- Thoracoscopic Resection of the First Rib for Thoracic Outlet Syndrome: A Case Report
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Jae Gul Kang, Soon Ho Chon, Kilsoo Yie, Min Koo Lee, Oh Sang Kwon, Song Hyun Lee, June Raphael Chon
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J Trauma Inj. 2017;30(2):63-65. Published online June 30, 2017
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DOI: https://doi.org/10.20408/jti.2017.30.2.63
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- Standard open procedures for resection of the first rib in thoracic outlet syndrome can prove to be quite difficult with extensive incisions. A minimal invasive procedure can also be painstaking, but provides an attractive alternative to the more radical open procedures. We report the details of the technique with direct video footage of the procedure performed in a 41-year-old man with thoracic outlet syndrome done entirely by thoracoscopic methods.
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- Thoracoscopy in Management of Chest Trauma: Our Three-year Jeju Experience
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Sung Hyun Lee, Kilsoo Yie, Jong Hyun Lee, Jae Gul Kang, Min Koo Lee, Oh Sang Kwon, Soon Ho Chon
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J Trauma Inj. 2017;30(2):33-40. Published online June 30, 2017
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DOI: https://doi.org/10.20408/jti.2017.30.2.33
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- PURPOSE
The role for minimally invasive surgery in chest trauma is vague, one that recently is more frequently performed, and one attractive option to be considered. Thoracoscopic surgery may improve morbidity, mortality, hasten recovery and shorten hospital stay.
METHODS
A total of 31 patients underwent video assisted thoracoscopic surgery for the treatment of blunt and penetrating chest trauma from June 9th, 2013 to March 21st, 2016 in Jeju, South Korea.
RESULTS
Twenty-three patients were males and eight patients were females. Their ages ranged from 23 to 81 years. The cause of injury was due to traffic accident in 17 patients, fall down in 5 patients, bicycle accident in 2 patients, battery in 2 patients, crushing injury in 2 patients, and slip down, kicked by horse, and stab wound in one patient each. Video assisted thoracoscopic exploration was performed in the 18 patients with flail chest or greater than 3 displaced ribs. The thoracoscopic procedures done were hematoma evacuation in 13 patients, partial rib fragment excision in 9 patients, lung suture in 5 patients, bleeding control (ligation or electrocautery) in 3 patients with massive hemothorax, diaphragmatic repair in two patients, wedge resection in two patients and decortication in 1 patient. There was only one patient with conversion to open thoracotomy.
CONCLUSION
There is a broad range of procedures that can be done by thoracoscopic surgery and a painful thoracotomy incision can be avoided. Thoracoscopic surgery can be done safely and swiftly in the trauma patient.
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Citations
Citations to this article as recorded by  - Video assisted thoracoscopic surgery vs thoracotomy in management of post traumatic retained hemothorax: a randomized study
Abd Elrahman Mohammed Khalaf, Ahmed Emadeldeen Ghoneim, Alaa Basiouni Mahmoud, Amr Abdelmonem Abdelwahab
The Cardiothoracic Surgeon.2023;[Epub] CrossRef
- Pericardial Tamponade following Perihepatic Gauze Packing for Blunt Hepatic Injury
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Jin Bong Ye, Young Hoon Sul, Seung Je Go, Oh Sang Kwon, Joong Suck Kim, Sang Soon Park, Gwan Woo Ku, Min Koo Lee, Yeong Cheol Kim
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J Trauma Inj. 2015;28(3):211-214. Published online September 30, 2015
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DOI: https://doi.org/10.20408/jti.2015.28.3.211
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- The primary and secondary survey was designed to identify all of a patient's injuries and prioritize their management. However 15 to 22.3% of patient with missed injuries had clinically significant missed injuries. To reduce missed injury, special attention should be focused on patients with severe anatomical injury or obtunded. Victims of blunt trauma commonly had multiple system involvement. Some reports indicate that inexperience, breakdown of estalished protocol, clinical error, and restriction of imaging studies may be responsible for presence of missed injury. The best way of reducing clinical significant of missed injuries was repeated clinical assessment.
Here we report a case of severe blunt hepatic injury patient and pericardial injury that was missed in primary and secondary survey. After damage control surgery of hepatic injury, she remained hemodynamically unstable. Further investigation found cardiac tamponade during intensive care. This was managed by pericardial window operation through previous abdominal incision and abdominal wound closure was performed.
