Woon-Won Kim

Outcome of children with blunt liver or spleen injuries: Experience from a single institution in Korea

INTRODUCTION The aim of this study is to evaluate the demographics, injury pattern, and treatment outcomes among children hospitalized for the management of blunt liver and spleen injury at a single institution in Korea, and to document trends in treatment strategies of children with blunt torso trauma. METHODS Children (<20 years) with blunt liver and spleen injuries, hospitalized at our center between May 2010 and February 2016, were included in the present study. Data were retrospectively analyzed for demographic and injury-related information were obtained. RESULTS During the study period, 34 patients with blunt liver injury and 21 patients with blunt spleen injury presented at the center. The most common cause of liver and spleen injury was motor vehicle collision, followed by fall. Thirty patients (88.2%) with liver injuries and 18 patients (85.7%) with spleen injuries were managed conservatively. No cases of mortality occurred in patients with spleen injury group; one patient (2.9%) died in patients with liver injury due to uncontrolled bleeding. CONCLUSIONS Our data demonstrated that 85.7% of patients with spleen injuries and 88.2% of patients with liver injuries were managed nonoperatively. Operative management was chosen more selectively, being applied in patients with high grade organ injury scores or abrupt changes in vital status. Our findings will contribute to the available data concerning children with traumatic injuries in Korea.

17 Cases of Acupuncture Related Pneumothorax and Factors Influencing Pneumothorax

OBJECTIVES Acupuncture is increasing in popularity as a complementary and alternative medicine. Pneumothorax is the most common and potentially serious adverse effect after acupuncture. This complication can cause fatality in the absence of rapid treatment. Here, we analyze the clinical presentation and discuss prevention of post-acupuncture pneumothorax and an approach to reducing this complication. METHODS Patients presenting with post-acupuncture pneumothorax in our hospital center during 2011-2015 were retrospectively analyzed. Body mass index (BMI), patients pre-acupuncture chief complaint and disease, and the characteristics associated with pneumothorax were assessed. The diagnosis of pneumothorax was based on clinical presentation and chest radiography. Conservative treatment or thoracostomy was performed. RESULTS Seventeen patients (15 women and 2 men) with a mean age of 42 years (range: 18-73 years) were included; three were underweight (BMI < 18.5kg/m2), 11 patients had a healthy weight (BMI= 18.5-22.95kg/m2), one was overweight (BMI = 23- 24.95kg/m2), and two were obese (BMI ≥ 25 kg/m2). All but one case of bilateral pneumothorax had unilateral pneumothorax (right side: 6; left side: 10). Chest pain or dyspnea, or both. were the initial symptoms in all patients. Twelve patients underwent immediate thoracostomy. The patient with bilateral pneumothorax underwent right-side thoracostomy, and subsequently left-side thoracostomy, due to progression of the left-side pneumothorax. Five patients were successfully managed conservatively. All patients had an excellent outcome; all were asymptomatic and exhibited a normal chest X-ray at follow-up. CONCLUSION Acupuncturists must be aware that delayed diagnosis and management of pneumothorax are life-threatening, and when symptoms of possible pneumothorax arise, patients should be advised to undergo an appropriate evaluation and intervention, particularly so in those with abnormal BMI.

Acute acalculous cholecystitis after laparoscopic appendectomy in a young healthy patient: report of a case.

Acute acalculous cholecystitis (AAC) is defined as acute inflammation of the gallbladder in the absence of gallstones. AAC occurs in patients after major surgery and in the presence of serious co-morbidities such as severe trauma, burns, sepsis, prolonged intravenous hyperalimentation and hemodynamic instability. AAC is rare in patients with none of the established risk factors. We present a case of a 38-year-old woman who developed AAC after laparoscopic appendectomy.