- Extensive Blunt Hepatic Injury due to Cross-over Traffic Accident: A Case Report of Conservative Management
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In Seok Jang, Sung Hwan Kim, Jung Eun Lee, Jong Woo Kim, Jun Young Choi, Il Woo Shin, Hyun Ok Kim
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J Trauma Inj. 2014;27(3):84-88.
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 Abstract
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- The severity of blunt hepatic injury correlates with internal organ damage. We experienced a patient, who had an extensive crushed liver injury. The patient was a 28-year-old man, who was involved in a traffic accident in which a wheel ran over his right upper abdomen. A grade V severe hepatic laceration was diagnosed with computed tomography. His vital signs were stable, so we could wait for times with conservative management. Bile leakage led to biloma and bile spillage into the peritoneal space. Selective percutaneous drainage was needed to control the several biloma. After four months of conservative management, could the patient was discharged in good condition.
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Summary
- Treatment of Combat-related Gunshot and Explosive Injuries to the Extremities
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Jung Eun Lee, Young Ho Lee, Goo Hyun Baek, Kyung Hag Lee, Young Jae Cho, Yeong Cheol Kim, Gil Joon Suh
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J Trauma Inj. 2013;26(3):111-124.
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Abstract
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We should prepare proper medical service for disaster control as South Korea is not free from terrorism and war, as we experienced through the two naval battles of the Yeonpyeong, one in 1999 and the other in 2002, the sinking of Cheonan in 2010, and the attack against the border island of Yeonpyeong in 2010. Moreover, North Korea's increasingly bellicose rhetoric and mounting military threats against the world demand instant action to address the issue. The aim of this article is to describe our experience with three patients with combat-related gunshot and explosive injuries to their extremities and to establish useful methods for the management of patients with combat-related injuries.
METHODS
Three personnel who had been injured by gunshot or explosion during either the second naval battle of the Yeonpyeong in 2002 or the attack against the border island of Yeonpyeong in 2010 were included in our retrospective analysis. There were one case of gunshot injury and two cases of explosive injuries to the extremities, and the injured regions were the left hand, the right foot, and the right humerus. In one case, the patient had accompanying abdominal injuries, and his vital signs were unstable. He recovered after early initial management and appropriate emergency surgery.
RESULTS
All patients underwent emergent surgical debridement and temporary fixation surgery in the same military hospital immediately after their evacuations from the combat area. After that, continuous administration of antibiotics and wound care were performed, and definite reconstructions were carried out in a delayed manner. In the two cases in which flap operations for soft tissue coverage were required, one operation was performed 5 weeks after the injury, and the other operation was performed 7 weeks after the injury. Definite procedures for osteosynthesis were performed at 3 months in all cases. Complete union and adequate functional recovery were achieved in all cases.
CONCLUSION
The patient should be stabilized and any life-threatening injuries must first be evaluated and treated with damage control surgery. Staged treatment and strict adherence to traditional principles for open fractures are recommended for combat-related gunshot and explosive injuries to the extremities.
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Summary
- The Adequacy of a Cross Table Lateral Cervical X-ray in Severely Traumatized Korean Patients
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Kyung Hag Lee, Yeong Cheol Kim, Seok Ho Choi, Gook Nam Han, Soo Un Lee, Jung Eun Lee, Gil Joon Suh, Yeo Kyu Yoon
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J Trauma Inj. 2012;25(4):241-246.
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Abstract
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- PURPOSE
The objective of this study was to investigate the appropriateness of the cross table lateral cervical X-ray used in the emergency department for severely traumatized Korean patients.
METHODS
Patients visiting our institution from May 2011 to May 2012, who had injury severity score (ISS) > 15 and who received a cervical X-ray in the emergency department, were included in this study. Data including demographics, ISS score, GCS score, and place where the x-ray was taken were collected to evaluate their relationship with appropriate coverage of the cervical X-ray. The appropriateness of a cervical cross lateral view X-ray was evaluated using exposure of the basion, and the opisthion, as well as the distal level of exposure.
RESULTS
Fifty-two patients were included in this study. The identification rate of the basion was 79.2%, and the identification rate of the opisthion was 88.7%. Complete exposure of C7/T1 was accomplished in 3.8% of the patients. The ISS was higher for X-ray taken in the trauma bay, but the range of exposure showed no difference between the places where the X-rays taken. Patients who had exposure of C 5/6 or more had lower body weight and body mass index (BMI) compared with unexposed patients.
CONCLUSION
In severely traumatized Korean patients, the adequacy of the cross table lateral cervical X-ray was inappropriate in most cases. No difference was observed in the exposure range between the places where the X-rays were taken, and patients with less exposure showed higher body weight and higher BMI.
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