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구기수,백정흠,박문기,곽승수 대한외상학회 1996 大韓外傷學會誌 Vol.9 No.1
We experienced the 45 cases of traumatic spleen injury at the department of General Surgery, Sun General Hospital from Jan. 1991 to Dec. 1995. There was 34 male and 11 female patients. The results were as follows : 1) The age distribution was ranged from 8 to 69 years. 2) 45 Patients had blunt trauma 35(traffic accident 28, fall down 5, gun shot 2), slipped down 7, and 3 had stab wound. 3) According to splenic injury scale, Grade N was most common in 17 cases(37.8%). Grade II was in 7 cases (8. 8%). Grade lll was in 16 cases (35. 6%). Grade V was in 8 cases(17. 8). 4) Associated injuries were record in 31 cases with intra-abdominal organ in 23 cases(51.1%) and extra-abdominal region in 24(53.3%). The most commonly involved intra-abdominal organ was liver in 11 cases(24.4%). 5) The diagnostic methods were abdominal CT scan in 26 (57. 8%) cases, CT+US in 2cases(4.4%) US in 2(4.4%)cases, Paracentesis+CT in 5(11.1%)cases, Paracentesis in 4(8.9%)cases, Explolaparotomy in 6(13.3%) cases. 6) The average transfusion requirments were 5. 57 units pack red cells. 7) The mortality was 6. 7%. Eighteen patients developed complications. The postoperative complication were three wound dehiscence, three subdiaphragmatic abscess, three ARDS, six pleural effusion, four atelectasis, and one acute mucosal erosion. 8) The average length of hospital stay was 18. 4 days.
구기수,곽승수,최재윤 대한외상학회 1995 大韓外傷學會誌 Vol.8 No.1
This report is a review of 181 patients who were admitted and treated due to abdominal trauma in the department of general surgery, Sun General Hospital, Tae Jeon from Jan. 1992 to Dec. 1994. The results are as follows: 1) The mal to Female ratio was 159: 122, with a significant predominance in male(7.1:1) and the age distribution revealed high incidence in both sexes of the those in the third decacle(25.4%) and 4th decade(22.6%). 2) The seasonal distribution was more common in summer(30.9%). 3) The causes of abdominal trauma in order of frequency were;traffuc accident(55.8%), stab wound(20. 0, violence(1.4%). Among the 181 cases of trauma, blunt trauma were 143 cases(79%) and penetrating trauma were 38 cases(20. 9%). 4) The clinical manifestions in order of frequency were : abdominal pain(88.9%), abdominal tenderness(86.1%), rebound tenderness(77%), abdominal rigidity(60.2%) and decreased peristalsis (39%). 5) The plain films of abdomen showed free air under the diaphragm in 22 cases(26.5%) of 83 cases with hollow viscus repture. 6) Operations were performed within 12 hours(in 64.1% of the cases) and within 24 hours(in 82.8% of the cases) from traurna attack. 7) The injured intraabdominal organs in order of frequency were: small bowel(39, 7%), spleen(14.3%), liver(13.8%) and mesentery(6.6%). Jejunum was the most common site of small bowel injuries. 8) The associated injuries in order of frequency were; the chest(43.6%), upper and lower extremity(11.6%) and pelvic bone fracture(6.6%). 9) Blood transfusions were not required in 77 cases(42.5%), but massive transfusions above 6 units were required in 55 cases(30.3%). 10) Post-operative complications developed in 73 cases(40,3%) of 181 cases in order of frequency were; pulmonary complication(20.4%), and intestinal obstruction(5.5%) and wound infection(5.5%). 11) The overall mortality rate of the abdominal trauma with rnultiple injuries was 4.4%(8 cases of 181 cases). The causes of death were hypovolemic shock in 3 cases, sepsis in 2 cases, brain injury in 2 cases and renal failure in 1 case.
구기수,곽승수,조정현,박경철 대한외상학회 1995 大韓外傷學會誌 Vol.8 No.1
We experienced the 17 cases of traumatic diaphragmatic injuries at the department of General surgery, Sun General Hospital from Jun, 1990 to Jun, 1994. There were 15 male and 2 female patients. The age distribution was ranged from 19 to 67 years. 13 Patients had blunt trauma(traffic accident 12, fall down 1), and 3 had penetrating injuries(stab wound), 1 patient had operation trauma. The ruptured sites were located on the left in 13 case, and on the right in 3 cases and 1case on the central port.ion. The most common symptoms were dyspnea and chest pain (82. 3%) Traumatic diaphragmatic hernia were suspected on the basis of an abdominal and chest plain X-ray findings in the trauma victim with multiple injuries. The 13 case of 17 patients(76,9%) were diagnosed and treated within 24 hours after trauma. We concluded that injuries to the diaphragm should be suspected in all patients with severe blunt torso traurna or with penetrating injuries in the diaphragm. Because of the nonspecificity of X-ray and the false negative other study, we believed that missed injuries and morbidity could be minimized by creful attention to the injuries.