Journal of Trauma and Injury

Original Articles

From trauma surgery to acute care surgery: a 4-year observational study at a single trauma center in Korea: Jung-Woo Woo, Jae Yool Jang, Yo Seok Cho, Hongkyung Shin, Chan Yong Park; J Trauma Inj. 2025;38(4):382-388. Published online December 31, 2025; DOI: https://doi.org/10.20408/jti.2025.0248

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Abstract PDF: Purpose
The acute care surgery (ACS) model establishes the capacity to immediately accommodate nontraumatic emergency surgery requiring urgent treatment while simultaneously elevating the existing trauma care system to the highest level. This study aims to evaluate the 4-year experience of operating after expanding the trauma surgery domain to ACS at this institution, which was designated as a lower-level trauma center by the local government in 2020.
Methods
A retrospective study was conducted using clinical records for patients who underwent surgery in the Division of Trauma and Acute Care Surgery over a 54-month period, from March 2021 to August 2025.
Results
Trauma volumes remained stable (10–20 cases semiannually) after ACS implementation, with surgical case numbers similar to those recorded before its introduction. Nontrauma volumes increased from 3 cases in March–August 2023 to 163 in March–August 2025.
Conclusions
The transition from the trauma surgery model to the ACS model successfully increased the efficiency of trauma and emergency general surgery within the level II low-volume environment, accomplishing without reducing the existing trauma caseload. These findings support the adoption of ACS in similar emergency medical institutions and offer insights relevant for national policy development concerning emergency general surgery in Korea.; Summary

Effects of the medical professional shortage caused by a resident walkout on scene-to-door time: a retrospective cohort study at a trauma center: Yo-Seok Cho, Jae Yool Jang, Jung-Woo Woo, Do Joong Park, Chan Yong Park; J Trauma Inj. 2025;38(4):335-342. Published online December 29, 2025; DOI: https://doi.org/10.20408/jti.2025.0128

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Abstract PDF Supplementary Material: Purpose
In February 2024, a nationwide resident walkout in Korea caused a temporary shortage of medical professionals. This study investigated whether the walkout influenced trauma care, with a particular focus on scene-to-door time and patients’ in-hospital course.
Methods
Trauma patients transported by emergency medical services between June 1, 2022, and March 31, 2025, were included if trauma team activation occurred upon emergency department arrival. Patients were divided into two groups: group 1 (post–COVID-19 normalization period) and group 2 (post–resident walkout period). The primary outcome was scene-to-door time.
Results
A total of 271 patients were analyzed: 117 in group 1 and 154 in group 2. The proportion of patients originating outside the primary service area increased from 16.7% to 31.3%. Intensive care unit admission rates decreased (65.0% vs. 22.1%), while interhospital transfers directly from the emergency department increased (7.7% vs. 18.8%). The median scene-to-door time rose from 28 to 44.5 minutes. Spline regression and locally estimated scatterplot smoothing analyses revealed no consistent temporal trend but showed greater variability during the walkout period. According to the generalized linear model, scene-to-door time was 42% longer during this period.
Conclusions
The resident walkout was associated with marked delays in scene-to-door time and shifts in in-hospital patient flow. These findings suggest that even temporary workforce shortages can disrupt both prehospital and in-hospital trauma care, underscoring the importance of response planning and adaptable system operations during workforce disruptions.; Summary

Editorial

The Last Temptation of Christ as terminal hallucination: a trauma surgeon’s interpretation of hypovolemic shock in literature and film: Kun Hwang, Chan Yong Park; J Trauma Inj. 2025;38(3):165-167. Published online September 29, 2025; DOI: https://doi.org/10.20408/jti.2025.0113

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PDF: Summary

Original Articles

Estimated blood storage requirements for a North Korean invasion of South Korea and South Korea’s preparedness: Kun Hwang, Chan Yong Park; J Trauma Inj. 2025;38(3):232-236. Published online September 29, 2025; DOI: https://doi.org/10.20408/jti.2025.0061

