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오탁혁 ( Tak Hyuk Oh ),이상철 ( Sang Cjeol Lee ),이덕헌 ( Deok Heon Lee ),조준용 ( Joon Yong Cho ) 대한외상학회 2014 大韓外傷學會誌 Vol.27 No.4
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. [ J Trauma Inj 2014; 27: 192-5 ]
피하기종의 Vacuum-assisted Closure Therapy
오탁혁 ( Tak Hyuk Oh ),이상철 ( Sang Cjeol Lee ),이덕헌 ( Deok Heon Lee ),조준용 ( Joon Yong Cho ) 대한외상학회 2015 大韓外傷學會誌 Vol.28 No.4
Subcutaneous emphysema is a benign condition following trauma (pneumothorax and oropharyngeal), cervical or thoracic procedures, and mediastinal infection. However, severe subcutaneous emphysema may be related to serious complications such as respiratory failure, airway compromise, and tension- related phenomena. Many alternative therapies have been tried to treat patients with this condition. We report our experience with vacuum-assisted closure therapy for treating patients with severe subcutaneous emphysema. [ J Trauma Inj 2015; 28: 276-279 ]
외상성 출혈성 쇼크 환자에서 발생한 비 폐쇄성 장간막 허혈
임경훈 ( Kyoung Hoon Lim ),정희경 ( Hee Kyung Jung ),조자윤 ( Ja Yun Cho ),이상철 ( Sang Cjeol Lee ),박진영 ( Jin Young Park ) 대한외상학회 2014 大韓外傷學會誌 Vol.27 No.4
Non-occlusive mesenteric ischemia (NOMI) encompasses all forms of mesenteric ischemia with patent mesenteric arteries. NOMI is commonly caused by decreased cardiac output resulting in hypoperfusion of peripheral mesenteric arteries. We report a case of NOMI secondary to hemorrhagic shock and rhabdomyolysis due to trauma. A 42-year-old man presented to our trauma center following a pedestrian trauma. On arrival, he was drowsy and in a state of hemorrhagic shock. He was found to have multiple fractures, both lung contusion and urethral rupture. An initial physical examination and abdominal computed tomography (CT) scan revealed no evidence of intra-abdominal injury. High doses of catecholamine were administered for initial 3 days due to unstable vital sign. On day 25 of hospitalization, follow- up abdominal CT scan demonstrated that short segment of small bowel loop was dilated and bowel wall was not enhanced. During exploratory laparotomy, necrosis of the terminal ileum with intact mesentery was detected and ileocecectomy was performed. His postoperative course was uneventful and is under rehabilitation. [ J Trauma Inj 2014; 27: 204-7 ]