A Clinical Study of Abdominal Trauma

, Hyung-Jin Lee

Original Article

Korean Journal of Legal Medicine 1980;4(1):84-92.

Department of Surgery, College of Medicine, Busan National University Busan, Korea

Abstract

Two hundred and ninety six patients with abdominal trauma who had been admitted to Busan National University Hospital for past 4 years from January 1976 to December 1979 were reviewed clinically and the following results were obtained. 1. The sex distribution was 261 males(88. 2%) and females (Il. 8%) with ratio of 7.5 : 1, and the age distribution revealed a high incidence in the third and fourth decades (58.5%). 2. The seasonal distribution showed the highest incidence in spring involving 94 cases (31.2%). Penetrating trauma was the most common in summer and blunt trauma was the most common in spring. 3. The mechanisms of abdominal trauma were blunt in 210 cases (70.9%) and penetrating in 86 cases (29.1%) with ratio of 2.4. : 1. Common causes of abdominal trauma were traffic accident (34%), stab wound (28.4%) and violence (20. 0 %) in order of frequency. 4. The clinical manifestations were abdominal pain (93.9%), abdominal tenderness (83. 1%), abdominal rigidity (61.1%), abdominal distension (34. 1%) etc. in order of frequency. 5. Conventional diagnostic procedures were valuable in determination of exploratory laparotomy. Abdominal tap was positive in 81.3% and pneumoperitoneum was found in 22.9% 6. About half of the patients were explored within 6 hours from trauma. 7. Injured organ was single intraabdominal in 224 cases (75. 6%) and multiple intraabdominal in 72 cases (24.3%) and in cases of single intraabdominal organ injured, jejunum was the most common, followed by ileum (38 cases) , liver (37 cases), spleen (27cases), mesentery (17 cases) etc. in order of frequency. 8. Associated extraabdominal injuries were chest trauma (15.7%), head trauma (7.1%), pelvic bone fracture (5.7%), lower extremities fracture (5.7%) etc. 9. Three hundred and seventy eight operative procedures were performed to 296 patients. 10. One hundred and thirty seven complications were developed in 81 cases(27. 4 %) postoperatively. The most common postoperative complication was wound complication (13.2%), followed by pulmonary complications (8.1%), adhesive ileus (5.7%), intraabdominal abscess, urinary tract infection etc. in order of frequency. 11. The mortality rate was 12.8% (38 cases), and main causes of death was hemorrhagic shock (31.6%), combined head trauma (23.6%), sepsis (18.4%), acute respiratory failure (13.2%), acute renal failure (7.9%) and hepatic failure(5.3%) in order of frequency.