• 제목/요약/키워드: Urgent surgery

검색결과 124건 처리시간 0.025초

Urgent Intracranial Carotid Artery Decompression after Penetrating Head Injury

  • Kim, Seong Joon;Park, Ik Seong
    • Journal of Korean Neurosurgical Society
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    • 제53권3호
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    • pp.180-182
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    • 2013
  • We describe a case of intracranial carotid artery occlusion due to penetrating craniofacial injury by high velocity foreign body that was relieved by decompressive surgery. A 46-year-old man presented with a penetrating wound to his face. A piece of an electric angular grinder disc became lodged in the anterior skull base. Computed tomography revealed that the disc had penetrated the unilateral paraclinoid and suprasellar areas without flow of the intracranial carotid artery on the lesion side. The cavernous sinus was also compromised. Removal of the anterior clinoid process reopened the carotid blood flow, and the injection of glue into the cavernous sinus restored complete hemostasis during extraction of the fragment from the face. Digital subtraction angiography revealed complete recanalization of the carotid artery without any evidence of dissection. Accurate diagnosis regarding the extent of the compromised structures and urgent decompressive surgery with adequate hemostasis minimized the severity of penetrating damage in our patient.

Thermo-Visual Evaluations of Acute Abdomen Pain in Children

  • Aleck Ovechkin;Kyeong-Seop Kim;Jeong-Whan Lee;Sang-Min Lee
    • KIEE International Transaction on Systems and Control
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    • 제2D권2호
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    • pp.59-64
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    • 2002
  • About two thirds of patients admitted to hospitals world-wide suffer from acute abdomen pains of varying degrees of severity. Acute abdomen pain due to appendicitis or pancreatitis usually requires urgent surgical treatment, whereas pain due to heart ischemia or enteroviral infection requires only drug treatment. In general, making an immediate decision about whether or not acute abdomen pain requires urgent surgery is very difficult. This decision becomes even more difficult when the patient is a young child who can't properly describe the abdominal pain. In this case, thermo-visual inspection can alternatively be used to decide whether urgent surgical treatment is necessary to cure the abdominal pain.

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Chondrosarcoma of the Heart

  • Kim, Do Jung;Wi, Jin Hong;Kim, Yonhee;Lee, Sak;Joo, Hyun-Chel;Youn, Young-Nam
    • Journal of Chest Surgery
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    • 제48권3호
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    • pp.199-201
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    • 2015
  • Chondrosarcoma is a rare entity of malignant tumor which arises from cartilaginous tissue, and the literatures on this disease are scarce. The first-line of treatment for cardiac chondrosarcoma is surgery. Due to early local recurrence and distant metastasis, the prognosis is poor even after complete surgical excision. We present a case of chondrosarcoma in the left atrium causing functional mitral stenosis which required urgent surgical intervention, and the successful treatment outcome.

Pseudoaneurysm Formation due to Popliteal Artery Injury Caused by Drilling during Medial Opening Wedge High Tibial Osteotomy

  • Chun, Keun Churl;So, Byung Jun;Kang, Hyun Tak;Chun, Churl-Hong
    • Knee surgery & related research
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    • 제30권4호
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    • pp.364-368
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    • 2018
  • We report a case of 53-year-old woman with an injured popliteal artery due to excessive drilling with a drill bit during medial opening wedge high tibial osteotomy (MOWHTO). Pseudoaneurysm was diagnosed three days after surgery and confirmed by urgent computed tomography (CT) angiography. Open vascular surgery with resection of the perivascular hematoma and end-to-end anastomosis using ipsilateral saphenous vein interposition graft was performed. CT angiography at 8 months postoperatively showed that blood flow was maintained without obstruction of the graft site and active dorsiflexion of the foot was possible. To reduce neurovascular injury during MOWHTO, it is important not to drill the far cortex at the proximal part of the osteotomy site when using a drill bit, and the metal should be positioned posteromedially as much as possible.

Successful Endoscopic Vacuum Therapy for Extensive Gastric Tubing Necrosis after Ivor-Lewis Esophagectomy: A Case Report

  • Hee Kyung Kim;Hyun Woo Jeon
    • Journal of Chest Surgery
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    • 제56권5호
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    • pp.362-366
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    • 2023
  • The stomach has become the most commonly used site for grafts to replace the esophagus in esophageal cancer surgery because of its good blood supply and ability to enable single-reconstruction anastomosis. However, anastomotic failure is a serious complication after esophageal cancer surgery. Unlike anastomotic leakage due to local ischemia, gastric tube necrosis is a life-threatening condition with a high mortality rate. Gastric tube necrosis involves extensive ischemia due to a decreased blood supply, and an urgent operation is mandatory in most cases. Endoscopic vacuum therapy (EVT) has been used for anastomotic leakage after esophageal surgery. In recent years, it has been successfully used for more extensive disease, including large esophageal perforation as an indication for reoperation. Hence, we report a case of extensive gastric tube necrosis treated by EVT after an Ivor Lewis operation.

