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16 "Abdominal injuries"
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Original Articles
Pediatric blunt pancreatic trauma at a single center in Korea: a retrospective review from 2007 to 2022
Joong Kee Youn, Hee-Beom Yang, Dayoung Ko, Hyun-Young Kim
J Trauma Inj. 2023;36(3):242-248.   Published online September 7, 2023
DOI: https://doi.org/10.20408/jti.2023.0016
  • 621 View
  • 28 Download
AbstractAbstract PDF
Purpose
Blunt pancreatic trauma in pediatric patients is relatively rare, yet it is associated with high risks of morbidity and mortality This study aimed to review pediatric patients with blunt pancreatic trauma treated at a single center and provide treatment guidelines.
Methods
This study included patients under the age of 18 years who visited our center's pediatric emergency department and were diagnosed with pancreatic injury due to abdominal trauma via radiological examination between January 2007 and December 2022. Patients’ medical records were retrospectively reviewed and analyzed.
Results
Among 107 patients with abdominal trauma, 14 had pancreatic injury, with a median age of 8.2 years (interquartile range, 3.1–12.3 years). Eight patients were male and six were female. The most common mechanism of injury was falls from a height and bicycle handlebars (four cases each). Six patients had associated injuries. Two patients had American Association for the Surgery of Trauma grade I or II, eight had grade III, and four had grade IV or V injuries. Eight patients underwent surgical resection, and four were discharged with only an intervention for duct injuries.
Conclusions
Patients with blunt pancreatic trauma at our center have been successfully treated with surgical modalities, and more recently through nonsurgical approaches involving active endoscopic and radiologic interventions.
Summary
Epidemiology and outcomes of patients with penetrating trauma in Incheon Metropolitan City, Korea based on National Emergency Department Information System data: a retrsopective cohort study
Youngmin Kim, Byungchul Yu, Se-Beom Jeon, Seung Hwan Lee, Jayun Cho, Jihun Gwak, Youngeun Park, Kang Kook Choi, Min A Lee, Gil Jae Lee, Jungnam Lee
J Trauma Inj. 2023;36(3):224-230.   Published online December 21, 2022
DOI: https://doi.org/10.20408/jti.2022.0055
  • 1,408 View
  • 46 Download
AbstractAbstract PDF
Purpose
Patients with penetrating injuries are at a high risk of mortality, and many of them require emergency surgery. Proper triage and transfer of the patient to the emergency department (ED), where immediate definitive treatment is available, is key to improving survival. This study aimed to evaluate the epidemiology and outcomes of patients with penetrating torso injuries in Incheon Metropolitan City.
Methods
Data from trauma patients between 2014 and 2018 (5 years) were extracted from the National Emergency Department Information System. In this study, patients with penetrating injuries to the torso (chest and abdomen) were selected, while those with superficial injuries were excluded.
Results
Of 66,285 patients with penetrating trauma, 752 with injuries to the torso were enrolled in this study. In the study population, 345 patients (45.9%) were admitted to the ward or intensive care unit (ICU), 20 (2.7%) were transferred to other hospitals, and 10 (1.3%) died in the ED. Among the admitted patients, 173 (50.1%) underwent nonoperative management and 172 (49.9%) underwent operative management. There were no deaths in the nonoperative management group, but 10 patients (5.8%) died after operative management. The transferred patients showed a significantly longer time from injury to ED arrival, percentage of ICU admissions, and mortality. There were also significant differences in the percentage of operative management, ICU admissions, ED stay time, and mortality between hospitals.
Conclusions
Proper triage guidelines need to be implemented so that patients with torso penetrating trauma in Incheon can be transferred directly to the regional trauma center for definitive treatment.
Summary
Case Reports
Management of a traumatic anorectal full-thickness laceration: a case report
Laura Fortuna, Andrea Bottari, Riccardo Somigli, Sandro Giannessi
J Trauma Inj. 2022;35(3):215-218.   Published online May 19, 2022
DOI: https://doi.org/10.20408/jti.2021.0049
  • 2,219 View
  • 121 Download
AbstractAbstract PDF
The rectum is the least frequently injured organ in trauma, with an incidence of about 1% to 3% in trauma cases involving civilians. Most rectal injuries are caused by gunshot wounds, blunt force trauma, and stab wounds. A 46-year-old male patient was crushed between two vehicles while he was working. He was hemodynamically unstable, and the Focused Assessment with Sonography for Trauma showed hemoperitoneum and hemoretroperitoneum; therefore, damage control surgery with pelvic packing was performed. A subsequent whole-body computed tomography scan showed a displaced pelvic bone and sacrum fracture. There was evidence of an anorectal full-thickness laceration and urethral laceration. In second-look surgery performed 48 hours later, the pelvis was stabilized with external fixators, and it was decided to proceed with loop sigmoid colostomy. A tractioned rectal probe with an internal balloon was positioned in order to approach the flaps of the rectal wall laceration. On postoperative day 13, a radiological examination with endoluminal contrast injected from the stoma after removal of the balloon was performed and showed no evidence of extraluminal leak. Rectosigmoidoscopy, rectal manometry, anal sphincter electromyography, and trans-stomic transit examinations showed normal findings, indicating that it was appropriate to proceed with the closure of the colostomy. The postoperative course was uneventful. The optimal management for extraperitoneal penetrating rectal injuries continues to evolve. Primary repair with fecal diversion is the mainstay of treatment, and a conservative approach to rectal lacerations with an internal balloon in a rectal probe could provide a possibility for healing with a lower risk of complications.
Summary
Traumatic abdominal wall hernia with hemoperitoneum caused by blunt injury: laparoscopic exploration with mini-laparotomy repair. A case report
Euisung Jeong, Hyunseok Jang, Younggoun Jo, Yunchul Park, Naa Lee, Jungchul Kim
J Trauma Inj. 2022;35(1):61-65.   Published online December 23, 2021
DOI: https://doi.org/10.20408/jti.2021.0062
  • 2,490 View
  • 65 Download
AbstractAbstract PDF
Traumatic abdominal wall hernia is a very rare clinical entity. Herein, we report the case of a patient who was transferred from a local clinic to the emergency department because of left lower abdominal pain. Initially, an intra-abdominal hematoma was observed on computed tomography and no extravasation was noted. Conservative treatment was initiated, and the patient’s symptoms were slightly relieved. However, though abdominal pain was relieved during the hospital stay, bowel herniation was suspected in the left periumbilical area. Follow-up computed tomography showed traumatic abdominal wall hernia with hemoperitoneum in the abdomen. We performed a laparoscopic exploration of the injury site and hernia lesion. The anterior abdominal wall hernia was successfully closed.
Summary
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
  • 4,522 View
  • 178 Download
AbstractAbstract 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
Original Articles
Indications for Laparotomy in Patients with Abdominal Penetrating Injuries Presenting with Ambiguous Computed Tomography Findings
Eun Ji Choi, Sanghee Choi, Byung Hee Kang
J Trauma Inj. 2021;34(2):112-118.   Published online June 8, 2021
DOI: https://doi.org/10.20408/jti.2020.0058
  • 2,637 View
  • 88 Download
AbstractAbstract PDF
Purpose

