Endoscopic sympathicotomy is the choice of the treatment for hyperhidrosis. There are some recognized risks such as Honer's syndrome and Hemopneumothorax; however, Chylothorax has very rarely been reported after thoracic sympathicotomy. We recently encountered a case of chylothorax. Early diagnosis and prompt treatment is noteworthy.
Chylothorax* ; Early Diagnosis ; Hemopneumothorax ; Hyperhidrosis

Although it is very rare, hemopneumothorax can occur during breast augmentation. This potentially fatal surgical complication can be experienced by any plastic surgeon who performs breast augmentation surgery. In this article, we present a case from our institution and review the related literature in order to explore the etiological mechanism of hemopneumothorax, as well as preventive measures and treatments. In addition, we have tried to emphasize the importance of a thorough knowledge of anatomical variations and proper surgical techniques as ways to minimize the likelihood of this complication.
Breast* ; Hemopneumothorax* ; Hemorrhage ; Hemothorax ; Plastics ; Pneumothorax ; Wounds and Injuries

Judet's rib struts which are designed for osteosynthesis are made of stainless steel. This report describes clinical analysis of our experiences of 30 cases with the operative stabilization of multiple rib fractures with Judet's rib struts from December, 1995, to December, 1996 in Chungmoo Hospital, Chounan. Our indications for operative stabilization were as follows: 14 cases in flail chest, 8 cases in severe displacement of rib including segmental fractures, 7 cases in additional procedures during intrathoracic operation, and 1 case in other cause. Postoperative artificial ventilation is needed in only 1 case for 5 days and posto- perative complications were few: 2 cases of hemopneumothorax, 2 cases of alcohol with- drawal delirium, and 1 case of postoperative hepatitis. Average duration of hospital admission who have limited thoracic injuries was 10.5 days. Though more comparative studies is necessary, we find this technique to be better than previously published methods, since it provides better stabilization and immobilization of the ribs and shortening the duration of hospital admission.
Delirium ; Flail Chest ; Hemopneumothorax ; Hepatitis ; Immobilization ; Rib Fractures* ; Ribs* ; Stainless Steel ; Thoracic Injuries ; Ventilation

Video-assisted thoracoscopic surgery has recently evolved as an alternative to thoracotomy for several thoracic disorders. Today it is viewed as a sparing and safe alternative to thoracotomy for a wide spectrum of indication. Using video-assisted operative thoracoscopy, we operated on 33 patients during the 2 years of our experience from June 1993 to June 1995. They were diagnosed as recurrent pneumothorax in 16, visible bulla on X-ray in 6, prolonged air leakage (longer than 7days) in 4, bilataral pneumothorax in 3, hyperhidrosis in 2, previous contralateral pneumothorax in 1, primary hemopneumothorax 1. The average duration of chest tube placement was 2.1+/-0.4 days. The mean postoperative hospital stay was 3.4+/-0.6 days. The complication was persistent air leakage (longer than 48 hours) in 3 case. Video-assisted thoracic surgery is safe, decreased pain, and shortens hospital stay.
Chest Tubes ; Hemopneumothorax ; Humans ; Hyperhidrosis ; Length of Stay ; Pneumothorax ; Thoracic Surgery, Video-Assisted* ; Thoracoscopy ; Thoracotomy

OBJECTIVETo explore the management of thoracic spinal trauma (TST) associated with closed thoracoabdominal injuries (CTAI).

METHODSA retrospective study was made on 259 patients with TST admitted to our department as an emergency treatment from January 1996 to June 2001. We summarized the clinical features of TST associated with CTAI.

RESULTSAmong 259 patients with thoracic spinal trauma, 112 were associated with CTAI. Traffic accident was the most common cause. The force causing upper TST was more violent than that causing the lower. Pulmonary complications were the leading cause of death in this group. Surgery could not improve neurological function for completely paraplegic patients.

CONCLUSIONSThe reason that upper TST has the tendency to be associated with CTAI is its special anatomical feature. Routine ultrasonic examination can avoid misdiagnosis of latent closed abdominal injuries associated with spinal injury. The presence of potential injuries, especially CTAI, should be considered when deciding whether or not to perform surgery early.

Adult ; Female ; Hemopneumothorax ; diagnosis ; Humans ; Male ; Paracentesis ; Retrospective Studies ; Spinal Cord Injuries ; diagnosis ; Thoracic Injuries ; diagnosis

Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Female ; Hemopneumothorax ; surgery ; Humans ; Infant ; Male ; Middle Aged ; Paracentesis ; Thoracoscopy

