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KMID : 0371319660080050283
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Journal of the Korean Surgical Society
1966 Volume.8 No. 5 p.283 ~ p.290
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Clinical Observation on Chest and Abdominal Injuries
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金鎭福/Kim, Jin Bok
孫鍾夏/金垠燮/裵柄源/Sohn, Jong Ha/Kim, Un Sup/Bae, Byong Won
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Abstract
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A clinical observation was made on 206 cases of abdomial and chest injuries treated at the Capital Army Hospital during the past 5 years from August 1960 to August 1965.
1. 102 cases of chest injuries, 94 cases of abdominal injuries and 10 cases of combined thoraco-abdominal injuries were seen.
2. Penetrating gunshot wound accounted for 470 of chest injuries, 59.4% of abdominal injuries and 50% of combined thoraco-abdominal injuries.
3. Penetrating wound predominated over blind wound by a ratio of 1.7 to 1.0.
4. 79.9% of the wounded patients were seen and operated on within six hours after the injury.
5. Among 33 cases of colon injuries, primary closure of the perforation was carried out on 13 cases with good result. It is considered relatively safe to perform primary closure of the perforated colon if it is per- . formed during early post-injury period and there is no gross contamination of the abdominal cavity at the time of exploration. Feasibility of primary closure of the injured of colon largely depends on the time length frcm the injury to surgery, size of perforation and whether or not the perforation is walled-off by surrounding structures preventing further leakage of intestinal content into the abdominal cavity.
6. The most common complication following surgery was wound infection, 29.6% in abdominal injuries, 16.6% in chest injuried and 60% in combined thoraco-abdominal injuries.
7. Overall mortality was 8.7%, and in detail 8.8% for chest injuries, for abdominal injuries, and 20% for combined thoraco-abdominal injuries. A close relationship was seen between the mortality and multiplicity of injured organs, and admission blood pressure. The injury of the kidney showed the highest mortality, rate of 28.5%and the injury of the spleen and liver showed -the lowest mortality rate of 12.5%.
8. The most common cause of death that accounted for 50.0% of mortality, was irreversible hemorrhagic shock, and acute cardio pulmonary insufficiency and acute renal shut down accounted for 16.5% of mortality.
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