• 대한두개안면성형외과학회지
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• 제20권3호
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• pp.199-202
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• 2019

Traumatic subcutaneous emphysema, which is the infiltration of air into subcutaneous tissues due to trauma, is caused by various factors such as chest and/or abdominal trauma, facial fractures, and barotrauma caused by mechanical ventilation. In this case report, a 32-year-old woman developed traumatic subcutaneous emphysema after undergoing abdominal liposuction at a local clinic. She was subsequently admitted to Busan Paik Hospital, and with early diagnosis and conservative treatment, she was discharged on the seventh day of hospitalization with no complications. However, because traumatic subcutaneous emphysema may accompany other injuries for various reasons, radiological examination and various tests should be performed to prevent serious complications and sequelae.

• 대한치과의사협회지
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• 제56권11호
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• pp.598-604
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• 2018

Cervicofacial subcutaneous emphysema is defined as the abnormal introduction of air into the subcutaneous tissues of the head and neck. It is mainly iatrogenic and traumatic in origin. Our two case reports are also due to the same cause, but the features of the trauma and the site of the dental treatment are different from the existing reports. A 29-year-old man visited our hospital with facial swelling and pain after experiencing facial trauma in a soccer game. Another 55-year-old woman visited with similar symptoms after replacement of her maxillary anterior fixed prosthesis. In the two cases presented, subcutaneous emphysema was gradually treated with no complications during antibiotic prophylaxis and supportive care. In this paper, we report two cases of traumatic and iatrogenic subcutaneous emphysema and their diagnoses, etiologies, complications, and treatments based on a literature review.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제16권2호
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• pp.202-207
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• 1994

본원에서는 안면부 손상후 발생한 피하기종과 기종격이 있는 두 환자를 치험하였다. 다른부위 손산 없이 단독으로 안면부 손상후 발생한 피하기종과 기종격은 예후가 좋고 자연치유가 잘되지만 심각한 합병증 및 후유증을 방지하기 위하여 세심한 관찰 및 보존적 처치가 요구된다. 이에 저자들은 증상, 진단. 해부학적구조, 발생가전, 합병증, 치료양식등의 문헌고찰과 더불어 치험 증례를 보고 하는 바이다.

• 대한기관식도과학회지
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• 제10권2호
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• pp.58-62
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• 2004

Spontaneous rupture of the pulmonary alveoli after a sudden increase intra-alveolar pressure is a common cause of pneumomediastinum, which is usually seen in healthy young men. Other common causes are traumatic and iatrogenic rupture of the airway and esophagus; however, pneumomediastinum following cervicofacial emphysema is much rarer and is occasionally found after dental surgical procedures, head and neck surgery, or accidental trauma. We present two cases of pneumomediastinum following cervicofacial subcutaneous emphysema after oral trauma. They constitute an uncommon clinical entity, So its radiologic appearance, clinical presentation, and diagnosis are described.

• 한국임상수의학회지
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• 제29권2호
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• pp.190-193
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• 2012

2개월령의 알래스카 말라뮤트견이 교상후 호흡곤란과 경부피하기종을 주증으로 내원하였다. 신체검사에서 두 개의 작은 피부열상과 경부의 염발음이 확인되었다 방사선 검사에서 종격기종과 피하기종이 관찰되었다. 종격동기종의 원인을 파악하기 위해서 컴퓨터 단층촬영검사를 실시하였다. 컴퓨터 단층촬영검사결과 경도의 기관열상이 2군데에서 관찰되었다. 컴퓨터 단층촬영검사는 기관의 외상성의 진단에 유용하며, 특히 열상의 위치와 정도를 잘 영상화할 수 있으므로 정확한 처치와 이로 인한 부작용을 줄일 수 있다.

