Xiphoid elongation is a rare phenomenon where the xiphoid process elongates after stimuli such as surgery, physical therapy, or trauma. We report on a 47-year-old male involved in a traffic accident who went into cardiac arrest. He received ongoing cardiopulmonary resuscitation for nine minutes before recovery of cardiac rhythm, and transfer from a local hospital to the trauma center. He received management for hypotensive shock which was temporarily corrected using Resuscitative Endovascular Balloon Occlusion of the Aorta, and underwent trauma laparotomy in which ileocolic artery ligation and a splenectomy were performed. Six months later, the patient reported epigastric discomfort when he bent over. A hard, linear mass was palpated along the upper midline incision scar and a computed tomography scan showed an elongated xiphoid process (10 cm). The patient underwent surgical excision, and electrocauterization of the xiphoid process. This is a rare case of xiphoid elongation following multiple stimuli to the xiphoid process.
Purpose This study evaluated the surgical volumes and types of specific surgical procedures in a single trauma center for 3 consecutive years.
Methods From January 2014 to December 2016 there were 9,530 injury cases in the trauma registry that were reviewed.
Results There were 1,502 patients (15.8%) with an injury severity score over 15, of which 426 (28.4%) underwent an emergency operation or had an interventional radiology procedure. There were 186 craniotomies, 87 laparotomies, and 74 interventional radiology procedures performed.
Conclusion The number of emergency operations by each dedicated trauma surgeon was very low therefore implementation of an acute-care surgery model is appropriate to consider together with changes to the training program for trauma surgeons.
Citations
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Integrating acute care surgery in South Korea: enhancing trauma and non-trauma emergency care Jin Young Lee, Seheon Kim, Jin Bong Ye, Jin Suk Lee, Younghoon Sul World Journal of Emergency Surgery.2025;[Epub] CrossRef
Role of Trauma Surgeons at a Regional Trauma Center in South Korea Dongmin Seo, Inhae Heo, Hohyung Jung, Kyoungwon Jung Journal of Acute Care Surgery.2024; 14(3): 94. CrossRef
Understanding Regional Trauma Centers and managing a trauma care system in South Korea: a systematic review Jeehye Im, Eun Won Seo, Kyoungwon Jung, Junsik Kwon Annals of Surgical Treatment and Research.2023; 104(2): 61. CrossRef
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, Giljae Lee
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