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Journal of the Korean Society of Traumatology 2011;24(2):82-88.
Clinical Aspects and Prognostic Factors Of Small Bowel Perforation After Blunt Abdominal Trauma
Ji Won Kim, Seung Su Kwak, Mun Ki Park, Yong Pyeong Koo
Department of Surgery, Daejun Sun Hospital, Daejeon, Korea. corlcorl@hanmail.net
복부 둔상에 의한 소장 천공 환자의 임상 양상 및 예후 인자
김지원∙곽승수∙박문기∙구용평
대전 선병원 외과
Received: 1 April 2011   • Revised: 2 June 2011   • Accepted: 15 September 2011
Abstract
PURPOSE
The incidence of abdominal trauma with intra-abdominal organ injury or bowel rupture is increasing. Articles on the diagnosis, symptoms and treatment of small bowel perforation due to blunt trauma have been reported, but reports on the relationship of mortality and morbidity to clinical factors for prognosis are minimal. The purposes of this study are to evaluate the morbidity and mortality of patients with small bowel perforation after blunt abdominal trauma on the basis of clinical examinationand to analyze factors associated with the prognosisfor blunt abdominal trauma with small bowel perforation.
METHODS
The clinical data on patients with small bowel perforation due to blunt trauma who underwent emergency surgery from January 1994 to December 2009 were retrospectively analyzed. The correlation of each prognostic factor to morbidity and mortality, and the relationship among prognostic factors were analyzed.
RESULTS
A total of 83 patients met the inclusion criteria: The malewas 81.9% .The mean age was 45.6 years.The mean APACHE II score was 5.75.The mean time interval between injury and surgery was 395.9 minutes.The mean surgery time was 111.1 minutes. Forty seven patients had surgery for ileal perforations, and primary closure was done for 51patients. The mean admission period was 15.3 days, and the mean fasting time was 4.5 days. There were 6 deaths (7.2%), and 25 patientssuffered from complications.
CONCLUSION
The patient's age and the APACHE II score on admission were important prognostic factors that effecteda patient's progress. Especially, this study shows that the APACHE II score had effect on the operation time, admission period, the treatment period, the fasting time, the mortality rate, and the complication rate.
Key Words: Small bowel perforation; Blunt abdominal trauma; Age; APACHE II score


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