• Title/Summary/Keyword: primary closure

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Burr Hole Drainage : Could Be Another Treatment Option for Cerebrospinal Fluid Leakage after Unidentified Dural Tear during Spinal Surgery?

  • Huh, Jisoon
    • Journal of Korean Neurosurgical Society
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    • v.53 no.1
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    • pp.59-61
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    • 2013
  • Authors report a rare case of acute intracranial subdural and intraventricular hemorrhage that were caused by intracranial hypotension resulted from cerebrospinal fluid leakage through an unidentified dural tear site during spinal surgery. The initial brain computed tomography image showed acute hemorrhages combined with preexisting asymptomatic chronic subdural hemorrhage. One burr hole was made over the right parietal skull to drain intracranial hemorrhages and subsequent drainage of cerebrospinal fluid induced by closure of the durotomy site. Among various methods to treat cerebrospinal fluid leakage through unidentified dural injury site, primary repair and spinal subarachnoid drainage are well known treatment options. The brain imaging study to diagnose intracranial hemorrhage should be taken before selecting the treatment method, especially for spinal subarachnoid drainage. Similar mechanism to its spinal counterpart, cranial cerebrospinal fluid drainage has not been mentioned in previous article and could be another treatment option to seal off an unidentified dural tear in particular case of drainage of intracranial hemorrhage is needed.

Congenital Esophgeal Anomaly -6 Cases- (선천성 식도 폐쇄증 -치험 6례-)

  • 최진호
    • Journal of Chest Surgery
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    • v.28 no.6
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    • pp.637-639
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    • 1995
  • Congenital esophageal anomaly with or without tracheoesophageal fistula was rare congenital disease.We experienced 6 cases of congenital esophageal atresia, with tracheoesophageal fistula [5 cases and one esophageal atresia without fistula, were treated in the Department of Thoracic and Cardiovascular Surgery, Kangnam Sacred Heart Hospital, Hallym university, from May, 1992 to July, 1994. The type of four cases were upper blind pouch and lower tracheo or broncho esophageal fistula and one case H-type fistula with no esophageal atresia, and the one case was esophageal atresia without fistula. We performed modified Haight`s method, one case was primary closure with feeding gastrostomy and stomach interposition. Three were died due to respiratory failure on 7 and 9th postoperative days.Three were recovered uneventfully.

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치과 응급 환자의 유형 분석 및 일차 응급처치

  • Kim, Ji-Hong;Kim, Yeong-Gyun;Kim, Hyeon-Tae
    • The Journal of the Korean dental association
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    • v.38 no.7 s.374
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    • pp.656-663
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    • 2000
  • Recently dental emergency patients tend to increase and diversify because of increased living quality and acknowledgement of health care. We performed this study to understand the pattern of dental emergency and perform the adequate diagnosis and treatment. From August 1998 to July 1999, we inverstigated the rate of dental emergency, distribution according to disease pattern, monthly distribution, and types of emergency treatment from all the emergency patients that visited emergency medicine of Daejin Medical Center, Jesaeng Hospital. There were 266 dental patients(0.978%) from total 27,192 emergency patients. Types of emergency situations included lip lacerations, teeth fracture, teeth missing or avulsion, TMJ contusion, mandible fracture, tongue laceration, toothache, teeth luxation, and so forth. Dental emergency had highest frequency in July. The most common treatments included primary closure of soft tissue lacerations, fixations of luxated teeth and medications.

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Total Tongue Reconstruction with Folded Anterolateral Thigh Free Flap (전방 외측 대퇴 유리 피판을 접어서 시행한 혀 재건의 증례 보고)

  • Lee, Hyung-Chul;Kim, Eun-Key
    • Archives of Reconstructive Microsurgery
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    • v.20 no.1
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    • pp.57-59
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    • 2011
  • Tongue reconstruction after oncologic resection with free flap is important to conserve function and shape. Vertical rectus myocutaneous free flap is usually used for total tongue reconstruction, but our patient was thin and primary closure after flap elevation seemed hard. So we used anterolateral thigh free flap to reduce donor site morbidity and to maintain bulk of the tongue as much as possible. Deepithelization of both middle side of flap and folding was done to mimic normal tongue base's shape and volume. Flap survived without complication and patient underwent concurrent chemoradiation therapy three weeks after surgery. Anterolateral thigh free flap can be good candidate for total tongue reconstruction especially in thin patient.

