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골반골 골절에서 손상 제어 개복술 후 지속적인 출혈의 치료: 동맥 색전술 -증례보고-
김기훈 ( Ki Hoon Kim ),경규혁 ( Kyu Hyouk Kyung ),김진수 ( Jin Su Kim ),박성진 ( Sung Jin Park ),남소현 ( So Hyun Nam ),김운원 ( Woon Won Kim ),김용한 ( Yong Han Kim ) 대한외상학회 2011 大韓外傷學會誌 Vol.24 No.2
Massive bleeding due to traumatic pelvic bone fracture is a leading cause of death. Thus, several methods to control bleeding have been attempted, but none of these has yet been clearly established. After an automobile accident, a 34-year-old motorist was admitted to the Emergency Department for right hip, leg and abdominal pain. Because the patient`s pressure remained consistently low and pelvic bone fracture and abdominal bleeding were found on radiologic examination, an explorative laparotomy was performed. After pelvic packing and bleeding control, bleeding still continued, so Angiography was performed, and arterial embolization for bleeding was performed.
골절을 동반한 다발성 외상 환자에서 발생한 비결석성 담낭염
김기훈 ( Ki Hoon Kim ),경규혁 ( Kyu Hyouk Kyung ),김진수 ( Jin Su Kim ),김관우 ( Kwan U Kim ),김운원 ( Woon Won Kim ),김지완 ( Ji Wan Kim ) 대한외상학회 2012 大韓外傷學會誌 Vol.25 No.4
Purpose: The purpose of this study is to investigate the incidence of acalculous cholecystitis after multiple trauma with fractures and to analyze the characteristics of cholecystitis. Methods: We performed a retrospective study of multiple trauma patients with fractures between April 2010 and April 2012. Sixty-nine patients were identified, and the average age was 46.8(range: 15-74) years. Data were collected regarding associated injury, injury severity score (ISS), the diagnosis time after trauma, diagnostic tool, and management Results: There were three cases(4.3%) of cholecystitis among the 69 cases, and cholecystitis was diagnosed an average of 20.7(range: 8-33) days after injury. Two patients complained of abdominal pain at diagnosis, but the other patient who had undergone surgery for small bowel perforation at the time of the injury had no abdominal pain. All three patients had abnormal liver function tests (LFTs) at diagnosis. The cholecystitis was confirmed with ultrasonography or computed tomography, and all cases were acalculous cholecystitis. At first, percutaneous transhepatic gallbladder drainage was performed; then, laparoscopic cholecystectomy (LC) was tried an average of 12(range: 11-13) days later. An laparoscopic cholecystectomy was successfully done in only one case, the other cases being converted to an open cholecystectomy due to severe inflammation. Conclusion: The incidence of acaculous cholecystitis was 4.3% after multiple trauma with fractures. We should consider cholecystitis in patients with abdominal pain, fever and elevated LFTs after multiple trauma. (J Trauma Inj 2012;25:203-208)