Language：Japanese  

We experienced a traumatic victim with thoracic and abdominal injury with hemorrhagic shock, who was successfully treated with damage control. Thoracic drainage revealed more than 300 ml/hour of continuous hemorrhage in the left thoracic cavity with 60-80 mmHg of non-responding hypotention. Although we performed emergency partial resection of the injured lung, intraabdominal packing and transcatheter arterial embolization, intrathoracic hemorrhage and hemorrhagic shock was not controlled. We decided re-thoracotomy and performed peri-pulmonary packing around the injured lung, by which we successfully controlled temporary intrathoracic hemorrhage and definitive left lower lobectomy. Peri-pulmonary packing was effective for intrathoracic hemostasis without lethal ventilatory and circulatory complication in this case.

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Language：Japanese   Publisher：Japanese Society for Abdominal Emergency Medicine  

Patients with acute abdominal pain are often treated as difficult and troublesome cases by doctors with some specialties other than gastroenterology because comples and vague methods are required for the diagnostic procedure such as abdominal palpation and evaluation of abdominal CT images. Today, most hospitals have accepted non-reserved patients with acute abdomminal pain. In this report, we evaluated the numbers of emergency surgeries for acute abdominal pain treated in the hospitals in the typical urbane city and its rural area. In the urbane area each hospital treated different spectrum of emergency cases of acute abdominal pain. On the contrary in rural area, one large hospital treated both most emergency and non-emergency cases. To confirm high acceptability of patients with acute abdominal pain, we should consider role sharing of each hospital in urbane area which brings high acceptability of these patients in total district. And we should consider non-administrative strategy produced by medical associations which include duty of all specialists to work as generalist in some period.

DOI： 10.11231/jaem.31.739

CiNii Books

J-GLOBAL

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Language：Japanese   Publisher：一般社団法人日本外科学会  

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