복부 둔상에 의한 간손상의 비수술적 치료성적의 고찰

Serial abdominal CT studies are an integral part of the non-operative treatment of blunt hepst- ic injuries and seem to be useful in monitoring resorption of hemoperitoneum and the healing pattern of intrahepatic hematomas and lacerations. The current study was conducted to evaluate the safety of non-operative management of blunt hepatic trauma in hemodynamically stable patients regardless of injury severity. Twenty five cases of hepatic injury caused by blunt abdominal trauma during 1993-1997 are reviewed. The mean age was 24 with a range of 3 to 58; 68% were male and 28% were children. The most frequent etiologic factor was traffic accidents(76%). Abdominal CT scan, AST/ALT level and vital signs were using the initial diagnostic modality in all patients. With using Injury Severity Scale of American Association for the Surgery of Trauma(AAST), 13 cases(52%) were Grade I, 7 cases(28%) were Grade II, 5 cases(20%) were Grade 3. We transfused the packed RBC in 6 cases. Most cases had shown high serum aminotrans- ferase which were normalized after 2-3 weeks. The severity of abdominal CT-Grading system was not statistically correlated with the prognosis of hepatic injured patients(p>0.05). Non-operative management in blunt hepatic trauma could be considered in most hemodynamically stable patients without evidence of other intraabdominal injuries, regardless of the injured CT-Grading system and trasfusion amount.