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KMID : 0371319750170010013
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Journal of the Korean Surgical Society
1975 Volume.17 No. 1 p.13 ~ p.22
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Clinical Observation of Blunt and Penetrating Abdominal Trauma
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李世一/Lee, Se Il
安榮植/朴基一/金春奎/Song, Young Sik/Park, Ki Il/Kim, Choon Kyu
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Abstract
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This report is consist of a review of 162 patients who were sustained blunt and penetrating trauma on the abdomen during past. 10 years, from 1964 to 1973, and who were treated on the, surgical department of Severance Hospital.
The causes of blunt trauma (132 cases, 8T. 5%) were car accidents (63 cases, 38.9%), violence (38 cases, 23.5%), and falling (20 cases, 12.3%). The causes of penetrating trauma (30 cases, 18.5%) were stab injuries (22 cases, 13.5%) and missile (4 cases, 2.5%).
The clinical manifestations were abdominal pain (92%), tenderness (81%), rebound tenderness (75.4%), rigidity(70.6%), diminished peristalsis (70%), and abdominal distension (50%), in the order of frequency.
The isolated organ injuries were 70 cases (43.2%). Most injured organ was multiple and ass-ociated with the organ in intraperitoneal and/or extraperitoneal region. The common injured organs in blunt trauma were spleen (35 cases 26.6%), liver (31 cases, 23.5%), small intestine
(31 cases, 23.5%), kidney (26 cases, 19.7%).
The common injured organs in penetrating trauma were liver (12 cases, 40%), stomach (10 cases, 33.3%) and small intestine (30%).
The most common associated injuries in extraperitoneal region were chest injuries (27 cases, 16.7%), pelvic bone fracture and fracture of lower extremity (13 cases, 8%) and etc.
Simple closure or resection and end to end anastomosis was possible in most cases of injuries of stomach, duodenum, small intestine, urinary bladder and diaphragm. In the injuries of large intestine, colostomy only or with primary closure or resection and anastomosis were done. Liver was treated with primary closure and drainage in most cases. All cases of spleen injury were treated with splenectomy. In the kidney injuries, conservative treatment was done in 16 cases (55.2%) and nephrectemy in 9 cases (31%).-
The major complications were infection (36 cases, 22.2%), pulmonary complication (11 cases, 6.8%) and septicemia (8 cases, 4.9%). Complication was seen in 55 patients (37.4%).
Motality was 13%. The main causes of death were hypovolemia (8 cases, 4.9%), septicemia (7 cases, 4.3%), brain injuries (2 cases, 1.2%), and renal shutdown (2 cases, 1.2%).
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