This is a retrospective study of 45 cases of Hepatic trauma which were treated at the department of surgery, Koryo General Hospital from january 1981 to December 1992. We made the two periods along with or without use of CT scan in diagnosis of
hepatic
trauma. The first period was from january 1981 to december 1984 without use of CT scan. The second period was from january 1985 to December 1992 with use of CT scan.
We compared the multiple list such as age, sex and cause of trauma, clinical menifestations, diagnosis and methods, difefernece of preoperative and postoperative CT findings, managements due to CT findings, complications, and mortality,
morbidity.
@ES The following results were obtained.
@EN 1) the ratio between male and female was 4.6 : 1 and peak age was the 4th dacede.
2) the most common cause was traffic accidents(84.4%) such as in-car or pedestrian accidents, autobicycle, and bicycle accldents.
3) The peritoneal irritation was the most frequent sign in the hepatic trauma patients.
4) The most commonly associated organ injury were abdomen, An example of abdominal organ injury, Colon was most frequent injury organ. The others were chest, long bones, large vessels. The only hepatic trauma was in 26.2% of cases.
5) In the second period, abdominal Ct scan showed high diagnostic accuracy for detection of liver and other organs trauma, exclusively. Nonoperative management(40.0%, 18/29 cases) was eration cause of incorrect severity of hepatic injury in the
CT
sca.
The other patients obtained good result during follow up for 12 weeks.
6) the total complication rate was 41.9%. The most frequent complications were pulmonary problems and sepsis. In the nonoperative management, complcation rate was 35.7%.
7) Postoperative mortality was 15.6%. In the nonoperative cases, there was no mortality
8) In the appropriate indications such as stable vital signs, no other organ injury in the CT scan, the nonoperative management with closed observation was first choice in the second period so, we could obtained the good results and avoided the
unnecessary laparotomy.
|