Pub Date : 2023-06-30DOI: 10.24184/tip.2023.8.1.11
Myung Yup Hyun, Dong Hun Kim, Yoonjung Heo
Laparoscopic exploration for blunt trauma is safe in patients with stable hemodynamics. However, proceeding with a laparoscopic procedure can be unsafe in some cases; thus, switching to laparotomy is necessary. Herein, we present a case of laparoscopy converted to a laparotomy due to a large amount of food-material spillage. This case demonstrates that prompt conversion to open surgery is another quality required for successful outcomes in trauma.
{"title":"Conversion or not: a challenging laparoscopic case of gastric rupture after a blunt trauma","authors":"Myung Yup Hyun, Dong Hun Kim, Yoonjung Heo","doi":"10.24184/tip.2023.8.1.11","DOIUrl":"https://doi.org/10.24184/tip.2023.8.1.11","url":null,"abstract":"Laparoscopic exploration for blunt trauma is safe in patients with stable hemodynamics. However, proceeding with a laparoscopic procedure can be unsafe in some cases; thus, switching to laparotomy is necessary. Herein, we present a case of laparoscopy converted to a laparotomy due to a large amount of food-material spillage. This case demonstrates that prompt conversion to open surgery is another quality required for successful outcomes in trauma.","PeriodicalId":224399,"journal":{"name":"Trauma Image and Procedure","volume":"438 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139366346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hancheol Jo, Seok Won Lee, In-Ho Jung, Dong Hun Kim
Fat embolism (FE) occurs frequently after trauma, particularly the fracture of long bones in the lower extremities. FE syndrome (FES) is defined as the clinical symptoms and signs of organ dysfunction caused by the obstruction of capillaries by fat emboli and inflammatory reaction. Cerebral involvement, respiratory insufficiency, and petechial rash constitute classical triad. Brain magnetic resonance imaging (MRI) is a sensitive imaging technique for diagnosing cerebral involvement and severity of damage in FES. This study presents a case of FES that was diagnosed based on typical manifestation on brain MRI and treated conservatively without complications.
{"title":"Fat embolism syndrome with a typical manifestation on brain magnetic resonance imaging: a case report","authors":"Hancheol Jo, Seok Won Lee, In-Ho Jung, Dong Hun Kim","doi":"10.24184/tip.2023.8.1.1","DOIUrl":"https://doi.org/10.24184/tip.2023.8.1.1","url":null,"abstract":"Fat embolism (FE) occurs frequently after trauma, particularly the fracture of long bones in the lower extremities. FE syndrome (FES) is defined as the clinical symptoms and signs of organ dysfunction caused by the obstruction of capillaries by fat emboli and inflammatory reaction. Cerebral involvement, respiratory insufficiency, and petechial rash constitute classical triad. Brain magnetic resonance imaging (MRI) is a sensitive imaging technique for diagnosing cerebral involvement and severity of damage in FES. This study presents a case of FES that was diagnosed based on typical manifestation on brain MRI and treated conservatively without complications.","PeriodicalId":224399,"journal":{"name":"Trauma Image and Procedure","volume":"118 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139367722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Visceral artery pseudoaneurysms after trauma are relatively rare but are associated with a high mortality rate in the case of rupture; thus, they are typically treated when identified. Traumatic pseudoaneurysms arising from the branches of the superior mesenteric artery are rarely described; however, they are clinically important lesions because of the risk of hemorrhage and bowel ischemia. Herein, we present a case of a visceral artery pseudoaneurysm identified approximately 2 months after abdominal blunt trauma.
{"title":"Visceral artery pseudoaneurysm after blunt trauma","authors":"Woosup Lee, Pil Young Jung","doi":"10.24184/tip.2023.8.1.4","DOIUrl":"https://doi.org/10.24184/tip.2023.8.1.4","url":null,"abstract":"Visceral artery pseudoaneurysms after trauma are relatively rare but are associated with a high mortality rate in the case of rupture; thus, they are typically treated when identified. Traumatic pseudoaneurysms arising from the branches of the superior mesenteric artery are rarely described; however, they are clinically important lesions because of the risk of hemorrhage and bowel ischemia. Herein, we present a case of a visceral artery pseudoaneurysm identified approximately 2 months after abdominal blunt trauma.","PeriodicalId":224399,"journal":{"name":"Trauma Image and Procedure","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139366937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tube thoracostomy is one of the essential skills for physicians. However, tube malposition is a common issue, and little is known about the reasons for malposition or the underlying mechanism. This report presents a case of tube malposition with an identifiable cause. A patient with traumatic cardiac arrest and severe chest injury was transported. Bilateral thoracostomy was performed because of tension pneumothorax, and 400 mL of blood was drained from the left tube. However, while securing the tube, it was pushed out by 3–4 cm before complete fixation. The tube was advanced back in further without retrying the tube placement. However, postmortem chest X-ray imaging revealed the malposition of the left tube. The only reason for malposition in this patient was the advancement of the pulled-out tube without replacement. To reduce the rate of tube malposition, it is necessary to reinsert the tube rather than advancing the pulled-out tube.