Negative laparotomy in patients with abdominal penetrating injuries (APIs) is associated with deleterious outcomes and unnecessary expense; however, the indications for laparotomy in hemodynamically stable patients with ambiguous computed tomography (CT) findings remain unclear. This study aimed to identify the factors associated with negative laparotomy. findings

Methods

Data of patients who underwent laparotomy for APIs between 2011 and 2019 were retrospectively reviewed. Patients who presented with definite indications for laparotomy were excluded. The patients were dichotomized into negative and positive laparotomy groups, and the baseline characteristics, laboratory test results, and CT findings were compared between the groups.

Results

Of 55 patients with ambiguous CT findings, 38 and 17 patients were assigned to the negative and positive laparotomy groups, respectively. There was no significant difference between the groups with respect to the baseline characteristics or the nature of the ambiguous CT findings. However, the laboratory test results showed that there was a difference in the percentage of neutrophils between the groups (negative: 55.6% [range 47.4–66.1%] vs. positive: 79.8% [range 77.6–88.2%], p<0.001), although the total white blood cell count was not significantly different. The mean duration of hospital stay for the negative laparotomy group was 13.1 days, and seven patients (18.4%) experienced complications.

Conclusions

Diagnostic factors definitively indicative of laparotomy were not identified, although the percentage of neutrophils might be helpful. However, routine laparotomy in patients with peritoneal injuries could result in instances of negative laparotomy.

