The diagnosis and management of acute abdominal problems in the patient with spinal cord injuries are different to the normal neuraxis because of the profound neurologic deficity.
Twenty-nine cases of laparotomies in-patient with spinal cord injuries were performed during the period of Jan. 1979 to Dec. 1983 at the Department of Surgery of Korea Veterans Hospital and the clinical analysis is carried out on these cases.
The results were summarized as follows:
1) Autonomic dysreflexia has developed in 6 cases of 7 patients with complete lesion of the spinal cordat, and above T-6, who had an acute inflammatory abdominal disease.
2) Among 29 case of the abdominal problem patient with spinal cord injury, increased pulse rate has developed in 25 cases, which was irrespective of level of cord lesin.
3) The patient with spinal cord, lesion atT-12 or below had intact sensation to abdominal viscera that was able to early complaint of localized pain, especially in appendicitis.
4) Tetraplegia with surgical abdomen had a radiating pain to shoulder that was helpful sign in diagnosis.
5) In the operative management of 6 peptic ulcer patients with spinal cord injury, 5 cases had subtotal gastrectomy, without any postoperative complication, especially such as prolonged gastric stasis.
From our result of analysis, it can be concluded that patient with spinal cord injuries can tolerate the abdominal operative procedure and postoperative course when physicians have .a working knowledge of nervous system disease and change in physiology it produces.
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