管道胸腔造口术是医生的基本技能之一。然而，插管错位是一个常见问题，人们对错位的原因或潜在机制知之甚少。本报告介绍了一例原因明确的插管错位病例。患者因创伤性心脏骤停和严重胸部损伤被送往医院。因张力性气胸而进行了双侧胸腔造口术，并从左侧插管中引流出 400 毫升血液。然而，在固定插管时，插管在完全固定前被推出了 3-4 厘米。在没有重新尝试插管的情况下，插管又被推了回去。然而，死后胸部 X 光成像显示左侧插管位置不正。该患者插管位置不正的唯一原因是将拔出的插管推进后没有更换。为了降低插管错位率，有必要重新插入插管，而不是推进拔出的插管。
{"title":"A possible cause of chest tube malposition","authors":"Hyung Il Kim","doi":"10.24184/tip.2023.8.1.8","DOIUrl":"https://doi.org/10.24184/tip.2023.8.1.8","url":null,"abstract":"Tube thoracostomy is one of the essential skills for physicians. However, tube malposition is a common issue, and little is known about the reasons for malposition or the underlying mechanism. This report presents a case of tube malposition with an identifiable cause. A patient with traumatic cardiac arrest and severe chest injury was transported. Bilateral thoracostomy was performed because of tension pneumothorax, and 400 mL of blood was drained from the left tube. However, while securing the tube, it was pushed out by 3–4 cm before complete fixation. The tube was advanced back in further without retrying the tube placement. However, postmortem chest X-ray imaging revealed the malposition of the left tube. The only reason for malposition in this patient was the advancement of the pulled-out tube without replacement. To reduce the rate of tube malposition, it is necessary to reinsert the tube rather than advancing the pulled-out tube.","PeriodicalId":224399,"journal":{"name":"Trauma Image and Procedure","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139366741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-30DOI: 10.24184/tip.2023.8.1.14
Kwang Hyun Kim, Sung Woo Jang, Pil Young Jung
Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by the production of autoantibodies that result in the inflammation of multiple organs. Herein, we present the case of a patient with SLE who experienced delayed perforation of the small bowel with necrotic changes following blunt trauma. Even though the initial radiological findings were negative, the delayed small bowel perforation could be diagnosed based on suspicion via history taking and subsequent physical examination.
{"title":"Delayed small bowel perforation caused by a necrotic change in a patient with systemic lupus erythematosus after blunt trauma","authors":"Kwang Hyun Kim, Sung Woo Jang, Pil Young Jung","doi":"10.24184/tip.2023.8.1.14","DOIUrl":"https://doi.org/10.24184/tip.2023.8.1.14","url":null,"abstract":"Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by the production of autoantibodies that result in the inflammation of multiple organs. Herein, we present the case of a patient with SLE who experienced delayed perforation of the small bowel with necrotic changes following blunt trauma. Even though the initial radiological findings were negative, the delayed small bowel perforation could be diagnosed based on suspicion via history taking and subsequent physical examination.","PeriodicalId":224399,"journal":{"name":"Trauma Image and Procedure","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139366959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Trauma patients have concentrated in trauma centers where they receive systematic treatment. The number of severe trauma patients has increased annually since the establishment of trauma centers in Korea in 2013. Injury appearance increased with the proportion of compound injuries instead of single injuries (81.1% versus 18.9%) and the emergency room mortality and post-admission mortality are 4.7% and 13.2% respectively (1). The trauma system in Korea has greatly developed for many years with the close cooperation between the government and trauma centers. Trauma doctors’ knowledge about trauma and management procedures has also been greatly developed at the same time. Also recently the procedures performed in trauma resuscitation rooms have gradually changed to endovascular procedures. In particular, resuscitative endovascular balloon occlusion of the aorta (REBOA) is more popular than in the past in order to treat patients with traumatic hemorrhage. Therefore, some trauma centers require patients to obtain the femoral artery and venous route simultaneously on arrival, before vascular collapse occurs, and implement REBOA immediately when REBOA is needed. Some authors also carefully suggest that on the primary survey basis of advanced trauma life support (ATLS), ABCDE (airway, breathing, circulation, disability, environment, and exposure) should be added to provide early vascular guarantee for endovascular procedure and resuscitation, so as to produce the concept of AABCDE (airway and early vascular access, breathing, circulation, disability, environment, and