• Title/Summary/Keyword: traumatic injury

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Treatment results of cardiac tamponade due to thoracic trauma at Jeju Regional Trauma Center, Korea: a case series

  • Jeong Woo Oh;Minjeong Chae
    • Journal of Trauma and Injury
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    • v.36 no.3
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    • pp.180-186
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    • 2023
  • Purpose: The purpose of this study was to report the treatment results of patients with traumatic cardiac tamponade after the opening of Jeju Regional Trauma Center. Methods: We analyzed the treatment outcomes of patients with traumatic cardiac tamponade who were treated at Jeju Regional Trauma Center from January 2018 to August 2022. Results: Seven patients with traumatic cardiac tamponade were treated. The male to female ratio was 1.33:1 (four male and three female patients) and the average age was 60.3±7.2 years. The mechanism of injury was blunt trauma in six cases and penetrating injury in one case. Upon arrival at the emergency department, pericardiostomy was performed in four cases, and an emergency operation was performed in six cases. Pericardiostomy alone was performed in one patient, who had cardiac tamponade due to extrapericardial suprahepatic inferior vena cava rupture. The causes of cardiac tamponade were right atrium appendage rupture in one case, right ventricle rupture in one case, inferior vena cava rupture in two cases, right atrium and left atrium rupture in one case, both atria and left ventricle rupture in one case, and intercostal artery rupture in one case. In three cases, intraoperative cardiopulmonary bypass was required. Two of the seven patients died (mortality rate, 28.5%). Conclusions: Relatively favorable treatment results were observed for traumatic cardiac tamponade patients after Jeju Regional Trauma Center was established.

Thoracolumbar Spine Injury (흉요추부 손상)

  • Ahn, Myun-Whan
    • Journal of Yeungnam Medical Science
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    • v.19 no.2
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    • pp.73-91
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    • 2002
  • Method of management of the spine injury should be determined, based on the status of neurological injury as well as on the presence of traumatic instability. At the thoracic and lumbar spine, patterns of neurological injury are different from the cervical spine due to their neuro-anatomical characteristics. Especially, at the thoracolumbar junction, neurological injury patterns with their respective prognosis vary from the complete cord injury or conus medullaris syndrome to the cauda equina syndrome according to the injury level. The concept of Holdsworth's instability based on the posterior ligament complex theory has evolved into the current 3-column theory of Denis. Flexion-rotation injury and fracture-dislocation are well known to be unstable that surgical fixation is frequently needed for these injuries. However, there have been some controversies for the stability of burst fractures and their treatment, such as indirect or direct decompression and anterior or posterior approach. In this article, current concepts and management of traumatic instabilities at the thoracic and lumbar spine have been reviewed and summarized.

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Management of Thoracic Aortic Injury after Blunt Trauma: Nine Cases at a Single Medical Center

  • Lee, Kyungwon;Lee, Jae Gil
    • Journal of Trauma and Injury
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    • v.29 no.4
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    • pp.146-150
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    • 2016
  • Purpose: Traumatic aortic injuries are rare, but life threatening condition. They usually occur after high velocity impact on the chest or abdomen such as traffic accident or fall. We report the experiences of the traumatic aortic injuries at a single center. Methods: We retrospectively reviewed the medical records of nine patients with aortic injury resulting from the blunt trauma from Jan. 2010 to May. 2016. Results: The mean age was $51.1{\pm}20.8$ years old, and ten (90.9%) were men. The mechanisms of injury were traffic accidents in seven patients (motorcycle accidents; 3, car accidents; 4), and four in fall injury. Most common injured sites were thoracic aorta (9, 81.8%). Aortic injuries were repaired by endovascular approach in four patients, and by open graft surgery in four. Two patients were managed conservatively. Nine patients survived without any complications. Conclusion: We had experienced different approaches for management of aortic injuries after blunt trauma according to locations and severity of lesions.

Case study of Oriental Medicine Treatment with Mae-sun therapy of the spinal cord injury due to lumbar burst fracture (방출성 요추 골절로 인한 척수손상 환자에 대해 매선요법을 가미한 한방치료를 시행한 치험례)

  • Kwon, Gi-Sun;Park, Jung-Ah;Noh, Ju-Hwan;Kim, Cheol-Hong
    • Journal of Pharmacopuncture
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    • v.13 no.1
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    • pp.129-144
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    • 2010
  • Objective : Traumatic lumbar burst fracture causes significant spinal cord injury. This report is intended to estimate the efficacy using oriental treatment on a patient with lumbar burst fracture and spinal cord injury. Methods : From 21th December, 2009 to 5th February, 2010, 1 female inpatient diagnosed with lumbar burst fracture and spinal cord injury was treated with general oriental medicine therapy : mae-sun therapy ; acupuncture ; moxibustion ; pharmacopuncture ; physical therapy and herbal medication. TUG, SCIMII and VAS were used for evaluation of gait disturbance and pain in both feet. Measurement of self voiding amount and remaining amount through CIC was used for evaluation of neurogenic vesical dysfunction. Results : The patient showed a certain degree of improvement in gait disturbance, pain in both feet and neurogenic vesical dysfunction through above evaluation methods. Conclusion : Oriental treatments such as mae-sun therapy, acupuncture and moxibustion therapy, pharmacopuncture therapy and herbal medication can be effective for spinal cord injury due to traumatic lumbar burst fracture.