Summary
Diagnostic and Therapeutic Laparoscopy for Abdominal Trauma: A Single Surgeon’s Experience at a Level I Trauma Center
Hancheol Jo, Dong Hun Kim
J Trauma Inj. 2021;34(4):248-256.   Published online March 15, 2021
DOI: https://doi.org/10.20408/jti.2020.0081
  • 3,122 View
  • 103 Download
AbstractAbstract PDF
Purpose

Laparoscopy has various advantages over laparotomy in terms of postoperative recovery. The number of surgeons using laparoscopy as a diagnostic and therapeutic tool in abdominal trauma patients is increasing, whereas open conversion is becoming less common. This report summarizes a single surgeon’s experience of laparoscopy at a level I trauma center and evaluates the feasibility of laparoscopy as a diagnostic and therapeutic tool for abdominal trauma patients.

Methods

In total, 30 abdominal trauma patients underwent laparoscopy by a single surgeon from October 2014 to May 2020. The purpose of laparoscopy was categorized as diagnostic or therapeutic. Patients were classified into three groups by type of surgery: total laparoscopic surgery (TLS), laparoscopy-assisted surgery (LAS), or open conversion (OC). Univariate analysis was performed to determine the advantages and disadvantages.

Results

The mechanism of injury was blunt in 19 (63.3%) and penetrating in 11 patients (36.7%). Eleven (36.7%) and 19 patients (63.3%) underwent diagnostic and therapeutic laparoscopy, respectively. The hospital stay was shorter for patients who underwent diagnostic laparoscopy than for those who underwent therapeutic laparoscopy (5.0 days vs. 13.0 days), but no other surgical outcomes differed between the groups. TLS, LAS, and OC were performed in 12 (52.2%), eight (34.8%), and three patients (13.0%), respectively. There was no significant difference in morbidity and mortality among the three groups.

Conclusions

Laparoscopic surgery for selected cases of abdominal trauma may be feasible and safe as a diagnostic and therapeutic tool in hemodynamically stable patients due to the low OC rate and the absence of fatal morbidity and mortality.

Summary
The Prognosis of Traumatic Small Bowel Injury Accompanied by Liver Injury
Yu Seong Noh, Sung Won Jung, Tae Gil Heo, Pyong Wha Choi, Jae Il Kim, Heung Man Jun, Yong Chan Shin, Sung Min Jung, Eun Hae Um
J Trauma Inj. 2021;34(1):44-49.   Published online December 7, 2020
DOI: https://doi.org/10.20408/jti.2020.0052
  • 8,228 View
  • 98 Download
AbstractAbstract PDF
Purpose

The aim of this study was to elucidate the prognosis, and other clinical features, such as time to surgery and the amount of transfusion, of small bowel injury (SBI) accompanied by liver injury (LI).

Methods

We investigated 221 patients with SBI who visited an emergency center from October 2000 to March 2019. We excluded patients with injuries that directly led to mortality, and the remaining 149 patients were divided into the SBI alone (SBI-A) group and the SBI accompanied by LI (SBI-LI) group. Data were collected for preoperative and surgical outcome variables, and the treatment results were compared between groups.

Results

The SBI-LI group had a higher mortality rate than the SBI-A group (22.4% vs. 14.3%), but this difference was not statistically significant (p=0.061). There were no significant differences between the SBI-A and SBI-LI groups, except for the amount of red blood cell (RBC) transfusion (SBI-A: 3.53±0.1 vs. SBI-LI: 8.38±0.7 packs, p=0.035) and the length of intensive care unit (ICU) stay (SBI-A: 6.7±0.2 vs. SBI-LI: 11.1±0.5 days, p=0.047).

Conclusions

The SBI-LI group required more RBC transfusions and longer ICU stays than the SBI-A group. SBI accompanied by LI may show higher mortality than SBI alone; however, since the difference was not statistically significant in the present study, larger-scale follow-up research is needed.

Summary
Feasibility of Early Definitive Internal Fixation of Pelvic Bone Fractures in Therapeutic Open Abdomen
Kyunghak Choi, Kwang-Hwan Jung, Min Ae Keum, Sungjeep Kim, Jihoon T Kim, Kyu-Hyouck Kyoung
J Trauma Inj. 2020;33(1):18-22.   Published online March 30, 2020
DOI: https://doi.org/10.20408/jti.2019.044
  • 4,448 View
  • 99 Download
AbstractAbstract PDF
Purpose

Damage control laparotomy has contributed to improved survival rates for severe abdominal injuries. A large part of severe abdominal injury occurs with a concomitant pelvic bone fracture. The safety and effectiveness of internal fixation of pelvic bone fracture(s) has not been established. The aim of the present study was to evaluate infection risk in the pelvic surgical site in patients who underwent emergent abdominal surgery.

