Journal of Trauma and Injury

The Korean Society of Traumatology (대한외상학회)
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Multiple Intraabdominal Solid Organ Injuries after Blunt Trauma

외상후 복부 다발성 고형장기 손상

  • Park, Hyung Do (Department of Emergency Medicine, Ulsan University Hospital, University of Ulsan College of Medicine) ;
  • Kim, Sun Hyu (Department of Emergency Medicine, Ulsan University Hospital, University of Ulsan College of Medicine) ;
  • Lee, Jong Hwa (Department of Radiology, Ulsan University Hospital, University of Ulsan College of Medicine) ;
  • Hong, Jung Seok (Department of Emergency Medicine, Ulsan University Hospital, University of Ulsan College of Medicine) ;
  • Hong, Eun Seog (Department of Emergency Medicine, Ulsan University Hospital, University of Ulsan College of Medicine)
  • 박형도 (울산대학교병원 응급의학과) ;
  • 김선휴 (울산대학교병원 응급의학과) ;
  • 이종화 (울산대학교병원 영상의학과) ;
  • 홍정석 (울산대학교병원 응급의학과) ;
  • 홍은석 (울산대학교병원 응급의학과)
  • Received : 2009.08.14
  • Accepted : 2009.09.25
  • Published : 2009.12.30
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Abstract

Purpose: This study evaluated the characteristics and the prognosis of multiple intraabdominal solid organ injuries, including those to the liver, spleen, and kidney, after blunt trauma. Methods: From January 2001 to March 2009, 39 patients with multiple intraabdominal solid organ injuries, which had been confirmed by contrast-enhanced computed tomography after blunt trauma, were included in this retrospective study. The injury severity score (ISS), abbreviated injury scale (AIS), revised trauma score (RTS), American Association for the Surgery of Trauma (AAST) injury grade of solid organs, initial hemodynamic status, blood gas analysis, blood transfusion, and the mortality were the main outcome measurements. Results: Injured groups were classified into liver/kidney (n=17), liver/spleen (n=4), spleen/kidney (n=13), and liver/kidney/spleen (n=5) groups. Patients were older in the liver/kidney group than in the liver/kidney/spleen group (43 vs 18 years, p=0.023). The initial systolic blood pressures tended to be lower in the liver/kidney group than in the other groups (84 vs 105, 112, and 114 mmHg, p=0.087). The amounts of 24-hour packed RBC transfusion were 32 units in the liver/kidney group and 4 units in the liver/kidney/spleen group, but the difference was not statistically significant. Differences were found in neither the RTS, ISS, and AIS for head, chest, abdominal, and pelvic injuries nor the AAST injury grade for solid organ, but injuries to the chest were more severe in the liver/spleen group than in the spleen/kidney group (AIS 4.0 vs 2.8, p=0.028). Conservative treatment was the most frequent applied treatment in all groups. There were 6 mortalities : 3 due to hypovolemia, 2 to sepsis, and 1 to brain injury. Mortalities occurred only in the liver/kidney group. Conclusion: Patients who had intraabdominal solid organ injuries of the liver and the kidney simultaneously, tended to be transfused more at an early time after trauma, to have lower initial systolic blood pressures, and to have a higher mortality.

Keywords

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