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Abstract PDF: Purpose
Hemorrhage is the leading cause of preventable battlefield deaths, and up to 30% of casualties could survive with timely transfusions. In a potential North Korea–South Korea conflict, ensuring adequate blood supply would be crucial for military medical readiness. This study estimated the 2-week blood demand in such a conflict and evaluated South Korea’s preparedness to meet it.
Methods
A multifaceted approach was employed, incorporating historical casualty data, medical literature on battlefield transfusions, South Korean blood supply reports, and military blood logistics models. Projections indicate 80,000 to 150,000 casualties within the first 2 weeks, with 30% of military and 15% of civilian casualties requiring transfusions. The estimated total blood demand ranges from 360,000 to 600,000 L, surpassing current South Korean reserves.
Results
Despite a 100,000-L prewar storage goal, weekly replenishment needs could reach 150,000 to 300,000 L, placing immense strain on collection, storage, and distribution systems. Key shortages include packed red blood cells, fresh frozen plasma, and platelets, with projected deficits of up to 120,000, 70,000, and 30,000 units, respectively. The logistical challenges of storing and transporting platelets, given their 5-day shelf life, make them particularly vulnerable to depletion. To address these shortages, a multipronged strategy is required, including pre-war stockpiling, mobile blood banks, rapid military-civilian coordination, international cooperation with US and other allies, and prioritization of whole blood over component therapy.
Conclusions
South Korea’s current blood reserves are insufficient for a large-scale war. A combination of strategic stockpiling, military-civilian coordination, and alternative blood sources (synthetic oxygen carriers, prewar autologous donation programs) is essential to sustaining medical operations and improving survival rates.; Summary

Comparison of pedestrian injury characteristics between preschoolers and early school-aged children in Korea: a cross-sectional study: Ha Na Jeong, Chan Yong Park; J Trauma Inj. 2025;38(3):211-220. Published online September 29, 2025; DOI: https://doi.org/10.20408/jti.2025.0040

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Abstract PDF: Purpose
Pedestrian traffic injuries pose a significant public health issue worldwide and remain prevalent in Korea despite ongoing efforts to improve traffic safety. To inform future initiatives aimed at addressing this problem, this study compared pedestrian injuries between preschoolers (aged 4–5 years) and early school-aged children (aged 6–7 years), using national data on pedestrian injuries in these groups.
Methods
This study analyzed secondary data from the 2020 Community-Based Severe Trauma Surveillance (2016–2020). Injury-related characteristics and outcome variables were compared between the two age groups. Additionally, the distribution of pedestrian injuries was analyzed by month, day, and time.
Results
Of 413 pedestrian injuries, 173 (41.9%) occurred in preschoolers and 240 (58.1%) occurred in early school-aged children. Injuries most frequently occurred in July for preschoolers (18.5%) and in June for early school-aged children (13.3%). Preschoolers experienced more injuries on Saturdays (22.0%), whereas early school-aged children had higher injury rates on Tuesdays and Thursday both (17.9%). Peak injury times were around 5 PM for preschoolers (16.2%) with a secondary peak at 9 AM (15.6%). For early school-aged children, 5 and 6 PM were peak injury times (both 14.6%), with a secondary peak at 3 PM (14.2%). The severe injury group (Injury Severity Score, 16–75) had a significantly higher mortality rate than the mild/moderate injury group (Injury Severity Score, 1–15; odds ratio, 5.65; P=0.006). Furthermore, the mortality rate was significantly higher at local emergency centers than at regional trauma centers (odds ratio, 4.00; P=0.011).
Conclusions
Understanding the distinct characteristics of pedestrian injuries among young children can inform targeted interventions and policies, ultimately mitigating this problem and improving traffic safety for children in Korea and globally.; Summary

Lessons from foreign military surgeons in the Korean War: advancing trauma surgery and preparing for future conflicts: Kun Hwang, Chan Yong Park; J Trauma Inj. 2025;38(2):103-110. Published online June 16, 2025; DOI: https://doi.org/10.20408/jti.2025.0041

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Abstract PDF

Purpose
The Korean War (1950–1953) significantly advanced military medicine, with foreign military surgeons playing a pivotal role in transforming trauma care under extreme conditions.
Methods
Resources such as PubMed, JSTOR, and reports from participating nations formed the basis of this study. A thorough comparative analysis was performed to examine the similarities and differences in medical practices between the United Nations Command and North Korean forces.
Results
The United States introduced Mobile Army Surgical Hospitals, revolutionizing trauma care by enabling rapid intervention near combat zones. Innovations such as helicopter evacuation, whole blood transfusions, and antibiotic treatments reduced mortality rates among treated soldiers to as low as 3%. British surgeons excelled in managing abdominal wounds and performing orthopedic surgery, often undertaking limb-saving procedures. Field hospitals provided comprehensive care for combat injuries and infectious diseases—a major concern given the inadequate sanitation. The Indian 60th Parachute Field Ambulance treated over 20,000 casualties, demonstrating adaptability in harsh environments. The Indian Field Hospital not only treated military casualties but also provided care to Korean civilians, offering life-saving medical interventions under challenging conditions. Denmark deployed the hospital ship MS Jutlandia, equipped with advanced surgical facilities, enabling a level of medical care that was not practical on land. The Swedish Red Cross Field Hospital in Busan delivered crucial medical aid to both military personnel and civilians; its staff focused on civilian outreach and controlling epidemics, with treatments targeting diseases such as typhoid and tuberculosis. Norwegian mobile surgical teams specialized in rapid interventions near combat zones, performing life-saving operations within hours of injury and thus minimizing complications and increasing survival rates.
Conclusions
The lessons learned from these contributions continue to influence modern military and civilian healthcare systems, highlighting the importance of innovation, collaboration, and resilience in conflict settings.

