ABSTRACT
PURPOSE: Rib and sternal fractures are common complications of chest compressions during cardiopulmonary resuscitation (CPR). The aim of this study is to investigate skeletal chest injuries following chest compressions and factors associated with skeletal chest injuries. METHODS: A retrospective study was conducted for 10 years from January 2005 to February 2015. Skeletal chest injuries in patients who underwent computerized tomography (CT) after return of spontaneous circulation (ROSC) were analyzed. The exclusion criteria were patients with insufficient medical records, under 18 years old, traumatic cardiac arrest, and out-of-hospital cardiac arrest. RESULTS: During the period 106 patients were included. The CT scan after ROSC showed that 47 patients (44.3%) had rib fractures, and 20 patients (18.9%) had sternal fractures. The rib fracture group showed higher age (73 vs 61, p<0.001), longer CPR time (10 vs 6 min, p<0.001), and higher incidence of sternal fracture (34% vs 6.8%, p<0.001). The sternal fracture group showed longer CPR time (10 vs 7, p<0.05) and higher incidence of rib fractures (80% vs 4.7%, p<0.001). In multivariate logistic regression analysis, age (OR 1.087; 95% CI 1.041 to 1.134, p<0.001), CPR time (OR 1.200; 95% CI 1.087 to 1.323, p<0.001), and sternal fracture (OR 4.524; 95% CI 1.259 to 16.697, p=0.021) showed significant association with rib fracture. CONCLUSION: Rib and sternal fractures are frequent complications in patients who underwent CPR. In hospital cardiac arrest patients with older age, longer CPR time, and sternal fracture needed more precaution for rib fractures and other complications.
Subject(s)
Humans , Cardiopulmonary Resuscitation , Heart Arrest , Incidence , Logistic Models , Medical Records , Out-of-Hospital Cardiac Arrest , Retrospective Studies , Rib Fractures , Ribs , Thoracic Injuries , Thorax , Tomography, X-Ray ComputedABSTRACT
Superior mesenteric artery (SMA) syndrome results from compression of the third portion of the duodenum by the superior mesenteric artery or one of its branches where this vessel crosses over the duodenum as it descends from the aorta. Recently 2 cases of SMA syndrome were experienced. A 43-year-old female and a 41-year-old male were admitted due to complaints of frequent postprandial abdominal distension and vomiting for 4 months. An UGI series and abdominal CT scan revealed distension of stomach and duodenum with a cut-off in the duodenal third portion. Both patients underwent duodenojejunostomy with successful symptom relief.
Subject(s)
Adult , Female , Humans , Male , Aorta , Duodenum , Mesenteric Artery, Superior , Stomach , Superior Mesenteric Artery Syndrome , Tomography, X-Ray Computed , VomitingABSTRACT
There are few reports of hepatitis related to the Chinese Medicine in Korea. Because herbal medicine contains many ingredients, it is confused what ingredient causes the hepatitis. We experienced a case of acute hepatitis developed after consumption of Chinese herbal medicine, Ho-Shou-Wu, for 75 days which contains only one component, Polygonum multiflorum, in a 55 year-old woman. And gradual recovery from hepatitis was observed after stopping the medication. Drug-induced hepatitis was diagnosed with typical clinical course and exclusion of all the possible causes of acute hepatocellular injury. We report this case with review of literature.