Methods

This single-center retrospective observational study was based on data collected from a prospectively maintained registry between January 2015 and June 2019. Patients who underwent laparotomy and pelvic internal fixation were included. Individuals <18 and ≥80 years of age, those with no microbiological investigations, and those who underwent one-stage abdominal surgery were excluded. Comprehensive statistical comparative analysis was not performed due to the small number of enrolled patients.

Results

A total of six patients met the inclusion criteria, and the most common injury mechanism was anterior-posterior compression (67%). The average duration of open abdomen was 98 hours (range, 44–198), and the time interval between abdominal closure and pelvic surgery was 98 hours. One patient (16.7%) died due to multi-organ dysfunction syndrome. Micro-organisms were identified in the abdominal surgical site in five patients (83%), with no micro-organisms in pelvic surgical sites. There was no unplanned implant removal.

Conclusions

Internal fixation of pelvic bone fracture(s) could be performed in the state of open abdomen, and the advantages of early fixation may countervail the risks for cross contamination.

Summary
Case Reports
Heterotopic Ossification in the Abdominal Wall after Exploratory Laparotomy
Hohyun Kim
J Trauma Inj. 2018;31(3):177-180.   Published online December 31, 2018
DOI: https://doi.org/10.20408/jti.2018.047
  • 3,929 View
  • 105 Download
  • 2 Citations
AbstractAbstract PDF

Heterotopic bone formation in abdominal incisions is a recognized but uncommon sequela of abdominal surgery. On the other hand, the formation of ectopic bone is a well-recognized complication following arthroplasty of the hip. Heterotopic ossification of midline abdominal incision scars is a subtype of myositis ossificans traumatica. Ectopic bone formation of midline abdominal incisions may cause regional pain or discomfort in the patient after surgery. If symptomatic, treatment is complete excision with primary closure. Radiologically, it is important to distinguish this benign entity from postoperative complications. We report a 69-year-old male who underwent exploratory laparotomy for traumatic small bowel perforation. A segment of abnormal hard tissue was found in the abdominal wall. Heterotopic ossification may occur at various sites and is a recognized but infrequent sequela of exploratory laparotomy. This case high-lights clinical and etiological features of this finding.

Summary

Citations

Citations to this article as recorded by  
  • Heterotopic Ossification in the Midline Scar in Xiphoid and Sub-xiphoid Region
    Vadivalagianambi Sivakumar, Venkatraman Indiran
    Indian Journal of Surgery.2022;[Epub]     CrossRef
  • Unusual osseous metaplasia following hernia repair with Prolene mesh: a case report
    Awrad Nasralla, Bonnie Tsang
    Journal of Surgical Case Reports.2019;[Epub]     CrossRef
Splenic Autotransplantation after Blunt Spleen Injury in Children
Hojun Lee, Byung Hee Kang, Junsik Kwon, John Cook-Jong Lee
J Trauma Inj. 2018;31(2):87-90.   Published online August 31, 2018
DOI: https://doi.org/10.20408/jti.2018.31.2.87
  • 4,218 View
  • 75 Download
  • 1 Citations
AbstractAbstract PDF

Non-operative management has been preferred in blunt spleen injury. Moreover children are more susceptible to post-splenectomy infection, spleen should be preserved if possible. However, splenectomy is inevitable to patients with severe splenic injury. Therefore splenic autotransplantation could be the last chance for preserving splenic function in these patients although efficacy has not proven. Here we reported four cases of children who were underwent splenic autotransplantation successfully after blunt trauma.

