Journal of Trauma and Injury

Hydronephrosis during Conservative Treatment for a Renal Injury Patient: Maru Kim, Joongsuck Kim, Sung Jeep Kim, Hang Joo Cho; J Trauma Inj. 2017;30(2):47-50. Published online June 30, 2017; DOI: https://doi.org/10.20408/jti.2017.30.2.47

1,948 View
11 Download

Abstract PDF: A 21-year-old male visited our emergency room. He could not remember the mechanism of injury. He was found beside a motorcycle. Initial vital sign was stable. Observation and conservative treatment were planned at the intensive care unit (ICU). On the third day at ICU, he complained sudden flank pain. It was colicky and hard to control. Without the pain, he had no specific symptom, sign, or laboratory findings. On computed tomography, renal pelvis was filled with hematoma which induced hydronephrosis. Double-J catheter and percutaneous nephrostomy was implemented by an intervention radiologist. Hematome in the renal pelvis was aspirated during the procedure. Symptom of the patient was subsided after the procedure. He was discharged without specific complications.; Summary

Frequency of Post-Concussion Syndrome in Korean Patients with Minor Head Injury: Ji Young Lee, Young Hoon Yoon, Roger J Lewis, Juliana Tolles; J Trauma Inj. 2017;30(2):41-46. Published online June 30, 2017; DOI: https://doi.org/10.20408/jti.2017.30.2.41

2,029 View
19 Download

Abstract PDF: PURPOSE
To determine the incidence of post-concussion syndrome (PCS) in Korean patients after minor traumatic brain injury.
METHODS
We conducted an observational cohort study of a convenience sample of patients presenting to the emergency department of a major academic Korean hospital. Patients who visited the Emergency Department for head trauma were screened. A researcher questioned the subject regarding his or her symptoms. Subjects were contacted by phone approximately 2 weeks after their Emergency Department visit and questioned about subsequent symptoms and subsequent visits for medical care.
RESULTS
Only 8% of subjects reported any post-concussion symptoms. Only 0.4% had three or more symptoms which might have met criteria for PCS. The median peak onset of symptoms was 3 days after injury.
CONCLUSION
The incidence of PCS is Korean patients is much lower than that documented for patients in the United States or other western countries. On the other hand, this study results could give an idea that mild trauma could also cause the PCS. Further study is needed to replicate this finding and investigate possible explanations for this difference.; Summary

Thoracoscopy in Management of Chest Trauma: Our Three-year Jeju Experience: Sung Hyun Lee, Kilsoo Yie, Jong Hyun Lee, Jae Gul Kang, Min Koo Lee, Oh Sang Kwon, Soon Ho Chon; J Trauma Inj. 2017;30(2):33-40. Published online June 30, 2017; DOI: https://doi.org/10.20408/jti.2017.30.2.33

2,457 View
26 Download
1 Citations

Abstract PDF

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.

Summary

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

Changes of Clinical Practice in Gastrointestinal Perforation with the Increasing Use of Computed Tomography: Ji Min Park, Young Hoon Yoon, Timothy Horeczko, Amy Hideko Kaji, Roger J Lewis; J Trauma Inj. 2017;30(2):25-32. Published online June 30, 2017; DOI: https://doi.org/10.20408/jti.2017.30.2.25

2,201 View
19 Download
2 Citations

Abstract PDF

PURPOSE
The use of computed tomography (CT) to evaluate acute abdominal complaints has increased over the past two decades. We investigated how the clinical practice of patients with intestinal perforation has changed with the increasing use of abdominal CT in the emergency department (ED).
METHODS
We compared ED arrival to CT time, ED arrival to surgical consultation time, and ED arrival to operation time according to the method of diagnosis from 2003?2004 and 2013?2014.
RESULTS
In patients with gastrointestinal perforation, time from ED arrival to CT was shorter (111.4±66.2 min vs. 199.0±97.5 min, p=0.001) but time to surgical consultation was longer (135.1±78.8 vs. 77.9±123.7, p=0.006) in 2013?2014 than in 2003?2004. There was no statistically significant difference in time to operation for perforation confirmed either by plain film or CT between the two time periods. There was no statistically significant difference in length of hospital or ICU stay or mortality between the two groups.
CONCLUSION
With the increasing use of abdominal CT in ED, ED arrival to CT time has decreased and ED arrival to surgical consultation time has increased in gastrointestinal perforation. These changes of clinical performance do not delay ED arrival to operation time or adversely influence patient outcome.