Surgical Outcomes in Patients with Simultaneous Traumatic Brain and Torso Injuries in a Single Regional Trauma Center over a 5-Year Period

  • Yun, Jung-Ho
    • Journal of Trauma and Injury
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    • v.34 no.4
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    • pp.270-278
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    • 2021
  • Purpose: The purpose of the study is to analyze the results of surgical treatment of patients with brain and torso injury for 5 years in a single regional trauma center. Methods: We analyzed multiple trauma patients who underwent brain surgery and torso surgery for chest or abdominal injury simultaneously or sequentially among all 14,175 trauma patients who visited Dankook University Hospital Regional Trauma Center from January 2015 to December 2019. Results: A total of 25 patients underwent brain surgery and chest or abdominal surgery, with an average age of 55.4 years, 17 men and eight women. As a result of surgical treatment, there were 14 patients who underwent the surgery on the same day (resuscitative surgery), of which five patients underwent surgery simultaneously, four patients underwent brain surgery first, and one patient underwent chest surgery first, four patients underwent abdominal surgery first. Among the 25 treated patients, the 10 patients died, which the cause of death was five severe brain injuries and four hemorrhagic shocks. Conclusions: In multiple damaged patients require both torso surgery and head surgery, poor prognosis was associated with low initial Glasgow Coma Scale and high Injury Severity Score. On the other hand, patients had good prognosis when blood pressure was maintained and operation for traumatic brain injury was performed first. At the same time, patients who had operation on head and torso simultaneously had extremely low survival rates. This may be associated with secondary brain injury due to low perfusion pressure or continuous hypotension and the traumatic coagulopathy caused by massive bleeding.

Traumatic Bilateral Diaphragmatic Ruptures in a 6-Year-Old Boy

  • Kim, Sung Jin;Kim, Hyuck;Lee, Jun Ho
    • Journal of Trauma and Injury
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    • v.31 no.1
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    • pp.19-23
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    • 2018
  • Traumatic diaphragmatic rupture is an unusual finding that may occur after blunt trauma. In addition, diaphragmatic rupture occurring bilaterally is extremely rare. We experienced a 6-year-old boy with bilateral diaphragmatic rupture, whom survived after surgical treatment by open thoracotomy but, complicated with spinal cord injury discovered after surgery.

The Effect of Acute Coagulopathy in Profoundly Traumatic Patients on Acute and Early Deaths (고도 중증외상 환자에서 급성 혈액응고장애가 초기 및 조기 사망에 미치는 영향)

  • Noh, Minsu;Yang, Song-Soo;Kyoung, Kyu-Hyouck
    • Journal of Trauma and Injury
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    • v.27 no.4
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    • pp.158-164
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    • 2014
  • Purpose: Numerous studies have investigated the pattern of traumatic death with a focus on the injury mechanism, the severity of the injury and the presence of hemorrhage. Acute coagulopathy has been treated as only one of many complications. The purpose of this study was to investigate the influence of acute coagulopathy on acute and early death due to trauma. Methods: A retrospective analysis of trauma patients with injury severity score (ISS)${\geq}25$ who had been treated between January 2011 and December 2012 was conducted. Based on the time of injury, traumatic death was categorized into acute (within 48 hours) and early (from 3 to 7 days). The correlations between various parameters within 24 hours after injury and time of death were analyzed. Results: A total of 124 patients were enrolled. Of them, 8.1% (n=10) of the patients experienced acute mortality. For those patients, significant differences in initial systolic blood pressure, coagulopathy score, amount of transfusion, abbreviated injury scale of the head and neck, the abdomen and the extremities were noted. Early mortality was experienced by 7.0% (n=8) of the patients, only coagulopathy score was found to be a significant independent risk factor for acute (odds ratio: 3.127; 95% confidence interval: 1.185-8.252; p=0.021) and early mortality (odds ratio: 2.470; 95% confidence interval: 1.029-5.929; p=0.043). Conclusion: Acute traumatic coagulopathy has an important role in the mortality, even after the acute phase. Early management and prevention of acute coagulopathy may improve survival of trauma patients.

