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KMID : 0360720150280030211
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Journal of the Korean Society Traumatology
2015 Volume.28 No. 3 p.211 ~ p.214
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Pericardial Tamponade following Perihepatic Gauze Packing for Blunt Hepatic Injury
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Ye Jin-Bong
Sul Young-Hoon
Go Seung-Je
Kwon Oh-sang
Kim Joong-Suck
Park Sang-Soon
Ku Gwan-Woo
Lee Min-Ku
Kim Yeong-Cheol
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Abstract
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The primary and secondary survey was designed to identify all of a patient’s injuries and prioritize their management. However 15 to 22.3% of patient with missed injuries had clinically significant missed injuries. To reduce missed injury, special attention should be focused on patients with severe anatomical injury or obtunded. Victims of blunt trauma commonly had multiple system involvement. Some reports indicate that inexperience, breakdown of estalished protocol, clinical error, and restriction of imaging studies may be responsible for presence of missed injury. The best way of reducing clinical significant of missed injuries was repeated clinical assessment.
Here we report a case of severe blunt hepatic injury patient and pericardial injury that was missed in primary and secondary survey. After damage control surgery of hepatic injury, she remained hemodynamically unstable. Further investigation found cardiac tamponade during intensive care. This was managed by pericardial window operation through previous abdominal incision and abdominal wound closure was performed.
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KEYWORD
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Primary survey, Secondary survey, Missed injury, Blunt hepatic injury, Pericardial tamponade
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