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KMID : 0371619980140020227
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Journal of Wonkwang Medical Science
1998 Volume.14 No. 2 p.227 ~ p.233
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Gastrointestinal injuries in abdominal trauma
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Ann Jin-Hong
So Byung-Jun
Lee Jeong-Kyun
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Abstract
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Purpose:> We performed this study to evaluate certain factors and events contributing to the overall profile of the victim of abdominal trauma.
Methods: 73 cases were analysed retrospectively who underwent operation for gastrointestinal injury from abdominal trauma at Wonkwang University Hospital from january 1995 to June 1998. Blunt injury account for 59 cases( 80%) and penetrating injury for 14 cases(20%) of the victims.
Results: 1) The sex distribution was 62 males(85%) and 11 females(15%) with ratio of 5.6:1 and the age distribution revealed a high incidence in forths and fifth decades. 2) The causes of blunt trauma were traffic accidents (39 cases, 68.4%), violence (10 cases, 17.5%), and fall down (5cases, 8.8%),. The causes of penetrating trauma were stab injury (14 cases, 87.5%) and others (2 cases). 3) The clinical manifestations were abdominal tenderness (71.2%), abdominal pain(68.5%), rebound tenderness(52%), decreased bowel sound(38.3%), and abdominal distention(15%). 4) The plain films of abdomen showed free air under the diaphragm in 13 cases(17.8%) among the 73 cases of hollow viscus ruptures. Abdominal paracentesis was performed in 54 cases among 73 cases of hollow viscus rupture, of which 32 cases(59.3 %) revealed positive findings. 5) The peritoneal lavage was valuable in diagnosis, positive findings was 16 cases(84.2%) among 19 cases. 6) The injuried organs were small intestine (53 cases, 72.6%), colon(21cases, 28.8%). 7) The commonly associated extraabdominal injury were extremity fractures (38.2%), chest trauma(29.4%) and soft tissue injury(11.7%). 8) Postoperative complication were developed in 34 cases(46 %), which were intestinal obstruction (10 cases), pulmonary complication (7 cases), wound infection (6 cases), intraabdominal abscess (4 cases). 9) The overall mortality rate was 5.4 %. The causes of death were sepsis (2 cases), hypovolemic shock (1 case), and renal failure (1 case). The deaths and complications were increased by severe associated injuries(1 death in 28cases of 2 organ injury and 2 death in 11 casess of 3 or more organ injury) and diagnostic delay (1 death in 6cases of delayed operation).
Conclusions: Repeated physical examinations, tests, and careful attention will be required in abdominal injury to avoid complicaton and mortality.
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KEYWORD
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Gastrointestinal injury, Abdominal trauma
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