• Title/Summary/Keyword: Injured Patient

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Hematoma in Neck after Stellate Ganglion Block (성상신경절 차단후에 발생한 경부혈종)

  • Han, Young-Jin;Choi, Huhn
    • The Korean Journal of Pain
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    • v.7 no.2
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    • pp.270-272
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    • 1994
  • A 43 year old male patient injured in a traffic accident was admitted to the department of general surgery for the treatment of spleen rupture and multiple rib fractures. After subphrenic abscess occurred after splenectomy was treated. After 50 days of admission, left facial palsy occurred with sensory neural hearing loss, and tinnitus by longitudinal fracture of left temporal bone. The patients was consulted to pain clinic for further evaluation and treatment. The patient was treated with stellate ganglion block with 1% lidocaine 6ml one time daily. On 19th day, stellate ganglion block was given as usual, and the patient complained of pain in the neck and headache the next day. Two days later, mild fever elevation and hematoma in the neck were found. Hematoma was drained with hemovac. Ruptured muscular branch of vertebral artery was ligated surgically but the ligation was released in the next day and the hematoma was removed and the artery religated. Five units of packed RBC were transfused during the period and the patient was discharged without any sequelae.

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Analysis of Patients Injured in Demonstraions (장기간의 집회시위로 인한 환자 발생에 대한 분석)

  • Lee, Kyoung Mi
    • Journal of Trauma and Injury
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    • v.22 no.2
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    • pp.179-183
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    • 2009
  • Purpose: This study was conducted to determine the level of medical care required for mass-gatherings and to describe the types of illness and injury that may occur during demonstrations. Methods: We conducted a retrospective review of the medical records for patients injured during demonstrations. Results: From May to August at 2008, a total of 932,000 participants attended demonstrations. Most patients were occurred from June to July, a total of 126 patients were evaluated and treated at the emergency center of our hospital. The mean patient age was $31.8{\pm}9.8$ years, and men predominated over women. The vast majority of patients were experienced trauma (88.9%). The diagnostic categories were contusion (49.2%), laceration (20.6%), fracture (6.3%), syncope/dizziness (5.5%), ocular injuries (3.9%), dyspnea (3.9%), other trauma (3.1%), and abdominal complaints (1.5%). Two patients were admitted. Conclusion: The rate and the acuity of patients seen at these demonstrations was low. Nevertheless, a full on-site physician and transportation system is recommended during similar incidents.

Microsurgical DREZotomy for Treatment of Intractable Central Pain in Patient with Spinal Cord Injury (척수 손상 환자의 중추성 통증에 대하여 시행한 Microsurgical DREZotomy의 효과)

  • Lee, Zee-Ihn;Kim, Seong-Ho;Ahn, Sang-Ho;Jang, Sung-Ho
    • Journal of Yeungnam Medical Science
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    • v.19 no.1
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    • pp.49-54
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    • 2002
  • The central pain in patient with spinal cord injury is a common and disabling sequela. The microsurgical DREZ(Dorsal Root Entry Zone)otomy is a surgical procedure effective in the treatment of intractable pain and spasticity in spinal cord injured patients. It consists of a microsurgical lesions performed in the ventrolateral region of the dorsal root entry zone at the selected levels. This report presents one case with incomplete paraplegia patient, who had chronic central neuropathic pain ineffective to many conservative treatments in bilateral T10 and right T11 segments and both lower extremities, is relieved from the pain after microsurgical DREZotomy. In conclusion, microsurgical DREZotomy is one method of effective treatments for spinal cord injured patients with intractable central neuropathic pain.

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Intracardiac a Aortic Foreign Body (심장 및 대동맥내 이물 치험 1례)

  • 방정희;편승환
    • Journal of Chest Surgery
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    • v.30 no.9
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    • pp.932-935
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    • 1997
  • A 50-year-old male patient was admitted due to right ventricular & aortic foreign bodies with ascending aortic pseudoaneurysm. The patient had a history of Kirschner wire fixation of right sternoclavicular joint 3 months ago. Under cardiopulmonary bypass, two K-wires were removed and injured pulmonary valve leaflet and aortic wall were repaired successfully The postoperative course was uneventful and the patient was discharged on the 14th postoperative day.

