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RISS 인기검색어
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- 저자 : 우병완(Byung Won Woo) (검색결과 3 건)
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간장 ( 肝臟 ) 및 담도 ( 膽道 ) : 소아 문맥압 항진증의 외과적 치료
우병완(Byung Won Woo),정성은(Sung Eun Jung),박귀원(Kwi Won Park),이성철(Seong cheol Lee),김우기(Woo Ki Kim) 대한소화기학회 1990 대한소화기학회지 Vol.22 No.4
N/A We clinically analysed 9 cases of portal hypertension pediatric patient with esophageal variceal bleeding who underwent shunt ioeration from January,1985 to J anuary, 1990, at the department of pediatric surgery, Seoul National University Childrens Hospital. The results were as follows; 1) The mean age at operations was 10 years (3 years 3 months-15 years 2 months). 2)The main initial sign, being the cause of visiting hospital, was splenomegaly (7/9). 3) The causes of portal hyoertensian were portal vein thrombosis (6/9), congenital hepatic fibrosis (2/9), and post hepatitic liver cirrhosis (1/9). 4) The methods of shunts were mainly, Warren shunts (8/9) and central splenorenal shunt (1/9). 5) There was one operative moitality case due to aggravation of preoperative renal failure and sepeis with DIC.
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윤여규(Yeo Kyu Youn),최국진(Kuk Jin Choe),우병완(Byung Won Woo) 대한소화기학회 1989 대한소화기학회지 Vol.21 No.3
N/A Rectovaginal fistula is a relatively rare disease in surgical field. Its incidence is reported as less than 5% in anorectal fistula. This study was based on 20 cases of rectovginal fistulas during 10 years from January 1st, 1978 to December 31th, 1988 at the Department of Surgery, Seoul National University Hospital. The results were as follows; 1) Age ranged from 22years to 68years. The peak incidence was in 5th decades. 2) Considering the etiologic distribution, cancer invasion, iatrogenic injury, obstertric injury and chemical injury were 40%, 30%, 25%, 5%, respectively. In the age group below 39years, trauma was the leading cause of rectovaginal fisrula(5/6), but in the age group above 49years, cancer invasion was leading cause(8/14). 3) Causative operations of 6 iatrogenic injury patients were one Weltheims operation due to cervix ca., one transabdominal hysterectony and bilateral salphingo-oophorectomy due to cervix ca, one bilateral oophorectomy due to ovarian cystic teratoma, one low anterior resection due to rectal ca and two dilatation and currettages. 4) The most frequent symptom was vaginal feces passage(69%). 5) Main repair procedure was primary closure and the overall success rate was 50%. The success rate in primary closure only was 60% and the success rate in primary closure with colostomy was 25 %
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원형섭,김상은,배성만,박철완,이 근,조상훈,김상일,우병완 大韓應急醫學會 1996 대한응급의학회지 Vol.7 No.1
Extremity vascular trauma is common in most emergency centers, and controversy remains about the optimal management of arterial injuries. Retrospectively we reviewed the records of 23 patients who had upper or lower extremity arterial trauma from July 1994 to December 1995. The purpose of this study was to evaluate our department`s management policy to major arterial injuries. The leading cause of major arterial injuries was penetrating trauma. We found that there were clinical findings such as absence of or decreased strength of pulsation(82.6%), cool ischemic extremity(69.6%), large expanding hematoma(43.5%), major bleeding(17.4%) and bruit or thill(8.7%). We gave the priority to management of life-threatening injuries and applied the pressure dressing to wounds as early as possible. There were 18 men(78.3%) and 5 women(21.7%); the mean age was 35(range 20-56 years old) years. There were 12 arterial injuries(52.2%) in the upper extremity and 11 arterial injuries(47.8%) in the lower exteremity. The most commonly injured artery was the brachial artery in the upper(34.8%) and the femoral artery in the lower(30.4%) extremity. The etiology included knife stabbing in 10 patients(43.5%), motor vehicle accidents in 6(26.1%), industrial accidents in 4(17.4%), falls in 2(8.7%) and a farm equipment accident in 1 patient(4.3%). The associated injuries were muscle injuries(78.3%), fracture(56.5%), nerve injuries(52.2%), vein injuries(43.5%), shock(17.4%) and dislocation(13.0%). All patients with arterial injuries were given a preoperative prophylactic antibiotic and TIG(tetanus immunoglobulin). We used Doppler technique as a means of detecting the blood flow. Fourteen patients(60.9%) underwent preoperative arteriography in the radiology department. We performed surgical exploration as soon as major arterial injuries were suspected. The most common methods of treating major arterial injuries were interposition vein graft(69.6%) and end to end anastomosis(21.7%). Systemic or locally infused heparin was used for all vascular repairs. In many of our patients(56.5%), fasciotomy was performed before the vascular repair, as a part of the exploration of the distal arteries. There were 2 amputations(8.7%) but no death. The reason for secondary amputation were wound infection in one and failure to achieve sufficient arterial flow to the involved extremity with resulting gangrene in the other. As the time factor is vitally important in the management of arterial injuries, we advocate prompt and early surgical treatment within 6 hours of the trauma. In conclusion, we believe that the crucial factorsin successful management of major arterial injuries of the extremities are early diagnosis, prompt treatment, complete debridement, fasciotomy when indicated, and simultaneous treatment of concomitant injuries.
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