- Delayed Diaphragmatic Injury with Massive Hemothorax Due to Lower Rib Fracture
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Woo Shik Kim, Joong Suck Kim
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J Trauma Inj. 2015;28(2):79-82. Published online June 30, 2015
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DOI: https://doi.org/10.20408/jti.2015.28.2.79
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- Simple rib fracture is one of most common injury after blunt thoracic trauma found in approximately 7% to 40% of cases. Delayed traumatic diaphragmatic injury with massive hemothorax after rib fracture is rare but a potentially life-threatening condition. We present a rare case of a 79-year-old male with delayed diaphragmatic injury with massive hemothorax due to fracture of the lower ribs. Under thoracoscopy, hemothorax was evacuated, diaphragmatic rupture was identified and repaired, and the lower ribs were fixed with metal plate (s). Although simple lower rib fractures may be the only clinical finding, close observation and monitoring are required because of the possibility of diaphragmatic and/or intraabdominal organ injury.
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Citations
Citations to this article as recorded by  - Fatal Delayed Hemothorax after Simple Rib Fracture
Minju Lee, Sang Bum Lim, Hye Jeong Kim, Sohyung Park, Hongil Ha
Korean Journal of Legal Medicine.2017; 41(2): 56. CrossRef
- A Case of Successful Endoscopic and Conservative Treatment for Intentional Ingestion of Sharp Foreign Bodies in the Alimentary Tract
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Jong Min Park, Seong Yup Kim, Il Yong Chung, Woo Shik Kim, Yong Chul Shin, Yeong Cheol Kim, Sei Hyeog Park
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J Trauma Inj. 2013;26(4):304-307.
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- Food bolus impaction is the most common cause of esophageal foreign body obstruction in adults. Other causes include intentional ingestion in psychiatric patients or prison inmates. We experienced successful treatment of a patient with intentional ingestion of multiple sharp foreign bodies(25 cutter and razor fragments). A 47-year-old male patient who was suffering from chronic alcoholism was admitted, via the emergency room, with dysphagia and neck pain. He was suffering from alcoholic liver cirrhosis and psychiatric problems, such as chronic alcoholism, anxiety disorder and insomnia. The patient had intended to leave the hospital after having swallowed the sharp objects. Plain radiographs and computed tomography (CT) scan showed multiple, scattered metal fragments in the esophagus, stomach, and small bowel. We performed emergent endoscopy and successfully removed one impacted blade in the upper esophagus using by a snare with an overtube. The rest of the fragments had already passed through the pylorus, so we could not find them with endoscopy. We checked the patient with simple abdominal radiographs and careful physical examinations every day. All remaining fragments were uneventfully excreted through stool during the patient's 6 day hospital stay. Finally, we were able to confirm the presence of the objects in the stool, and radiographs were negative. The patient was discharged without complications after 14 days hospital stay and then was followed by the Department of Psychiatry.
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- Traumatic Organized Hematoma Mimicking Intra-peritoneal Tumor: A Case Report
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Jong Min Park, Seong Yup Kim, Il Yong Chung, Woo Shik Kim, Yong Chul Shin, Yeong Cheol Kim, Sei Hyeog Park
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J Trauma Inj. 2013;26(4):300-303.
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- Blunt abdominal trauma is commonly encountered in the emergency department. The lack of historical data and the presence of distracting injuries or altered mental status, from head injury or intoxication, can make these injuries difficult to diagnose and manage. We experienced a case of traumatic organized hematoma misdiagnosed as intra-peritoneal tumor with intestinal obstruction. A 52-year-old homeless male patient who have chronic alcoholism was admitted via emergency room with infra-umbilical abdominal pain. At admission, he was drunken status and so we could not be aware of blows to the abdomen. He had a unknown large operation scar on mid abdomen. A computed tomography (CT) scan showed the intestinal obstruction of the ileum level with 5.5cm sized mesenteric tumor. We performed adhesiolysis and widely segmental resection of small bowel including tumor with side-to-side anastomosis due to great discrepancy in size. He stated later that he was a victim of the violence before 3 weeks. A final pathologic report revealed well encapsulated, traumatic mesenteric hematoma with organizing thrombi, ischemia and abscess formation with multiple adhesion bands. Finally, the patient was discharged without complications on postoperative day 14.
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