• Journal of Chest Surgery
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• 제10권1호
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• pp.38-43
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• 1977

With the adevance of widespread mechanization and high-speed era, the incidence of traumatic rupture of the tracheobronchial tree has been increased considerably. We have experienced these diseased of the 3 cases in our department. The first case was a 25 year old male who was severe dyspneic and subcutaneous emphysema, hemoptysis, and hemopneumothorax of both side were noted. During tracheostomy, it was found that the 2net ring of the trachea was ruptured. No definitive procedure was made on admission. Corrective surgery was performed with end-to-end anastomosis on 31 post-traumatic day. The second case was a 43 year old female who received multiple stab wounds on the anterior neck and it was found that the cricoid cartilage was transected partially. The injured cartilage was approximated with interrupted suture of No. 600 wire. The third case was a 19 year old male who had sustained a compression chest injury without external wound or rib fracture. At five days after trauma, he had suffered from dyspnea, and obstruction of the left main bronchus due to traumatic bronchial rupture was confirmed by means of bronchoscopy and bronchography at two weeks after the trauma. End-to-end anastomosis of the bronchus was performed and the left lung was aerated well. Mild postoperative stenosis of trachea was remained in the first case. Others were uneventful.

• Journal of Trauma and Injury
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• 제21권2호
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• pp.91-99
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• 2008

Purpose: Multiple rib fracture (MRF) and a hemopneumothorax accompany with most blunt chest traumas. We aimed to analyze the factors increasing the probability of a hemopneumothorax. In addition, other injuries accompanying MRF were analyzed. Methods: We retrospectively reviewed the medical records of 154 mutiple rib fracture patients who visited our hospital between January 2005 and December 2007. The medical records were reviewed for sex, age, mechanism of injury, location, number of fractures, distance of dislocated rib fragments, and presence of complications. We measured the distance of bony dislocations by using the PACS (Picture Archiving and Communication System). Results: The average number of rib fractures was $3.7{\pm}2.1$, and the number of rib fractures significantly influenced the incidence of a hemothorax (p<0.001). The risk of a hemothorax was increased in a bilateral MRF compared to a unilateral MRF (p=0.027). The distance of dislocated rib fragments influenced the probability of a hemothorax significantly (p=0.018), and subcutaneous emphysema and lung contusion were significantly associated with a pneumothorax (p=0.021, p=0.036). Conclusion: The number of MRFs did not influence the risk for a pneumothorax, but did influence the risk for a hemothorax. The laterality, distance of dislocation, also had an influence on the risk for a hemothorax. Also, subcutaneous emphysema and lung contusion were increased in cases with a pneumothorax. We must consider the possibility of a hemothorax even when the initial chest X-ray shows no evidence of a hemothorax. If a lung contusion is present, then an occult pneumothorax must be considered.

• Journal of Chest Surgery
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• 제23권3호
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• pp.588-593
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• 1990

The rupture of tracheobronchial tree caused by non penetrating blunt trauma is being increased in incidence though it is still rarely occurred on now Because this type of injury is uncommon, a high index of suspicion should be maintained in all crush injuries involving the chest. Early diagnosis and primary repair not only restore normal lung function but also avoid the difficulties and complications associated with delayed diagnosis and repair. We experienced a case of tracheobronchial rupture caused by non penetrating blunt chest trauma without rib fracture. The patient was a 16 year old male who was a high school student. He was compressed on anterior chest by hand ball goal post being failed down on the morning of admission day. After this accident, he was suffered from progressively developing dyspnea and subcutaneous emphysema on face, neck and anterior chest. The diagnosis, tracheal rupture, was made by chest CT and bronchoscopy. After right thoracotomy, the ruptured site was directly closed by using interrupted suture. Post-operative course was uneventful. Thus we report this case of traumatic tracheal rupture with review of literature.