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- Wound Probing in Neck Trauma Patients
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Jin Bong Ye, Young Hoon Sul, Yun Su Mun, Seung Je Go, Oh Sang Kwon, Gwan Woo Ku, Min Koo Lee
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J Trauma Inj. 2015;28(3):198-201. Published online September 30, 2015
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DOI: https://doi.org/10.20408/jti.2015.28.3.198
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- Neck trauma is a relatively uncommon but can be a life-threatening injury. Several guidelines for neck trauma is established to recommend a proper management such as no clamping of bleeding vessels, no probing of wounds, Trendelenberg position for preventing venous air embolism. Here, we present a regretful case of 49-year-old man with neck trauma presenting undesired bleeding after probing of wound, and then discuss about treatment guildeline for neck trauma with a review.
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- Successful Treatment of a Traumatic Hepatic Arterioportal Fistula: A Case Report
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Yun Su Mun, Oh Sang Kwon, Jang Young Lee, Gyeong Nam Park, Hyun Young Han, Min Koo Lee
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J Trauma Inj. 2013;26(1):22-25.
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- Severe blunt abdominal trauma frequently involves the liver. The development of nonsurgical treatment of liver trauma has led to more frequent appearance of unusual complications. A hepatic arterioportal fistula (APF) is a rare complication of liver trauma. We present a case of traumatic APF in a patient with liver trauma. A 31-year-old male visited our emergency department with pain in the right upper abdomen following a traffic accident. Initial physical exam and abdominal computed tomography (CT) revealed liver laceration with hemoperitoneum. An abdominal CT obtained on day 11 revealed early opacification of the right portal vein on the arterial phase. After we had come to suspect an APF of the liver, its presence was confirmed on angiography. It was subsequently managed by using transcatheter coil embolization. In patients with portal hypertension and no evidence or history of cirrhosis, one should consider an APF as a potential etiology if history of liver biopsy or penetrating trauma exists. In a patient with liver trauma, serial abdominal CT is important for early detection and treatment of an APF.
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- Ureteral Injury Caused By Blunt Trauma: A Case Report
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Oh Sang Kwon, Yun Su Mun, Seung Hwo Woo, Hyun Young Han, Jung Joo Hwang, Jang Young Lee, Min Koo Lee
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J Trauma Inj. 2012;25(4):291-295.
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- Ureteral trauma is rare, accounting for less than 1% of all urologic traumas. However, a missed ureteral injury can result in significant morbidity and mortality. The purpose of this case presentation is to suggest another method for early detection of ureteral injury in blunt traumatic patient.
A 47-years-old man was injured in pedestrian traffic accident. He undergone 3-phase abdominal CT initially and had had a short-term follow-up simple. We suspected ureteral injury. Our final diagnosis of a ureteral injury was based on follow-up and antegrade pyeloureterography, he underwent emergency surgery.
We detected the ureteral injury early and took a definitive action within 24 hours.
In blunt trauma, if abnormal fluid collection in the perirenal retroperitoneal space is detect, the presence of a ureteral injury should be suspected, so a short-term simple X-ray or abdominal CT, within a few hours after initial abdominal CT, may be useful.
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- Experience with Blunt Pancreatic Trauma at Eulji University Hospital
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Seung Hyun Yang, Yun Su Mun, Oh Sang Kwon, Min Koo Lee
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J Trauma Inj. 2012;25(4):261-266.
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Traumatic pancreatic injury is not common in abdominal trauma injury. However, the morbidity and the mortality rates of patients with pancreatic injury, which are related with difficulties of initial assessment, establishment of diagnosis, and treatment are relatively high. The aim of this study is to review our institution's experience and suggest a diagnosis and therapeutic algorithm for use in cases involving traumatic pancreatic injury.
METHODS
Eighteen(18) patients with blunt pancreatic injury from January, 2004 to October 2012 were included in this study. We analyzed treatment and diagnosis method, other organ injury, treatment interval, hospital stay and complications retrospectively.
RESULTS
Nine patients were treated with conservative medication and another nine patients were treated surgically. Complications occurred in nine patients, and one patient died due to intraventricular hemorrhage and subdural hemorrhage with multiple organ failure. Delayed surgery was performed in three cases. The early and delayed surgery groups showed difference in hospital stay and intensive care unit stay. Delayed surgery was associated with a longer hospital stay (p=0.007) than immediate surgery.
CONCLUSION
In blunt pancreatic trauma, proper early diagnosis and prompt treatment are recommended necessity. Based on this review of our experience, we also suggest the adoption of our institution's algorithm for cases involving traumatic pancreatic injury.
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