• Journal of Korean Neurosurgical Society
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• 제56권5호
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• pp.428-430
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• 2014

Isolated traumatic pseudoaneurysms of the basilar artery are extremely rare but often fatal resulting in a mortality rate as high as 50%. A 51-year-old man presented with craniofacial injury after blunt trauma. A brain computed tomography (CT) scan showed thick basal subarachnoid hemorrhage associated with multiple craniofacial fractures, while CT angiography revealed contrast extravasation at the distal basilar artery with pseudoaneurysm formation. After this primary survey, the condition of the patient suddenly deteriorated. Conventional angiography confirmed the contrast extravasation resulted from pseudoaneurysm formation, which was successfully treated with endovascular coil embolization. Decompressive craniectomy and coma therapy with propofol were also performed. However, the patient died on the 7th hospital day because of the poor initial clinical condition. The current case is the first report of acute pseudoaneurysm rupture arising from the basilar artery within the first day after trauma. Our findings suggest the possibility that pseudoaneurysm rupture should be considered if brain CT shows thick traumatic subarachnoid hemorrhage on the basal cistern with a basal skull fracture.

• Archives of Plastic Surgery
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• 제36권3호
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• pp.341-343
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• 2009

Purpose: Morel - Lavallee lesions is post - traumatic effusion at subcutaneous layer. Early management of Morel - Lavallee lesion is percutaneous drainage and compression. Surgical excision is recommended for cases that are chronic. Method: 41 - year old male patient had slow growing, painful mass on left thigh, which has been present for 3 years. He had a history of blunt trauma 3 years ago. Computed tomography presented $10{\times}10{\times}5cm$ sized cystic mass on left thigh, between subcutaneous fat layer and muscle fascia layer. The mass was surgically removed and biopsy was performed. Result: Histopathological examination shows chronic inflammation and fibrotic change. After 6 month follow - up period, postoperative course was uneventful. Conclusion: We performed surgical excision of Morel - Lavalle lesion in a patient who had trauma 3 years ago. We report a case of Morel - Lavallee lesion with the review of the literatures.

• Journal of Trauma and Injury
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• 제23권1호
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• pp.53-55
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• 2010

A thyroid cartilage fracture is a rare entity and can be overlooked easily. Such cases are difficult to diagnose, and assessment and treatment guidelines are difficult to determine. CT of the neck region may be useful when acute airway intervention is not required or when more information regarding the neck's anatomy is required for management decisions. We describe a case of a thyroid cartilage fracture with displacement. In the emergency department (ED), neck CT and fiberoptic nasopharyngoscopy were used to assess the status of the patient's (a male) vocal chords immediately. He remained unable to phonate continuously. After an immediate assessment, we decided to use steroid and conservative therapy. The patient had a good recovery and was without symptoms one month after injury. There is no question that early surgical repair of neck injuries affords the best results for airway and voice patency in most cases however, we suspect that surgical repair is not needed in all cases. Early recognition and an accurate therapy plan for a thyroid fracture with displacement are essential. Therefore, the emergency physician's immediate and careful decision based on endoscopy and neck CT is important for the patient's long-term recovery.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제27권6호
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• pp.551-555
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• 2001

False aneurysms(Pseudoaneurysms) and arteriovenous fistulas have only rarely been reported in the facial region. In this region the false aneurysm arises most frequently in the superficial temporal and facial artery, but other branches of the external carotid are sometimes involved, including the maxillary and lingual artery. False aneurysms can be occurred by blunt trauma that either laceration or rupture the full thickness of the arterial wall. The diagnosis of a false arterial aneurysm can be often made solely on the basis of physical examination. Angiography is helpful for conformation, for delineating the lesion and its vascular supply, and for ruling out the presence of associated vascular lesions such as arteriovenous fistulas. Ultrasonography may also be useful in delineating lesions that are not easily accessible for physical examination. Treatment of false aneurysms is excision, ligation, and arterial embolization. This is a case of false aneurysm of the lingual artery after facial trauma caused by traffic accident. The lesion was successfully treated by embolization and ligation of the lingual and facial branches of the external carotid artery.

• Journal of Chest Surgery
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• 제31권2호
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• pp.182-185
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• 1998

최근 교통사고와 산업재해로 인한 기관지파열상이 증가하고 있는 추세이다. 일단 기관지 파열상이 발생한 경우는 매우 심각한 증상을 유발하여 생명의 위협을 초래하고, 많은 합병증을 야기하기 때문에 조기 진단과 조기 치료가 원칙이다. 본 저자들은 승용차 전복사고로 흉부둔상을 받아 좌주기관지가 완전 절단된 21세 여자 환자에서 수상후 14일이 경과된 후, 기관지내시경과 흉부 단층 촬영으로 확진하고 , 기관지 성형술과 단단문합술을 시행하였으며 술후 2일간의 호기말양압을 이용한 인공호흡기 적용, 기관지내시경을 이용한 분비액 흡인, 지속적인 물리치료와 체위 배액요법을 시행하여 좌폐기능이 완전 정상화되었음을 추적 검사하에 확인하였다.

