Browse > Article
http://dx.doi.org/10.20408/jti.2020.0052

The Prognosis of Traumatic Small Bowel Injury Accompanied by Liver Injury  

Noh, Yu Seong (Department of Surgery, Ilsan Paik Hospital, Inje University College of Medicine)
Jung, Sung Won (Department of Surgery, Ilsan Paik Hospital, Inje University College of Medicine)
Heo, Tae Gil (Department of Surgery, Ilsan Paik Hospital, Inje University College of Medicine)
Choi, Pyong Wha (Department of Surgery, Ilsan Paik Hospital, Inje University College of Medicine)
Kim, Jae Il (Department of Surgery, Ilsan Paik Hospital, Inje University College of Medicine)
Jun, Heung Man (Department of Surgery, Ilsan Paik Hospital, Inje University College of Medicine)
Shin, Yong Chan (Department of Surgery, Ilsan Paik Hospital, Inje University College of Medicine)
Jung, Sung Min (Department of Surgery, Ilsan Paik Hospital, Inje University College of Medicine)
Um, Eun Hae (Department of Surgery, Ilsan Paik Hospital, Inje University College of Medicine)
Publication Information
Journal of Trauma and Injury / v.34, no.1, 2021 , pp. 44-49 More about this Journal
Abstract
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.
Keywords
Abdominal injuries; Intestines; Liver; Lacerations; Prognosis;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Edubio MN. ASA physical status score as a predictive tool of mortality in emergency postoperative abdominal injuries in the ICU. BJMMR 2017;21:1-7.   DOI
2 Fakhry SM, Watts DD, Luchette FA; EAST Multi-Institutional Hollow Viscus Injury Research Group. Current diagnostic approaches lack sensitivity in the diagnosis of perforated blunt small bowel injury: analysis from 275,557 trauma admissions from the EAST multi-institutional HVI trial. J Trauma 2003;54:295-306.   DOI
3 Maxwell RA, Fabian TC. Current management of colon trauma. World J Surg 2003;27:632-9.   DOI
4 Mostafa G, Gunter OL, Norton HJ, McElhiney BM, Bailey DF, Jacobs DG. Age, blood transfusion, and survival after trauma. Am Surg 2004;70:357-63.
5 Kafie F, Tominaga GT, Yoong B, Waxman K. Factors related to outcome in blunt intestinal injuries requiring operation. Am Surg 1997;63:889-92.
6 Slotta JE, Justinger C, Kollmar O, Kollmar C, Schafer T, Schilling MK. Liver injury following blunt abdominal trauma: a new mechanism-driven classification. Surg Today 2014;44:241-6.   DOI
7 Davis JJ, Cohn I Jr, Nance FC. Diagnosis and management of blunt abdominal trauma. Ann Surg 1976;183:672-8.   DOI
8 Fraga GP, Silva FH, Almeida NA, Curi JC, Mantovani M. Blunt abdominal trauma with small bowel injury: are isolated lesions riskier than associated lesions? Acta Cir Bras 2008;23:192-7.   DOI
9 Watts DD, Fakhry SM; EAST Multi-Institutional Hollow Viscus Injury Research Group. Incidence of hollow viscus injury in blunt trauma: an analysis from 275,557 trauma admissions from the East multi-institutional trial. J Trauma 2003;54:289-94.   DOI
10 Faria GR, Almeida AB, Moreira H, Barbosa E, Correia-da-Silva P, Costa-Maia J. Prognostic factors for traumatic bowel injuries: killing time. World J Surg 2012;36:807-12.   DOI
11 Norrman G, Tingstedt B, Ekelund M, Andersson R. Non-operative management of blunt liver trauma: feasible and safe also in centres with a low trauma incidence. HPB (Oxford) 2009;11:50-6.   DOI
12 Kim JW, Kwak SS, Park MK, Koo YP. Clinical aspects and prognostic factors of small bowel perforation after blunt abdominal trauma. J Korean Soc Traumatol 2011;24:82-8.
13 Hoyt DB, Coimbra R, Acosta J. Management of acute trauma. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston textbook of surgery. 18th ed. Philadelphia:W.B.Saunders;2004:507-8.
14 Vance BM. Traumatic lesions of the intestine caused by non-penetrating blunt force. Arch Surg 1923;7:197-212.   DOI
15 Chandler CF, Lane JS, Waxman KS. Seatbelt sign following blunt trauma is associated with increased incidence of abdominal injury. Am Surg 1997;63:885-8.
16 Croce MA, Fabian TC, Stewart RM, Pritchard FE, Minard G, Kudsk KA. Correlation of abdominal trauma index and injury severity score with abdominal septic complications in penetrating and blunt trauma. J Trauma 1992;32:380-7; discussion 387-8.   DOI
17 Bull JP. The Injury Severity Score of road traffic casualties in relation to mortality, time of death, hospital treatment time and disability. Accid Anal Prev 1975;7:249-55.   DOI