Summary

Citations

Citations to this article as recorded by

A case report of gastrointestinal perforation in patient after biliary stent insertion and the overview of gastrointestinal perforation
Ga-Young Lee, Chan-Ran Park, Jung-hyo Cho, Chang-gue Son, Nam-hun Lee
Journal of Korean Medicine.2022; 43(3): 195. CrossRef
GASTROİNTESTİNAL PERFORASYON TANISINDA KULLANILAN GÖRÜNTÜLEME YÖNTEMLERİ VE GÖRÜNTÜLEME BULGULARI
Mehtap ILGAR, Tuna ŞAHİN
Cukurova Anestezi ve Cerrahi Bilimler Dergisi.2022; 5(2): 199. CrossRef

The Impact of Trauma Center Establishment on Laparotomy Patterns and Outcomes in Severe Hemoperitoneum Patients: Min A Lee, Jungnam Lee, Min Chung, Giljae Lee, Jaejeong Park, Kangkook Choi, Byung Chul Yoo; J Trauma Inj. 2017;30(1):6-11. Published online March 31, 2017; DOI: https://doi.org/10.20408/jti.2017.30.1.6

1,941 View
21 Download

Abstract PDF: PURPOSE
The establishment of the trauma system has changed the quality of trauma care in many countries. As one of the first designated level I trauma centers in Korea, we hypothesized that there were changes in laparotomy patterns and subsequent survival rates after the center was established.
METHODS
This was a 5-year retrospective study of all severe hemoperitoneum patients who were transfused with more than 10 units of packed red blood cells (RBCs) within 24 h of hospitalization. Variables related to trauma were collected throughout the study period, and the patients admitted before (period 1) and after (period 2) the establishment of a trauma center were compared.
RESULTS
Forty-five patients were managed from January 2009 to March 2015. The baseline patient characteristics of the two groups, including age, Injury Severity Score, blood pressure, and hemoglobin levels, were similar. The time to the operating room (OR) was 144.3±51.5 min (period 1) and 79.9±44.1 min (period 2) (p<0.0001). Damage control surgery (DCS) was performed in 17% of patients during period 1 and in 73% during period 2. The number of actual survivors (n=10) was higher than expected (n=8) in period 2.
CONCLUSION
This is the first study analyzing the impact of a trauma center on the management of specific injuries, such as severe hemoperitoneum, in patients in Korea. During the study, the time to OR was shortened and DCS was used to a greater extent as a surgical procedure.; Summary

Penetrating Cardiac Injury and Traumatic Pericardial Effusion Caused by a Nail Gun: Willem Guillermo Calderon Miranda, Edgardo Jim?nez Fuentes, Nidia Escobar Hern?ndez, Luis Rafael Moscote Salazar, Paul M Parizel; J Trauma Inj. 2017;30(1):21-23. Published online March 31, 2017; DOI: https://doi.org/10.20408/jti.2017.30.1.21

2,241 View
19 Download

Abstract PDF: Penetrating cardiac injury caused by nail gun is an uncommon life-threatening condition characterized by a rapidly severe hemodynamic status compromise. We report non-contrast-enhanced CT findings of a right ventricle myocardium injury leading to a fluid collection in the pericardial space with the same attenuation as blood. The CT findings well depicted the pathological feature of a significant cardiac injury and may be helpful for the surgical management.; Summary

Missed Traumatic Rupture of the Diaphragm: Sang Woo Ryu, Jaykey Chekar, In Ho Yi, Bo Ra Seo, Seong Huek Park, Seong Ju Go; J Trauma Inj. 2017;30(1):16-20. Published online March 31, 2017; DOI: https://doi.org/10.20408/jti.2017.30.1.16

2,377 View
18 Download
1 Citations

Abstract PDF

A 48-year-old man came to the emergency department with altered consciousness and hemoperitoneum following a pedestrian traffic accident. He underwent immediate emergency laparotomy, and on the second day, he required craniectomy because of increase of intracranial hemorrhage. A chest radiograph taken 7 days after admission, showed elevation of the right hemi-diaphragm, and follow-up chest CT showed a right-sided rupture of the diaphragm, which was surgically repaired. Rupture of the diaphragm can be easily overlooked and the diagnosis delayed, especially in unstable patients with multiple trauma or altered level of consciousness, as in the case reported here.

