuries and the Iatrogenic Spinal Disability (외상성 추간판 손상과 의원성 척추장애인 만들기)

  • Lee, Kyeong-Seok;Doh, Jae-Won;Yoon, Seok-Mann;Bae, Hack-Gun;Yun, Il-Gyu
    • Journal of Korean Neurosurgical Society
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    • v.29 no.7
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    • pp.935-939
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    • 2000
  • Objective : Traumatic disc lesion is a lesion with tremendous controversies. The causal relationships of this lesion are not established along with pathogenesis, diagnostic criteria, methods of treatment and the outcome. However, a significant number of patients with back pain after a trauma underwent spinal operations under the diagnosis of traumatic disc lesions. Such an ill-directed operation eventually produce a person with an iatrogenic disability. We present two illustrative cases, and tried to make a preventive method. Methods : We examined the path from mild trauma after a road traffic accident into the iatrogenic disability in two illustrative cases, who requested disability assessment and medical appraisement. We evaluated the reason and background for such an unwanted outcome and tried to find a method to reduce or prevent it by a literature review. Results : These two patients were admitted to the hospital with the diagnosis of lumbar sprain after a road traffic accidents. They eventually underwent spinal surgery under another diagnosis such as traumatic disc herniation or internal disc disruption. They stayed at the hospital for more than six months and finally lost their jobs. They became the disabled at last. Although they complained back pain, they never insisted by themselves that their symptoms were due to the traumatic disc lesion. To prevent such an iatrogenic disability, the doctors should assist them to go-back to the workplace promptly instead of a reckless extension of the treatment period. It may be necessary to evaluate the certificates to extend the treatment period with an additional diagnosis by a medical expert. To reduce the unnecessary long-term admission, a new billing system such as a partial share for the high cost of the treatment by the patients may be needed. Conclusion : It is not the patient but the doctors, who has the responsibility to avoid the unnecessary operations. All treating doctors should try to reduce or prevent such an iatrogenic complication caused by ourselves before we are forced to do so.

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Removal of a broken needle using three-dimensional computed tomography: a case report

  • Kim, Jin-Ha;Moon, Seong-Yong
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.39 no.5
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    • pp.251-253
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    • 2013
  • Inferior alveolar nerve block obtained maximum anesthetic effect using a small dose of local anesthetic agent, which also has low a complication incidence. Complications of an inferior alveolar nerve block include direct nerve damage, bleeding, trismus, temporary facial nerve palsy, and etc. Among them, the major iatrogenic complication is dental needle fracture. A fragment that disappears into the soft tissue would be hard to remove, giving rise to a legal problem. A 31-year-old woman was referred for the removal of a broken needle, following an inferior alveolar nerve block. Management involved the removal of the needle under local anesthesia with pre- and peri-operative computed tomography scans.

Fingertip replantations by only arteriorrhaphy without external bleeding (미세 현미경하 동맥 문합술 후 외출혈을 시행하지 않은 수지 첨부의 재접합)

  • Park, Hyoung Joon;Roh, Si Young;Kim, Jin Soo;Lee, Dong Chul;Ki, Sae Hwi;Yang, Jae Won
    • Archives of Plastic Surgery
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    • v.36 no.3
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    • pp.311-317
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    • 2009
  • Purpose: Traditionally, external bleeding is needed when only an arteriorrhaphy can be performed in cased where a venorrhaphy cannot be done at the initial reconstruction for a zone1 complete amputation. However, this salvage procedure has several iatrogenic complications. Therefore, we did not perform an external bleeding procedure, in cases where external bleeding was not appropriate due to the small size of the stump. Methods: From September 2006 to August 2007, 19 fingertip amputations, among 18 patients, were performed using only arteriorrhaphy without external bleeding; In total 95 fingertip amputations, with venorrhaphy or external bleeding procedures were excluded. The results were reviewed retrospectively to compare survival and complication rates. Results: The survival rate of only arteriorrhaphy without external bleeding is 84.2%. Additional operations for soft tissue problems of total or partial necrosis were performed in 5 cases. Conclusions: We found no difference in the survival and complication rates of only arteriorrhaphy without external bleeding compared to results of only arteriorrhaphy with external bleeding in other articles. Therefore, our results suggest that in some cases with a fingertip amputation, performing arteriorrhaphy only, without external bleeding, might be a better option than external bleeding due to reduced iatrogenic injuries and complications.