Summary

Citations

Citations to this article as recorded by

Classification of gunshot wounds of the thyroid gland
E.M. Khoroshun, I.A. Lurin, K.V. Misiura, V.V. Makarov, V.V. Nehoduiko, Yu.V. Bunin, B.M. Chernobil, N.Yu. Seliukova
INTERNATIONAL JOURNAL OF ENDOCRINOLOGY (Ukraine).2025; 21(7): 681. CrossRef

The causes and numbers of hospital admissions and deaths during the Korean War: Kun Hwang, Hun Kim, Chan Yong Park; J Trauma Inj. 2024;37(3):214-219. Published online September 30, 2024; DOI: https://doi.org/10.20408/jti.2023.0067

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PDF: Summary

Case Report

Life-threatening nasotracheal tube obstruction by a blood clot: a case report: Dajeong Lee, Chan Yong Park, Sang Wha Kim; J Trauma Inj. 2024;37(3):220-223. Published online September 3, 2024; DOI: https://doi.org/10.20408/jti.2023.0084

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Abstract PDF: The nasotracheal tube (NTT) is frequently used in oral and maxillofacial surgery and is generally considered a safe means of protecting the airway while ensuring an adequate surgical field. The most common complication associated with NTT is epistaxis, and only a few cases of foreign body obstruction have been reported. In this case report, the authors aimed to highlight the potential for NTT obstruction following surgery. A 24-year-old female patient, who underwent mandibuloplasty and rhinoplasty at a local clinic, was referred to our hospital patient due to dyspnea and edema on her right mandibular angle. Even with NTT, patient continued to experience mild dyspnea and tachypnea, so a T-piece was applied. However, tachycardia accompanied by a sudden worsening of dyspnea was observed, and bag-valve-mask ventilation was initiated promptly. But oxygen saturation remained unimproved, so an emergency cricothyroidotomy was performed. After 4 hours, the patient’s condition stabilized. Upon examination, the previously inserted NTT was identified, and a blood clot approximately 10 cm long at the NTT tip was discovered, causing lumen obstruction. The obstructions of NTT can lead to serious or life-threatening consequences if left unobserved or ignored. Therefore, when a patient with an NTT complains of dyspnea, clinicians should promptly investigate the possibility of partial NTT obstruction to ensure the airway’s security.; Summary

Review Article

Biomechanics of stabbing knife attack for trauma surgeons in Korea: a narrative review: Kun Hwang, Chan Yong Park; J Trauma Inj. 2024;37(1):1-5. Published online January 15, 2024; DOI: https://doi.org/10.20408/jti.2023.0057

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Abstract PDF

The aim of this paper was to review the biomechanics of knife injuries, including those that occur during stabbing rampages. In knife stab attacks, axial force and energy were found to be 1,885 N and 69 J, respectively. The mean velocity of a stabbing motion has been reported to range from 5 to 10 m/sec, with knife motions occurring between 0.62 and 1.07 seconds. This speed appears to surpass the defensive capabilities of unarmed, ordinarily trained law enforcement officers. Therefore, it is advisable to maintain a minimum distance of more than an arm's length from an individual visibly armed with a knife. In training for knife defense, particularly in preparation for close-quarter knife attacks, this timing should be kept in mind. Self-inflicted stab wounds exhibited a higher proportion of wounds to the neck and abdomen than assault wounds. Injuries from assault wounds presented a higher Injury Severity Score, but more procedures were performed on self-inflicted stab wounds. Wound characteristics are not different between nonsuicidal self-injury and suicidal self-wrist cutting injuries. Consequently, trauma surgeons cannot determine a patient's suicidal intent based solely on the characteristics of the wound. In Korea, percent of usage of lethal weapon is increasing. In violence as well as murders, the most frequently used weapon is knife. In the crimes using knife, 4.8% of victims are killed. Therefore, the provision of prehospital care by an emergency medical technician is crucial.

