• Journal of Chest Surgery
• /
• 제14권2호
• /
• pp.123-126
• /
• 1981

190 cases of the thoracic injuries experienced at the department of chest surgery, Chungnam National University Hospital, for 5 years from Jan. 1976 till Dec 1980, were analysed. The results are as follows; 1. The incidence rate of male to female was 5.1:1. The common age groups were 3rd, 4th and 5th decades, and the most common age group in the penetrating injury was 3rd decade. 2. The most common mode of the nonpenetrating injuries was a traffic accident [63.0%], and the most commonly used tool in the penetrating injuries is a knife [66.7%]. 3. The most common nonpenetrating injury was rib fracture [73.9%], and the common fracture sites were 5th, 6th, 7th and 8th ribs [especially, 7th rib]. The incidence rate of flail chest was 15% of the cases of the rib fractures. 4. The common associated injuries of the nonpenetrating were long bone fracture [18.3%], brain contusion [15.9%], and clavicle fracture etc.. 5. The common method of surgical treatment were closed thoracostomy [46.7%], thoracentesis, and open thoracotomy [7.4%] etc.. 6. The overall mortality was 2.8%. [Nonpenetrating; 0.8%, Penetrating; 6.3%]

• 한국응급구조학회지
• /
• 제9권1호
• /
• pp.89-93
• /
• 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 Trauma and Injury
• /
• 제36권3호
• /
• pp.224-230
• /
• 2023

Purpose: Patients with penetrating injuries are at a high risk of mortality, and many of them require emergency surgery. Proper triage and transfer of the patient to the emergency department (ED), where immediate definitive treatment is available, is key to improving survival. This study aimed to evaluate the epidemiology and outcomes of patients with penetrating torso injuries in Incheon Metropolitan City. Methods: Data from trauma patients between 2014 and 2018 (5 years) were extracted from the National Emergency Department Information System. In this study, patients with penetrating injuries to the torso (chest and abdomen) were selected, while those with superficial injuries were excluded. Results: Of 66,285 patients with penetrating trauma, 752 with injuries to the torso were enrolled in this study. In the study population, 345 patients (45.9%) were admitted to the ward or intensive care unit (ICU), 20 (2.7%) were transferred to other hospitals, and 10 (1.3%) died in the ED. Among the admitted patients, 173 (50.1%) underwent nonoperative management and 172 (49.9%) underwent operative management. There were no deaths in the nonoperative management group, but 10 patients (5.8%) died after operative management. The transferred patients showed a significantly longer time from injury to ED arrival, percentage of ICU admissions, and mortality. There were also significant differences in the percentage of operative management, ICU admissions, ED stay time, and mortality between hospitals. Conclusions: Proper triage guidelines need to be implemented so that patients with torso penetrating trauma in Incheon can be transferred directly to the regional trauma center for definitive treatment.

• Journal of Trauma and Injury
• /
• 제28권2호
• /
• pp.71-74
• /
• 2015

Penetrating neck trauma involving spinal cord injury is relatively uncommon, but can be life-threatening. We report a case of 59-year-old female who presented with hypotension after stab injury self-inflicted with a scissor to her neck. Although Open removal of the scissor and control of bleeding were successfully done, penetration of spinal cord resulted in a neurologic impairment.

