For trauma patients with severe shock, massive fluid resuscitation is necessary. However, shock and a large amount of fluid can cause bowel and retroperitoneal edema, which sometimes leads to abdominal compartment syndrome in patients without abdomino-pelvic injury. If other emergent operations except intraabdomen are needed, a distended abdomen is likely to be recognized late, leading to multiple organ dysfunction. Herein, we report two cases of a 23-year-old woman who was in a car accident and a 53-year old man who was pressed on his leg by a pressing machine; severe brain swelling and popliteal vessel injury were diagnosed, respectively. They were both in severe shock and massive fluid resuscitation was required in the emergency department. Distended abdomen was recognized in both the female and male patients immediately after neurosurgical operation and immediately before orthopaedic operation in the operating room, respectively. Decompressive laparotomy revealed massive ascites with retroperitoneal edema.
Abdomen ; Ascites ; Brain Edema ; Edema ; Emergency Service, Hospital ; Female ; Humans ; Intra-Abdominal Hypertension* ; Laparotomy ; Leg ; Male ; Operating Rooms* ; Resuscitation ; Shock ; Young Adult

The solitary fibrous tumor (SFT) is an uncommon benign tumor, which is usually found in the pleura. Even though SFTs have been reported in various areas including the head and neck these days, laryngeal SFT is very rare, not to mention the bilateral vocal fold. Here, we report a new case of bilateral laryngeal SFT with a review of related literature. A 67-year-old male patient was admitted to our institution because of husky voice he experienced for several months. Endoscopic examination revealed a bilateral vocal folds swelling. The lesion was removed with CO2 laser under direct suspension laryngoscope. The pathological diagnosis was made by various immunohistochemical stainings including vimentin, Bcl-2, CD99 and CD34. During the 24 months follow-up after the surgery, there was no sign of recurrence.
Aged ; Diagnosis ; Edema* ; Follow-Up Studies ; Head ; Humans ; Laryngoscopes ; Larynx ; Lasers, Gas ; Male ; Neck ; Pleura ; Recurrence ; Solitary Fibrous Tumors* ; Vimentin ; Vocal Cords* ; Voice

For trauma patients with severe shock, massive fluid resuscitation is necessary. However, shock and a large amount of fluid can cause bowel and retroperitoneal edema, which sometimes leads to abdominal compartment syndrome in patients without abdomino-pelvic injury. If other emergent operations except intraabdomen are needed, a distended abdomen is likely to be recognized late, leading to multiple organ dysfunction. Herein, we report two cases of a 23-year-old woman who was in a car accident and a 53-year old man who was pressed on his leg by a pressing machine; severe brain swelling and popliteal vessel injury were diagnosed, respectively. They were both in severe shock and massive fluid resuscitation was required in the emergency department. Distended abdomen was recognized in both the female and male patients immediately after neurosurgical operation and immediately before orthopaedic operation in the operating room, respectively. Decompressive laparotomy revealed massive ascites with retroperitoneal edema.
Abdomen ; Ascites ; Brain Edema ; Edema ; Emergency Service, Hospital ; Female ; Humans ; Intra-Abdominal Hypertension ; Laparotomy ; Leg ; Male ; Operating Rooms ; Resuscitation ; Shock ; Young Adult

PURPOSE: The purpose of this study was to verify the utility of existing Trauma and Injury Severity Score (TRISS) coefficients and to propose a new prediction model with a new set of TRISS coefficients or predictors. MATERIALS AND METHODS: Of the blunt adult trauma patients who were admitted to our hospital in 2014, those eligible for Korea Trauma Data Bank entry were selected to collect the TRISS predictors. The study data were input into the TRISS formula to obtain "probability of survival" values, which were examined for consistency with actual patient survival status. For TRISS coefficients, Major Trauma Outcome Study-derived values revised in 1995 and National Trauma Data Bank-derived and National Sample Project-derived coefficients revised in 2009 were used. Additionally, using a logistic regression method, a new set of coefficients was derived from our medical center's database. Areas under the receiver operating characteristic (ROC) curve (AUC) for each prediction ability were obtained, and a pairwise comparison of ROC curves was performed. RESULTS: In the statistical analysis, the AUCs (0.879-0.899) for predicting outcomes were lower than those of other countries. However, by adjusting the TRISS score using a continuous variable rather than a code for age, we were able to achieve higher AUCs [0.913 (95% confidence interval, 0.899 to 0.926)]. CONCLUSION: These results support further studies that will allow a more accurate prediction of prognosis for trauma patients. Furthermore, Korean TRISS coefficients or a new prediction model suited for Korea needs to be developed using a sufficiently sized sample.
Adolescent ; Adult ; Aged ; Databases, Factual ; Female ; Humans ; *Injury Severity Score ; Logistic Models ; Male ; Middle Aged ; Predictive Value of Tests ; Probability ; Prognosis ; ROC Curve ; Republic of Korea ; Trauma Centers/statistics & numerical data ; *Trauma Severity Indices ; Wounds, Nonpenetrating/*diagnosis