Summary

Citations

Citations to this article as recorded by  
  • Stumpfes Bauchtrauma bei Kindern und Jugendlichen: Behandlungskonzepte in der Akutphase
    M. C. Schunn, J. Schäfer, F. Neunhoeffer, J. Lieber, J. Fuchs
    Die Chirurgie.2023; 94(7): 651.     CrossRef
Isolated Common Hepatic Duct Injury after Blunt Abdominal Trauma
Yun Chul Park, Young Goun Jo, Wu Seong Kang, Eun Kyu Park, Hee Jun Kim, Jung Chul Kim
J Trauma Inj. 2017;30(4):231-234.   Published online December 30, 2017
DOI: https://doi.org/10.20408/jti.2017.30.4.231
  • 3,138 View
  • 42 Download
AbstractAbstract PDF

Extrahepatic bile duct injury is commonly associated with hepatic, duodenal, or pancreatic injuries, and isolated extrahepatic bile duct injury is rare. We report a patient who presented with an isolated extrahepatic bile duct injury after blunt trauma. A 50-year-old man was referred to our hospital after having suffered a fall down injury. His laboratory findings showed hyperbiliribinemia with elevated aspartate aminotransferase and alanine aminotransferase level. Initial abdominal computed tomography (CT) showed a mild degree of hemoperitoneum without evidence of abdominal solid organ injury. On the 3rd day of hospitalization, the patient complained of dyspnea and severe abdominal discomfort. Follow-up abdominal CT showed no significant interval change. Owing to the patient’s condition, Emergency laparotomy revealed a large amount of bile-containing fluid collection and about 1 cm in size laceration on the left lateral side of the common hepatic duct. Primary repair of the injured bile duct with T-tube insertion was performed On postoperative day (POD) 30, endoscopic retrograde cholangiopancreatography showed minimal bile leakage and endoscopic sphincteroplasty and endoscopic retrograde biliary drainage were performed. On POD 61, the T-tube was removed and the patient was discharged.

Summary
Isolated Dissection of the Celiac Artery after Blunt Trauma: A Case Report and Review of Literature
Ahram Han, Jihun Gwak, Gangkook Choi, Jae Jeong Park, Byungchul Yu, Gil Jae Lee, Jin Mo Kang
J Trauma Inj. 2017;30(4):220-226.   Published online December 30, 2017
DOI: https://doi.org/10.20408/jti.2017.30.4.220
  • 5,688 View
  • 104 Download
  • 7 Citations
AbstractAbstract PDF

Traumatic dissection of the celiac artery without aortic dissection is a rare event. Here we describe two cases of celiac artery dissection after blunt abdominal trauma managed conservatively without surgical or endovascular intervention.

