- Left Common Iliac Artery Rupture due to Hidden Blunt Trauma (Suspected Dildo-Masturbation Injury via Endovagina): A Case Report
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Kyu Hyouck Kyoung, Mi Jin Kim, Byung Ho Choi, Jung Seok Hong, Eun Seog Hong
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J Trauma Inj. 2014;27(4):211-214.
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 Abstract
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- A 34-year-old woman experienced a sudden cardiac arrest after complaining of abdominal pain. The cause of that serious event was a hidden hemorrhagic shock. On computed tomography of her pelvic area, we found that her left common iliac artery had been ruptured. No bone fractures were observed. Her angiography showed neither atherosclerosis nor an aneurysm of the artery. Because spontaneous ruptures of the common iliac artery are rare, we suspected, based on her husband's statement, that a hidden blunt trauma to the artery had occurred via an endo-vaginal route due to dildo masturbation. Unfortunately, she died without recovery, in spite of our having controlled the bleeding by using an angiographic endovascular stent-graft.
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Summary
- Traumatic Asphyxia due to Blunt Chest Trauma with External Auditory Canal Bleeding
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Je Ho Lee, Kyu Hyouck Kyoung, Jeong Won Kim, Hui Jun Yang, Eun Seog Hong
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J Trauma Inj. 2013;26(4):297-299.
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- Traumatic asphyxia, also called 'Perthes syndrome', is characterized by subconjunctival hemorrhage, cervicofacialpetechiae and cyanosis resulting from venous hypertension caused by an abrupt, severe, compressive force to the thoracoabdominal region. A 37-year-old male patient who was transferred to the emergency room due to chest trauma by overturning of a forkcrane. His head, neck, and shoulders showed severe ecchymosis, and his upper chest was cyanotic. There was bilateral subconjunctival hemorrhage and bilateral ear bleeding without tympanic rupture. Perthes syndrome is a rare condition and we treated a patient with typical and atypical symptoms; thus we report this case of Perthes syndrome.
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Summary
- Clinical Characteristics of Unstable Pelvic Bone Fractures Associated with Intra-abdominal Solid Organ Injury
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Sang Won Lee, Sun Hyu Kim, Eun Seog Hong, Ryeok Ahn
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J Korean Soc Traumatol. 2012;25(1):1-6.
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Abstract
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- PURPOSE
This study analyzed the characteristics of unstable pelvic bone fractures associated with intraabdominal solid organ injury.
METHODS
Medical records were retrospectively collected from January 2000 to December 2010 for patients with unstable pelvic bone fractures. Unstable pelvic bone fracture was defined as lateral compression types II and III, antero-posterior compression types II and III, vertical shear and combined type by young classification. Subjects were divided into two groups, with (injured group) and without (non-injured group) intra-abdominal solid organ injury, to evaluate whether the characteristics of the fractured depended on the presence of associated solid organ injury. Data included demographics, mechanism of injury, initial hemodynamic status, laboratory results, revised trauma score (RTS), abbreviated injury scale (AIS), injury severity score (ISS), amount of transfusion, admission to the intensive care unit (ICU), and mortality.
RESULTS
The subjects were 217 patients with a mean age of 44 years and included 134 male patients(61.8%). The injured group included 38 patients(16.9%). Traffic accidents were the most common mechanism of injury, and lateral compression was the most common type of fracture in all groups. The initial blood pressure was lower in the injured group, and the ISS was greater. The arterial pH was lower in the injured group, and shock within 24 hours after arrival at the emergency department was more frequent in the injured group. The amount of the transfused packed red blood cells within 24 hours was higher in the injured group than the non-injured group. Invasive treatment, including surgery and angiographic embolization, was more common in the injured group, and the stay in the ICU was longer in the injured group.
CONCLUSION
A need exists to decide on a diagnostic and therapeutic plan regarding the possibility of intraabdominal solid organ injury for hemodynamically unstable patients with unstable pelvic bone fractures and multiple associated injuries.
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Summary
- Characteristics of Stable Pelvic Bone Fractures with Intra-abdominal Solid Organ Injury
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Sang June Park, Sun Hyu Kim, Jong Hwa Lee, Ryeok Ahn, Eun Seog Hong
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J Korean Soc Traumatol. 2010;23(2):57-62.
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Abstract
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- PURPOSE
This study analyzed the characteristics of stable pelvic bone fractures with intra-abdominal solid organ injury.
METHODS
Medical records were retrospectively reviewed from January 2000 to December 2009 of patients with stable pelvic bone fractures. A stable pelvic bone fracture according to Young's classification is defined as a lateral compression type I and antero-posterior compression type I. Subjects were divided into two groups, one with (injured group) and one without (non-injured group) intra-abdominal solid organ injury, to evaluate the dependences of the characteristics on the presence of an intra-abdominal solid organ injury. Data including demographics, mechanism of injury, initial hemodynamic status, laboratory results, Revised Trauma Score (RTS), Abbreviated Injury Scale (AIS), Injury Severity Score (ISS), amount of transfusion, admission to intensive care unit (ICU), and mortality were analyzed.
