Jeon, Yang Bin
(Department of Trauma Surgery, Trauma Center, Gachon University Gil Medical Center)
,
Hyun, Sung Youl
(Department of Trauma Surgery, Trauma Center, Gachon University Gil Medical Center)
,
Ma, Dae Sung
(Department of Trauma Surgery, Trauma Center, Gachon University Gil Medical Center)
A 73-year-old man, who, in an inebriated state, had slipped in a flowerbed and was wounded on the left flank, was transferred to Trauma Center, Gil Medical Center, Gachon University College of Medicine. Based on the chest and abdominopelvic computed tomography, he was diagnosed with multiple rib fra...
A 73-year-old man, who, in an inebriated state, had slipped in a flowerbed and was wounded on the left flank, was transferred to Trauma Center, Gil Medical Center, Gachon University College of Medicine. Based on the chest and abdominopelvic computed tomography, he was diagnosed with multiple rib fractures and hemopneumothorax on the left hemithorax and was found to have a bony fragment in the spleen. He had not presented peritonitis and exsanguinous symptoms during the observation period. Seven days later, computed tomography of the abdomen showed suspected diaphragmatic injury and a retained foreign body in the spleen. On exploration by video assisted thoracoc surgery (VATS), a herniated omentum through the lacerated site of the diaphragm was observed. After omentectomy using Endo Gia, the foreign body in the spleen was observed through the lacerated site of the diaphragm. Traumatic diaphragm rupture with a foreign body, in the spleen, was successfully managed by video assisted thoracic surgery via the lacerated site of the diaphragm.
A 73-year-old man, who, in an inebriated state, had slipped in a flowerbed and was wounded on the left flank, was transferred to Trauma Center, Gil Medical Center, Gachon University College of Medicine. Based on the chest and abdominopelvic computed tomography, he was diagnosed with multiple rib fractures and hemopneumothorax on the left hemithorax and was found to have a bony fragment in the spleen. He had not presented peritonitis and exsanguinous symptoms during the observation period. Seven days later, computed tomography of the abdomen showed suspected diaphragmatic injury and a retained foreign body in the spleen. On exploration by video assisted thoracoc surgery (VATS), a herniated omentum through the lacerated site of the diaphragm was observed. After omentectomy using Endo Gia, the foreign body in the spleen was observed through the lacerated site of the diaphragm. Traumatic diaphragm rupture with a foreign body, in the spleen, was successfully managed by video assisted thoracic surgery via the lacerated site of the diaphragm.
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제안 방법
He was stable without signs or symptoms of peritonitis during observation period. After 7 days, he had a follow-up AP CT which revealed improving subcapsular hematoma of the spleen and retention of foreign body. However, compared with the previous AP CT, it was observed that there was an increase in the fat density in the thoracic cavity above the spleen and remainder of the hemothorax (Fig.
대상 데이터
A 73-year-old man, who, in an inebriated state, had slipped down on a flowerbed and was wounded on the left flank, was transferred to Trauma Center, Gil Medical Center, Gachon University College of Medicine. In the previous hospital, computed tomography (CT) of the chest and abdominopelvic (AP) region were evaluated and revealed moderate hemopneumothorax on the left hemithorax with multiple rib fractures from 9th to 12th, fracture of the spinous process of T12 and L1, and spleen laceration due to the presence of a bony fragment (Fig.
The vital signs of the patient were stable without signs of peritonitis. He was admitted to the Trauma Intensive Care Unit after a closed thoracostomy on the left hemithorax and a primary closure on the flank wound (about 5 cm). After 1 day, he was transferred to the general ward and was conservatively managed.
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