Summary

Citations

Citations to this article as recorded by  
  • Isolated celiac artery injury: Brief report, review of literature, and suggested grading guidelines
    Kanani Fahim, Neeman Uri, Hashavia Eyal, Timor Idit, Soffer Dror, Shimonovich Shachar
    Trauma.2024;[Epub]     CrossRef
  • Endovascular Stenting in a Rare Case of Multiple Spontaneous Visceral Arterial Dissections
    Jacxelyn Moran, Naveen Galla, Mona Ranade
    Vascular and Endovascular Surgery.2021; 55(3): 269.     CrossRef
  • Evaluation of isolated abdominal visceral artery dissection with multi-scale spiral computed tomography: a retrospective case series
    Qizhou He, Fei Yu, Yajun Fu, Bin Yang, Ran Huo, Rong Xian, Shulan Liu, Kali Liang, Guangcai Tang
    Journal of Cardiothoracic Surgery.2021;[Epub]     CrossRef
  • Diagnosis and treatment of isolated celiac artery dissection following blunt trauma: A case report
    Tohru Ishimine, Takahiro Ishigami, Kohei Chida, Kyohei Kawasaki, Naoki Taniguchi, Toshiho Tengan
    International Journal of Surgery Case Reports.2021; 89: 106617.     CrossRef
  • Retrospective Analysis and Systematic Review of Isolated Traumatic Dissections of the Celiac Artery
    Jens Birkl, Thomas Kahl, Henryk Thielemann, Sven Mutze, Leonie Goelz
    Annals of Vascular Surgery.2020; 66: 250.     CrossRef
  • Traumatic dissection of the coeliac artery and splenic injury following blunt trauma
    Bobby Vincent Li, Ramesh Damodaran Prabha, Maruthi Narra, Hung Nguyen
    BMJ Case Reports.2019; 12(8): e229405.     CrossRef
  • Symptomatic Isolated Celiac Artery Dissection following Blunt Trauma
    Sang Bong Lee, Hyuk Jae Jung, Jae Hun Kim
    Journal of Acute Care Surgery.2019; 9(2): 76.     CrossRef
Original Articles
Clinical Characteristics of Unstable Pelvic Bone Fractures Associated with Intra-abdominal Solid Organ Injury
Sang Won Lee, Sun Hyu Kim, Eun Seog Hong, Ryeok Ahn
J Korean Soc Traumatol. 2012;25(1):1-6.
  • 1,088 View
  • 9 Download
AbstractAbstract PDF
PURPOSE
This study analyzed the characteristics of unstable pelvic bone fractures associated with intraabdominal solid organ injury.
METHODS
Medical records were retrospectively collected from January 2000 to December 2010 for patients with unstable pelvic bone fractures. Unstable pelvic bone fracture was defined as lateral compression types II and III, antero-posterior compression types II and III, vertical shear and combined type by young classification. Subjects were divided into two groups, with (injured group) and without (non-injured group) intra-abdominal solid organ injury, to evaluate whether the characteristics of the fractured depended on the presence of associated solid organ injury. Data included demographics, mechanism of injury, initial hemodynamic status, laboratory results, revised trauma score (RTS), abbreviated injury scale (AIS), injury severity score (ISS), amount of transfusion, admission to the intensive care unit (ICU), and mortality.
RESULTS
The subjects were 217 patients with a mean age of 44 years and included 134 male patients(61.8%). The injured group included 38 patients(16.9%). Traffic accidents were the most common mechanism of injury, and lateral compression was the most common type of fracture in all groups. The initial blood pressure was lower in the injured group, and the ISS was greater. The arterial pH was lower in the injured group, and shock within 24 hours after arrival at the emergency department was more frequent in the injured group. The amount of the transfused packed red blood cells within 24 hours was higher in the injured group than the non-injured group. Invasive treatment, including surgery and angiographic embolization, was more common in the injured group, and the stay in the ICU was longer in the injured group.
CONCLUSION
A need exists to decide on a diagnostic and therapeutic plan regarding the possibility of intraabdominal solid organ injury for hemodynamically unstable patients with unstable pelvic bone fractures and multiple associated injuries.
Summary
Characteristics of Stable Pelvic Bone Fractures with Intra-abdominal Solid Organ Injury
Sang June Park, Sun Hyu Kim, Jong Hwa Lee, Ryeok Ahn, Eun Seog Hong
J Korean Soc Traumatol. 2010;23(2):57-62.
  • 1,143 View
  • 2 Download
AbstractAbstract PDF
PURPOSE
This study analyzed the characteristics of stable pelvic bone fractures with intra-abdominal solid organ injury.
METHODS
Medical records were retrospectively reviewed from January 2000 to December 2009 of patients with stable pelvic bone fractures. A stable pelvic bone fracture according to Young's classification is defined as a lateral compression type I and antero-posterior compression type I. Subjects were divided into two groups, one with (injured group) and one without (non-injured group) intra-abdominal solid organ injury, to evaluate the dependences of the characteristics on the presence of an intra-abdominal solid organ injury. Data including demographics, mechanism of injury, initial hemodynamic status, laboratory results, Revised Trauma Score (RTS), Abbreviated Injury Scale (AIS), Injury Severity Score (ISS), amount of transfusion, admission to intensive care unit (ICU), and mortality were analyzed.
RESULTS
The subjects were 128 patients with a mean age of 42 years old, of whom were 67 male patients (52.3%). The injured group had 21 patients(16.4%), and the most frequent injured solid organ was the liver. Traffic accident was the most common mechanism of injury and lateral compression was the most common type of fracture in all groups. Initial systolic blood pressure was lower in the injured group, and the ISS was greater in the injured group. Arterial pH was lower in the injured group, and shock within 24 hours after arrival at the emergency department was more frequent in the injured group. Transfused packed red blood cells within 24 hours were 8 patients(38.1%) in the injured group and 11 patients(10.3%) in the non-injured group. Conservative treatment was the most common therapeutic modality in all groups. Stay in the ICU was longer in the injured group, and three mortalities occurred.
CONCLUSION
There is a need to decide on a diagnostic and therapeutic plan regarding the possibility of intra-abdominal solid organ injury for hemodynamically unstable patients with stable pelvic bone fractures and for patients with stable pelvic bone fractures along with multiple associated injuries.
Summary

J Trauma Inj : Journal of Trauma and Injury