• Title/Summary/Keyword: blunt trauma

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Clinical Characteristics of Small Bowel Perforation due to Blunt Abdominal Trauma (복부 둔상으로 인한 소장 천공의 임상 양상에 대한 고찰)

  • Bae, Jung-Min
    • Journal of Trauma and Injury
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    • v.24 no.2
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    • pp.125-128
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    • 2011
  • Purpose: Blunt small bowel injury (SBI) is frequently combined other organ injury. So, clinical outcome and characteristics of SBI are influenced by other combined injuries. Thus, we analyzed isolated SBI patients and studied clinical outcome and characteristics. Methods: Between 2005 and 2010, 36 consecutive patients undergoing laparotomy due to isolated SBI were identified in a retrospectively collected. Database. Clinical outcome and characteristics were analyzed. Results: Laparotomy was performed in 36 patients. Primary repair was performed 17 patients. Segmental resection of small bowel was performed 19 patients. Median time gap from trauma to operation was 9 hours. In 24 hours from trauma, operation was performed 31 patients. Post operative death was 5 patients. Mean hospital stay was 18 days and median hospital stay was 12 days. There were significant differences between operation type and minor complication and hospital stay. And there were significant differences between time gap in 24 hours and minor complication. But, there were no significant between time gap and mortality. Conclusion: Although this study had many limitations, some valuable information was produced. When operation above 24 hours was delayed in SBI, minor complications were significantly increased. Segmental resection of small bowel in SBI were significantly increased minor complications and hospital stay. So, preventive measures for surgical site infection was important to reduce wound complication and hospital stay. Further continuous study and multi-center study were should be performed to improve clinical outcome in SBI.

Ureteral Injury Caused By Blunt Trauma: A Case Report (둔상에 의한 요관 손상 1례)

  • Kwon, Oh Sang;Mun, Yun Su;Woo, Seung Hwo;Han, Hyun Young;Hwang, Jung Joo;Lee, Jang Young;Lee, Min Koo
    • Journal of Trauma and Injury
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    • v.25 no.4
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    • pp.291-295
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    • 2012
  • Ureteral trauma is rare, accounting for less than 1% of all urologic traumas. However, a missed ureteral injury can result in significant morbidity and mortality. The purpose of this case presentation is to suggest another method for early detection of ureteral injury in blunt traumatic patient. A 47-years-old man was injured in pedestrian traffic accident. He undergone 3-phase abdominal CT initially and had had a short-term follow-up simple. We suspected ureteral injury. Our final diagnosis of a ureteral injury was based on follow-up and antegrade pyeloureterography, he underwent emergency surgery. We detected the ureteral injury early and took a definitive action within 24 hours. In blunt trauma, if abnormal fluid collection in the perirenal retroperitoneal space is detect, the presence of a ureteral injury should be suspected, so a short-term simple X-ray or abdominal CT, within a few hours after initial abdominal CT, may be useful.

Penetrating Injury to the Left Ventricle from a Fractured Rib Following Blunt Chest Trauma (흉부 둔상으로 골절된 늑골로 인해 발생한 좌심실 천공)

  • Oh, Tak-Hyuk;Lee, Sang Cjeol;Lee, Deok Heon;Cho, Joon Yong
    • Journal of Trauma and Injury
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    • v.27 no.4
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    • pp.192-195
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    • 2014
  • The perforation of a cardiac chamber by a fractured rib after blunt trauma is a rare event. Here, we report the case of patient who was referred for multiple rib fractures after a fall from a height. The patient was found to have a penetrating cardiac injury which was detected on a computed tomography chest scan. Computed tomography is a useful screening tool for victims of blunt chest trauma. Once cardiac perforation has been confirmed or is highly suspected, it is important to preserve the patient's vital signs until reaching the operating room by minimally manuplating the chest wall and permitting hypotension, which also prevents exsanguinating hemorrhage. For the same reasons, early cardiac tamponade may also improve the patient's survival.