exposure) (2). Another problem as important as securing blood vessels is securing difficult airways. Video laryngoscope’s popularity does not damage the glottis for patients with difficult airway, does not force tracheal intubation, reduces complications, and saves time (3). However, it seems that not all doctors working in emergency rooms and intensive care units are doing these procedures freely and/or have the correct anatomical blood vessel and trachea knowledge (4). It is believed that this is due to the lack of a systematic education and undefined operation methods in various clinical departments. The rapid acquisition of airway and blood vessels is directly related to the life safety of patients, especially in the field of trauma, which can be overcome by repeated and systematic management education. Therefore, this TIP (Trauma Image and Procedure) systematically collates and publishes the common central venous and arterial blood vessel accesses and difficult airway
{"title":"A thousand miles starts with a single step: vascular accesses and difficult intubation in the trauma and intensive care areas","authors":"Y. Jeon","doi":"10.24184/tip.2022.7.1.1","DOIUrl":"https://doi.org/10.24184/tip.2022.7.1.1","url":null,"abstract":"Trauma patients have concentrated in trauma centers where they receive systematic treatment. The number of severe trauma patients has increased annually since the establishment of trauma centers in Korea in 2013. Injury appearance increased with the proportion of compound injuries instead of single injuries (81.1% versus 18.9%) and the emergency room mortality and post-admission mortality are 4.7% and 13.2% respectively (1). The trauma system in Korea has greatly developed for many years with the close cooperation between the government and trauma centers. Trauma doctors’ knowledge about trauma and management procedures has also been greatly developed at the same time. Also recently the procedures performed in trauma resuscitation rooms have gradually changed to endovascular procedures. In particular, resuscitative endovascular balloon occlusion of the aorta (REBOA) is more popular than in the past in order to treat patients with traumatic hemorrhage. Therefore, some trauma centers require patients to obtain the femoral artery and venous route simultaneously on arrival, before vascular collapse occurs, and implement REBOA immediately when REBOA is needed. Some authors also carefully suggest that on the primary survey basis of advanced trauma life support (ATLS), ABCDE (airway, breathing, circulation, disability, environment, and exposure) should be added to provide early vascular guarantee for endovascular procedure and resuscitation, so as to produce the concept of AABCDE (airway and early vascular access, breathing, circulation, disability, environment, and exposure) (2). Another problem as important as securing blood vessels is securing difficult airways. Video laryngoscope’s popularity does not damage the glottis for patients with difficult airway, does not force tracheal intubation, reduces complications, and saves time (3). However, it seems that not all doctors working in emergency rooms and intensive care units are doing these procedures freely and/or have the correct anatomical blood vessel and trachea knowledge (4). It is believed that this is due to the lack of a systematic education and undefined operation methods in various clinical departments. The rapid acquisition of airway and blood vessels is directly related to the life safety of patients, especially in the field of trauma, which can be overcome by repeated and systematic management education. Therefore, this TIP (Trauma Image and Procedure) systematically collates and publishes the common central venous and arterial blood vessel accesses and difficult airway","PeriodicalId":224399,"journal":{"name":"Trauma Image and Procedure","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129251719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Central venous catheterization (CVC) is very common procedure in the emergency department and intensive care unit. Although patients undergoing CVC may have various indications and contraindications for this catheterization, the procedure is typically similar, regardless of the route. However, site-specific precautions also exist. This report describes the overall procedure for CVC with access by the internal jugular vein. Neurologic complications such as stroke and cranial air embolism, as well as mechanical complications such as hemopneumothorax and hematoma, can occur related to the internal jugular venous approach to CVC. Clinicians should be aware of these concerns for these patients population.
