Journal of Trauma and Injury

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

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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.

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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

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

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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.

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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

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

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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

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

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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

Long-term Fistula Formation Due to Retained Bullet in Lumbar Spine after Gunshot Injury: Se Il Jeon, Soo Bin Im, Je Hoon Jeong, Jang Gyu Cha; J Trauma Inj. 2017;30(2):51-54. Published online June 30, 2017; DOI: https://doi.org/10.20408/jti.2017.30.2.51

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Abstract PDF: We here report a case of long-term fistula formation due to bullet retention for 30 years in the lumbar spine after a gunshot injury, and describe its treatment. A 62-year-old male visited our hospital due to pus-like discharge from his left flank. The discharge had been present for 30 years, since his recovery from an abdominal gunshot injury. A spine radiography showed radiopaque material in the body of the third lumbar vertebra. Foreign body was removed using an anterolateral retroperitoneal approach. The postoperative course was uneventful. The patient was discharged 7 days after the operation and was followed-up for 8 months, during which time, the fistula did not reoccur. A bullet retained long term in the vertebral body may cause obstinate osteomyelitis and fistula formation. A fistula caused by a foreign body in the spine can be effectively treated by surgical removal.; Summary

Management of Perirectal Laceration without Fecal Diversion: A Case Report: Dae Hyun Cho, Seung Hwan Lee, Myung Jae Jung, Jae Gil Lee; J Trauma Inj. 2017;30(2):55-58. Published online June 30, 2017; DOI: https://doi.org/10.20408/jti.2017.30.2.55

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Abstract PDF: Clinical research on multiple lacerations of perineum or buttock is sparse and rare so limited to case reports. But a missed rectal injury combined bladder or vessel can have devastating consequence. Although it is generally known that it should be treated accompanying with diverting ileostomy or colostomy, the aim of this case is announce the possibility of management of perectal injury without diversion.; Summary

The Management of Lupus Thrombocytopenia in Poly Trauma Patient: Jin Bong Ye, Young Hoon Sul, Seung Je Go, Jung Hee Choi, Joong Suck Kim; J Trauma Inj. 2017;30(2):59-62. Published online June 30, 2017; DOI: https://doi.org/10.20408/jti.2017.30.2.59

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Abstract PDF: Lupus thrombocytopenia is a common clinical manifestation in systemic lupus erythematosus (SLE). It may present to clinicians with considerable therapeutic difficulties. We experienced a 40-year-old poly trauma patient with lupus thrombocytopenia who had been treated with immunosuppressive drugs for SLE. She was treated for refractory thrombocytopenia with platelet transfusion, corticosteroid and Intravenous immunoglobulin (IVIG). Fourteen days after admission, her platelet count started to increase, 101×103/ul at 16 days after admission. Trauma patients may carry various underlying diseases and thus trauma surgeons should always be aware and ready for peculiar situations.; Summary

Thoracoscopic Resection of the First Rib for Thoracic Outlet Syndrome: A Case Report: Jae Gul Kang, Soon Ho Chon, Kilsoo Yie, Min Koo Lee, Oh Sang Kwon, Song Hyun Lee, June Raphael Chon; J Trauma Inj. 2017;30(2):63-65. Published online June 30, 2017; DOI: https://doi.org/10.20408/jti.2017.30.2.63

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Abstract PDF: Standard open procedures for resection of the first rib in thoracic outlet syndrome can prove to be quite difficult with extensive incisions. A minimal invasive procedure can also be painstaking, but provides an attractive alternative to the more radical open procedures. We report the details of the technique with direct video footage of the procedure performed in a 41-year-old man with thoracic outlet syndrome done entirely by thoracoscopic methods.; Summary

Bilateral Oculomotor Nerve Palsy after Head Trauma: A Case Report: Hae Won Noh, Jae Young Song, Jong Hyun Kim, Jang Hun Kim; J Trauma Inj. 2017;30(2):66-69. Published online June 30, 2017; DOI: https://doi.org/10.20408/jti.2017.30.2.66

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Abstract PDF: We introduce a patient who was suffered from isolated traumatic bilateral oculomotor nerve palsy after head trauma. The patient presented with bilateral ptosis and abnormal pupilary responses with slightly drowsy mentality at first. Performed images demonstrated some hematomas along subarachnoid, intraventricular, subdural spaces and multiple small supratentorial contusions. There was no bony abnormality or ligament injury. We assumed that small amount of interpeduncular hematoma might be the proper lesion associated with oculomotor nerve palsies, since the clinical symptom and signs presented bilaterally and the oculomotor neural fascicles run through the interpeduncular fossa.; Summary

Traumatic Abdominal Wall Hernia: A Case Report: Youngro Yang, Kwangsig Kim; J Trauma Inj. 2017;30(2):70-73. Published online June 30, 2017; DOI: https://doi.org/10.20408/jti.2017.30.2.70

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Traumatic abdominal wall hernia is a rare condition that can follow any blunt trauma to the abdomen. Generally there has been an increase in the incidence of blunt abdominal trauma, although the case of traumatic abdominal wall hernias are rare. Probably due to the elasticity of the abdominal wall for resisting the shear forces generated by a traumatic impacts. In this case, we are reporting 1 rare case, diagnosed as an abdominal wall hernia associated with herniation of bowel loops due to blunt trauma without intra-abdominal injury including peritoneum.

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Traumatic abdominal wall hernia: a rare and often missed diagnosis in blunt trauma
Sohil Pothiawala, Sunder Balasubramaniam, Mujeeb Taib, Savitha Bhagvan
World Journal of Emergency Medicine.2022; 13(6): 492. CrossRef

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