Summary

Citations

Citations to this article as recorded by

Identification of Delayed Traumatic Diaphragmatic Injury: A Concise Review
Patricia J. Bartzak
Journal of Trauma Nursing.2022; 29(1): 47. CrossRef

Temporary Closure for Sternotomy in Patient with Massive Transfusion Might Be Lethal: Maru Kim, Joongsuck Kim, Sung Jeep Kim, Hang Joo Cho; J Trauma Inj. 2017;30(1):12-15. Published online March 31, 2017; DOI: https://doi.org/10.20408/jti.2017.30.1.12

2,014 View
10 Download

Abstract PDF: A 58-year-old male visited our emergency room for multiple traumas from explosion. On initial evaluation, hemopneumoperitoneum with liver laceration (grade 4) and colon perforation was identified. Hemopericardium with cardiac tamponade was also identified. Shrapnel was detected in the right ventricle. Damage control surgery was planned due to condition of hypotension. In operation room, control over bleeding was achieved after sternotomy, pericardiotomy, and laparotomy. Massive transfusion was done during operation. After gauze packing, operation was terminated with temporary closure (TC). Sanguineous fluid was drained profusely. Disseminated intravascular coagulopathy was confirmed through laboratory findings. No extravasation was discovered at hepatic angiogram. On re-operation, there was no active bleeding but oozing from sternotomy site was identified. Bone bleeding was impossible to control. Finally, reoperation was ended after gauze packing and TC all over again. The patient could survive for only a day after re-operation.; Summary

Efficacy of Nefopam Analgesia for Trauma Patients in the Emergency Department: Tae Youn Lim, Jung Youn Kim, Sung Hyuk Choi, Young Hoon Yoon; J Trauma Inj. 2017;30(1):1-5. Published online March 31, 2017; DOI: https://doi.org/10.20408/jti.2017.30.1.1

2,840 View
52 Download

Abstract PDF: PURPOSE
Nefopam is a centrally acting non-narcotic analgesic that has mostly been used for postoperative pain. We examined the efficacy of nefopam analgesia (alone and in combination with ketorolac) for trauma patients in the emergency department.
METHODS
We performed a retrospective chart review to select trauma patients who received nefopam at the emergency department of Korea University Medical Center Guro Hospital between January 2012 and December 2012. Patients younger than 15 years were excluded. The primary outcome measure was change of pain score (numeric rating scale) from baseline (before medication) to 30 min after medication. The secondary outcome measure was requirement for additional analgesia (pethidine).
RESULTS
Records of 1465 trauma patients who received analgesics in the emergency department from January 2012 to December 2012 were examined. Patients were classified into five groups according to initial analgesic: nefopam (n=112), ketorolac (n=867), pethidine (n=365), nefopam+ketorolac (92), and nefopam+pethidine (22). There were no significant differences in pain score reductions among the five groups. Twenty-two patients in the nefopam group, 141 in the ketorolac group, and 29 in the nefopam+ketorolac group required rescue analgesia with pethidine; these rates were not significantly different.
CONCLUSION
The efficacy of nefopam analgesia for trauma patients in the emergency department is comparable to that of more commonly used agents, including ketorolac and pethidine.; Summary

The Significance of Clinical Examination for Brain Lesion Differentiation of Patients with Head Trauma after Alcohol Intoxication: Yoon Hyun Jung, Dong Kil Jeong, Jung Won Lee, Hyung Jun Moon, Jae Hyung Choi, Jun Hwan Song; J Trauma Inj. 2016;29(4):99-104. Published online December 31, 2016; DOI: https://doi.org/10.20408/jti.2016.29.4.99

1,973 View
11 Download

Abstract PDF: PURPOSE
There are many patients visited to ED in an alcohol intoxicated state. For these patients, it is difficult to predict by only clinical examination whether he/she would have brain lesion. The purpose of this study is to research whether it is possible to predict brain lesion by only clinical examination findings, with comparing patients with/without actual brain lesions.
METHODS
A retrospective study was performed at a university hospital for the period 11 months with the medical records. As for the inclusion group, head trauma patients with objectively proved drunk, judging by their blood ethanol concentration, and performed the brain CT were selected. In terms of medical record, Glasgow coma scale (GCS), the presence of neurologic abnormalities, the presence of lesion on brain CT of the patients, were examined. From laboratory results, blood ethanol concentration, platelet count, prothrombin time (PT), activated partial thromboplastin time (aPTT) and glucose concentration were identified.
RESULTS
For this study, there were total 80 patients of inclusion group. There was no statistically significant difference in terms of GCS score and neurological examination abnormalities, between the group with brain lesion and the group without brain lesion on brain CT.
CONCLUSION
Alcohol intoxicated patient with head trauma visits the ED, it is not possible to distinguish or determine whether brain lesion exists or not by only clinical findings. In order to check the lesion existence, the image examination, therefore, should be considered and performed.; Summary

Concise Bedside Surgical Management of Profound Reperfusion Injury after Vascular Reconstruction in Severe Trauma Patient: Case Report: Hoe Jeong Chung, Seong yup Kim, Chun Sung Byun, Ki Youn Kwon, Pil Young Jung; J Trauma Inj. 2016;29(4):204-208. Published online December 31, 2016; DOI: https://doi.org/10.20408/jti.2016.29.4.204