Summary

Citations

Citations to this article as recorded by

Experimental investigation on dynamic stab resistance of high-performance multi-layer textile materials
Mulat Alubel Abtew, François Boussu, Irina Cristian, Bekinew Kitaw Dejene
Defence Technology.2025; 47: 1. CrossRef

Case Reports

Successful minimally invasive management using transcatheter arterial embolization in a hemodynamically stable elderly patient with mesenteric vascular injury in a hybrid emergency room system in Korea: a case report: So Ra Ahn, Joo Hyun Lee, Sang Hyun Seo, Chan Yong Park; J Trauma Inj. 2023;36(4):435-440. Published online July 25, 2023; DOI: https://doi.org/10.20408/jti.2023.0018

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2 Web of Science
3 Citations

Abstract PDF

Mesenteric injury occurs rarely in cases associated with blunt abdominal trauma. Despite its low incidence, mesenteric injury can lead to fatal outcomes such as hypovolemic shock due to hemoperitoneum or sepsis due to intestinal ischemia, or perforation-related peritonitis. For mesenteric injuries, especially those involving massive bleeding, intestinal ischemia, and perforation, the standard treatment is surgery. However, in the case of operative management, it should be borne in mind that there is a possibility of complications and mortality during and after surgery. The usefulness of transcatheter arterial embolization (TAE) is well known in solid organs but is controversial for mesenteric injury. We present a 75-year-old man with mesenteric injury due to blunt abdominal trauma. Initial abdominal computed tomography showed no hemoperitoneum, but a mesenteric contusion and pseudoaneurysm with a diameter of 17 mm were observed near the origin of the superior mesenteric artery. Since there were no findings requiring emergency surgery such as free air or intestinal ischemia, it was decided to perform nonoperative management with TAE using microcoils in hybrid emergency room system. TAE was performed successfully, and there were no complications such as bleeding, bowel ischemia, or delayed bowel perforation. He was discharged on the 23rd day after admission with percutaneous catheter drainage for drainage of mesenteric hematoma. The authors believe that treatment with TAE for highly selected elderly patients with mesenteric injuries has the positive aspect of minimally invasive management, considering the burden of general anesthesia and the various avoidable intraoperative and postoperative complications.

Summary

Citations

Citations to this article as recorded by

Management of a traumatic superior mesenteric artery injury using superselective angioembolization
Martha Ennis, Jurgienne Umali, David Pace
Journal of Vascular Surgery Cases, Innovations and.2025; 11(2): 101726. CrossRef
Successful Non-Operative Management of Middle Colic Artery Injury Using Transcatheter Arterial Embolization Performed in a Hybrid Emergency Room System
Joo Hyun Lee, So Ra Ahn, Sang Hyun Seo, Chan Yong Park
Journal of Acute Care Surgery.2025; 15(1): 30. CrossRef
Abdomen (A Pandora’s Box): A Delayed Presentation of Blunt Abdominal Injury With a Mesenteric Tear Leading to Gangrenous Bowel
Abishek Prasenaa, Thinagaran K, Reegan Jose , Karthick G
Cureus.2024;[Epub] CrossRef

Pre-Hospital and In-Hospital Management of an Abdominal Impalement Injury Caused by a Tree Branch: So Ra Ahn, Joo Hyun Lee, Keun Young Kim, Chan Yong Park; J Trauma Inj. 2021;34(4):288-293. Published online December 16, 2021; DOI: https://doi.org/10.20408/jti.2021.0051

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Abstract PDF: In South Korea, most patients who visit trauma centers with abdominal injuries have blunt trauma, and penetrating injuries are relatively rare. In extremely rare cases, some patients are admitted with a long object penetrating their abdomen, and these injuries are referred to as abdominal impalement injuries. Most cases of impalement injuries lead to fatal bleeding, and patients often die at the scene of the accident. However, patients who survive until reaching the hospital can have a good prognosis with optimal treatment. A 68-year-old female patient was admitted to the trauma center with a 4-cm-thick tree branch impaling her abdomen. The patient was transported by a medical helicopter and had stable vital signs at admission. The branch sticking out of the abdomen was quite long; thus, we carefully cut the branch with an electric saw to perform computed tomography (CT). CT revealed no signs of major blood vessel injury, but intestinal perforation was observed. During laparotomy, the tree branch was removed after confirming that there were no vascular injuries, and enterostomy was performed because of extensive intestinal injury. After treating other injuries, the patient was discharged without any complications except colostomy. Abdominal impalement injuries are treated using various approaches depending on the injury mechanism and injured region. However, the most important consideration is that the impaled object should not be removed during transportation and resuscitation. Instead, it should only be removed after checking for injuries to blood vessels during laparotomy in an environment where injury control is possible.; Summary

