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Background: Recently, the number of patients with the thorax or neck trauma has increased due to traffic accidents, industrial disasters, incidental accidents, and violence. Most of the thorax or neck injuries can be managed with conservative methods and simple surgical procedures, but an open thoracotomy or exploration will be necessary in emergent cases. Traumas to the thorax and the neck have an extremely poor prognosis when not diagnosed and treated early. Therefore, we analyzed the results of emergent operations in patients with thorax or neck trauma and their clinical courses. Methods: A clinical evaluation was performed on 56 patients treated with emergent operations for thorax or neck trauma from January 1997 to July 2003 according to their medical Results: There were 45 males and 11 females. The mean age was 36.1 years. The modes of injury were as follows: traffic accidents 14 cases, stab wounds 27 cases, industrial disasters 7 cases, and others 8 cases. The annual distribution of cases was as follows: 1997 year 9 cases, 1998 year 6 cases, 1999 year 7 cases, 2000 year 10 cases, 2001 10 cases, 2002 6 cases and 2003 8 cases. The injured organs were 13 cases of a ruptured diaphragm, 12 cases of a ruptured lung, 7 cases of a ruptured heart, 2 case of a ruptured aorta, 9 cases of a simple vessel ruptured and 4 cases of a ruptured esophagus and trachea. There were 9 (16%) overall deaths: 6 cases in deaths among the blunt-trauma cases and 3 deaths among the stab injury cases. Conclusion: Early diagnosis and surgical treatment is essential for thorax or neck trauma, to decrease the mortality and complications. Therefore, careful diagnostic procedure, appropriate preoperative management for hypovolemia, and early surgical treatment are essential. The setup an of emergency operation system should be considered as a reform measure.
현성열(Sung Youl Hyun),박국양(Kook Yang Park),이재웅(Jae Woong Lee),이창하(Chang Ha Lee),전양빈(Yang Bin Jeon),박철현(Chul Hyun Park),염석란(Suk Lan Youm),신종환(Jong Hwan Sin),민순식(Sun Sik Min),김재광(Jae Kwang Kim),임용수(Yong Su 대한흉부외과학회 2002 The Korean Journal of Thoracic and Cardiovascular Vol.35 No.12
현성열 ( Sung Youl Hyun ),강영준 ( Young Joon Kang ),김진주 ( Jin Joo Kim ),김용인 ( Yong In Kim ),김재광 ( Jae Kwang Kim ),임용수 ( Yong Su Lim ),양혁준 ( Hyuk Joon Yang ),서태석 ( Tae Suk Seo ),박희권 ( Hee Kwon Park ),이석기 ( 대한외상학회 2004 大韓外傷學會誌 Vol.17 No.2
Tracheal intubation is the most common cause of Tracheal stenosis. The treatment of trachea stenosis vary according to site or size of tracheal stenosis. Thirty six age old man was transferred our hospital for evaluation of dyspnea. Subglottic stenosis was shown on bronchoscopy & chest computerized tomography(CT) scan of neck. Balloon dilatation was performed and then patient breathed at ease. Tracheal resection and end-to-end anastomosis was applied to repetitive tracheal stenosis. Balloon dilatation before surgical management makes better respiratory difficulty. We report succesful application of surgical management after balloon dilatation in repetitive tracheal stenosis patient. We will suggest that the balloon dilatation improve symptoms before tracheal resection and end-to-end anastomosis or stent, if sugery or stent insertion are not applicable due to poor status of patient.
