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KMID : 0371319710130030085
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Journal of the Korean Surgical Society
1971 Volume.13 No. 3 p.85 ~ p.95
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Clinical Observation on Abdominal Gushot Wounds and Shell Fragment Wounds
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朴丁樹/Park, Jung Soo
李正燮/徐在皓/朴基一/沈英輔/Rhee, Jung Sup/Suh, Je Ho/Park, Ki Il/Sim, Young Bo
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Abstract
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A clinical observation was made on 155 cases of abdominal and combined thoracoabdominal gun
shot wounds and shell fragment wounds treated at the Capital Army Hospital during the past
5 years from August 1965 to August 1970.
1. 109 cases of abdominal injuries and 46 cases of combined thoracoabdominal injuries were seen.
2. Perforating wounds accounted for 74.3% of abdominal injuries, 71.4% of combined thoraco
abdominal injuries.
3. Perforating gunshot woundes accounted for 82.5% anad 17.5% of penetrating gunshot wounds.
perforating gunshot wounds predominated over penetrating gunshot wounds by a rati of 4.7:1.0.
The other hand, penetrating shell fragment wounds predominated over perforating wounds by
a 57.2%.
4. 44.5% of the wounded patients were seen during the summer times from July to September.
58.6% of the patients were occurred by a accidental firing and more than 60% of wounded patients
were seen in the ranks of early military life.
5. 74.8% of wounded patients were seen and operated on within 6 hours after injury.
6. Among 60 cases of colon injuries, primary closure of the perforation was carried out on 23
cases with good results.
It is relatively safe to perform primary closure of the perforated colon, if it is performed during
early post injury period and there is minial gross contamination of the abdominal cavity at the
time of exploration.
7. Most common complication following surgery was wound infection, 28.0% in abdominal
injuries and 23.1% in combined thoracoabdominal injuries.
8. Over all mortality was 15.4%, and in details 12.8% for abdominal injuries, and 21.7% for
combined thoracoabdominal injuries. A close relationship was seen between the mortality and injuries
of great vessels, multiplicity of injured organs, and lag period from injuries to surgery.
9. The injury of the great vessels showed highest mortality, rate of 87.5% and injury of the
small intestine(Je junum, Ileum) showed lowest mortality rate of 7.4%.
10. The most common cause of death thah accounted for 50.0% of mortality was irreversible
hemorrhagic shock, and serious generalized peritonitis with septicemia accounted for 33.3% of
mortality.
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