Non-Operative Management with Angioembolization of Grade IV and V Renal Injuries in a Hybrid Emergency Room System: So Ra Ahn, Sang Hyun Seo, Joo Hyun Lee, Chan Yong Park; J Trauma Inj. 2021;34(3):191-197. Published online September 30, 2021; DOI: https://doi.org/10.20408/jti.2021.0034

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Abstract PDF

Renal injuries occur in more than 10% of patients who sustain blunt abdominal injuries. Non-operative management (NOM) is the established treatment strategy for lowgrade (I–III) renal injuries. However, despite some evidence that NOM can be successfully applied to high-grade (IV, V) renal injuries, it remains unclear whether NOM is appropriate in such cases. The authors report two cases of high-grade renal injuries that underwent NOM after embolization in a hybrid emergency room (ER) system with a 24/7 in-house interventional radiology (IR) team. A 29-year-old male visited Wonkwang University Hospital Regional Trauma Center complaining of right abdominal pain after being hit by a rope. Computed tomography (CT) was performed 16 minutes after arrival, and the CT scan indicated a grade V right renal injury. Arterial embolization was initiated within 31 minutes of presentation. A 56-year-old male was transferred to Wonkwang University Hospital Regional Trauma Center with a complaint of right flank pain. He had initially presented to a nearby hospital after falling from a 3-m height. Thanks to the key CT images sent from the previous hospital prior to the patient’s arrival, angiography was performed within 8 minutes of the patient’s arrival and arterial embolization was completed within 25 minutes. Both patients were treated successfully through NOM with angioembolization and preserved kidneys. Hematoma in the first patient and urinoma in the second patient resolved with percutaneous catheter drainage. The authors believe that the hybrid ER system with an in-house IR team could contribute to NOM and kidney preservation even in high-grade renal injuries.

Summary

Citations

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From Clot to Cure: Navigating Vascular Pitfalls With Endovascular Salvage of a Delayed Renal Artery Pseudoaneurysm Following High-Energy Renal Trauma
Sampangi Raju S P, Ruby Kataria , Madhur Uniyal , Neeraj Kumar, Santhosh Balachandra
Cureus.2025;[Epub] CrossRef
Splenic artery embolization for trauma: a narrative review
Simon Roh
Journal of Trauma and Injury.2024; 37(4): 252. CrossRef
Endovascular embolization of persistent liver injuries not responding to conservative management: a narrative review
Simon Roh
Journal of Trauma and Injury.2023; 36(3): 165. CrossRef

Original Articles

Validity of the scoring system for traumatic liver injury: a generalized estimating equation analysis: Kangho Lee, Dongyeon Ryu, Hohyun Kim, Chang Ho Jeon, Jae Hun Kim, Chan Yong Park, Seok Ran Yeom; J Trauma Inj. 2022;35(1):25-33. Published online September 7, 2021; DOI: https://doi.org/10.20408/jti.2021.0009

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1 Web of Science
1 Citations

Abstract PDF Supplementary Material

Purpose
The scoring system for traumatic liver injury (SSTLI) was developed in 2015 to predict mortality in patients with polytraumatic liver injury. This study aimed to validate the SSTLI as a prognostic factor in patients with polytrauma and liver injury through a generalized estimating equation analysis. Methods: The medical records of 521 patients with traumatic liver injury from January 2015 to December 2019 were reviewed. The primary outcome variable was in-hospital mortality. All the risk factors were analyzed using multivariate logistic regression analysis. The SSTLI has five clinical measures (age, Injury Severity Score, serum total bilirubin level, prothrombin time, and creatinine level) chosen based on their predictive power. Each measure is scored as 0–1 (age and Injury Severity Score) or 0–3 (serum total bilirubin level, prothrombin time, and creatinine level). The SSTLI score corresponds to the total points for each item (0–11 points). Results: The areas under the curve of the SSTLI to predict mortality on post-traumatic days 0, 1, 3, and 5 were 0.736, 0.783, 0.830, and 0.824, respectively. A very good to excellent positive correlation was observed between the probability of mortality and the SSTLI score (γ=0.997, P<0.001). A value of 5 points was used as the threshold to distinguish low-risk (<5) from high-risk (≥5) patients. Multivariate analysis using the generalized estimating equation in the logistic regression model indicated that the SSTLI score was an independent predictor of mortality (odds ratio, 1.027; 95% confidence interval, 1.018–1.036; P<0.001). Conclusions: The SSTLI was verified to predict mortality in patients with polytrauma and liver injury. A score of ≥5 on the SSTLI indicated a high-risk of post-traumatic mortality.

