Journal of Acute Care Surgery

Trauma

Traumatic abdominal wall hernia associated with a cow horn in Korea: a case report: Hwajin Shin, Chan Yong Park; J Acute Care Surg 2025;15(2):82-85. Published online July 30, 2025; DOI: https://doi.org/10.17479/jacs.2025.0002

Abstract
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The diagnosis and evaluation of traumatic abdominal wall hernia can be challenging because of its low incidence and nonspecific clinical presentation. Without a high index of clinical suspicion, the detection of traumatic abdominal wall hernia may be delayed. A 71-year-old female patient was struck in the lower abdomen by a cow horn and initially received only conservative management at a local clinic. However, her pain worsened despite conservative measures, and she developed a reducible bulging mass. Computed tomography revealed an abdominal wall defect with small bowel herniation. She was transferred to our hospital's emergency department, where urgent surgery was performed. A laparotomy was conducted to repair the abdominal wall defect and explore potential intra-abdominal injuries. The defect was successfully repaired, and the patient was discharged without complications on postoperative day 10.

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Trauma, Procedure

Successful Non-Operative Management of Middle Colic Artery Injury Using Transcatheter Arterial Embolization Performed in a Hybrid Emergency Room System: Joo Hyun Lee, So Ra Ahn, Sang Hyun Seo, Chan Yong Park; J Acute Care Surg 2025;15(1):30-33. Published online March 21, 2025; DOI: https://doi.org/10.17479/jacs.2025.15.1.30

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Mesenteric injuries from blunt trauma are rare, but can result in life-threatening complications, including massive hemorrhage from mesenteric arterial disruption, bowel ischemia, necrosis, and perforation. Prompt diagnosis and treatment are critical, and surgical intervention is traditionally considered the gold standard intervention. Although transcatheter arterial embolization (TAE) is an established treatment for solid organ injuries following blunt abdominal trauma, its application to mesenteric injuries is less common. A 47-year-old male was admitted to our trauma center, which employes a hybrid emergency room system, after falling from a height of 3 meters. Abdominal computed tomography revealed active contrast extravasation from the middle colic artery which had a large hemoperitoneum, but no evidence of bowel injury. After initial resuscitation and stabilization, TAE was performed to control the hemorrhage. The patient was discharged 42 days after admission without significant complications. As a possible treatment option for mesenteric injuries without intestinal damage, we suggest TAE.

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Basic, Organ(liver, bowel, kideny etc.)

Relevant Clinical Findings of Patients with Extraperitoneal Bladder Injury Associated with Pelvic Fracture Who Underwent Operative Management: A 6-Year Retrospective Study: Sung Jin Park, Hohyun Kim, Chang Ho Jeon, Jae Hoon Jang, Jae Hun Kim, Sun Hyun Kim, Chan Ik Park, Sang Bong Lee, Seon Hee Kim, Chan Yong Park, Seok Ran Yeom; J Acute Care Surg 2021;11(1):14-21. Published online March 24, 2021; DOI: https://doi.org/10.17479/jacs.2021.1.14

Abstract
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Purpose
Management options for extraperitoneal bladder injury (EBI) associated with pelvic fracture are variable. Predictive factors of operative management (OM) in patients with EBI associated pelvic fracture have not been previously addressed. This study assessed the current epidemiology of blunt traumatic urinary bladder injury and evaluated relevant clinical findings of patients with EBI associated with pelvic fracture who received OM.

Methods
Patients with urinary bladder injury with or without pelvic fracture from blunt trauma from January 1, 2014 to December 31, 2019 were identified from the institute trauma registry (n = 12,891). Demographics, mechanism of injury, type of urinary bladder injury, pelvic fracture configuration, and management options were analysed in the study population (n = 9,894).