Management of Bile Leaks from Bilateral Intrahepatic Ducts after Blunt Trauma (둔상성 외상 후 양측 간내 담관에서 담즙 누출의 치료 사례 1례)

  • Kim, Dong Hun;Choi, Seokho;Go, Seung Je
    • Journal of Trauma and Injury
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    • v.27 no.3
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    • pp.89-93
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    • 2014
  • Bile leaks are complications that are much more frequent after a high-grade liver injury than after a low-grade liver injury. In this report, we describe the management of bile leaks that were encountered after angiographic embolization in a 27-year-old man with a high-grade blunt liver injury. He had undergone an abdominal irrigation and drainage with a laparotomy on post-injury day (PID) 16 due to bile peritonitis and continuous bile leaks from percutaneous abdominal drainage. He required three percutaneous drainage procedures for a biloma and liver abscesses in hepatic segments 4, 5 and 8, as well as endoscopic retrograde cholangiopancreatography with biliary stent placement into the intrahepatic biloma via the common bile duct. We detected communication between the biloma and the bilateral intrahepatic duct by using a tubogram. Follow-up abdominal computed tomography on PID 47 showed partial thrombosis of the inferior vena cava at the suprahepatic level, and the patient received anticoagulation therapy with low molecular weight heparin and rivaroxaban. As symptomatic improvement was achieved by using conservative management, the percutaneous drains were removed and the patient was discharged on PID 82.

A Case of Tension Viscerothorax : A Rare Complication of Diaphragmatic Rupture after Blunt Abdominal Trauma (복부둔상 후 발생한 긴장성 내장흉 1례)

  • Park, Maeng Real;Lee, Jae Ho;Ahn, Ji Yoon;Oh, Bum Jin;Kim, Won;Lim, Kyoung Soo
    • Journal of Trauma and Injury
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    • v.19 no.2
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    • pp.201-205
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    • 2006
  • Tension viscerothorax (gastrothorax) is rare life-threatening disease which is caused by air trapped in viscera. A distended viscera in the hemi-thorax shifts the mediastinal structures and causes extra-cardiac obstructive shock. A defective diaphragm is caused by abdominal trauma or a congenital anomaly. Traumatic diaphragmatic injury can be missed until herniation develops several years after blunt trauma. In our case, a 10-year old boy developed hemodynamic compromise in the emergency department. Three years earlier, he had suffered blunt abdominal trauma during a pedestrian traffic accident, but there was no evidence of diaphragmatic injury at that time. He was successfully resuscitated by gastric decompression and an emergent thoracic operation. The operation finding revealed a traumatic diaphragmatic injury. Tension viscerothorax is a rare, but catastrophic, condition, so we suggest that addition of tension viscerothorax to the Advanced Trauma and Life Support (ATLS) guidelines may be helpful.

Common Iliac Artery Injury due to Blunt Abdominal Trauma without a Pelvic Bone Fracture (복부 둔상 환자에서 골반 골절을 동반하지 않고 발생한 총장골동맥 손상 증례)

  • Jung, Pil Young;Byun, Chun Sung;Oh, Joong Hwan;Bae, Keum Seok
    • Journal of Trauma and Injury
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    • v.27 no.4
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    • pp.215-218
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    • 2014
  • Blunt abdominal trauma may often cause multiple vascular injuries. However, common iliac artery injuries without associated bony injury are very rarely seen in trauma patients. In the present case, a 77-year-old male patient who had no medical history was admitted via the emergency room with blunt abdominal trauma caused by a forklift. At admission, the patient was in shock and had abdominal distension. On abdomino-pelvic computed tomography (CT), the patient was seen to have hemoperitoneum, right common iliac artery thrombosis and left common iliac artery rupture. During surgery, an additional injury to inferior vena cava was confirmed, and a primary repair of the inferior vena cava was successfully performed. However, the bleeding from the left common iliac artery could not be controlled, even with multiple sutures, so the left common iliac artery was ligated. Through an inguinal skin incision, the right common iliac artery thrombosis was removed with a Forgaty catheter and a femoral-to-femoral bypass graft was successfully performed. After the post-operative 13th day, on a follow-up CT angiography, the femoral-to-femoral bypass graft was seen to have good patency, but a right common iliac artery dissection was diagnosed. Thus, a right common iliac artery stent was inserted. Finally, the patient was discharged without complications.

