• Title/Summary/Keyword: rupture of diaphragm

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Clinical Study of 53 Patients Requiring open Thoracotomy After Thoracic Injuries (흉부외상 환자중 개흉술이 필요했던 53례에 관한 임상적 고찰)

  • 김규만
    • Journal of Chest Surgery
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    • v.24 no.11
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    • pp.1115-1124
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    • 1991
  • Recently the thoracic injuries have been markedly increasing due to the vast increase of traffic accident, industrial disaster, and incidental accident as well as the frequent use of the murderous weapons including gun or rifle. Because the thoracic injuries could involve the heart, lung, and great vessels, and would influence the lives, prompt diagnosis and adequate treatment are essential. Most of thoracic injuries can be managed with the conservative treatment and simple surgical procedure such as closed thoracostomy, but certain cases require open thoracotomy to preserve lives and to return to their normal environment. The authors have analysed the result of 53 cases of open thoracotomy after thoracic injuries mainly according to the patient`s chart review. The mean age was 33.4 years old and male to female ratio was about 5: l. Injury mechanisms that elicited thoracic trauma indicated for open thoracotomy were penetrating[47%] and non-penetrating[53%] injuries. The Most common type of the thoracic lesion was hemothorax with or without pneumothorax and diaphragm rupture was the second. 58\ulcornero of thoracic injuries were accompanied by abdominal injuries and 47% by bone fractures. 34 patients were operated within 24 hours after injury and their average elapsed time was 13.6 hour. The remained patients were operated after 24 hours and their average elapsed time was 7.8 days. 71 cases of operative procedures containing some overlappings were performed: diaphragm repair[28], bleeding control[12], pulmonary and cardiac repair[4 cases] Postoperative complication rate was 32.1% and operative mortality rate was 9.4%[5/53].

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Chest dimension in spontaneous pneumothorax (자연기흉 환자의 흉곽계측)

  • Kim, Jong-Won;Lee, Jong-Su
    • Journal of Chest Surgery
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    • v.19 no.4
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    • pp.750-759
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    • 1986
  • Spontaneous pneumothorax is usually seen in young adult male. And typically, the patient is a tall, thin, 20- to 30-year-old male. Usually the pneumothorax results from rupture of a pulmonary bleb. Author reviewed 66 cases of spontaneous pneumothorax experienced in the Dept. of Thoracic & Cardiovascular Surgery, Pusan National University Hospital, since Jan., 1980 to Aug., 1986. The clinical data were summarized as follows: 1. The age distribution of spontaneous pneumothorax: 17 to 34 years old and mean age was 25.3 years. 2. The sex distribution of spontaneous pneumothorax: 52 in men, 14 in women and the ratio was 3.7:1. 3. Chest dimension in male patients: Maximum posteroanterior distance [MPA], MPA/Maximum width [MW]: Significantly smaller than control group. Distance from second to tenth rib on left [L2-10], Distance from second rib on right to diaphragm [R2-D], R2-D/MW: Significantly larger than control group. 4. Chest dimension in female patients: MPA, MW: Significantly smaller than control group. Distance from second rib on left to diaphragm [L2-D], Distance from second to tenth rib on right [R2-10], R2-D, L2-10/MW, L2-D/MW, R2-10/MW, R2-D/MW: Significantly larger than control group.

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The Prognostic Factors of Traumatic Diaphragmatic Rupture (외상성 횡격막 파열에서 예후에 영향을 미치는 인자)

  • Cho, Sukki;Lee, Eung-Bae;Seok, Yang-Ki
    • Journal of Chest Surgery
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    • v.43 no.1
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    • pp.47-52
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    • 2010
  • Background: Traumatic diaphragmatic rupture is not common, but it requires swiftly performing an emergency operation. This study was conducted to evaluate the prognostic factors for mortality after surgically treating traumatic diaphragmatic rupture. Material and Method: From Jan 2001 to Dec. 2008, we experienced 37 cases of multiple traumas with diaphragmatic injuries that were confirmed by surgical procedures. We evaluated various factors, including the type of injury, the associated injuries, the preoperative vital signs, the ISS, the time until surgery and the rupture size. Result: There were 30 patients with blunt trauma and 7 patients with penetrating trauma. Thirty-four patients had associated injuries and the mean ISS was 20.8. Postoperative complications occurred in 11 patients and hospital mortalities occurred in 6 patients. The prognostic factors that had an influence on the postoperative mortalities were the preoperative intubation state, the patient who exhibited hypotension and a high ISS. Conclusion: Traumatic diaphragmatic rupture is just one part of multiple traumas. The postoperative mortalities might depend on not only on the diaphragmatic rupture itself, but also on the severity of the associated injuries.

Broncho-Pleuro-Gastro-Colonic Fistula -A case report- (기관-흉강-위장-대장 누공 - 1예 보고 -)

  • Mun, Sung-Ho;Jang, In-Seok;Lee, Chung-Eun;Kim, Jong-Woo;Choi, Jun-Young;Rhie, Sang-Ho
    • Journal of Chest Surgery
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    • v.43 no.2
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    • pp.224-227
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    • 2010
  • A fistula between the respiratory and gastrointestinal systems is generally caused by infection and trauma. We experienced a 51-year old man with a broncho-pleuro-gastro-colonic fistula. He complained of chronic foul odor during respiration. He had suffered a traumatic diaphragmatic rupture 30 years ago. The infection of the diaphragm caused necrosis of the right lower lobe of the lung. It also caused a broncho-pleural fistula. The infection also created adhesion and a perforation of the gastric cardiac portion and the colonic splenic flexus portion of the gastro-intestinal track. We performed left lower lobectomy of the lung, reconstruction of the diaphragm and gastro-intestinal reanastomosis.

