Ho Hyoung Lee, Sung Ho Han, S. Yang, Keung Han Kim, Jung Suk Kim, Min Koo Lee, O. Kwon
A 65-year-old female underwent passenger traffic accident. She was putting a seat belt. She arrived at authors` emergency department via ground ambulance from other hospital. The patient complained of generalized abdominal pain, and her initial vital signs were blood pressure 101/51 mmHg, heart rate 85, respiratory rate 20, body temperature 36.8°C and sPO2 97%. A seat-belt sign was seen from her anterior chest wall to lower right abdominal wall. We detected free air and fluid collection in her abdominal cavity of computed tomography scan which was performed at the previous hospital (Fig. 3.). An emergency laparotomy was performed. About 1 L of fresh blood was collected in the abdominal cavity and a moderate amount of bowel spillage was detected. Multiple mesenteric lacerations were identified 190cm distal area from Treitz ligament and 5cm above from IC valve. Omental tearing was also identified. Cecal perforation was noted on the countermesenteric area. We decided one-stage operation. After adequate hemostasis, the omental and mesenteric tearing were repaired primarily. A partial cecaectomy was performed using stapler on the perforation of the cecum (Fig. 2.). The patient was discharged uneventfully.
{"title":"A Cecal Perforation in a Blunt Trauma","authors":"Ho Hyoung Lee, Sung Ho Han, S. Yang, Keung Han Kim, Jung Suk Kim, Min Koo Lee, O. Kwon","doi":"10.24184/TIP.2018.3.1.1","DOIUrl":"https://doi.org/10.24184/TIP.2018.3.1.1","url":null,"abstract":"A 65-year-old female underwent passenger traffic accident. She was putting a seat belt. She arrived at authors` emergency department via ground ambulance from other hospital. The patient complained of generalized abdominal pain, and her initial vital signs were blood pressure 101/51 mmHg, heart rate 85, respiratory rate 20, body temperature 36.8°C and sPO2 97%. A seat-belt sign was seen from her anterior chest wall to lower right abdominal wall. We detected free air and fluid collection in her abdominal cavity of computed tomography scan which was performed at the previous hospital (Fig. 3.). An emergency laparotomy was performed. About 1 L of fresh blood was collected in the abdominal cavity and a moderate amount of bowel spillage was detected. Multiple mesenteric lacerations were identified 190cm distal area from Treitz ligament and 5cm above from IC valve. Omental tearing was also identified. Cecal perforation was noted on the countermesenteric area. We decided one-stage operation. After adequate hemostasis, the omental and mesenteric tearing were repaired primarily. A partial cecaectomy was performed using stapler on the perforation of the cecum (Fig. 2.). The patient was discharged uneventfully.","PeriodicalId":224399,"journal":{"name":"Trauma Image and Procedure","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125153243","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 : 2018-05-31DOI: 10.24184/TIP.2018.3.1.28
Seokwon Joo, Y. Jeon
A 49-year-old male with sustained multiple comminuted right rib (3rd–9th) fractures, right pneumothorax, and a flail chest was referred to our hospital with complaints of severe pain. He previously underwent closed thoracostomy in the right thoracic cavity. Rib fixation was performed after 4 days. On evaluation, comminuted fractures of the 4–8th right ribs were detected. We followed a conventional method of using an 8or 6-hole-plate (MatrixRIB; DepuySynthes, USA) and an 8or 4-hole-plate (RibFix BluTM; DepuySynthes) for his rib fixation. The fourth rib was fixed using an 8-hole-plate (MatrixRIB). However, the distance of the intact portion on the 5–7th ribs was too long to be successfully managed using a conventionally used plate. Therefore, 8-hole-plates (Small Fragment Locking Compression Plate; DepuySynthes), which are usually employed for radius fixation, were used on these ribs. The 8 rib was fixed with an overlapping method with two flexible 4-hole-plates (RibFix BluTM) and a longer screw, considering the anatomy of the comminuted fractures (Fig. 1.). The patient was extubated the day after the operation and was transferred to the general ward on the second day after the operation. The plates were intact even on 40th postoperative day.
{"title":"Rib fixation with a plate for radius and overlapping technique in comminuted fractures","authors":"Seokwon Joo, Y. Jeon","doi":"10.24184/TIP.2018.3.1.28","DOIUrl":"https://doi.org/10.24184/TIP.2018.3.1.28","url":null,"abstract":"A 49-year-old male with sustained multiple comminuted right rib (3rd–9th) fractures, right pneumothorax, and a flail chest was referred to our hospital with complaints of severe pain. He previously underwent closed thoracostomy in the right thoracic cavity. Rib fixation was performed after 4 days. On evaluation, comminuted fractures of the 4–8th right ribs were detected. We followed a conventional method of using an 8or 6-hole-plate (MatrixRIB; DepuySynthes, USA) and an 8or 4-hole-plate (RibFix BluTM; DepuySynthes) for his rib fixation. The fourth rib was fixed using an 8-hole-plate (MatrixRIB). However, the distance of the intact portion on the 5–7th ribs was too long to be successfully managed using a conventionally used plate. Therefore, 8-hole-plates (Small Fragment Locking Compression Plate; DepuySynthes), which are usually employed for radius fixation, were used on these ribs. The 8 rib was fixed with an overlapping method with two flexible 4-hole-plates (RibFix BluTM) and a longer screw, considering the anatomy of the comminuted fractures (Fig. 1.). The patient was extubated the day after the operation and was transferred to the general ward on the second day after the operation. The plates were intact even on 40th postoperative day.","PeriodicalId":224399,"journal":{"name":"Trauma Image and Procedure","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134277307","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}
A 54-year-old male with no medical history was admitted to the emergency room with penetrating abdominal injury caused by an accidental air gun shot. Upon admission, he was hemodynamically stable and showed one entrance wound site on his abdomen (Fig. 1.). His plain X-ray and CT (Fig. 2.) revealed a bullet located in the abdomen wall. Accordingly, we planned an emergency surgery and detected omental injury, perforation of the anterior and posterior walls of the stomach, and multiple perforations of the ileum (at 5 sites) (Fig. 3.). We then performed primary repair of the stomach and ileum and removed the bullet. The patient recovered without any complications. Brief Image in Trauma eISSN: 2508-8033 pISSN: 2508-5298
{"title":"Abdominal Injury Caused by an Air Gun Shot","authors":"P. Y. Jung, H. Shim","doi":"10.24184/TIP.2018.3.1.8","DOIUrl":"https://doi.org/10.24184/TIP.2018.3.1.8","url":null,"abstract":"A 54-year-old male with no medical history was admitted to the emergency room with penetrating abdominal injury caused by an accidental air gun shot. Upon admission, he was hemodynamically stable and showed one entrance wound site on his abdomen (Fig. 1.). His plain X-ray and CT (Fig. 2.) revealed a bullet located in the abdomen wall. Accordingly, we planned an emergency surgery and detected omental injury, perforation of the anterior and posterior walls of the stomach, and multiple perforations of the ileum (at 5 sites) (Fig. 3.). We then performed primary repair of the stomach and ileum and removed the bullet. The patient recovered without any complications. Brief Image in Trauma eISSN: 2508-8033 pISSN: 2508-5298","PeriodicalId":224399,"journal":{"name":"Trauma Image and Procedure","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126791864","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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