• Title/Summary/Keyword: Vessel injury

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Clinical Evaluation of the Cardiac and Great Vessel Injury [17 cases] (심장 및 대혈관손상 17례에 대한 임상적 고찰)

  • 장동철
    • Journal of Chest Surgery
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    • v.20 no.1
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    • pp.101-105
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    • 1987
  • A clinical evaluation was performed on 17 cases of the cardiac and great vessel injuries above the subclavian vessel at the Department of Thoracic and Cardiovascular Surgery, Chungnam National University Hospital from April, 1980 to September, 1986. The results were as follows: 1. Sex distribution were 13 cases in male and 4 cases in female. In age range, second and third decades occupied in about 65% of total cases. 2. Modes of injury were penetrating wound is 14 cases and nonpenetrating wound in 3 cases. The stab wounds by knife were most frequent. 3. Time interval from injury to operation was mean 103 minutes. 4. Surgical approaches were performed with thoracotomy in 9 cases, median sternotomy in 3 cases and direct incision above the wound. 5. Sites of injury were heart in 10 cases and great vessel in 7 cases. The right ventricular injury was most common as 7 cases. 6. Operative procedures were performed with simple closure, vascular graft anastomosis and ligation. There was no postoperative death.

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Acute Cerebral Infarction after Head Injury

  • Kim, Seok-Won;Lee, Seung-Myung;Shin, Ho
    • Journal of Korean Neurosurgical Society
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    • v.38 no.5
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    • pp.393-395
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    • 2005
  • Cerebral infarction rarely occur following head injury. The authors present the case of a 39-year-old man with complete infarction in the middle cerebral artery[MCA] and anterior cerebral artery[ACA] territories ccurred immediately after head injury. He had compound depressed fracture in right frontal bone with no neurological deficit. After the depressed bone elevation, postoperative computed tomography scan showed the right MCA and ACA territory infarction with midline shift. Cerebral angiography obtained on the day after emergent decompressive craneictomy showed the complete occlusion of the internal carotid artery[ICA] at the level of lacerum ICA segment. There was no evidence of neck vessel dissection and basal skull fracture. Cerebral infarction can occur in an ultraearly period after head injury without neck vessel dissection or basal skull fracture. We stress the need for attention to the cerebral infarction as the cause of a rare neurological deterioration of the head trauma.

External Iliac Artery Injury Caused by Abdominal Stab Wound: A Case Report (복부 자상에 의한 외장골 동맥 손상에 대한 치험 1례)

  • Lee, Sang Bong;Kim, Jae Hun;Park, Chan Ik;Yeo, Kwang Hee
    • Journal of Trauma and Injury
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    • v.28 no.3
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    • pp.215-218
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    • 2015
  • Traumatic iliac vessel injuries constitute approximately 25% of all abdominal vascular injuries. Hospital mortality has been reported at 25~60% and is a result of uncontrolled hemorrhage and hypovolemic shock caused by extensive blood loss. We report the case of a 25-year-old female patient who experienced an external iliac artery injury caused by abdominal minimal stab wound. Traumatic iliac vessel injuries are life-threatening complication of abdominal or pelvic injuries and prompt diagnosis and accurate treatment are important.

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Management of Femoropopliteal Vascular Injuries after Trauma: Surgical Outcomes (외상 후 대퇴-오금 혈관손상의 치료: 수술 성적)

  • Chang, Sung Wook;Han, Sun;Ryu, Kyoung Min;Ryu, Jae-Wook
    • Journal of Trauma and Injury
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    • v.28 no.1
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    • pp.15-20
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    • 2015
  • Purpose: Vascular injuries caused by traffic, industrial accidents and by outside activities have increased in Korea. Especially, vascular injuries to the extremities can lead to limb loss and even mortality if they are not appropriately treated. The aim of the study was to evaluate the surgical outcomes of femoropopliteal vascular management after trauma. Methods: The medical records of 12 patients with femoropopliteal vascular injuries who were treated at Dankook University Hospital from 2011 to 2013 were reviewed. Iatrogenic vascular injuries were excluded. The clinical data including the causes of injury, associated injuries and surgical outcomes were analyzed retrospectively. Results: All patients were male, with a mean age of $46.8{\pm}16.3years$ (range: 26~69 years). The causes of vascular injuries were four traffic accidents, three industrial accidents, two iron plates, one outside activity, one glass injury and one knife injury. The average transit time between the place of the accident place and the emergency department was $3.0{\pm}2.1$ (0.5~12.5) hours, and the average preparation time for surgery was $8.0{\pm}6.7$ (1.7~23.3) hours. The anatomic injuries included the popliteal vessel in seven cases and the femoral vessel in five cases. The average Injury Severity Score (ISS) was $12.0{\pm}5.0$ (5~17), and the average Mangled Extremity Severity Score (MESS) was $5.7{\pm}2.1$ (2~9). The operation methods were four interposition grafts, three end-to-end anastomoses, two direct repairs and three patch angioplasties. One case required amputation of the injured extremity. Conclusion: Early recognition and revascularization of the injured vessel are mandatory to reduce limb loss and to obtain satisfactory outcomes. Therefore, careful/rapid evaluation of the vascular injuries and timely/successful surgical treatment are the keys to salvaging an injured limb.