{"title":"Internal jugular central venous catheterization: a focus on the procedure","authors":"Hyung Il Kim","doi":"10.24184/tip.2022.7.1.8","DOIUrl":"https://doi.org/10.24184/tip.2022.7.1.8","url":null,"abstract":"Central venous catheterization (CVC) is very common procedure in the emergency department and intensive care unit. Although patients undergoing CVC may have various indications and contraindications for this catheterization, the procedure is typically similar, regardless of the route. However, site-specific precautions also exist. This report describes the overall procedure for CVC with access by the internal jugular vein. Neurologic complications such as stroke and cranial air embolism, as well as mechanical complications such as hemopneumothorax and hematoma, can occur related to the internal jugular venous approach to CVC. Clinicians should be aware of these concerns for these patients population.","PeriodicalId":224399,"journal":{"name":"Trauma Image and Procedure","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130847493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-30DOI: 10.24184/tip.2022.7.1.15
J. Cho
Central venous catheterization is a typical technique performed in the emergency department and intensive care unit. Most subclavian vein access may be inserted without help, using anatomic landmarks alone. This study aimed to present the precise procedure of central venous catheterization via the subclavian vein and endovascular techniques using a simulation video clip.
{"title":"Subclavian venous catheterization: focused on the procedure","authors":"J. Cho","doi":"10.24184/tip.2022.7.1.15","DOIUrl":"https://doi.org/10.24184/tip.2022.7.1.15","url":null,"abstract":"Central venous catheterization is a typical technique performed in the emergency department and intensive care unit. Most subclavian vein access may be inserted without help, using anatomic landmarks alone. This study aimed to present the precise procedure of central venous catheterization via the subclavian vein and endovascular techniques using a simulation video clip.","PeriodicalId":224399,"journal":{"name":"Trauma Image and Procedure","volume":"501 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116198065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-30DOI: 10.24184/tip.2022.7.1.18
S. Chang
A central venous catheter (CVC) is usually placed to replace the spilled blood volume or inject a vasopressor. Among central catheterizations, the anatomy of the femoral vessel is lesser complex than that of others, and femoral venous catheterization is most easily cannulated percutaneously. However, endovascular training should be considered to complete the deployment of the central catheter and prevent complications systematically. Therefore, this study aimed to share the precise CVC procedure in the femoral vein and to impart endovascular techniques through simulation video clips and pictures.
{"title":"Central venous catheterization into the femoral vein","authors":"S. Chang","doi":"10.24184/tip.2022.7.1.18","DOIUrl":"https://doi.org/10.24184/tip.2022.7.1.18","url":null,"abstract":"A central venous catheter (CVC) is usually placed to replace the spilled blood volume or inject a vasopressor. Among central catheterizations, the anatomy of the femoral vessel is lesser complex than that of others, and femoral venous catheterization is most easily cannulated percutaneously. However, endovascular training should be considered to complete the deployment of the central catheter and prevent complications systematically. Therefore, this study aimed to share the precise CVC procedure in the femoral vein and to impart endovascular techniques through simulation video clips and pictures.","PeriodicalId":224399,"journal":{"name":"Trauma Image and Procedure","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114967733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Central venous catheterization (CVC) is frequently performed in critical care medicine. However, there is a lack of standardized CVC training. The Airway & Catheter Cannulation Education–from Starters to Specialists (ACCESS) course was developed for a systematic airway and catheterization management. A stepwise A to Z approach for safe and successful CVC is the focus of the current review, while providing a guideline for the ACCESS course. In addition, special care for CVC in trauma patients is discussed.
{"title":"A stepwise “A to Z” central venous catheterization approach: a brief review","authors":"Yoonjung Heo","doi":"10.24184/tip.2022.7.1.3","DOIUrl":"https://doi.org/10.24184/tip.2022.7.1.3","url":null,"abstract":"Central venous catheterization (CVC) is frequently performed in critical care medicine. However, there is a lack of standardized CVC training. The Airway & Catheter Cannulation Education–from Starters to Specialists (ACCESS) course was developed for a systematic airway and catheterization management. A stepwise A to Z approach for safe and successful CVC is the focus of the current review, while providing a guideline for the ACCESS course. In addition, special care for CVC in trauma patients is discussed.","PeriodicalId":224399,"journal":{"name":"Trauma Image and Procedure","volume":"54 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117039474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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