Urinary bladder rupture during voiding cystourethrography

  • Lee, Kyong-Ok;Park, Se-Jin;Shin, Jae-Il;Lee, Suk-Young;Kim, Kee-Hyuck
    • Clinical and Experimental Pediatrics
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    • v.55 no.5
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    • pp.181-184
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    • 2012
  • Voiding cystourethrography (VCUG) is a commonly performed diagnostic procedure for the evaluation of vesicoureteral reflux with urinary tract infection or congenital renal diseases in children. The procedure is relatively simple and cost-effective, and complications are very rare. The iatrogenic complication of VCUG range from discomfort, urinary tract infection to bacteremia, as well as bladder rupture. Bladder rupture is a rare complication of VCUG, and only a few cases were reported. Bladder rupture among healthy children during VCUG is an especially uncommon event. Bladder rupture associated with VCUG is usually more common in chronically unused bladders like chronic renal failure. Presented is a case of bladder rupture that occurred during a VCUG in a healthy 9-month-old infant, due to instilled action of dye by high pressure. This injury completely healed after 7 days of operation, and it was confirmed with a postoperative cystography. The patient's bladder volume, underlying disease, velocity of the contrast media instilled, catheter size, and styles of instillation are important factors to prevent bladder rupture during VCUG. Management of bladder rupture should be individualized, but the majority of infants are treated with the operation. In conclusion, bladder rupture is a rare complication, however, delicate attention is needed in order to prevent more dire situations.

Non-surgical treatment of hemorrhagic shock caused by rupture of iatrogenic pseudoaneurysm (의인성 가성낭종 파열에 의한 출혈성 쇽의 비수술적 치료)

  • Kim, Soon Young;Kim, Tae Jun;Na, Seong Kyun;Park, Seung Ah;Jung, Dong Min;Kim, Yong Kyun;Jo, Sang-Ho
    • Journal of Yeungnam Medical Science
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    • v.31 no.1
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    • pp.17-20
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    • 2014
  • Iatrogenic femoral artery pseudoaneurysm is a complication in patients undergoing catheterization. The risk increased when large-bore sheaths, concomitant anticoagulation therapy, and antiplatelet therapy are used during the intervention. Ultrasound-guided thrombin injection has become the treatment of choice. Rapid expansion, rupture, infection, and mass effect resulting in distal or cutaneous ischaemia or peripheral neuropathy, as well as failure of other treatment options are all indications for surgery. We report a 48-year-old man who developed hemorrhagic shock due to femoral pseudoaneurysm rupture after coronary angiography, and successfully treated by ultrasound-guided thrombin injection.

Percutaneous Transhepatic Removal of Migrated Biliary Stent from a Chronic Biloma Cavity (만성 담즙종 공동 내로 이동한 담도 스텐트의 경피경간적 제거)

  • Hyoung Nam Lee
    • Journal of the Korean Society of Radiology
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    • v.81 no.2
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    • pp.442-447
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    • 2020
  • Iatrogenic foreign bodies are a challenging complication to both the interventional radiologist and patient, resulting in impaired quality of life and substantial financial cost. The case report describes a successful percutaneous transhepatic removal of an intra-abdominal foreign body. A 72-year-old man underwent surgery for placement of a retrievable covered stent for refractory bile leakage after left hemihepatectomy. Three days after placement, stent folding and migration into a chronic biloma cavity occurred via the bile leakage site. By using a balloon catheter technique, the folded stent could be straightened and repositioned into the bile duct to minimize stent-strut injury during retrieval. The interventional approach could be a valid treatment option for intra-abdominal foreign bodies, as well as intravascular foreign bodies. A thorough understanding of devices and techniques can provide the interventional radiologist with valuable information regarding procedural planning and the management of iatrogenic foreign bodies.

Delayed Iatrogenic Diaphragmatic Hernia after Left Lower Lobectomy

  • Hong, Tae Hee;Choi, Yong Soo
    • Journal of Chest Surgery
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    • v.50 no.6
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    • pp.456-459
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    • 2017
  • A 66-year-old patient undergoing regular follow-up at Samsung Medical Center after left lower lobectomy visited the emergency department around 9 months postoperatively because of nausea and vomiting after routine esophagogastroduodenoscopy at a local clinic. Abdominal computed tomography showed the stomach herniating into the left thoracic cavity. We explored the pleural cavity via video-assisted thoracic surgery (VATS). Adhesiolysis around the herniated stomach and laparotomic reduction under video assistance were successfully performed. The diaphragmatic defect was repaired via VATS. The postoperative course was uneventful, and he was discharged with resolved digestive tract symptoms.