Experimental Study on the Two-Stage Light-Gas Gun (2단 경가스총에 대한 실험적 연구)

  • Lee, Jung-Kuen;Lee, Jong-Sung;Kim, Heuy-Dong;Koo, Ja-Ye
    • Proceedings of the Korean Society of Propulsion Engineers Conference
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    • 2010.05a
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    • pp.345-348
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    • 2010
  • Light gas guns have a large number of applications in various fields of engineering. A two-stage light gas gun can develop an extremely high pressure in a very short interval of time. This can be employed efficiently in the application of ultra-high pressure liquid jets. In general, the two-stage light gas gun is made up of a high pressure tube, a compression tube and a launch tube, each stage being separated by diaphragms. The first diaphragm is installed downstream of the high pressure tube and the second, downstream of the compression tube. In the present study, experiments are carried out to investigate the projectile velocity and pressure behavior in the tubes according to the pressure changes at diaphragm opening. It is found that the rupture pressure of the first diaphragm has a dominant influence on projectile velocity. It is also observed that at pressures greater than 14 bar, the pressure in the launch tube exceeds that in the compression tube.

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Clinical Evaluation of Traumatic Diaphragmatic Ruptures (외상성 횡격막 파열에 대한 임상적 고찰)

  • 조재민;김은기;이종국;박승일
    • Journal of Chest Surgery
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    • v.29 no.11
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    • pp.1257-1262
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    • 1996
  • From January 1989 to February 1996, 50 patients with a traumatic diaphragmatic rupture were treated at the Yonsei University Wonju College of Medicine. There were 40 male and 10 female patients. The ages ranged from 2 to 80 years, with peak incidence in third decades. Thirty-nine cases had blunt trauma (traffic accident 29, falls down 7, others 3), and 11 cases had penetrating injuries (stab injury 9, gun shot 1, broken glass 1). The most common symptoms were dyspnea (76%), chest pain (58%), and abdominal pain (52%). In blunt trauma, the rupture was located in the left in 30 cases, right in 9 cases and in penetrating trauma, the rupture was located in the left in 8 cases and in the right in 3 cases. Eighteen cases underwent thoracotomy alone, 29 cases underwent laparotomy only and 3 cases had combined thoracotomy and laparotomy. The postoperative mortality occurred in 6% (3 cases), and the cause of death were septic shock (1), intracranial hemorrhage (1), and respiratory failure (1).

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COMPUTATIONAL STUDY OF THE DRIVER GAS COMPRESSION PROCESS IN THE BALLISTIC RANGE

  • Rajesh, G.;Kang, H.G.;Kim, H.D.
    • Proceedings of the KSME Conference
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    • 2007.05b
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    • pp.2775-2780
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    • 2007
  • The ballistic range has long been employed in a variety of engineering fields such as high-speed impact engineering, projectile aerodynamics and aeroballistics, since it can create very high-pressure states in a short time. Since the operation of the ballistic range includes many complicated processes, each should be studied in detail for the best operation of the device. One of the main processes which have a major influence in its operation is the compression of the driver gas. Most of the studies available in this field hardly discuss this process in detail and thus lack a proper understanding of its effect. In the present study, a computational analysis has been made to investigate the compression process in the pump tube of a ballistic range. The results obtained are validated with some experimental data. It is seen that the pump tube parameters and the piston mass significantly affect the compression process and the time to build up the required diaphragm rupture pressure.

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Thoracic Splenosis after Splenic and Diaphragmatic Injury

  • Ha, You Jin;Hong, Tae Hee;Choi, Yong Soo
    • Journal of Chest Surgery
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    • v.52 no.1
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    • pp.47-50
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    • 2019
  • Thoracic splenosis is a rare disease that develops as a result of autotransplantation of splenic tissue into the thoracic cavity following splenic and diaphragmatic injury. We report the case of a 53-year-old man with a chief complaint of heartburn and cough. He had a history of traumatic diaphragmatic rupture treated with surgical repair and splenectomy 15 years ago. Imaging studies revealed a paraesophageal mass, and surgical resection was performed considering the possibility of Castleman disease or an esophageal submucosal tumor. Pathologic results showed findings of normal splenic tissue. The patient was discharged on postoperative day 5 without any complications.

Computational Study of the Operating Processes of a Ballistic Range (Ballistic Range의 작동과정에 대한 수치 해석적 연구)

  • Rajesh, G.;Kang, H.G.;Kim, H.D.
    • Proceedings of the Korean Society of Propulsion Engineers Conference
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    • 2007.11a
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    • pp.68-71
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    • 2007
  • A computational study has been performed using a chimera scheme to study the various operating processes inside a ballistic range. The compression flow fields in the pump tube and projectile motion in the launch tube are captured for various piston masses and diaphragm rupture pressures. The effect of a shock tube in between the pump tube and launch tube is analyzed. The results are compared with available experimental data. It is noted that, by adding a shock tube in between the pump tube and launch tube, the peak pressure in the ballistic range can be reduced without appreciable reduction in the velocity of the projectile.

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