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Surgical Repair of Tracheal Stenosis with Tracheoesophageal Fistula Induced by Prolonged Endotracheal Intubation - Report of A Case - (기관삽관에 의한 기관협착및 기관 식도루: 수술치험 1례)

  • 허강배
    • Journal of Chest Surgery
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    • v.25 no.6
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    • pp.581-587
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    • 1992
  • Tracheoesophageal fistula[TEF] is a rare but life-threatening lesion that may occur from ventilation with a cuffed tube. It occurs most frequently when an inlying esophageal tube is also being used-usually for feeding purposes. The mechanism of injury appears to be pressure experted on the tracheal wall by the cuff, which then compresses the "party wall" of the trachea and esophagus against the foreign body that lies in the esophagus. The patient was 32 years old female who had been receiving a treatment of respiratory failure induced by postoperative sepsis with assist ventilator and nasogastric tubal feeding. Sudden attack of abdominal gas distention and massive drainage of gas through N-G tube were developed during assist ventilation in that patient, so we diagnosed as tracheal stenosis with a tracheoesophageal fistula induced by prolonged endotracheal intubation We performed tracheal reconstruction and primary closure of perforated esophagus after weaning ventilator. The postoperative course was uneventiful.eventiful.

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Diagnosis and Management of BRONJ(bisphosphonate related osteonecrosis of jaw) (BRONJ(bisphosphonate related osteonecrosis of jaw)의 진단과 치료)

  • Paeng, Jun-Young
    • The Journal of the Korean dental association
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    • v.49 no.7
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    • pp.378-388
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    • 2011
  • BRONJ(Bisphosphonate Related Osteonecrosis of Jaws) is not easy to be managed because it responds less predictably to established surgical treatment algorithms for osteomyelitis or osteoradionecrosis. The guidelines recommend that any kind of surgery should be delayed if possible. In the latest stage-dependent recommendations of the AAOMS in 2009, a conservative regime with antibiotics, antibacterial mouthe rinses and pain control in stages 0 to II. Some investigators have described the benefits of early osteotomy with primary wound closure. However, there are only a few publications with a standardized surgical concepts. In this reviews, various aspects of diagnosis and management of BRONJ will be discussed.

Management of a Gunshot Wound at the Temporal Region: Case Report (측두 부위의 총상 환자에 대한 처치: 증례보고)

  • Lee, Ju-Min;Ahn, Kyung-Yong;Shin, Sang-Hun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.34 no.1
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    • pp.81-84
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    • 2012
  • Gunshot wounds are unpredictable and require early, precise diagnosis and treatment. A penetrating gunshot wound can be fatal due to compromised airway, hypovolemic shock, lead poisoning and infection. This case report describes a 48-year-old male patient who had a suicidal gunshot wound on the right temporomandibular joint area using an air rifle. We successfully managed the patient by preoperative embolization, surgical removal of the foreign body and primary closure.

Transvenous occlusion of patent ductus arteriosus using an embolization coil in a Maltese dog

  • Lee, Seung-Gon;Moon, Hyeong-Sun;Choi, Ran;Hyun, Changbaig
    • Korean Journal of Veterinary Research
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    • v.47 no.4
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    • pp.461-467
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    • 2007
  • A 6-year-old female Maltese dog (body weight 2.0 kg) was referred to the Veterinary Teaching Hospital, Kangwon National University with primary complaints including exercise intolerance and heart murmur. Based on clinical and diagnostic findings including grade V/VI left basal continuous murmur, bounding femoral pulsation, left ventricular enlargement pattern in electrocardiogram, cardiomegaly with aortic bulging on the thoracic radiography, and shunt flow between aorta and pulmonary artery on the echocardiography, the dog was diagnosed as the left-to-right patent ductus arteriosus. The patent ductus arteriosus was successfully treated by lodging a single embolization coil with transjugular approach.

Intralobar Pulmonary Sequestration with Hemoptysis and Hemothorax (혈흉과 각혈을 동반한 내엽성 폐분리증)

  • Park, Jeong-Min;Oh, Bong-Suk
    • Journal of Chest Surgery
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    • v.40 no.10
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    • pp.708-710
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    • 2007
  • A 60-year-old female entered the emergency unit with a chief complaint of hemoptysis. Based on the computer tomographic image analysis of the chest, the patient was diagnosed as having an intralobar pulmonary sequestration that accompanied a hemothorax, and the hemothorax was do to the rupture of a pseudocyst. Pulmonary lobectomy of the left lower lobe and primary closure of an aberrant artery were both performed as an emergency operation. After one week following the operation, the patient was discharged without any postoperative complications.

Pyriform Sinus Perforation after Intubation (기관내 삽관 후 발생한 이상와 천공)

  • Yu, Seung Woo;Park, Jun Hee;Choi, Ji Yun;Do, Nam Yong
    • Korean Journal of Bronchoesophagology
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    • v.17 no.1
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    • pp.65-67
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    • 2011
  • Pyriform sinus perforation is a rare complication of endotracheal intubation. It most commonly occurs at the hands of the less experienced physician in emergency situations. It can occur after traumatic intubation and is potentially lethal. The site most commonly perforated is the pharynx, posterior to the cricopharyngeal muscle; the second most common site is the pyriform sinus. We report a case of pyriform sinus perforation after endotracheal intubation, which was successfully treated with primary closure.

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