- Tetanus Developing after a Traumatic Rectal Rupture: A Case Report
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Jin Soo Kim, Ki Hoon Kim, Sung Jin Park, So Hyun Nam, Woon Won Kim, Yong Han Kim
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J Trauma Inj. 2013;26(3):214-217.
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- Tetanus is a neurologic disorder caused by a tetanospasmin released from Clostridium tetani and usually occurs as a result of a dirty open wound or abrasion. Post traumatic tetanus is a life threatening disease and has a mortality rate of 15~39%. Because of a nationwide active immunization program, tetanus is a rare disease in Korea.
Thus, many physicians have little experience with its diagnosis and management, and misdiagnosis and therapeutic delay may have catastrophic consequences.
We report a case of tetanus that developed in a patient who had been diagnosed with a traumatic rectal rupture.
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Summary
- Acalculous Cholecystitis Following Multiple Trauma with Fractures
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Ki Hoon Kim, Kyu Hyouk Kyung, Jin Su Kim, Kwan U Kim, Woon Won Kim, Ji Wan Kim
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J Trauma Inj. 2012;25(4):203-208.
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The purpose of this study is to investigate the incidence of acalculous cholecystitis after multiple trauma with fractures and to analyze the characteristics of cholecystitis.
METHODS
We performed a retrospective study of multiple trauma patients with fractures between April 2010 and April 2012. Sixty-nine patients were identified, and the average age was 46.8(range: 15-74) years. Data were collected regarding associated injury, injury severity score (ISS), the diagnosis time after trauma, diagnostic tool, and management.
RESULTS
There were three cases(4.3%) of cholecystitis among the 69 cases, and cholecystitis was diagnosed an average of 20.7(range: 8-33) days after injury. Two patients complained of abdominal pain at diagnosis, but the other patient who had undergone surgery for small bowel perforation at the time of the injury had no abdominal pain. All three patients had abnormal liver function tests (LFTs) at diagnosis. The cholecystitis was confirmed with ultrasonography or computed tomography, and all cases were acalculous cholecystitis. At first, percutaneous transhepatic gallbladder drainage was performed; then, laparoscopic cholecystectomy (LC) was tried an average of 12(range: 11-13) days later. An laparoscopic cholecystectomy was successfully done in only one case, the other cases being converted to an open cholecystectomy due to severe inflammation.
CONCLUSION
The incidence of acaculous cholecystitis was 4.3% after multiple trauma with fractures. We should consider cholecystitis in patients with abdominal pain, fever and elevated LFTs after multiple trauma.
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Summary
- Right Diaphragmatic Rupture after Blunt Trauma: Case Report
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Ki Hoon Kim, Jin Su Kim, Sung Jin Park, Woon Won Kim, Do Kyun Kang, Ho Gi Min, Yong Han Kim, Cheol Gyu O
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J Korean Soc Traumatol. 2012;25(3):87-90.
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- Blunt diaphragmatic rupture (BDR) is a relatively rare injury and occurs in 0.8% to 7% of all thorocoabdominal blunt trauma. Especially right diaphragmatic rupture after blunt abdominal trauma is a rarer than left. The diagnosis of BDR can be missed while evaluating the multiple trauma patient. Other severe injuries may mask BDR during the primary resuscitation and survey. We experienced two cases of traumatic rupture of right diaphragm, one diagnosed immediately and the other diagnosed delayed. In this paper we present two cases of traumatic diaphragmatic rupture.
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Summary
- Serious Bleeding Complication Due to the Use of Low-molecular-weight heparin to treat a Traumatic Patient with Acute Renal Failure
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Kyu Hyouck Kyoung, Woon Won Kim, Sung Jin Park, Ki Hoon Kim, Jin Soo Kim, Jong Kwon Park
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J Korean Soc Traumatol. 2011;24(2):164-167.
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- Trauma is an important risk factor for a pulmonary thromboembolism, and anticoagulation is essential to prevent deep vein thrombosis (DVT) in patients with trauma. Low-molecular-weight heparin (LMWH) is excreted in the kidney; therefore, using LMWH in patients with renal insufficiency may increase the risk of bleeding complication. The following case describes a 55-year-old traffic accident victim who had massive bleeding and underwent a laparotomy for bleeding control. The patient had acute renal failure, and enoxaparin was administered for the prophylaxis of DVT. Although the patient suffered from serious complications such as pericardial hematoma, the patient recovered without sequellae and was discharged at day 84.
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Summary
- Treatment of Ongoing Bleeding after a Damage Control Laparotomy for a Pelvic Bone Fracture: Arterial Embolization: A Case Report
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Ki Hoon Kim, Kyu Hyouk Kyung, Jin Su Kim, Sung Jin Park, So Hyun Nam, Woon Won Kim, Yong Han Kim
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J Korean Soc Traumatol. 2011;24(2):159-163.
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- Massive bleeding due to traumatic pelvic bone fracture is a leading cause of death. Thus, several methods to control bleeding have been attempted, but none of these has yet been clearly established. After an automobile accident, a 34-year-old motorist was admitted to the Emergency Department for right hip,leg and abdominal pain. Because the patient's pressure remained consistently low and pelvic bone fracture and abdominal bleeding were found on radiologic examination, an explorative laparotomy was performed. After pelvic packing and bleeding control, bleeding still continued, so Angiography was performed, and arterial embolization for bleeding was performed.
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