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KMID : 0371319710130010045
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Journal of the Korean Surgical Society
1971 Volume.13 No. 1 p.45 ~ p.57
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Abdominal Injury, 469 Cases, Evacuated from South Viet Nam
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Abstract
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This report consist of review and analysis of 469 cases of abdominal injuries evacuated from South
Viet Nam, admitted to Dept. of General Surgery of Seoul and CHin Hae Naval Hospital from 1965
to 1970; in regard to date of injury, rank distribution, age distribution, wounding agent, nature of
injury, injured organs, kind of management, postoperative complications, time interval, duration of
admission and results of patients with brief review of literature.
The results are as follows,
1) The number of adbitted patient was 169 in 1968, 117 in 1967, 98 in 1969, 52 in 1966 and 33
in 1970.
2) In rank distribution, PFC was 45.6%, CPL 27,9%, SGT 11.6%, SSGT 11.6%, i.e below
SGT 85.1% and below SSGT 96.7%.
3) In regard to age distribution, 92 cases (23.7%) was 23 year old, 70 cases (18.0%) 22 year
old, 64 cases (16.5%) 21 year old, 48 cases (12.3%) 20 year old, 40 cases (10.3%) 24 year old
and 31 cases (8.0%) 19 year old age. 90% of all cases consist of below 24 year old.
4) In regard to wounding gent, 77 cases (25.3%) was due to small arms and 227 cases (74.7%)
was due to fragmentation missiles.
5) In nature of injury, 165 cases (53.7%) was injured only in abdominal wall, 125 cases (40.7%)
was intraperitoneal penetrating and 17 cases (5.5%) was intraperitoneal through -through injury.
6) In regard to injured organs, 74 cases ( 34.1%) had injury in small intestine, 45 cases (20.7%)
in colon, 33 cases (15.2%) in liver, 21 cases (9.7%) in spleen, 18 cases (8.3%) in stomach, 12
cases (5.5%) in diaphragm, 7 cases (3.2%) in rectum, 2 cases (0.9%) in pancreas, 2 cases (0.9%)
in cecum, 2 cases (0.9%) in esphagus and 1 case (0.5%) in cystic duct.
7) In associated injuries, 159 cases on lower extremities, 101 case on upper extremi
ties, 69 cases on chest, 51 cases on buttock, 40 cases on face, 29 cases on back, 23 cases on neck,
20 cases on shoulder, 20 cases on flank, 10 cases on scalp, 10 cases on scrotum, 8 cases on kidney,
7 cases on groin, and 6 cases on penis.
8) The number of exploratory laparotomy was 170, in whom 26 cases (15.3%) was of negative
finding, 144 cases was of positive finding. Of these 144 cases, enterorrhaphy was performed in 41
cases (28.5%), colostomy in 41 cases (28.5%), enterectomy in 33 cases (22.9%), hepatorrhaphy in
23 cases (16.0%), splenectomy in 21 cases (14.6^), colectomy in 15 cases (10.4%), gastrorrhaphy
in 15 cases (10.4%), diaphragm repair in 8 cases (5.6%) and nephrectomy in 6 cases (4.2%).
9) There was one case, i.e. on laparotomy due to abdominal injury, it was found that duplication
of jejunum and retroperitoneal teratoma were present, it was treated with jejunectomy and extir
pation of teratome.
10) An example of multiple operations in a person was partial gastrectomy, vagotomy, splenectomy,
left hepatic lobectomy, left nphrectomy and distal pancreatectomy.
11) In post-operative complications, wound infections were found in 29 cases (46.8%), intestinal
fustula in 8 cases (12.9%), subphrenic abscess in 6 case (9.7%), mechanical ileus in 5 cases (8.1
%), wound dihiscence in 4 cases (6.5%) and evisceration in 3 cases (4.8%).
12) Time interval was within 24 hours from injury to first management, one to two months
from injury to evacuation into Korea and average duration of admission was 3 to 5 months in our
department.
13) Discahrge from hospital was in 291 case (63.1%), transfer to other department in 58 cases
(12.6%) and discharge from service in 107 cases (23.3%).
14) Major surgical management during admission in our hospital, were closure of colostomy in 40
cases, skin graft in 20 cases, removal of foreign body (bullet, fragmentation missiles and suture
material) in 11 cases, debridement and secondary closure in 8 cases and adhesiotomy and resection of
adhesive band in 6 cases etc.
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