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KMID : 0371319840260020148
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Journal of the Korean Surgical Society
1984 Volume.26 No. 2 p.148 ~ p.158
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Non-Penetrating Abdominal Trauma
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장환식/Chang, Hwan-Shik
김홍용/백낙환/Kim Hong-Yong/Paik, Nak-Hwan
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Abstract
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Clinical records of 105 patients who were operated upon for blunt abdominal trauma at Paik Hospital, Seoul, Inje Medical College during the period of 8 years from January, 1975 to December, 1982, were analyzed.
The results of analysis are;
1) The sex distribution was 90 males and 15 females with ratio of 6:1, and the age distribution revealed the highest incidence in 3rd and 4th decades of life(58. 1%). Seasonal distribution showed no definite difference.
2) The most common cause of trauma was Vehicle accident(68.6%), the passenger accident 43.8% and pedestrian accident 25.8%, and the next was violence(l8.1%).
3) Common clinical manifestations were abdominal pain(81.9%), abdominal tenderness (90.5%), abdominal rigidity(65.7%), rebound tenderness(55.2%), abdominal distension (55.2%) and diminished bowel sound(55.2%).
4) Twenty percent of patients were operated upon within 6 hours after injury, and 71.4% within 24 hours.
5) Periphral WBC count was increased above 10, 001/mm3 in 84.8% of the patients. Among the patients with hollow viscus rupture, 47.6% showed free air on their simple abdominal X.ray films. Abdominal paracentesis, performed in 51 patients, showed positive results in 38 patients (74.5%).
6) Among 105 patients, 48(45.8%) had associated extraabdomjnal injury. Chest injury (21.9%) was the most commonly associated injury and was followed by extremity fracture (20.9%), pelvic fracture(14.3%) and head injury(7.6%).
7) Among 105 patients, 147 organ injuries were found. Sixty.nine patients(65.7%) had single organ injury, 22 patients(2l.0%) had two organ injuries and 14 patients(13.3%) had three or more organ injuries.
8) The most commonly injured organ was small intestine(29.3%), followed by spleen (10.9%), kidney(lO,9%), liver(10.2%) and retroperitoneal hematoma(10.26%).
9) Postoperative complications developed in 37 patients(35.2%). Wound infection(15.2%) and pulmonary complications(12.4%) were common complications.
10) The mortality rate was 8.6%. The causes of death were hemorrhagic, shock, renal failure, acute head injury and sepsis
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