Background: Blunt thoracic trauma in children has a high morbidity and mortality. In this study, we assessed the significance of the injury pattern, mechanism and initial status in emergency department on severity and prognosis in pediatric blunt thoracic trauma patients. Method: We retrospectively reviewed medical records and chest X-ray and CT images of 111 pediatric blunt thoracic trauma patients from October 2000 to June 2005. Data recorded age, gender, season, injury mechanism, injury pattern, associated injury, length of hospital stay and cause of death. Result: Of all 111 patients, 68 patients were injured by motor vehicle accidents, 30 were falls, 5 were motorcycle accidents, 3 were sports accidents and 5 were miscellaneous. In thoracic trauma, single injury of lung contusion were 35 patients and 32 patients had multiple thoracic injuries. Hospital stay in school age group were longer than preschool age group. The causes of death were brain injury in 9, respiratory distress in 4, and hypovolemic shock in 2 patients. Emergently transfused and mechanically ventilated patients had higher mortality rates than other patients. Patients required emergency operation and patients with multiple thoracic injuries had higher mortality rates. Conclusion: In this study, patients with combined injury, emergency transfusion, mechanical ventilation, emergency operation, multiple injuries in chest X-ray had higher mortality rates. Therefore in these pediatric blunt thoracic trauma patients, accurate initial diagnosis and proper management is required.
박신웅 ( Shin Woong Park ),현성열 ( Sung Youl Hyun ),김진주 ( Jin Joo Kim ),임용수 ( Yong Su Lim ),조진성 ( Jin Sung Cho ),양혁준 ( Hyuk Jun Yang ),박원빈 ( Won Bin Park ),우재혁 ( Jae Hyug Woo ),장재호 ( Jae Ho Jang ) 대한외상학회 2013 大韓外傷學會誌 Vol.26 No.3
Purpose: Trauma is one of the major cause of death in Korea. This study focused on the survival rate and the neurologic outcome for patients with traumatic cardiac arrest (CA) at one emergency center. Methods: We retrospectively reviewed the medical records of patients with traumatic CA who were seen at a regional emergency medical center from January 2010 to December 2011. From among major trauma patients at that medical center, adults older than 18 years of age who had CA were included in this study. CA included outof- hospital CA with arrival at the Emergency Department (ED) within three hours and in-hospital CA. We checked the survival rate and the neurologic outcome. Results: A total of 61 patients were analyzed: 32 patients had return of spontaneous circulation (ROSC), 6 patients survived to discharge (survival rate: 9.84%), and 4 were still alive 90 days after discharge. The Cerebral performance category (CPC) scores at 6 months after discharge showed 1 good and 5 poor in neurologic outcomes. Factors such as initial rhythm of CA, part with major injury, Revised Trauma Score (RTS) and pH, were significant for ROSC, survival, and neurologic outcome in patients with traumatic CA. Conclusion: In this study, patients who had traumatic CA showed a 9.84% survival rate and a 1.64% good neurologic outcome. The results are poorer than those for CA caused by disease. Multi-center, prospective studies are needed.
Purpose: A traumatic lung cyst (TLC) is a rare complication and is usually detected with a pulmonary contusion. This study attempted to identify the prognostic factors and the clinical characteristics for pulmonary contusion with TLCs. Methods: We retrospectively reviewed the medical records and chest CT findings of 71 TLC patients who visited our hospital from January 2006 to December 2007. Patients were assessed for any clinical characteristics. We evaluated significant differences between the survival and the death groups for patients with a traumatic lung cyst. Results: The male-to-female ratio of patients with TLCs was 54:17, and the mean age of the patients was 37.70±19.78 years with 36.6% of the patients being under 30 years forage. The cause of blunt thoracic trauma was mainly pedestrian traffic accidents (26.8%) and falls (25.4%). Associated conditions included pulmonary contusion in 68 patients (95.7%), hemopneumothorax in 63 patients (88.7%), and rib fracture in 52 patitents (73.2%). There was no consistent relationship between the number of TLCs and the pulmonary contusion score. The overall mortality rate of TLC patients was 26.8%. Death correlated with a need for ventilatory assistance, mean arterial pressure, worst mean arterial pressure in 24 hours, initial pH and base excess, worst pH and base excess in 24 hours, refractory shock, initial GCS score, and pulmonary contusion score. Conclusion: The presence of the aforementioned predictors indicate serious injury, which is the main determinant of the outcome for thoracic injuries with TLCs. (J Korean Soc Traumatol 2008;21:100-107)