Clinical Study on the Case of Patient with Traumatic Brachial Plexus Injury (외상성 상완신경총 환자 1례에 대한 한의학적 임상증례보고)

  • Choi, Yi-Jeong;Shin, Hwa-Young;Kim, Sung-Jin;Lee, Yong-Eun;Lee, Bong-Hyo;Lee, Yun-Kyu;Kim, Jae-Su;Lee, Hyun-Jong;Kwon, Hyo-Jung;Jung, Tae-Young;Lim, Seong-Chul
    • Journal of Acupuncture Research
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    • v.29 no.2
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    • pp.99-106
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    • 2012
  • Objectives : The purpose on this study is to report clinical effects of oriental medicine for traumatic brachial plexus injury. Methods : The patient was treated using acupuncture, electroacupuncture, beevenom acupuncture treatment, herbal medication, moxibustion and physical treatment. And the effects for traumatic brachial plexus injury have measured in VAS, sthenometry and dermatome of upper limb. Results : 1. VAS of upper limb pain was changed to go down at less than half. 2. Sthenometry was improved slowly than VAS. 3. Dermatome of upper limb were improved gradually. Conclusions : Oriental medical treatment showed positive effect on traumatic brachial plexus injury.

Personality Assessment Inventory Profiles of Patients with Mild and Severe Traumatic Brain Injury (경증 및 중증 외상성 뇌손상 환자의 성격평가 질문지 프로파일)

  • Kweon, Seok-Joon;Rho, Seung-Ho
    • Korean Journal of Biological Psychiatry
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    • v.12 no.1
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    • pp.20-31
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    • 2005
  • Objectives:This study was designed to investigate the characteristics of personality changes and emotional distress using the Personality Assessment Inventory (PAI) in patients with traumatic brain injury(TBI), divided into mild (MTBI) and severe (STBI) groups according to the severity of injury. Methods:The subjects were consisted of 25 patients with MTBI, 25 patients with STBI, and 25 normal controls. They were interviewed with the PAI. The data were analyzed by ${\chi}^2$ test, analysis of variance and Tukey test. Results:The results were the followings. First, Negative Impression in validity scales was elevated above cutoff point(T score 70) in both MTBI and STBI groups. Second, the clinical scales of which scores elevated above the cutoff point were Somatic Complaints, Anxiety, Anxiety-Related Disorders, Depression, and Schizophrenia in the MTBI, and Somatic Complaints and Depression in the STBI. Third, the clinical subscales above the cutoff point were Conversion, Somatization, Health Concerns, Affective Anxiety, Physiological Anxiety, Traumatic Stress, Cognitive Depression, Affective Depression, Physiological Depression, Thought Disorder, and Affective Instability in the MTBI, and Health Concerns, Cognitive Depression, Affective Depression, and Physiological Depression in the STBI. Fourth, Suicide Ideation in treatment scales was the only scale above the cutoff point in the MTBI and the others of the treatment and interpersonal scales in the MTBI and all of these scales of the STBI were not elevated above the cutoff point. Fifth, the scales of which scores showed significant difference between the MTBI and the STBI were Somatic Complaints, Anxiety, Depression, and Suicide Ideation, the subscales were Conversion, Somatization, Health Concerns, Affective Anxiety, Physiological Anxiety, Physiological Depression, and Psychotic Experiences. Conclusion:These results suggest that the patients with MTBI had more somatic and anxiety symptoms, depressed mood, and suicidal ideation than the patients with STBI. These characteristics are generally consistent with clinical observation and findings from previous studies of the patients with TBI, and the PAI seems to be a beneficial adjunctive assessment tool for the evaluation of patients with traumatic brain injury.

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A Case of Headache and Memory Disorder after Traumatic Brain Injury Treated with Modified Seogakjihwang-tang (외상성 뇌손상 후두통과 기억장애가 발생한 환자에 서각지황탕가감방(犀角地黃湯加減方)을 투여한 1례 보고)

  • Lee, Sang-Ah;Kwon, Tae-Wook;Kim, Myung-Ho;Son, Han-Beom;Ahn, Lib;Jang, Myung-Woong;Choi, Dong-Jun
    • The Journal of Internal Korean Medicine
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    • v.34 no.4
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    • pp.438-446
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    • 2013
  • The purpose of this study is to report the clinical effects of modified Seogakjihwang-tang on a patient who had headache and memory disorder after traumatic brain injury, which were considered as the result of blood stasis. The patient had headache and memory disorder after traumatic brain injury and treated with modified Seogakjihwang-tang three times a day for 60days. As a result, the numerical rating scale and pain rating score of headache decreased and the scores of mini-mental state examination-Korea, the Korean version of Montreal cognitive assessment and the mini-memory test increased during treatment with modified Seogakjihwang-tang. Therefore, this case supports a possibility that modified Seogakjihwang-tang might be an effective treatment to patients with headache and memory disorder after traumatic brain injury.