In an effort to characterize the trend of renal injury of recent years, we reviewed the charts and x-ray films of 50 patients with renal trauma which occurred in the last 6 years. They were 42 males and 8 females with a mean age of 26.4 years (range: 5 to 66) and most of them are younger generation. The main causes of injury were related to falling down in 21 cases (42%) and traffic accident in 17 cases (34%), followed by stab injury in 7 cases and assault in 5 cases. The severity of renal injury was classified using the renal injury scale which was published by the Organ Injury Scaling (O.I.S.) Committee of the American Association for the Surgery of Trauma (A.A.S.T.) in 1989. According to radiologic and operative findings, they were classified as follows; Grade I, 4 cases; Grade II, 7 cases; Grade III, 12 cases; Grade IV, 23 cases; and Grade V, 4 cases. Of the 50 patients, 39 had gross hematuria and remaining 11 patients had microscopic hematuria. There was no correlation between the degree of hematuria and the severity of renal injury (p=0.098). The major combined other organ injuries were hemoperitoneum in 12 cases, fracture of extremities in 8 cases, liver laceration in 5 cases, hemopneumothorax in 4 cases and intestinal perforation in 2 cases. Surgical treatment was performed in 27 cases (54%) and the remaining 23 cases (46%) which were renal laceration of various degrees without intraperitoneal injuries were managed conservatively.
Accidents, Traffic ; Extremities ; Female ; Hematuria ; Hemoperitoneum ; Hemopneumothorax ; Humans ; Intestinal Perforation ; Kidney ; Lacerations ; Liver ; Male ; X-Ray Film

PURPOSE: Multiple rib fracture (MRF) and a hemopneumothorax accompany with most blunt chest traumas. We aimed to analyze the factors increasing the probability of a hemopneumothorax. In addition, other injuries accompanying MRF were analyzed. METHODS: We retrospectively reviewed the medical records of 154 mutiple rib fracture patients who visited our hospital between January 2005 and December 2007. The medical records were reviewed for sex, age, mechanism of injury, location, number of fractures, distance of dislocated rib fragments, and presence of complications. We measured the distance of bony dislocations by using the PACS (Picture Archiving and Communication System). RESULTS: The average number of rib fractures was 3.7+/-2.1, and the number of rib fractures significantly influenced the incidence of a hemothorax (p<0.001). The risk of a phemothorax was increased in a bilateral MRF compared to a unilateral MRF (p=0.027). The distance of dislocated rib fragments influenced the probability of a hemothorax significantly (p=0.018), and subcutaneous emphysema and lung contusion were significantly associated with a pneumothorax (p=0.021, p=0.036). CONCLUSION: The number of MRFs did not influence the risk for a pneumothorax, but did influence the risk for a hemothorax. The laterality, distance of dislocation, also had an influence on the risk for a hemothorax. Also, subcutaneous emphysema and lung contusion were increased in cases with a pneumothorax. We must consider the possibility of a hemothorax even when the initial chest X-ray shows no evidence of a hemothorax. If a lung contusion is present, then an occult pneumothorax must be considered.
Contusions ; Dislocations ; Hemopneumothorax ; Hemothorax ; Humans ; Incidence ; Lung ; Medical Records ; Pneumothorax ; Retrospective Studies ; Rib Fractures ; Ribs ; Subcutaneous Emphysema ; Thorax

Extracorporeal membrane oxygenation (ECMO) has been used successfully in critically ill patients with traumatic lung injury and offers an additional treatment modality. ECMO is mainly used as a bridge treatment to delayed surgical management; however, only a few case reports have presented the successful application of ECMO as intraoperative support during the surgical repair of traumatic bronchial injury. A 38-year-old man visited our hospital after a blunt chest trauma. His chest imaging showed hemopneumothorax in the left hemithorax and a finding suspicious for left main bronchus rupture. Bronchoscopy was performed and confirmed a tear in the left main bronchus and a congenital tracheal bronchus. We decided to provide venovenous ECMO support during surgery for bronchial repair. We successfully performed main bronchial repair in this traumatic patient with a congenital tracheal bronchus. We suggest that venovenous ECMO offers a good option for the treatment of bronchial rupture when adequate ventilation is not possible.
Adult ; Bronchi ; Bronchoscopy ; Critical Illness ; Extracorporeal Membrane Oxygenation* ; Hemopneumothorax ; Humans ; Lung Injury ; Rupture* ; Tears ; Thorax ; Ventilation ; Wounds, Nonpenetrating

BACKGROUND: The purpose of this study is to describe the characteristics of malpractice claims related to hemopneumothorax and to identify the causes and potential preventability of such claims. MATERIAL AND METHOD: A retrospective study was performed by reviewing the records in the Lawnb website and Lx CD-rom: the records on closed malpractice claims involving hemopneumothorax were abstracted from the files available for analysis. The records were reviewed and were analysed to determine the etiology of hemopneumothorax, patient age, results of lawsuit and indemnity payment, underlying diseases, cause of death or complications, and the factors associated with a successful defense. RESULT: Seven closed claim involving hemopneumothorax were founded in the data for malpractice. Three claims were supreme court decision, one was a high court decision and three claims were district court decision. The most common cause of death was tension pneumothorax. Four of which resulted in indemnity payments. CONCLUSION: While malpractice claims involving hemopneumothorax were uncommon, they resulted in a high rate and amount of indemnity payments. Claims are more common in pediatric patients. In case of iatrogenic hemopneumothorax, post-procedural X-ray can improve patient outcome and is also associated with decreased indemnity risks. Informed consent is also important.
Cause of Death ; CD-ROM ; Hemopneumothorax* ; Hemothorax ; Humans ; Informed Consent ; Jurisprudence ; Malpractice ; Pneumothorax ; Retrospective Studies ; Supreme Court Decisions