Rectal Injury Associated with Pelvic Fracture

( Jihun Gwak ),( Min A Lee ),( Byungchul Yu ),( Kang Kook Choi ) 대한외상학회 2016 大韓外傷學會誌 Vol.29 No.4

Rectal injury is seen in 1-2% of all pelvic fractures, and lower urinary tract injury occurs in up to 7%. These injuries are rare, but if missed, can lead to a severe septic response. Rectal injury may be suspected by the presence of gross blood on digital rectal examination. However, this classic sign is not always present on physical examination. If an Antero-Posterior Compression type pelvic fracture is seen, we should consider the possibility of rectal and lower urinary tract injury. It is important to define the anatomic location of the rectal injury as it relates to the peritoneal reflection. Trauma to the intraperitoneal rectum should be managed as a colonic injury. Extraperitoneal rectal injury should be managed with fecal diversion regardless of primary repair. We present the case of a 46-year-old man who was referred to our hospital following a major trauma to the pelvis in a pedestrian accident. [ J Trauma Inj 2016; 29: 201-203 ]

Blush on Computed Tomography and Transcatheter Arterial Embolization in Pelvic Fracture

Gwak, Jihun,Yoon, Yong-Cheol,Lee, Min A,Yu, Byungchul,Jang, Myung Jin,Choi, Kang Kook The Korean Society of Traumatology 2016 大韓外傷學會誌 Vol.29 No.4

Purpose: Bleeding is the primary cause of death after severe pelvic fracture. Transcatheter arterial embolization (TAE) is the mainstay of treatment for arterial bleeding. This study aimed to determine the frequency of bleeding by angiography of blush-positive pelvic fractures on computed tomography (CT) images. The bleeding arteries that were involved were investigated by pelvic angiography. Methods: This retrospective cohort study evaluated 83 pelvic fracture patients who were treated in the intensive care unit of the author's trauma center between January 01, 2013 and April 30, 2015. Results: Overall mortality was 9 of 83 patients (10.8%). Blush was observed in 37 patients; blush-positive patients had significantly higher mortality (24.3%) than blush-negative patients (0%). Twenty-four of the 83 patients (28.9%) underwent pelvic angiography. Bleeding was showed in 22 of 24 patients in pelvic angiography. TAE was successfully performed in 21 (95.5%) of the bleeding 22 patients. Angiography was performed in 23 of 37 blush-positive patients, and arterial bleeding was identified in 21 (91.3%). A total 33 bleeding arteries were identified in 22 angiography-positive patients. The most frequent origin of bleeding was internal iliac artery (69.7%) followed by the external iliac artery (18.2%) and lumbar arteries (12.1%). Conclusion: The vascular blush observed in CT scans indicates sites of ongoing bleeding in pelvic angiography. TAE is an excellent therapeutic option for arterial bleeding and has a high success rate with few complications.

Enteroatmospheric Fistula Associated with Open Abdomen

Gwak, Jihun,Lee, Min A,Ma, Dae Sung,Choi, Kang Kook The Korean Society of Traumatology 2016 大韓外傷學會誌 Vol.29 No.4

Enteroatmospheric fistula (EAF) is one of the most devastating complications in patients with an open abdomen and has associated morbidity and mortality rates. No gold standard therapy has been established for the treatment of EAF, and thus, treatment decision making is dependent on the experience of medical staff. Nevertheless, treatment involves the following; 1) sepsis must be managed, 2) sufficient nutritional support must be provided, and 3) effluent must be isolated from skin and open viscera. Here the authors present the case of a 29-year-old man who developed enteroatmospheric fistula after damage control laparotomy.

Rectal Injury Associated with Pelvic Fracture

Gwak, Jihun,Lee, Min A,Yu, Byungchul,Choi, Kang Kook The Korean Society of Traumatology 2016 大韓外傷學會誌 Vol.29 No.4

Rectal injury is seen in 1-2% of all pelvic fractures, and lower urinary tract injury occurs in up to 7%. These injuries are rare, but if missed, can lead to a severe septic response. Rectal injury may be suspected by the presence of gross blood on digital rectal examination. However, this classic sign is not always present on physical examination. If an Antero-Posterior Compression type pelvic fracture is seen, we should consider the possibility of rectal and lower urinary tract injury. It is important to define the anatomic location of the rectal injury as it relates to the peritoneal reflection. Trauma to the intraperitoneal rectum should be managed as a colonic injury. Extraperitoneal rectal injury should be managed with fecal diversion regardless of primary repair. We present the case of a 46-year-old man who was referred to our hospital following a major trauma to the pelvis in a pedestrian accident.

