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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 ]
Bae Chae-Min,Son Shin-Ah,Lee Yong Jik,Lee Sang Cjeol 대한흉부외과학회 2023 Journal of Chest Surgery (J Chest Surg) Vol.56 No.2
Background: Multiple rib fractures are common in blunt chest trauma. Until recently, most surgical rib fixations for multiple rib fractures were performed via open thoracotomy. However, due to the invasive nature of tissue dissection and the resulting large wound, an alternative endoscopic approach has emerged that minimizes the postoperative complications caused by the manipulation of injured tissue and lung during an open thoracotomy. Methods: Our study concentrated on patients with multiple rib fractures who underwent surgical stabilization of rib fractures (SSRF) between June 2018 and May 2020. We found 27 patients who underwent SSRF using video-assisted thoracoscopic surgery. The study design was a retrospective review of the patients’ charts and surgical records. Results: No intraoperative events or procedure-related deaths occurred. Implant-related irritation occurred in 4 patients, and 1 death resulted from concomitant trauma. The average hospital stay was 30.2±20.1 days, and ventilators were used for 12 of the 22 patients admitted to the intensive care unit. None of the patients experienced major pulmonary complications such as pneumonia or acute respiratory distress syndrome. Conclusion: Minimally invasive rib stabilization surgery with the assistance of a thoracoscope is expected to become more widely used in patients with multiple rib fractures. This method will also assist patients in a quick recovery.
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 ]