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김선희 ( Seon Hee Kim ),조정수 ( Jeong Su Cho ),김영대 ( Yeong Dae Kim ),이호석 ( Ho Seok I ),송승환 ( Seung Hwan Song ),허업 ( Up Huh ),김재훈 ( Jae Hun Kim ),박성진 ( Sung Jin Park ) 대한외상학회 2012 大韓外傷學會誌 Vol.25 No.4
Purpose: Diaphragmatic rupture following trauma is often an associated and missed injury. This report is about our experience with treating traumatic diaphragmatic rupture (TDR). Methods: From January 2007 to September 2012, 18 patients who had a diaphragmatic rupture due to blunt trauma or penetrating injury underwent an operation for diaphragmatic rupture at our hospital. We retrospectively reviewed their medical records, including demographic factors, initial vital signs, associated injuries, interval between trauma and diagnosis, injured side of the diaphragm, diagnostic tools, surgical method or approaches, operative time, herniated organs, complications, and mortality. Results: The average age of the patients was 43 years, and 16 patients were male. Causes of trauma included motor vehicle crashes (n=7), falls (n=7), and stab wounds (n=5). The TDR was right-sided in 6 patients and left-sided in 12. The diagnosis was made by using a chest X-ray (n=3), and thorax or upper abdominal computed tomography (n=15). Ten(10) patients were diagnosed within 12 hours. A thoracotomy was performed in 8 patients, a video-assisted thoracoscopic surgery in 4 patients, a laparotomy in 3 patients, and a sternotomy in one patient. Herniated organs were the omentum (n=11), stomach (n=8), spleen and colon (n=6), and liver (n=6). Eighteen diaphragmatic injuries were repaired primarily. Seven patients underwent ventilator care, and two of them had pneumonia and acute respiratory distress syndrome. There were no operative mortalities. Conclusion: Early diagnosis and surgical treatment determine the successful management of TDR with or without the herniation of abdominal organs. The surgical approach to TDR is chosen based on accompanying organ injuries and the injured side. (J Trauma Inj 2012;25:217-222)
늑골 골절에 의해 발생한 지연성 대동맥 손상에 대한 치험 1례
김창완 ( Chang Wan Kim ),최선우 ( Seon Uoo Choi ),김선희 ( Seon Hee Kim ),김재훈 ( Jae Hun Kim ),황정주 ( Jung Joo Hwang ),조현민 ( Hyun Min Cho ),송승환 ( Seung Hwan Song ),조정수 ( Jeong Su Cho ) 대한외상학회 2015 大韓外傷學會誌 Vol.28 No.1
Traumatic aortic injury is well recognized as a primary cause of instantaneous death in victims of thoracic blunt trauma presenting with an aortic rupture or dissection, particularly after a deceleration injury. However, a direct aortic injury caused by a fractured rib segment after blunt thoracic trauma is extremely rare. We report the case of a 43-yearold male patient who experienced an aortic injury caused by the sharp edge of a fractured rib after multiple rib fractures due to blunt thoracic trauma. [ J Trauma Inj 2015; 28: 31-33 ]