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KMID : 0371319730150070007
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Journal of the Korean Surgical Society
1973 Volume.15 No. 7 p.7 ~ p.16
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A Clinical Observation of 177 Cases of Thoracic and Abdominal Injury
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林敏一/Lim, M.I.
咸泰元/裵振善/孫鍾夏/Hahm, T.W./Bae, J.S./Son, J.H.
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Abstract
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This study is a review and analysis of 177 cases of thoracic and abdominal injuries who were admitted and treated in Dept. of General Surgery, Seoul Red Cross Hospital, from April, 1968 to August, 1972.
The results are as follows;
1. The number of admitted patient was 21 cases in 1968, 37 cases in 1969, 58 cases in 1970, 48 cases in 1971, 13 cases in 1972.
2. The number of abdominal injury was 120, thoracic injury was 38, and 6 cases of comb; ned thoracoabdominal injury.
3. Male was out-numbered female by the ratio of 3.9 : 1.
4. In regard to age distribution, X12 cases (6. 8%) were 1st decade, 35 cases (19.80) 2nd decade, 48 cases (27. 1%) 3rd decade, and 4th decade, 19 cases (10.8%) 5th decade, 10 cases (5.6%) 6th decade, 5 cases (2.8%) above the age of 61.
The peak incidence was 3rd and 4th decade.
5. Most common mode of injury was traffic accident (42.3%), stab wound (20.3%) and fistkicking (14.1%), in order of frequency.
6. Among 177 cases, 42 cases were penetrating injury, whereas 135 cases were non-penetrating injury.
7. 27% of injured patients were operated between 12 and 24 hours after injury.
8. In regard to intra-abdominal organs, 37 cases (22.6%) had injury in small intestine, 29 cases (17.7%) in spleen, 20 cases (12.2%) in liver, 17 cases (10.4%) in kidney, ureter, bladder, 15 cases (9. 1%) in retroperitoneum and in mesentery, respectively. 44 cases in chest.
9. In associated injuries, bony fracture was notified in 87 cases, head injury in 4 cases, and the orthers in 11 cases.
10. The number of exploratory laparotomy was 117, in whom 110 cases (94%) were positive finding, 7 cases were negative finding.
The operative procedures were as follows, enterorrhaphy was perofrmed in 30 cases, enterectomy and anastomosis in 7 cases, splenectomy in 29 cases, hepatorrhaph.y and removal of foreign body in 17 cases, hepatic artery ligation in 3 cases, gastrorrhaphy in 8 cases, prim. closure of colon in 3 cases, cecostomy in 1 case, colostomy in 2 cases, colectomy in 1 case, pancreatectomy in 2 cases, nephrectomy in 6 cases, repair of diaphragm in 4 cases.
11. Among 52 cases of hollow viscus rupture, the number of positive ´subphrenic ´ air shadow of, plane abdominal X-ray film was 24 cases (46. 1%).
12.´ Abdominal paracentesis was performed in 46 cases, and all the cases revealed positive finding (100%).
13. The most common symptom was abdominal pain (91.7%) on abdominal injury, and chest pain (86.8%) on chest injury.
14. Most common complications were wound infection, which occured in 9 cases (5.1%), pleural effusion in 6 cases(3.36%), sepsis in 3 cases (1.68%), renal failure in 3 cases (1.68%), suture failure in 3 cases (1.68%).
15. Over all mortality rate was 7.9%, 9.2% for abdominal injury, 2.6% for chest injury, 33.3% for combined thoraco-abd. injury.
The causes of death were shock (6 cases), sepsis (3 cases), renal failure (3 cases) and concomitant head injury (2 cases).
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