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Huge Psoas Muscle Hematoma due to Lumbar Segmental Vessel Injury Following Percutaneous Endoscopic Lumbar Discectomy

  • Kim, Hyeun-Sung;Ju, Chang-Il;Kim, Seok-Won;Kim, Jong-Gue
    • Journal of Korean Neurosurgical Society
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    • v.45 no.3
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    • pp.192-195
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    • 2009
  • We present a case of an acute psoas muscle hematoma following percutaneous endoscopic lumbar discectomy. A 60-year-old female who presented with far lateral lumbar disc herniation underwent endoscopic discectomy on the right side at the L4-5 level. On the second postoperative day, the patient complained of severe right flank and leg pain and her blood pressure decreased. A computed tomography scan showed a large acute psoas muscle hematoma at right L4-5 level. The patient was transfused with packed red blood cells and placed at absolute bed rest. After observing the patient in intensive care, the severe flank and leg pain subsided, but the mild back pain persisted. Although percutaneous endoscopic lumbar discectomy is an effective minimally invasive surgical technique for the treatment of lumbar disc herniation, this case highlights the inherent risks of acute lumbar segmental vessel injury.

Brachial Plexus Injury as a Complication after Nerve Block or Vessel Puncture

  • Kim, Hyun Jung;Park, Sang Hyun;Shin, Hye Young;Choi, Yun Suk
    • The Korean Journal of Pain
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    • v.27 no.3
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    • pp.210-218
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    • 2014
  • Brachial plexus injury is a potential complication of a brachial plexus block or vessel puncture. It results from direct needle trauma, neurotoxicity of injection agents and hematoma formation. The neurological presentation may range from minor transient pain to severe sensory disturbance or motor loss with poor recovery. The management includes conservative treatment and surgical exploration. Especially if a hematoma forms, it should be removed promptly. Comprehensive knowledge of anatomy and adept skills are crucial to avoid nerve injuries. Whenever possible, the patient should not be heavily sedated and should be encouraged to immediately inform the doctor of any experience of numbness/paresthesia during the nerve block or vessel puncture.

Mondor's Disease Developed after Ultrasound-assisted Liposuction for Treatment of Axillary Bromhidrosis

  • Lee, Hee Jong;Kim, Eun Key
    • Archives of Reconstructive Microsurgery
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    • v.23 no.1
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    • pp.33-35
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    • 2014
  • Mondor's disease is an uncommon condition characterized by a palpable, cord-shaped structure, which causes pain when pressed. Its known pathophysiology is thrombophlebitis of the superficial venous system. Although reported repeatedly, its definite cause is unknown and various possible causes have been identified, including surgery, irradiation, infection, malignancy, and trauma. We diagnosed this case to be Mondor's disease of the antecubital venous system, probably due to thermal injury of the proximal tributaries of the basilic or cephalic vein. Risk of thermal injury to the skin flap or the portal site remains a common complication, and as thermal injury to the blood vessel might also be considered, attention must be given when suctioning the area near a large superficial vessel.