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Spinal Cord Stimulation in a Patient with Preganglionic and Postganglionic Brachial Plexus Injury -A case report- (절전, 절후 신경손상을 동반한 상완신경총병증 환자에서 시행한 척수자극술 -증례보고-)

  • Hong, Ji Hee;Jang, Hyun Sug
    • The Korean Journal of Pain
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    • v.21 no.3
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    • pp.244-247
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    • 2008
  • After a traumatic brachial plexus injury, 80% of patients develop severe pain in the deafferentated arm. This type of pain is considered very resistant to many forms of therapy. When we plan treatments for the patient who suffer from a pain from traumatic brachial plexus injury, clarifying the location of injured nerve is very important. EMG (electromyography), NCV (nerve conduction study), MRI (magnetic resonance imaging) and CT (computed tomography) myelography are recommended diagnostic method for this purpose. Here, we presented a patient who was suspected to have both preganglionic and postganglionic brachial plexus lesion by EMG and NCV study, he showed favorable response after spinal cord stimulation.

Application of acellular dermal matrix without skin graft in fingertip injury (수지 첨부 손상에서 피부이식을 동반하지 않은 무세포 진피조직의 사용)

  • Lee, Dong Hui;Kang, Jae Kyoung
    • Journal of Medicine and Life Science
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    • v.15 no.1
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    • pp.23-26
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    • 2018
  • The most common surgical repair method for fingertip injuries are replantation, flap coverage, and skin graft. In fingertip injury cases, acellular dermal matrix (ADM) is generally used in a two-stage operation. In the present case, only ADM was used in a 67-year-old male patient with a right fifth fingertip injury. The patient was undergoing chemotherapy after surgery for colon cancer, preventing prolonged hospitalization. In addition, wound healing was likely to be problematic. As a typical surgical method might have been difficult to apply in such a patient, we performed a one-stage operation, using only ADM on the injured area. Postoperative followup for 3 months showed good wound healing. Accordingly, we report a successful treatment outcome using ADM alone for a fingertip injury.

Successful treatment of fungal central thrombophlebitis by surgical thrombectomy in Korea: a case report

  • Eun Ji Lee;Jihoon T. Kim
    • Journal of Trauma and Injury
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    • v.36 no.3
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    • pp.276-280
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    • 2023
  • Fungal thrombophlebitis of the central vein is a rare, life-threatening disease associated with significant morbidity and mortality. It requires immediate central venous catheter removal and intravenous antifungal therapy, combined in some cases with either anticoagulation or aggressive surgical debridement. A 70-year-old male patient injured by a falling object weighing 1,000 kg was transferred to our hospital. A contained rupture of the abdominal aorta with retroperitoneal hematoma was treated with primary aortic repair, and a small bowel perforation with mesenteric laceration was treated with resection and anastomosis. After a computed tomography scan, the patient was diagnosed with thrombophlebitis of the left internal jugular vein and brachiocephalic vein. Despite antifungal treatment, fever and candidemia persisted. Therefore, emergency debridement and thrombectomy were performed. After the operation, the patient was treated with an oral antifungal agent and direct oral anticoagulants. During a 1-year follow-up, no signs of candidemia relapse were observed. There is no optimal timing of surgical treatment for relapsed fungal central thrombophlebitis. Surgical treatment should be considered for early recovery.

Analysis of external environmental factors affecting patient transport time

  • LEE, Hyeryeong;PARK, Sang Woong;YUN, Eunjeong;KIM, Dakyeong;CHOI, Hea Kyung
    • The Korean Journal of Food & Health Convergence
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    • v.8 no.6
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    • pp.11-17
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    • 2022
  • Emergency transport is directly related to the life of the patient, and rapid transport to the hospital is crucial. However, external environmental factors such as traffic or weather, interfere with hospital transport. In this study, we investigated the external environment affecting hospital transport time. We examined the transfer time and patient treatment time of emergency patients in an area of northern Gyeonggi-do from 2018 to 2020. Diagnosis after arrival at the hospital was used, and on-site treatment time was measured from paramedic arrival time at the scene to departure. Furthermore, we examined whether there was a correlation between the time paramedics left the scene and hospital arrival time through the reason for the delay as recorded in the emergency log. Traffic jams had the greatest impact on patient transport, while transport delays occurred due to heavy rain, but not snow. Among injured patients, electrical accidents were the most problematic in terms of on-site treatment time. This was because a lot of first aid is needed in electrical accidents. It must be necessary to mobilize two ambulances in an emergency through the expansion of infrastructure, prepare a plan for rapid transport in heavy rain, and implement strong laws against transport obstruction.

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.

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.