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J Trauma Inj > Volume 28(3); 2015 > Article
Journal of Trauma and Injury 2015;28(3):211-214.
DOI: https://doi.org/10.20408/jti.2015.28.3.211    Published online September 30, 2015.
Pericardial Tamponade following Perihepatic Gauze Packing for Blunt Hepatic Injury
Jin Bong Ye, Young Hoon Sul, Seung Je Go, Oh Sang Kwon, Joong Suck Kim, Sang Soon Park, Gwan Woo Ku, Min Koo Lee, Yeong Cheol Kim
1Department of Surgery, Eulji University Hospital, Daejeon, Korea. ssulyh@eulji.ac.kr
2Department of Thoracic and Cardiovascular Surgery, Eulji University Hospital, Daejeon, Korea.
둔상성 간손상 환자의 손상 통제술 후 발생한 심낭압전
예진봉, 설영훈, 고승제, 권오상, 김중석, 박상순1, 구관우1, 이민구, 김영철
을지대학교병원 외과,
1을지대학교병원 흉부외과
Received: 20 July 2015   • Revised: 24 August 2015   • Accepted: 4 October 2015
Abstract
The primary and secondary survey was designed to identify all of a patient's injuries and prioritize their management. However 15 to 22.3% of patient with missed injuries had clinically significant missed injuries. To reduce missed injury, special attention should be focused on patients with severe anatomical injury or obtunded. Victims of blunt trauma commonly had multiple system involvement. Some reports indicate that inexperience, breakdown of estalished protocol, clinical error, and restriction of imaging studies may be responsible for presence of missed injury. The best way of reducing clinical significant of missed injuries was repeated clinical assessment. Here we report a case of severe blunt hepatic injury patient and pericardial injury that was missed in primary and secondary survey. After damage control surgery of hepatic injury, she remained hemodynamically unstable. Further investigation found cardiac tamponade during intensive care. This was managed by pericardial window operation through previous abdominal incision and abdominal wound closure was performed.
Key Words: Primary survey; Secondary survey; Missed injury; Blunt hepatic injury; Pericardial tamponade


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