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J Trauma Inj > Volume 28(4); 2015 > Article
Journal of Trauma and Injury 2015;28(4):284-291.
DOI: https://doi.org/10.20408/jti.2015.28.4.284    Published online December 31, 2015.
Nonoperative Treatment for Abdominal Injury in Multiple Trauma Patients: Experience in the Metropolitan Tertiary Hospital in Korea (2009~2014)
Seung Young Oh, Gil Joon Suh
1Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.
2Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Korea. suhgil@snu.ac.kr
다발성 손상 환자에서의 복부 손상에 대한 비수술적 치료: 권역 외상 센터가 아닌 3차 병원의 치료 경험(2009~2014)
오승영, 서길준1
서울대학교 의과대학 외과학교실,
1서울대학교 의과대학 응급의학교실
Received: 3 December 2015   • Revised: 10 December 2015   • Accepted: 11 December 2015
Abstract
The aim of this study is to present a nonoperative treatment for abdominal injuries in patients with multiple traumas and to discuss the role of metropolitan tertiary hospital, non-regional trauma centers. We collected data from patients with multiple traumas including abdominal injuries from 2009 to 2014. Patient characteristics, associated injuries, short-term outcomes and departments that managed the patients overall were analyzed. Based on treatment modalities for abdominal injury, patients were divided into two groups: the operative treatment group and the nonoperative treatment group. We compared differences in patient characteristics, injury mechanisms, initial vital signs, detailed injury types, lengths of hospital and ICU stays. Of the 167 patients with multiple traumas, abdominal injuries were found in 57 patients. The injury mechanism for 44 patients (77.2%) was traffic accidents, and associated extra-abdominal injuries were shown in 45 patients (78.9%). The mean lengths of hospital and ICU stays for the 57 patients were 36.4 days and 8.3 days, respectively. The in-hospital mortality rate was 8.8%. Ten patients (17.5%) were treated operatively, and 47 patients (82.5%) were treated nonoperatively. Among the 47 patients in the nonoperative treatment group, 17 patients received embolization, and 3 patients underwent a percutaneous drainage procedure. Operative treatments were used more in patients with injuries to the pancreas and bowel. No patient required additional surgery or died due to the failure of nonoperative treatment. No differences in the clinical characteristics except for the detailed injury type were observed between the two groups. In appropriately selected patients with multiple traumas including abdominal injuries, nonoperative treatment is a safe and feasible. For rapid and accurate managements of these patients, well-trained trauma surgeons who can manage problems with the various systems in the human body and who can decide whether nonoperative treatment is appropriate or not are required.
Key Words: Multiple traumas; Abdominal injury; Nonoperative treatment


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