• Journal of Trauma and Injury
• /
• 제34권4호
• /
• pp.288-293
• /
• 2021

In South Korea, most patients who visit trauma centers with abdominal injuries have blunt trauma, and penetrating injuries are relatively rare. In extremely rare cases, some patients are admitted with a long object penetrating their abdomen, and these injuries are referred to as abdominal impalement injuries. Most cases of impalement injuries lead to fatal bleeding, and patients often die at the scene of the accident. However, patients who survive until reaching the hospital can have a good prognosis with optimal treatment. A 68-year-old female patient was admitted to the trauma center with a 4-cm-thick tree branch impaling her abdomen. The patient was transported by a medical helicopter and had stable vital signs at admission. The branch sticking out of the abdomen was quite long; thus, we carefully cut the branch with an electric saw to perform computed tomography (CT). CT revealed no signs of major blood vessel injury, but intestinal perforation was observed. During laparotomy, the tree branch was removed after confirming that there were no vascular injuries, and enterostomy was performed because of extensive intestinal injury. After treating other injuries, the patient was discharged without any complications except colostomy. Abdominal impalement injuries are treated using various approaches depending on the injury mechanism and injured region. However, the most important consideration is that the impaled object should not be removed during transportation and resuscitation. Instead, it should only be removed after checking for injuries to blood vessels during laparotomy in an environment where injury control is possible.

• Journal of Chest Surgery
• /
• 제50권5호
• /
• pp.399-402
• /
• 2017

We report the case of a patient with penetrating chest trauma (right chest) who had undergone a left pneumonectomy due to pulmonary tuberculosis 24 years ago. We performed an emergent thoracotomy, finding an opening of the penetrating wound in a lower-lobe basal segment of the right lung. A stapled tractotomy was performed along the tract. Bleeding control and air-leakage control was done easily and rapidly. The patient was discharged without any complications on the seventh day of admission. Tractotomy can be a good option for treating penetrating lung injuries in patients with limited lung function who need emergent surgery.

• Journal of Chest Surgery
• /
• 제28권12호
• /
• pp.1167-1173
• /
• 1995

We evaluated fifty three cases of traumatic diaphragmatic injuries that we have experienced from Jan.1973 to Oct.1994. The age distribution of the pateint was ranged from 1 to 74 years. Sex ratio is 39:14 with male dominence. The traumatic diaphragmatic injuries were due to blunt trauma in 37[Left 22, Right 15 cases and penetrating trauma in 16[Left 9, Right 7 cases. In blunt trauma, Preoperative diagnosis of the diaphragmatic injuries was possible in 27 patients[72% , and in penetrating trauma, 14 patients[88% . Among 37 in blunt traumas, 22[58% cases, and among 16 in penetrating traumas, 13[88% cases were operated within 24 hours. The most common herniated abdominal organ in the thorax was stomach[14/53 . The traumatic diaphragmatic repair of 50 cases were performed by thoracic approach in 23 cases, thoracoabdominal approach in 8 cases and abdominal approach in 19 cases, and in 3 cases, not operated. Hospital mortality [including not operated patients[3 was 17%[9/53 and the causes of death were intracranial hematoma[1 , hypertensive encephalopathy[1 and asphyxia[1 , and among operated patients[6 , combined head injury[2 , multiorgan failure[2 , hypovolemic shock[1 , and pulmonary edema & renal failure[1 . All deaths had related to the severity of associated injuries.

• Journal of Trauma and Injury
• /
• 제20권1호
• /
• pp.47-51
• /
• 2007

Penetrating chest trauma caused by the components of one's own car is rare in motor vehicle accidents. We experienced two cases of penetrating chest injury caused by the sideview mirror of the patient's vehicle. One was a 25-year-old man. The sideview mirror penetrated the left chest, went through the diaphragm, and ruptured the spleen. He was in shock upon arrival at the emergency room. An emergency thoracotomy and laparotomy were done. The ruptured spleen was resected, the lung and the diaphragm were debrided and repaired, and the chest wall was reconstructed. The other patient was a 57-year-old male, who was transported to our emergency room with the sideview mirror of his truck stuck into his right chest wall as the result of an accident. He also had a right Bennet's fracture and an open fracture of the right tibia. Air had been sucked into the right pleural cavity through the wound. Multiple rib fractures and lung lacerations had also occurred. Removal of the sideview mirror, repair of the lacerated lung, and reconstruction of chest wall were done immediately. Both patients recovered without complication and were discharged.

• Journal of Trauma and Injury
• /
• 제25권3호
• /
• pp.94-96
• /
• 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
• /
• 제28권1호
• /
• pp.47-52
• /
• 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.