Summary

Citations

Citations to this article as recorded by

Liver Trauma: Management in the Emergency Setting and Medico-Legal Implications
Angela Saviano, Veronica Ojetti, Christian Zanza, Francesco Franceschi, Yaroslava Longhitano, Ermelinda Martuscelli, Aniello Maiese, Gianpietro Volonnino, Giuseppe Bertozzi, Michela Ferrara, Raffaele La Russa
Diagnostics.2022; 12(6): 1456. CrossRef

Characteristics of Traffic Accidents on Highways: An Analysis Based on Patients Treated at a Regional Trauma Center: Sung Yong Lee, Kyung Hoon Sun, Chan Yong Park, Tae Hoon Kim; J Trauma Inj. 2021;34(4):263-269. Published online June 4, 2021; DOI: https://doi.org/10.20408/jti.2020.0063

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1 Citations

Abstract PDF

Purpose

There have been increasing concerns about serious traffic accidents on highways. The purpose of this study was to analyze factors affecting traffic accidents on highways and the severity of the resulting injuries.

Methods

This retrospective study was conducted at a regional trauma center. We reviewed 594 patients who had been in 114 traffic accidents on highways from January 2018 to June 2020. We collected demographic data, clinical data, accident-related factors, and meteorological data (weather and temperature).

Results

Environmental risk factors were found to be significantly associated with the incidence of traffic accidents on highways. Injury severity and the death rate were higher in sedans than in any other type of vehicle. Tunnels were the most common location of accidents, accounting for 47 accidents (41.2%) and 269 injured patients (45.3%). The injury severity of individuals riding in the driver’s seat (front seat) was high, regardless of vehicle type. Three meteorological risk factors were found to be significantly associated with traffic accidents: rainy roads (odds ratio [OR] 2.08; 95% confidence interval [CI] 1.84–3.29; p=0.01), icy or snowy roads (OR 5.12; 95% CI 2.88–7.33; p<0.01), and foggy conditions (OR 2.94; 95% CI 2.15–4.03; p<0.05).

Conclusions

The injury severity of patients was affected by seat position and type of vehicle, and the frequency of accident was affected by the location. The incidence of traffic accidents was strongly influenced by meteorological conditions (rain, snow/ice, and fog).

Summary

Citations

Citations to this article as recorded by

What are the individual and joint impacts of key meteorological factors on the risk of unintentional injuries? A case-crossover study of over 147,800 cases from a sentinel-based surveillance system
Xiao Lin, Tian Tian, Congxing Shi, Pengyu Wang, Shimin Chen, Tong Guo, Zhiqiang Li, Boheng Liang, Wangjian Zhang, Pengzhe Qin, Yuantao Hao
Sustainable Cities and Society.2023; 91: 104413. CrossRef

Case Report

Splenic Artery Bleeding into the Extraperitoneal Space Mimicking Mesenteric Injury: A Rare Case of Blunt Trauma: Sang Hyun Seo, Hyun Seok Jung, Chan Yong Park; J Trauma Inj. 2021;34(2):141-145. Published online March 15, 2021; DOI: https://doi.org/10.20408/jti.2020.0076

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Abstract PDF: Splenic injury is a common result of blunt trauma, and bleeding occurs mainly inside the splenic capsule and may leak into the peritoneal space. Herein, we report a case where active bleeding occurred in the splenic artery and only leaked into the extraperitoneal space. This is the first case of this phenomenon in a trauma patient in the English-language literature. Bleeding passed through the peritoneum, leaked into the anterior pararenal space, and continued along the extraperitoneal space to the prevesical space of the pelvis. Therefore, on the initial computed tomography (CT) scan, the bleeding appeared to be in the left paracolic gutter, so we suspected mesenteric bleeding. However, after the CT series was fully reconstructed, we accurately read the scans and confirmed splenic injury with active bleeding. If there had been a suspicion of bowel or mesenteric injury, surgery would have been required, but fortunately surgery could be avoided in this case. The patient was successfully treated with angioembolization.; Summary

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