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Case Report
- Preperitoneal pelvic packing as a salvage operation for postoperative retroperitoneal bleeding with hemodynamic instability after the Kocher-Langenbeck approach to the acetabulum: a case report
- Doo-Hun Kim, Maru Kim, Dae-Sang Lee, Tae Hwa Hong, Hangjoo Cho
- J Trauma Inj. 2025;38(3):285-289. Published online June 25, 2025
- DOI: https://doi.org/10.20408/jti.2024.0087
- 4,275 View
- 59 Download
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Abstract
PDF - Pelvic fractures result from high-energy trauma, and when accompanied by hemorrhagic shock, the mortality rate increases to 40%. Pelvic fractures are anatomically categorized as pelvic ring disruptions and acetabular fractures, each requiring different treatment methods and approaches. Acetabular fractures, which also result from high-energy injuries, may be accompanied by hemorrhagic shock. Treatment options for pelvic fractures with hemorrhagic shock include angioembolization, preperitoneal pelvic packing (PPP), and emergency laparotomy. In hemodynamically stable patients, early total care may be attempted, and for acetabular fractures (posterior column), the Kocher-Langenbeck approach is the treatment of choice. This case report describes the use of PPP as a salvage operation for postoperative retroperitoneal bleeding with hemodynamic instability following a Kocher-Langenbeck approach for an acetabular fracture with pelvic ring injury. The patient was discharged without postoperative complications such as bone displacement or surgical site infection. While PPP is commonly employed as an initial treatment modality for pelvic fractures with hemorrhagic shock, it may also be valuable in managing postoperative retroperitoneal bleeding with hemorrhagic shock.
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SummaryOriginal Article
- Vulnerability of the border area: analysis of the Traffic Accident Analysis System in Korea
- Doo-Hun Kim, Hangjoo Cho, Sung Yub Jeong, Maru Kim
- J Trauma Inj. 2025;38(2):91-96. Published online June 19, 2025
- DOI: https://doi.org/10.20408/jti.2024.0100
- 3,368 View
- 58 Download
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Abstract
PDF
- Purpose
This study assessed patient vulnerability following traffic accidents (TAs) in Korea’s border area (BA).
Methods
The BA includes cities and counties directly adjacent to the demilitarized zone with North Korea. The rear area (RA) is defined as the area immediately adjacent to the BA. TA data from 2017 to 2021 were obtained from the Traffic Accident Analysis System in Korea. Information on road length, population, number of TAs, injured patients, and fatalities was collected. The number of TAs and fatalities per 1 km of road length and per 100,000 people was calculated. Severity (number of fatalities per 100 TA cases) and lethality (number of fatalities divided by the sum of fatalities and injured patients) were used to assess the vulnerability of each area.
Results
A total of 55,463 TAs were analyzed. Although the RA exhibited higher numbers of TAs and deceased patients per 1 km of road length and per 100,000 people, the BA showed significantly higher fatalities per 100,000 people as well as increased severity and lethality.
Conclusions
The BA is more likely to be associated with death following TAs, despite a lower overall TA incidence compared to the RA. Further analysis is needed to address and mitigate this vulnerability. -
SummaryCase Report
- Bleeding control of an injury to the infrarenal inferior vena cava and right external iliac vein by ipsilateral internal iliac artery and superficial femoral vein ligation after blunt abdominal trauma in Korea: a case report
- Hoonsung Park, Maru Kim, Dae Sang Lee, Tae Hwa Hong, Doo-Hun Kim, Hang joo Cho
- J Trauma Inj. 2023;36(4):441-446. Published online November 17, 2023
- DOI: https://doi.org/10.20408/jti.2023.0019
- 5,137 View
- 52 Download
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Abstract
PDF
- Inferior vena cava (IVC) injuries, while accounting for fewer than 0.5% of blunt abdominal trauma cases, are among the most difficult to manage. Despite advancements in prehospital care, transportation, operative techniques, and perioperative management, the mortality rate for IVC injuries has remained at 20% to 66% for several decades. Furthermore, 30% to 50% of patients with IVC injuries succumb during the prehospital phase. A 65-year-old male patient, who had been struck in the back by a 500-kg excavator shovel at a construction site, was transported to a regional trauma center. Injuries to the right side of the infrarenal IVC and the right external iliac vein (EIV) were suspected, along with fractures to the right iliac bone and sacrum. The injury to the right side of the infrarenal IVC wall was repaired, and the right internal iliac artery was ligated. However, persistent bleeding around the right EIV was observed, and we were unable to achieve proximal and distal control of the right EIV. Attempts at prolonged manual compression were unsuccessful. To decrease venous return, we ligated the right superficial femoral vein. This reduced the amount of bleeding, enabling us to secure the surgical field. We ultimately controlled the bleeding, and approximately 5 L of blood products were infused intraoperatively. A second-look operation was performed 2 days later, by which time most of the bleeding sites had ceased. Orthopedic surgeons then took over the operation, performing closed reduction and external fixation. Five days later, the patient underwent definitive fixation and was transferred for rehabilitation on postoperative day 22.
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