소아복부둔상시 저혈량성 쇽과 연관된 복부전산화 단층촬영술의 유용성 = A Significance of Abdominal CT Manifestration Associatrd with Hypovolemic Shock in Blunt Abdominal Trauma of Children

다국어 초록 (Multilingual Abstract)

Background: We reviewed retrospectively the clinical features and contrast material-enhanced computed tomography(CT) after blunt abdominal trauma demonstrated a characteristic hypoperfusion complex. Our purpose were to evaluate the hypothesis that children with this "hypoperfusion complex" CT finding were associated with a tenuous hemodynamic state, severe injury and a poor outcome.
Methods: Between January 1996 and December 1999, 39 consecutive children who sustained blunt trauma and were suspected clinically of having intraabdominal injury underwent CT. Demographic data, blood pressure, indication for CT, pediatric trauma score(PTS) and Glasgow coma score(GCS) were recorded at the time of the initial examination.
Results: Three of the 39 children(8%) demonstrated a characteristic finding at CT which was described as the hypoperfusion complex. The "hypoperfusion complex" was present in the 3 of the 39 traumatized children(8%), but was the main radiographic finding in the 3 of the 14 children with a severe pediatric trauma score(PTS＜8) and in the 3 of the 6 children with a Glasgow coma score(GCS＜8) who were examined with CT.
Conclusion: The CT findings in all children with the hypoperfusion complex by definition included marked, diffuse dilatation of the intestine with fluid; abnormally intense contrast enhancement of the bowel wall, mesentery, kidney and/or pancreas; decreased caliber of the abdominal aorta and inferior vena cava(IVC); and moderate to large peritoneal fluid collection. This "hypoperfusion complex" is a relatively rarely observed in injured children but appears to be associated with severe injury and a poor outcome. The pediatric trauma score provides a useful profile of injury severity in children. Prompt diagnosis of hypovolemic shock is important so that supportive therapy can be instituted to prevent further metabolic abnormalities and their potential cardiotoxic effects. In summary, the intense multiorgan enhancement pattern seen in the hypoperfusion complex indicates tenuous hemodynamic stability and is associated with a poor outcom.

목차 (Table of Contents)

• Ⅰ.서론
• Ⅱ.대상과 방법
• Ⅲ.결과
• Ⅳ.고찰
• Ⅴ.결론