RESULTS
The subjects were 128 patients with a mean age of 42 years old, of whom were 67 male patients (52.3%). The injured group had 21 patients(16.4%), and the most frequent injured solid organ was the liver. Traffic accident was the most common mechanism of injury and lateral compression was the most common type of fracture in all groups. Initial systolic blood pressure was lower in the injured group, and the ISS was greater in the injured group. Arterial pH was lower in the injured group, and shock within 24 hours after arrival at the emergency department was more frequent in the injured group. Transfused packed red blood cells within 24 hours were 8 patients(38.1%) in the injured group and 11 patients(10.3%) in the non-injured group. Conservative treatment was the most common therapeutic modality in all groups. Stay in the ICU was longer in the injured group, and three mortalities occurred.
CONCLUSION
There is a need to decide on a diagnostic and therapeutic plan regarding the possibility of intra-abdominal solid organ injury for hemodynamically unstable patients with stable pelvic bone fractures and for patients with stable pelvic bone fractures along with multiple associated injuries.
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Summary
- Comparison of Intraperitoneal and Retroperitoneal/Pelvic Contrast Extravasation: The Characteristics and Prognosis of the Each Patient Group with Arterial Embolization according to the Abdominal Computed Tomography Scanning after Blunt Trauma
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Ji Young Yoon, Sun Hyu Kim, Ryeok Ahn, Jae Cheol Hwang, Eun Seog Hong
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J Korean Soc Traumatol. 2009;22(2):199-205.
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Abstract
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- PURPOSE
This study compared the characteristics of and the prognosis for intraperitoneal and retroperitoneal/pelvic contrast extravasation, which had been confirmed by enhanced abdominal CT scan, after blunt trauma in patients who had undergone angiographic embolization.
METHODS
From January 2001 to March 2009, data were retrospectively collected regarding patients who had undergone contrast extravasation (CE) on CT scanning and arterial embolization after blunt trauma. The study patient group was divided into the intraperitoneal and the retroperitoneal/pelvic groups according to the area of contrast extravasation. We reviewed the initial demographic data, the location of injury, the solid organ injury, the embolized vessel, and the clinical outcome.
RESULTS
The mean age of the study subjects was 40.2+/-2.6 years old, and there were 24 male patients. The intraperitoneal group included 10 patients, and retroperitoneal/pelvic group was comprised of 17 patients. The amount of transfusion from presentation to intervention and during the first 24 hours was greater in the retroperitoneal/pelvic group than in the intraperitoneal group. The intraperitoneal group showed a higher frequency and severity of liver injury than the retroperitoneal/pelvic group. Angiography revealed that the hepatic artery (n=4) was the most frequently embolized vessel in the intraperitoneal group, while the internal iliac artery (n=6), followed by the renal artery (n=4), internal pudendal artery (n=3), and the gluteal artery (n=2), were the most frequently injured vessels in the retroperitoneal/pelvic group.
CONCLUSION
In patients with intra-abdominal contrast extravasation found on CT scanning and arterial embolization after blunt trauma, the need for transfusion was less in the intra-abdominal group than in the retroperitoneal/pelvic group. Liver injury was also more frequent and severe in the intraperitoneal group than in the retroperitoneal/pelvic group.
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Summary
- Multiple Intraabdominal Solid Organ Injuries after Blunt Trauma
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Hyung Do Park, Sun Hyu Kim, Jong Hwa Lee, Jung Seok Hong, Eun Seog Hong
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J Korean Soc Traumatol. 2009;22(2):193-198.
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Abstract
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- PURPOSE
This study evaluated the characteristics and the prognosis of multiple intraabdominal solid organ injuries, including those to the liver, spleen, and kidney, after blunt trauma.
METHODS
From January 2001 to March 2009, 39 patients with multiple intraabdominal solid organ injuries, which had been confirmed by contrast-enhanced computed tomography after blunt trauma, were included in this retrospective study. The injury severity score (ISS), abbreviated injury scale (AIS), revised trauma score (RTS), American Association for the Surgery of Trauma (AAST) injury grade of solid organs, initial hemodynamic status, blood gas analysis, blood transfusion, and the mortality were the main outcome measurements.
RESULTS
Injured groups were classified into liver/kidney (n=17), liver/spleen (n=4), spleen/kidney (n=13), and liver/kidney/spleen (n=5) groups. Patients were older in the liver/kidney group than in the liver/kidney/spleen group (43 vs 18 years, p=0.023). The initial systolic blood pressures tended to be lower in the liver/kidney group than in the other groups (84 vs 105, 112, and 114 mmHg, p=0.087). The amounts of 24-hour packed RBC transfusion were 32 units in the liver/kidney group and 4 units in the liver/kidney/spleen group, but the difference was not statistically significant. Differences were found in neither the RTS, ISS, and AIS for head, chest, abdominal, and pelvic injuries nor the AAST injury grade for solid organ, but injuries to the chest were more severe in the liver/spleen group than in the spleen/kidney group (AIS 4.0 vs 2.8, p=0.028). Conservative treatment was the most frequent applied treatment in all groups. There were 6 mortalities : 3 due to hypovolemia, 2 to sepsis, and 1 to brain injury. Mortalities occurred only in the liver/kidney group.
CONCLUSION
Patients who had intraabdominal solid organ injuries of the liver and the kidney simultaneously, tended to be transfused more at an early time after trauma, to have lower initial systolic blood pressures, and to have a higher mortality.
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