Acute Myocardial Infarction caused by Left Coronary Artery Aneurysm following Blunt Chest Trauma - A case report - (흉부 둔상 후 발생한 좌측 관상동맥 동맥류에 의한 급성 심근경색증 - 1예 보고 -)

  • Park, Il-Hwan;Yoo, Kyung-Jong;Oh, Joong-Hwan
    • Journal of Chest Surgery
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    • v.40 no.3 s.272
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    • pp.228-231
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    • 2007
  • Chest trauma can lead to various cardiac complications ranging from arrythmia to myocardial rupture. Coronary artery injury in patients with blunt chest trauma is rare, and traumatic aneurysm of the left coronary artery is even more unusual than right coronary artery. Injury to the coronary arteries, including intimal aneurysm, dissection, laceration, arteriovenous fistula and thrombosis, are sequelae that rarely occur after a blunt trauma. Occlusion of the coronary artery results is a serious complication for the patient via acute myocardial infarction, We report here on a case of acute myocardial infarction with coronary artery aneurysm that arose from blunt chest trauma in a 33-year-old male, and he was successfully managed by a coronary bypass graft without performing cardiopulmonary bypass.

Celiac Artery Compression After a Spine Fracture, and Pericardium Rupture After Blunt Trauma: A Case Report from a Single Injury

  • Kim, Joongsuck;Cho, Hyun Min;Kim, Sung Hwan;Jung, Seong Hoon;Sohn, Jeong Eun;Lee, Kwangmin
    • Journal of Trauma and Injury
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    • v.34 no.2
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    • pp.130-135
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    • 2021
  • Celiac artery compression is a rare condition in which the celiac artery is compressed by the median arcuate ligament. Case reports of compression after trauma are hard to find. Blunt traumatic pericardium rupture is also a rare condition. We report a single patient who experienced both rare conditions from a single blunt injury. An 18-year-old woman was brought to the trauma center after a fatal motorcycle accident, in which she was a passenger. The driver was found dead. Her vital signs were stable, but she complained of mild abdominal pain, chest wall pain, and severe back pain. There were no definite neurologic deficits. Her initial computed tomography (CT) scan revealed multiple rib fractures, moderate lung contusions with hemothorax, moderate liver injury, and severe lumbar spine fracture and dislocation. She was brought to the angiography room to check for active bleeding in the liver, which was not apparent. However, the guide wire was not able to pass through the celiac trunk. A review of the initial CT revealed kinking of the celiac trunk, which was assumed to be due to altered anatomy of the median arcuate ligament caused by spine fractures. Immediate fixation of the vertebrae was performed. During recovery, her hemothorax remained loculated. Suspecting empyema, thoracotomy was performed at 3 weeks after admission, revealing organized hematoma without pus formation, as well as rupture of the pericardium, which was immediately sutured, and decortication was carried out. Five weeks after admission, she had recovered without complications and was discharged home.

Abdominal Organ Injuries with Chyloperitoneum after Blunt Tauma: A Case Report (유미복막증이 동반된 복부장기 손상)

  • Kim, Young Hwan;Jung, Yooun Joong;Hong, Suk-Kyung
    • Journal of Trauma and Injury
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    • v.25 no.3
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    • pp.105-108
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    • 2012
  • Chyloperitoneum or chylous ascite after trauma is a rare condition. It can develop after direct injuries of lymphatic vessels or cisterna chyli. Though isolated chyle duct injury has sometimes been reported, chyloperitoneum is generally accompanied by various kinds of damage to other intraabdominal organs. There's still no established therapeutic protocol regarding the treatment of chyloperitoneum when it is accompanied by the serious injuries of intraabdominal organs. We describe a 66-year-old male with serious intraabdominal organ injuries after blunt trauma. In our case, chyloperitoneum developed due to the injuries to the mesenteric lymph vessels and compression of cisterna chyli by hematoma around aorta.

Isolated Traumatic Injury of the Pancreatic Head: A Case Report

  • Kim, Dong Hun
    • Journal of Trauma and Injury
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    • v.29 no.2
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    • pp.51-55
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    • 2016
  • Isolated injury to the pancreas after abdominal trauma is uncommon, and a delay in diagnosis and treatment can increase the morbidity and mortality. Therapeutic decisions with respect to pancreatic trauma are usually made based on the site of injury and the status of the pancreatic ductal system. In this report, we describe the surgical management of pancreatic head transection as an isolated injury following blunt abdominal trauma. A 55-year-old man presented with epigastric pain that radiated to the back. Abdominal computed tomography revealed a hematoma in the pancreatic head and upstream dilatation of the main pancreatic duct. Endoscopic retrograde cholangiopancreatography showed complete disruption of and contrast leakage from the main pancreatic duct in the pancreatic head region with a nonenhanced upstream duct. Emergency pancreaticoduodenectomy was successfully performed, and the patient was discharged on postoperative day 9 without any complications.