Finger Injury by Green Onion Cutting Machine (파절기에 의한 수지손상)

  • Yim, Young Min;Oh, Deuk Young;Jung, Sung No;Rhie, Jong Won;Ahn, Sang Tae;Kwon, Ho
    • Archives of Plastic Surgery
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    • v.36 no.1
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    • pp.46-50
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    • 2009
  • Purpose: Finger injury by green onion cutting machine is one of the common hand injuries in the kitchen. It has a unique feature: there are multiple parellel laceration 3 - 5 mm wide. There are two directions of injuries(vertical, oblique). It may involve bone, tendon, nerve, and vessel injuries. We discuss its management and the long - term progress. Methods: We have treated six patients from 2003 to 2007. We carried out low tension approximation with thin suture materials to avoid ischemia and performed the additional operation as nail bed repair, tenorrhaphy, open reduction, vessel anastomosis, and composite graft. We reviewed the record of initial injury and collected the follow - up record. Results: They were all middle aged - women who had worked in the kitchen. Right hand was dominent over left hand. The ratio of the directions was 3 : 3 (vertical : oblique). They were all competely healed although there were three atrophy, four hyperesthesia, and one nail deformity. Conclusion: Finger injury by green onion cutting machine is a unique pattern of laceration with various accompanied injuries. It may look like a severe form of injury, but in most cases have relatively favorable progress. We have to perform careful examination of accompanied injuries and carry out the proper management. First and foremost, the user especially in the middle aged women should be warned to be careful in handling this risky machine.

CLINICAL STUDY OF COMPLICATIONS OF ORTHOGNATHIC SURGERY FOR THE DENTOFACIAL DEFORMITIES (악변형환자의 악교정수술시 합병증에 관한 연구)

  • Kim, Yeo-Gab;Lee, Sang-Chull;Lee, Baek-Soo;Kim, Byung-Ju
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.16 no.3
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    • pp.247-258
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    • 1994
  • We got this conclusion from an investigation about complications from 144 cases of 130 patients who were to be searched their personal records, admission chart, clinical laboratory sheet, anesthetic record, consult sheet and radiographic opinion. They had orthognathic surgery for maxillofacial deformity treatment at the department of oral and maxillofacial surgery in dental school of Kyung Hee university for 4 years and 10 months, from March 1989 to December 1993. 1. In the intraoperative phase, by the frequency of complication, blood vessel injury was found the most-22%, and then soft tissue injury, unfavorable osteotomy split, and there were some cases of tooth injury and inappropriate osteotomy. In the mandibular segmental osteotomy, blood vessel injury was found the most frequently-20 cases (27%), soft tissue injury, unfavorable osteotomy split were the second frequent cases, and then unfavorable fragment position was found. In the extraoral vertical ramus osteotomy and Le Fort I osteotomy also, blood vessel injury and nerve injury were found the most. 2. In the postoperative hospitalization phase, by the frequency of complication, hematoma (23%) was happened the most, except for that, lkie the complication that can be happened by adverse reaction of medicine or long hospital life. In the case of SSRO, there were 21 cases (20%) of hematoma, and this wal the most frequently case. In the case of EVRO, hematoma wasn't happened that much-2 case (4%). 3. In the follow up phase, relaps, numbness and TMJ dysfunction were happened. In mandibular surgery, the forward relapse percentage of point B, was 27% when used wire fixation on SSRO, was 15% by miniplate fixation on SSRO and was 7% on EVRO. In the case of SSRO, numbness was kind of high, comparing to ordinary surgery-12 cases(16 There were many difficulties in analyzing this data accurately, Although orthognathic surgery is done many times, only available date is from the "success" stories and data is not consistently recorded for the cases with complications. In this manner, much essential informantion is lost and overlooked. When data is charted including those cases that are seemingly insignificalt, we can have a much clearer understanding and more accurate guide on treatment protocols.

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The Sundt Encircling Clip as a Vascular Rescue : A Case Report and a Review of Repair Methods for Arterial Tearing

  • Kim, Jin Kwon;Kim, Jae Hoon;Kim, Duk Ryung;Kang, Hee In
    • Journal of Korean Neurosurgical Society
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    • v.55 no.6
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    • pp.353-356
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    • 2014
  • The Sundt encircling clip was developed to repair defects of the vessel wall. With the advent of microvascular techniques, most parts of the damaged vessel wall during aneurysm surgery can be repaired by primary closure or by the bypass technique. However, these methods are not always successful. Here, we illustrate two cases of surgical clipping with the Sundt encircling clip in the ruptured internal carotid artery trunk aneurysm. The Sundt clip provides prompt control of unexpected tearing of the vessel wall or aneurysm and plays an important role in vascular rescue during aneurysm surgery.