• Journal of Trauma and Injury
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• 제22권1호
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• pp.119-122
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• 2009

Traumatic abdominal wall hernia after blunt abdominal trauma is rare. The prevalence of traumatic abdominal wall hernia in published series is approximately 1%. Recently, by the use of computed tomography has increased the number of occult traumatic abdominal wall hernias (TAWH). A 47-year-old woman presented to the emergency room soon after a traffic accident. She was fully conscious and complained of diffuse, dull, abdominal pain. She had a seat belt on at the time of the accident. Initial computed tomography showed that the lower left abdominal wall had a defect and that a part of the small bowel had herniated through the defect. During the operation, we made an incision at the defect site and confirmed the defect. The defect size was about $15{\times}5cm$. The muscle layers were repaired in layers with absorbable sutures. Prolen mesh was layed down and fixed on the site of the repaired muscle defect. After 6 months, hernia had not recurred, and no weakness of the repaired abdominal wall layers was identified. The patient's postoperative body functions were normal.

• Journal of Trauma and Injury
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• 제26권1호
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• pp.18-21
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• 2013

Pancreatic injury following blunt abdominal trauma is rare, but it has high morbidity and mortality. Various treatments have been attempted, but none has yet been clearly established. The pancreatic neck transection is usually managed by using a distal pancreatectomy with or without a splenectomy. However, pancreatic insufficiency and the risk of post-splenectomy infection remain significant problems. To avoid these problems in patients with a pancreatic neck transection, one may use a pancreaticoenteric anastomosis as a treatment option, but a pancreatic fistula from the pancreaticoenteric anastomosis remains a significant cause of morbidity and mortality. Recently, several reports proposed the binding pancreaticogastrostomy to minimize the possibility of a postoperative pancreatic fistula developing after pancreatic surgery. Thus, we report a case of a traumatic pancreatic neck transection successfully treated with a binding pancreaticogastrostomy.

• Journal of Chest Surgery
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• 제30권6호
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• pp.617-620
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• 1997

외상에 의한 흉부손상중 좌심실류와 하행대동맥류는 매우 드문데 그 이유는 아마도 대부분의 환자가 사고 당시 즉시 사망하기 때문일 것이다. 본 예는 5세 남자 환아로 버스에 치어 급성호흡부전과 폐부종으로 인한 ARDS 로 다발성 장기부전이 발생하여 뇌경색과 신부전의 합병증이 동반되어 치료후 퇴원하여 외래 추적조사중 심초음파 검사상 좌심실류와 전자자기공명(hm))상 좌심실류 및 하행대동맥류 진단하에 외상후 74일만에 전순환 정지하에 좌심실류절제술과 하행대동맥류절제술 및 인조혈관대체술을 시행하였으며, 술후 환자는 특별한 문제없이 퇴원하였다.

• Journal of Chest Surgery
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• 제33권12호
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• pp.968-970
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• 2000

26세 남자가 길가다 버스에 치어, 다발성 늑골골절, 흉골골절, 우견갑골골절, 좌쇄골하동맥 폐색, 외상성 기관식도루로 입원 치료 중 이완기 심잡읍이 생겼다. 심초음파 검사에서 심한 대동맥판 폐쇄 부전과 증식물로 진단하였다. 심폐기 운영 하에 좌 우 관상 동맥 첨판에 10mm, 7mm 파열을 발견 5-0 Prolene 연속 봉합하여 좋은 수술 결과를 얻고 환자는 수술 14일에 퇴원하였다.

• Journal of Trauma and Injury
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• 제37권1호
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• pp.79-82
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• 2024

The potential for traumatic brain injury resulting from falling coconuts is frequently overlooked. These incidents can cause focal lesions in the form of brain hemorrhage. Corpus callosum hemorrhage due to blunt trauma from a falling object is rare and typically associated with poor prognosis. The purpose of this report is to detail a case of corpus callosum hemorrhage caused by a coconut fall and to discuss the conservative management approach employed. We report the case of a 54-year-old woman who was admitted to the hospital with symptoms of unconsciousness, headache, and expressive aphasia after being struck by a falling coconut. Notably, hemorrhage was detected within the body of the corpus callosum, as revealed by imaging findings. The patient received intensive monitoring and treatment in the intensive care unit, including oxygen therapy, saline infusion, an osmotic diuretic, analgesics, and medication to prevent stress ulcers. The patient demonstrated marked clinical improvement while undergoing conservative treatment. Despite the typically unfavorable prognosis of these rare injuries, our patient exhibited meaningful clinical improvement with conservative treatment. Timely diagnosis and appropriate interventions were crucial in managing the patient's condition. This report emphasizes the importance of considering traumatic brain injury caused by falling coconuts and highlights the need for further research and awareness in this area.