Results
Of the 1,400 patients who had pelvic and/or acetabular fracture, 32 (2.3%) had urinary bladder injury. Of the 8,494 patients without pelvic and/or acetabular fracture, 12 (0.1%) had nonpelvic fracture urinary bladder injury. The total incidence of urinary bladder injuries in the study population was 0.4% (44/9,894). Patients with EBI associated with pelvic fracture who underwent OM, had a higher frequency of high-grade pelvic injury (100% vs 0%, p = 0.015), concomitant pelvic surgery (75.0% vs 0%, p = 0.001), and non-lateral compression type pelvic fracture (62.5% vs 10.0%, p = 0.043) compared with patients who underwent non-operative management of EBI.

Conclusions
These data suggest that OM may be considered especially in patients with EBI associated with pelvic fracture with high grade pelvic injury, concomitant pelvic surgery, and nonlateral compression type pelvic fracture.

Citations

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Delayed healing of extraperitoneal bladder rupture after open reduction for pelvic fracture: A case report
Yu-Cheng Pei, Yeong-Chin Jou
Tungs' Medical Journal.2025; 19(2): 131. CrossRef

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Trauma, Others

Delayed Splenic Pseudoaneurysm Formation after Angioembolization: Chan Yong Park; J Acute Care Surg 2018;8(2):80-81. Published online October 30, 2018; DOI: https://doi.org/10.17479/jacs.2018.8.2.80

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Others

Aberrant Left Internal Iliac Artery Originating from the Aortic Bifurcation: Chan Yong Park; J Acute Care Surg 2018;8(2):78-79. Published online October 30, 2018; DOI: https://doi.org/10.17479/jacs.2018.8.2.78

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Trauma

Stab Wound Extension for the Eviscerated Small Bowel with Severe Ischemic Changes: Chan Kyu Lee, Chan Yong Park, Kwang Hee Yeo, Ho Hyun Kim; J Acute Care Surg 2018;8(2):71-73. Published online October 30, 2018; DOI: https://doi.org/10.17479/jacs.2018.8.2.71

Abstract
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An abdominal stab wound with evisceration is an indication of an emergency laparotomy. We encountered a case of a very severe ischemic change in the eviscerated small bowel as a result of stabbing. The patient was considered to have a high possibility of progressing to strangulation of the small bowel. Therefore, a stab wound extension was performed as a decompression in the emergency department before definite surgery in the operating room. Most of the small bowel could be saved except for the segment with the damage caused by the stab injury. The patient was discharged without complications.

Citations

Citations to this article as recorded by

Intestinal Evisceration in Children From the Bite of the Domestic Pig, Sus scrofa domesticus: A Report of Two Cases
Dennis S. Mazingi, Precious Mutambanengwe, Taurai Zimunhu, Tungamirai Gwatirisa, Bothwell A. Mbuwayesango, Kudzayi Munanzvi, Constantine Muparadzi, Mugove Moyo, Yvette Mwanza
Wilderness & Environmental Medicine.2019; 30(4): 454. CrossRef

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Procedure, Trauma

Successful Endovascular Management of Post-Traumatic Phlegmasia Cerulea Dolens from Rupture of the External Iliac Vein: Chan Yong Park, Hyun Min Cho, Kwang Hee Yeo, June Pill Seok, Chan Kyu Lee; J Acute Care Surg 2017;7(2):87-89. Published online October 30, 2017; DOI: https://doi.org/10.17479/jacs.2017.7.2.87

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We report a rare case of a 47-year-old male with posttraumatic phlegmasia cerulea dolens caused by a ruptured right external iliac vein and treated with an endovascular venous stent graft. The patient was the victim of motor vehicle accident, and suffered direct injuries to the head and abdomen. The patient had a cyanotic and swollen right lower leg. Abdominal and lower extremity computed tomography angiography revealed a large retroperitoneal hematoma caused by a ruptured right external iliac vein, and grade I liver injury. The right external iliac vein rupture was successfully treated with a venous stent graft, followed by inferior vena cava filtering, because a venous thrombus was identified below the stent graft. He initially was hemodynamically unstable but recovered following treatment. The patient was comatose when presenting at the emergency department. He was discharged, fully recovered, on hospital day 18.