심장판막 재수술: 29례 보 (Reoperations for valvular heart disease: report of 29 cases)

  • 김은기
    • Journal of Chest Surgery
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    • 제16권4호
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    • pp.498-505
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    • 1983
  • It has been over 20 years since successful operations of Cardiac valves at the Department of Thoracic and Cardiovascular surgery, college of medicine, Yonsei University. About six hundreds of patients with severely symptomatic valvular heart disease have had valve operations with complete loss or sharp decrease in their cardiac symptoms since 1956. As the number of cardiac patient increases, reoperation on valves assumes greater importance. To define the group of patients undergoing reoperations on valves and the factors influencing their survival, we have reviewed our experiences of the reoperation on valves at the Yonsei University, Severance Hospital. This is a report of 29 cases which was undergone secondary or more surgery for valvular heart disease from 1966 to 1983. The primary operations includes 159 cases of open heart surgery from 1966 to 1975 and 476 cases from 1976 to march, 1983. The secondary operations are classified into groups of secondary valvuloplasty or valvotomy [8 cases], prosthetic valve replacement following valvuloplasty or valvotomy [14 cases] and prosthetic valve rereplacement [2 case] for such as calcification, degeneration and perforation of the cusps and paravalvular leakage, of the bioprosthetic valves. The leading indication for reoperation of mitral valve was restenosis or stenoinsufficiency, The indications of aortic valve replacement was active bacterial endocarditis, medically uncontrollable prosthetic endocarditis or paravalvular leakage. Overall death rate of the reoperation was 17.4% [5 death among the 29 patients] and the leading causes of death were myocardial failure, arrhythmia, cerebral embolism, acute renal failure due to low output syndrome. And it was followed by sepsis associated with active prosthetic endocarditis. The death rate of reoperation was 4.3% in the elective cases except urgent cases and the death rate of overall cardiac valve except reoperation cases was 4.1% in the last two years. Although the general mortality of reoperation was high, both mortality rates were comparable except emergency cases due to urgent preoperative patient’s condition.

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요추 추간판 제거술중 발생한 대혈관 손상 수술 치험 -2례 보고- (Treatment for Maior Vascular Injuries of Lower Lumbar Disc Surgery -2 Cases Report)

  • 김승우;황윤호
    • Journal of Chest Surgery
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    • 제30권6호
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    • pp.621-624
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    • 1997
  • 하부 요추 추간판 탈출증시에 척추 후궁 절제술 및 추간판 제거술은 흔히 실행되며, 그로 인한 혈관 손상 합병증은 드물게 생기고 있다. 혈관 손상으로 인해서 수술 환자의 혈압이 떨어져도 외부로 출혈이 없으면 무시되기도 하지만, 만약 수술후 환자의 혈압이 심하게 떨어지거나, 저혈압 상태가 오래 지속된다면, 먼저 혈관 손상을 의심해야 하며, 즉시 개복술을 시행해야 된다. 부산 백병원 흉부외과 의국에서는 2례에 대한 경험을 했기에 보고한다.

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기관협착증 치험 1 (Reconstruction of tracheal stenosis: report of one case)

  • 윤갑진
    • Journal of Chest Surgery
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    • 제17권3호
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    • pp.492-496
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    • 1984
  • For the treatment of acute respiratory failure and emergency care of an urgent patient, tracheostomy in itself may have been a life saving procedure. But, tracheal stenosis gives serious clinical manifestation which can only be corrected by surgical intervention in many occasions. We experienced one case of tracheal stenosis following tracheostomy for assisted ventilation. Tracheogram showed a 4.0 cm segmental narrowing below the tracheostoma. Before reconstruction, we tried to T-tube cannulation, but the result was not satisfactory. So we resected the narrowed segment and tracheal reconstruction was performed with uneventful result.

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Repair of Acute Post Infarction Mitral Regurgitation with Papillary Muscle Reimplantation - A case report -

  • Park, Won-Kyoun;Kim, Joon-Bum;Choo, Suk-Jung
    • Journal of Chest Surgery
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    • 제44권4호
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    • pp.285-287
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    • 2011
  • A 53-year-old man presenting with dyspnea and chest pain was diagnosed with acute myocardial infarction secondary to occlusion of the left circumflex coronary artery. Urgent revascularization by percutaneous stenting was successfully performed. However, the post-echocardiography revealed a ruptured papillary muscle that was causing severe mitral regurgitation and aggravation of congestive heart failure. The patient subsequently underwent mitral valve repair with papillary muscle re-implantation. Postoperative echocardiography showed a competent mitral valve without residual stenosis or regurgitation. The patient was discharged from the hospital with an uneventful recovery and has been doing well on outpatient follow up.

Unusual Case of Overt Aortic Dissection Mimicking Aortic Intramural Hematoma

  • Disha, Kushtrim;Kuntze, Thomas;Girdauskas, Evaldas
    • Journal of Chest Surgery
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    • 제49권2호
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    • pp.126-129
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    • 2016
  • We report an interesting case in which overt aortic dissection mimicked two episodes of aortic intramural hematoma (IMH) (Stanford A, DeBakey I). This took place over the course of four days and had a major influence on the surgical treatment strategy. The first episode of IMH regressed completely within 15 hours after it was clinically diagnosed and verified using imaging techniques. The recurrence of IMH was detected three days thereafter, resulting in an urgent surgical intervention. Overt aortic dissection with evidence of an intimal tear was diagnosed intraoperatively.