• Journal of Chest Surgery
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• 제43권6호
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• pp.675-680
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• 2010

배경: 이 연구는 외상성 기관-기관지 손상의 특징적인 임상 증상 및 영상학적 소견 등에 대하여 알아보고자 하였다. 대상 및 방법: 2003년 1월부터 2009년 12월까지 본원 응급실을 통해서 내원한 외상 환자들 중에서 수술을 통해서 외상성 기관-기관지 손상으로 진단된 6명의 환자를 대상으로 하였다. 외상의 종류, 동반된 손상, 진단 방법 및 수술까지 걸린 시간, 수술 소견 및 수술 방법, 예후 등에 대해서 조사해 보고 후향적으로 진단에 중요한 인자 등을 알아 보았다. 결과: 손상의 원인으로는 교통사고가 1명, 낙상 및 흉부에 강한 압박을 받은 경우가 5명이었다. 주 증상으로 피하기종, 호흡 곤란, 통증 등이 있었으며 영상소견으로는 기흉, 종격동 기종, 혈흉, 늑골 골절, 폐좌상 등이 있었다. 기관지 내시경을 시행하지 않은 상태에서 2명에서는 흉부 CT 소견에서 기관-기관지 손상이 의심되었지만 나머지 4명에서는 의심하지 못했다. 수상 부위는 기관부위가 2예, 기관지가 4예 있었다. 수술은 개흉술을 통한 일차 문합을 시행하였고 수술 후 사망과 문합 부위 유출은 없었으며 1명에서 술 후 성대 마비가 있었다. 진단에 도움이 되는 특징적인 소견으로는 흉관 삽입 후 음압의 적용에도 불구하고 지속적인 심한 폐 허탈이 가장 중요한 소견이었으며, 흉부 CT에서의 기관-기관지의 주행 경로의 단절이 진단에 중요하였다. 결론: 외상성 기관-기관지 손상은 의심하지 않으면 진단이 쉽지 않으나, 특징적인 흉관 삽입 후의 임상 증상과 영상 소견은 진단에 큰 도움을 주었다.

• Journal of Chest Surgery
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• 제13권3호
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• pp.212-218
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• 1980

A severe crushing injury of the chest produce a very striking syndrome referred to as traumatic asphyxia. This syndrome is characterized by bluish-red discoloration of the skin which is limited to the distribution of the valveless veins of the head and neck. And also if it is characterized by bilateral subconjunctival hemorrhages and neurological manifestations. But these clinical entities faded away progressively in a few weeks. Apporximately 90% of the patients who live for more than a few hours will recover from traumatic asphyxia when it occurs as a single entity. And so, death results from either severe associated injuries of from subsequent infection, rather than from pulmonary or cardiac insufficiency in traumatic asphyxia. We have experienced 4 cases of traumatic asphyxia with severe crushing thoracic injuries at department of the chest surgery, Captial Armed forces General Hospital during about 3 years from April 1977 to Aug. 1980. The 1st 22 year-old male was struct 2$\frac{1}{2}$ ton truck on the road and was transferred to this hospital immediately. He had taken tracheostomy due to severe dyspnea with contusion pneumonia and for removal of a large amount of bronchial secretion. The 2nd case was 23 year-old male who was got buried in a chasm. In this case, the heavy metal post tumbled over him back while at work. The 3rd case was 39 year-old male who leapt out of a window in 5th story while fire broke out in living room by oil stove heating. He had multiple rib fracture with right hemothor x and right colle's fracture and pelvic bone fracture. The last 22 year-old male was run over by a gun carriage. The wheel of this gun carriage passed over his thorax and right chin. He was brought to this hospital by helicopter. when he was first examined at emergency room, he was in semicomatose state and has pneurmomediastinum with multiple rib fracture and severe subcutaneous emphysema. As soon as he arrived, bilateral closed thoracostomy was performed and cardiopulmonary resuscitation was done. In hospital 8th weeks, chest series showed fibrothorax in right side even if chest wall stabilized. All 4 cases had multiple petechiae over their facees and chest and bilateral subconjunctival hemorrhages referred to as traumatic asphyxia. 3 cases except one case who received splenectomy, had been suffered from contusion pneumonia and had been treated with respiratory care. In these 3 cases, they had warning of impending injury before accident, and took a deep breath hold it and braces himself. And also, even if he had not impending fear in remaining one case, he had taken a deep breath and had got valsalva maneuver for pulling off the heavy metal post. Intrathoracic pressure rose suddenly and resulted to traumatic asphyxia in this situation. All these cases were recovered completely without sequelae except one fibrothorax, right.