This is a clinical analysis of 45 patients with traumatic hepatic injuries treated at the General surgery Department of Hallym University's Kangdong Sacred Heart Hospital from December 1986 through December 1989. Of the 45 patients, 32 have
undergone
surgical operations, while 13 under went conservative treatment. Followings are are relevant clinical results;
1) Regarding age groups; 14 patients (31%) were in their twenties, followed by 10 years or younger age group and the age group of the thirties.
2) Ratio between male and female was 4 to 1, i. e., 36 male patients (80%) and 9 female patients (20%).
3) Blunt trauma was the most frequent cause of the hepatic injury whereby 35 patients were suffering. Of these 35, 27 pateints (77%) were due to traffic accidents, 3 (9%) patients were hospitalized because of fall-down and 5 (14%) were caused by
street
violences. And, 10 patients were stabbed to be penetrated in the liver. Of the traffic accident victims, there were 13 pedestrians and, 14 passengers of various vehccles.
4) Of the 35 patients with blunt trauma, 22 patients (63%) have undergone surgical operations while the remaining 13 received conservative treatment. All 10 patients with penetrating injury have undergone surgical operations.
5) In the cases of abdominal blunt trauma, patients were classified by 5 different categories which ranged class 1 through class 5.
Of the class I patients, 8 out of 12 patients revealed abnormality (average 367/290) as the the SGOT/SGPT, Fifteen patients in class II as well as 7 patients in class III showed abnormality as to the SGOT/SGPT, whose respective average were
229/120
and
553/232. The average time span required for them to recover normal SGOT/SGPT were approximately 10 days.
6) 6 out of 12 class I patients have undergone surgical operations, 8 out of 15 class III patients and all 7 class III patients have undergone surgical operations as well. Surgical operations applid to class I and II patients were primary
closure
and
drainages.
7) Also, of the 35 blunt trauma patients, 27 patients (77%) received associated injuries. And, 17 of these 27 have undergone surgical operation while 10 patients received conservative treatment. As to the associated injuries, most frequent cases
were
associated with fractures in the chest or riba. Three out of 10 patients who suffered head injury died.
8) Five out of 10 patients with penetrating injury revealed associate injury of durable nature. And, of such patients, 3 suffered penetrations in the chest.
9) Most popular surgical operation employed was primary closure and drainage method (22 cases, 69%). There were 4 cases of drainage method, 3 of hepatic A. ligation and, 2 hepatic resections.
10) Of the surgical operations, 10 patients suffered complications and, the most common complication was pulmonary complications.
11) Mortalities were higher where there was less TS, higher IS or lower TRISS. And, where there was higher TRISS, mortality decreased. It is considered that TS, IS and TRISS shall be applied as index for the evaluation and transfer of the trauma
patient.
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