2,611 View
27 Download

Abstract PDF: For an orthopaedic surgeon, the critical decisions to either amputate or salvage a limb with severe crushing injury with progressive ischemic change due to arterial rupture or occlusion can become a clinical dilemma at the Emergency Department (ED). And reperfusion injury is one of the fetal complications after vascular reconstruction. The authors present a case which was able to save patient's life by rapid vessel ligation at bedside to prevent severe reperfusion injury. A 43-year-old male patient with no pre-existing medical conditions was transported by helicopter to Level I trauma center from incident scene. Initial result of extended focused assessment with sonography for trauma (eFAST) was negative. The trauma series X-rays at the trauma bay of ED showed a multiple contiguous rib fractures with hemothorax and his pelvic radiograph revealed a complex pelvic trauma of an Anterior Posterior Compression (APC) Type II. Lower extremity computed tomography showed a discontinuity in common femoral artery at the fracture site and no distal run off. Surgical finding revealed a complete rupture of common femoral artery and vein around the fracture site. But due to the age aspect of the patient, the operating team decided a vascular repair rather than amputation even if the anticipated reperfusion time was 7 hours from the onset of trauma. Only two hours after the reperfusion, the patient was in a state of shock when his arterial blood gas analysis (ABGA) showed a drop of pH from 7.32 to 7.18. An imminent bedside procedure of aseptic opening the surgical site and clamping the anastomosis site was taken place rather than undergoing a surgery of amputation because of ultimately unstable vital sign. The authors would like to emphasize the importance of rapid decision making and prompt vessel ligation which supply blood flow to the ischemic limb to increase the survival rate in case of profound reperfusion injury.; Summary

Rectal Injury Associated with Pelvic Fracture: Jihun Gwak, Min A Lee, Byungchul Yu, Kang Kook Choi; J Trauma Inj. 2016;29(4):201-203. Published online December 31, 2016; DOI: https://doi.org/10.20408/jti.2016.29.4.201

4,326 View
61 Download
1 Citations

Abstract PDF

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.

Summary

Citations

Citations to this article as recorded by

Rectal Perforation Associated with a Pelvic Fracture Managed with Lateral Caudal Axial Pattern Flap Surgery Using the Tail to Skin Defect in a Mixed-Breed Dog
Jongjin Lee, Jinsu Kang, Namsoo Kim, Suyoung Heo
Journal of Veterinary Clinics.2021; 38(5): 240. CrossRef

Enteroatmospheric Fistula Associated with Open Abdomen: Jihun Gwak, Min A Lee, Dae Sung Ma, Kang Kook Choi; J Trauma Inj. 2016;29(4):195-200. Published online December 31, 2016; DOI: https://doi.org/10.20408/jti.2016.29.4.195

2,215 View
17 Download

Abstract PDF: 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.; Summary

Pseudo-renal Failure Caused by Urinary Bladder Rupture in Multiple Trauma Patient: Jihoon Jang, Kyoung Hoon Lim; J Trauma Inj. 2016;29(4):191-194. Published online December 31, 2016; DOI: https://doi.org/10.20408/jti.2016.29.4.191

2,464 View
21 Download

Abstract PDF: Pseudo-renal failure presents with renal failure characteristics, such as hypercreatininemia and hyperkalemia without a change in glomerular filtration rate or structure of the kidney. Pseudo-renal failure due to trauma is difficult to diagnose, because symptoms are non-specific and other factors may cause hypercreatininemia and hyperkalemia. In a trauma patient, especially one with pelvic injury, the abrupt elevation of potassium, blood urea nitrogen, and creatinine levels without previous medical history is a key feature in the diagnosis of urinary ascites. We report a case of pseudo-renal failure caused by intraperitoneal bladder rupture in a multiple trauma patient.; Summary

Forearm Replantation for a Patient Presented with Major Amputation Injury: A Case Report: Jihoon Jang, Kyoung Hoon Lim, Joon Woo Kim, Hyung Kee Kim; J Trauma Inj. 2016;29(4):187-190. Published online December 31, 2016; DOI: https://doi.org/10.20408/jti.2016.29.4.187

2,200 View
11 Download

Abstract PDF: With the development of safety measures for employees who work with dangerous machinery, the frequency of amputation injuries has been decreasing with resultant decrease in replantation procedures. However, in some patients with major amputation injury, replantation is still necessary for the preservation of limb and it's function. The replantation of the upper extremity (UE) is a complex and technically demanding surgical procedure. For the successful replantation of UE, the type of injury, reconstruction sequence, ischemic time, and other combined injury of patient should be considered. We report a case of major amputation of UE by guillotine-type injury and discuss the treatment process of this patient.; Summary

Article category