Journal of Trauma and Injury

  • 제27권3호
  • /
  • Pages.84-88
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  • 2014
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  • 2799-4317(pISSN)
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  • 2287-1683(eISSN)
대한외상학회 (The Korean Society of Traumatology)
권호 표지

전단교통사고에 의한 광범위 간장손상 - 보존치료 1례

Extensive Blunt Hepatic Injury due to Cross-over Traffic Accident - A Case Report of Conservative Management

  • 장인석 (경상대학교 의학전문대학원 흉부외과학교실) ;
  • 김성환 (경상대학교 의학전문대학원 흉부외과학교실) ;
  • 이정은 (경상대학교 의학전문대학원 흉부외과학교실) ;
  • 김종우 (경상대학교 의학전문대학원 흉부외과학교실) ;
  • 최준영 (경상대학교 의학전문대학원 흉부외과학교실) ;
  • 신일우 (경상대학교 건강과학대학원 마취과학교실) ;
  • 김현옥 (경상대학교 건강과학대학원 내과학교실)
  • Jang, In-Seok (Department of Cardiovascular and Thoracic Surgery, Gyeongsang National University Hospital, Institute of Health Science, Gyeongsang National University, Health Science Institutes, Gyeongsang National University) ;
  • Kim, Sung Hwan (Department of Cardiovascular and Thoracic Surgery, Gyeongsang National University Hospital, Institute of Health Science, Gyeongsang National University, Health Science Institutes, Gyeongsang National University) ;
  • Lee, Jung Eun (Department of Cardiovascular and Thoracic Surgery, Gyeongsang National University Hospital, Institute of Health Science, Gyeongsang National University, Health Science Institutes, Gyeongsang National University) ;
  • Kim, Jong Woo (Department of Cardiovascular and Thoracic Surgery, Gyeongsang National University Hospital, Institute of Health Science, Gyeongsang National University, Health Science Institutes, Gyeongsang National University) ;
  • Choi, Jun Young (Department of Cardiovascular and Thoracic Surgery, Gyeongsang National University Hospital, Institute of Health Science, Gyeongsang National University, Health Science Institutes, Gyeongsang National University) ;
  • Shin, Il Woo (Department of Anesthesiology, Gyeongsang National University Hospital, Institute of Health Science, Gyeongsang National University, Health Science Institutes, Gyeongsang National University) ;
  • Kim, Hyun Ok (Department of Internal Medicine, Gyeongsang National University Hospital, Institute of Health Science, Gyeongsang National University, Health Science Institutes, Gyeongsang National University)
  • 투고 : 2014.04.10
  • 심사 : 2014.07.08
  • 발행 : 2014.09.30
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초록

The severity of blunt hepatic injury correlates with internal organ damage. We experienced a patient, who had an extensive crushed liver injury. The patient was a 28-year-old man, who was involved in a traffic accident in which a wheel ran over his right upper abdomen. A grade V severe hepatic laceration was diagnosed with computed tomography. His vital signs were stable, so we could wait for times with conservative management. Bile leakage led to biloma and bile spillage into the peritoneal space. Selective percutaneous drainage was needed to control the several biloma. After four months of conservative management, could the patient was discharged in good condition.

키워드

참고문헌

  1. Farnell MB, Spencer MP, Thompson E, Williams HJ Jr, Mucha P Jr, Ilstrup DM. Nonoperative management of blunt hepatic trauma. Surgery 1988; 104: 748-56.
  2. Moore EF, Shackford SR, Pachter Hi, McAninch JW, Browner BD, Champion HR. et al. Organ injury scaling: spleen, liver and kidney. J Trauma 1989; 29: 1664-6. https://doi.org/10.1097/00005373-198912000-00013
  3. Moore EE, Cogbill TH, Jurkovich GJ, Shackford SR, Malangoni MA, Champion HR. Organ injury scaling: Spleen and Liver (1994 Revision). J Trauma 1995; 38: 323-4. https://doi.org/10.1097/00005373-199503000-00001
  4. Yoon HM, Yoon YS, Shin SH, Cho JY, Park DJ, Kim HH. et al. Clinical Analysis on Patients with Traumatic Liver Injury. J Trauma Inj 2007; 20: 125-9.
  5. Stavros G, Vasilis V, Stylianos G, Nikitas D, Ioannis B, Spyros D, et al. Operative and nonoperative management of blunt hepatic trauma in adults: a single-center. J Hepatobiliary Pancreat Surg 2007; 14: 387-91. https://doi.org/10.1007/s00534-006-1177-2
  6. Lee YJ, Jung GG, Lim BC, Hong SC, Lee JS, Park ST, et al. Clinical Review of Blunt Hepatic Trauma. J Trauma Inj 2000; 13: 157-64.
  7. Choi SM, Chae MK, Kim TY, Kim SY, Baek MJ, Lee MS, et al. Nonoperative management of Blunt hepatic trauma. J Trauma Inj 2002; 15: 14-21.
  8. Coughlin PA, Stringer MD, Lodge JPA, Pollard SG, Prasad KR, Toogood GJ. Management of blunt liver trauma in a tertiary referral centre. Br J Surg 2004; 91: 317-21. https://doi.org/10.1002/bjs.4410
  9. Ajai KM, Timothy CF, Martin AC, Timothy JG, Kenneth AK, Gayle M, et al. Blunt hepatic injury: A paradigm shift from operative to nonoperative. Ann Surg 2000; 231: 804-13. https://doi.org/10.1097/00000658-200006000-00004
  10. Veroux M, Cillo U, Brolese A, Madia C, Fiamingo P, Zanus G, et al. Blunt liver injury: from non-operative management to liver transplantation. Injury Int J Care Injured 2003; 34: 181-6. https://doi.org/10.1016/S0020-1383(02)00283-8
  11. Fang JF, Wong YC, Lin BC, Hsu YP, Chen MF. The CT Risk Factors for the Need of Operative Treatment in Initially Hemodynamically Stable Patients After Blunt Hepatic Trauma. J Trauma 2006; 61: 547-54. https://doi.org/10.1097/01.ta.0000196571.12389.ee