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KMID : 0378019880310050033
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New Medical Journal
1988 Volume.31 No. 5 p.33 ~ p.38
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Selective Management of Abdominal Trauma
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Abstract
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This report is a review of 33 cases with abdominal injury which were admitted, not operated emer.ently and managed conservatively in the department of surgery, Guro hospital, Korea University duri g the period of 4 years from Sep. 1983 to Aug. 1987.
The following results were obtained.
1. The sex distribution was 25 males and 8 females with the ratio of 3.1:1 and the highest age incidence showed in 2nd decade (39.3%).
2. Among the 33 cases of abdominal trauma, blunt injuries were 21 cases (63.6%) and penetraing incidies were 12 cases (36.3%). According to the, causes of injury, traffic accident (42.4%) was most common,followed by stab wound (36.3%), kick or blow (12.1%) and falls or slip (9.0%).
3. The most common clinical manifestation was abdominal pain (81.8%). Other manifestations we, dominal tenderness (75.7%), abdominal wall rigidity (27.7%), nausea and vomiting (24.2%) and hest discomfort (21.2%) in the order of frequency.
4. Associated extraabdominal organ injuries were soft tissue injury (12.1%), thoracic injury (9.0%1 and head injury (6.0%) in the order of frequency.
5. The duration of nothing by mouth was within 24 hours in 24 cases (88.8%) and average hospitaliz : tion was 6 days.
6. The result of peritoneal savage were weakly positive in 19 cases (57.5%) and the cases with fresh orm RBC ratio under 10% were include nonoperative management.
7. The surgical indications of observed cases were increased fluid collection around the solid organs, de eased hematocrit value in repeated check, no improved peritoneal irritation sign within 24 hours, an i increased ratio of fresh form RBC in repeated peritoneal lavage.
8. The indications of nonoperative management included non-penetration of the peritoneum, improved abdominal condition and negative or unchanged minimal positive findings of abdominal sonogram and CT scan in the patient with stable vital sign after initial fluid administration and transfusion.
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