Blush on Computed Tomography and Transcatheter Arterial Embolization in Pelvic Fracture

( Jihun Gwak ),( Yong-cheol Yoon ),( Min A Lee ),( Byungchul Yu ),( Myung Jin Jang ),( Kang Kook Choi ) 대한외상학회 2016 大韓外傷學會誌 Vol.29 No.4

Purpose: Bleeding is the primary cause of death after severe pelvic fracture. Transcatheter arterial embolization (TAE) is the mainstay of treatment for arterial bleeding. This study aimed to determine the frequency of bleeding by angiography of blush-positive pelvic fractures on computed tomography (CT) images. The bleeding arteries that were involved were investigated by pelvic angiography. Methods: This retrospective cohort study evaluated 83 pelvic fracture patients who were treated in the intensive care unit of the author`s trauma center between January 01, 2013 and April 30, 2015. Results: Overall mortality was 9 of 83 patients (10.8%). Blush was observed in 37 patients; blush-positive patients had significantly higher mortality (24.3%) than blush-negative patients (0%). Twenty-four of the 83 patients (28.9%) underwent pelvic angiography. Bleeding was showed in 22 of 24 patients in pelvic angiography. TAE was successfully performed in 21 (95.5%) of the bleeding 22 patients. Angiography was performed in 23 of 37 blush-positive patients, and arterial bleeding was identified in 21 (91.3%). A total 33 bleeding arteries were identified in 22 angiography-positive patients. The most frequent origin of bleeding was internal iliac artery (69.7%) followed by the external iliac artery (18.2%) and lumbar arteries (12.1%). Conclusion: The vascular blush observed in CT scans indicates sites of ongoing bleeding in pelvic angiography. TAE is an excellent therapeutic option for arterial bleeding and has a high success rate with few complications. [ J Trauma Inj 2016; 29: 161-166 ]

Enteroatmospheric Fistula Associated with Open Abdomen

( Jihun Gwak ),( Min A Lee ),( Dae Sung Ma ),( Kang Kook Choi ) 대한외상학회 2016 大韓外傷學會誌 Vol.29 No.4

Enteroatmospheric fistula (EAF) is one of the most devastating complications in patients with an open abdomen and has associated morbidity and mortality rates. No gold standard therapy has been established for the treatment of EAF, and thus, treatment decision making is dependent on the experience of medical staff. Nevertheless, treatment involves the following; 1) sepsis must be managed, 2) sufficient nutritional support must be provided, and 3) effluent must be isolated from skin and open viscera. Here the authors present the case of a 29-year-old man who developed enteroatmospheric fistula after damage control laparotomy. [ J Trauma Inj 2016; 29: 195-200 ]

Isolated Dissection of the Celiac Artery after Blunt Trauma: A Case Report and Review of Literature

Han, Ahram,Gwak, Jihun,Choi, Gangkook,Park, Jae Jeong,Yu, Byungchul,Lee, Gil Jae,Kang, Jin Mo The Korean Society of Traumatology 2017 大韓外傷學會誌 Vol.30 No.4

Traumatic dissection of the celiac artery without aortic dissection is a rare event. Here we describe two cases of celiac artery dissection after blunt abdominal trauma managed conservatively without surgical or endovascular intervention.

Photosensitive polyimides in patterning for positive-tone photoresists

Young Jun Gwak,Jihun Seo,Ki Seung Kim,Seung Woo Lee 한국고분자학회 2016 한국고분자학회 학술대회 연구논문 초록집 Vol.41 No.2

Isolated Dissection of the Celiac Artery after Blunt Trauma: A Case Report and Review of Literature

( Ahram Han ),( Jihun Gwak ),( Gangkook Choi ),( Jae Jeong Park ),( Byungchul Yu ),( Gil Jae Lee ),( Jin Mo Kang ) 대한외상학회 2017 大韓外傷學會誌 Vol.30 No.4

Traumatic dissection of the celiac artery without aortic dissection is a rare event. Here we describe two cases of celiac artery dissection after blunt abdominal trauma managed conservatively without surgical or endovascular intervention.

Synthesis of Polyimide having Spiropyran Group And Optoelectrical Properties

DeokGi Hong,YoungJun Gwak,JiHun Seo,Seong Woo Lee 한국고분자학회 2016 한국고분자학회 학술대회 연구논문 초록집 Vol.41 No.2