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김용호,이근,고영관,주홍재,양혁준 대한외상학회 1996 大韓外傷學會誌 Vol.9 No.1
Because of the anatomical location of pancreas and duodeum and many associated injuries, the early diagnosis and proper management were somewhat difficult. Pancreas and duodenal inju.ries still carry a combined morbidity and mortality rate in excess of 40%. Although these organs were relatively protected in the retroperitoneum, high-speed motor-vehicle accidents have contributed to an increasing incidence of trauma. We have retrospectively reviewed 45 patients who sustained pancreatic and/or duodenal injuries, treated at the Department of Surgery, Kyung Hee University Hospital and Jungang-Gil Hospital, from Mar. 1984 to Mar 1995. Following results were obtained: 1) The sex distribution was 38 males and 7 females with a ratio of 5.4:1 and the highest incidence showed in the 3rd and 4th decades(55.6%). 2) The mode of injuries were 37 cases(82.2%) of blunt trauma and 8 cases(17.8%) of penetrating trauma. 3) The cases operated within 8 hours from injury were 19(49.2%) and the cases in 8 to 16 hours were 7(16.7%). 4) The serum amylase on admission was increased in 17 cases(37.8%). 5) The plain films of abdomen and chest X-ray showed free air in 12 cases(26.7%) and abdominal CT scan showed the injury in 15 cases(33. 3%). 6) The associated. Injuries in abdominal organs were as follows in decreasing order of frequency; retroperitoneum(12), liver(11), mesentery(10), spleen(9), small intestine(8), stomach(5), and large intestine(5). 7) The ATI value was minimal 5 to maximal 43 with mean 29. 7 and ISS value was minimal 9 to maximal 43 with mean 26.4. 8) The operat,ive management according to the extent of injury and the type of lesion was variable. 9) The postoperative complications were pulmonary complication, sepsis, intraabdominal abscess, wound infection, pancreatic fistula, pseudocyst, and anastomosis leakage. 10) The mortality rate was 13. 3%, and the cause of death was sepsis in all cases.