경희대학교
의과대학 외과학교실, 응급의학교실*,
가천의과대학
부속 길병원 응급의학교실**
성충경·김명천*·고영관*·주흥재·양혁준**·이
근**
A
Clinical Review of Patients Combined with Head Injury and
Abdominal Injury
Choong
Kyung Sung, M.D., Myung Chun Kim, M.D*, Young
Gwan Ko., M.D.* ,
Hoong Zae Joo, M.D. , Hyuk
Jun Yang, M.D.**, Keun Lee, M.D.**
Department
of General Surgery, Department of Emergency Medicine.
College
of Medicine, Kyunghee University.
Department
of Emergency Medicine, Gil Medical Center. Kachon Medical College..
In
the management of multiple trauma, especially combined with head injury and abdominal
injury, the initial diagnosis and treatment are determined with difficulty. We studied
50 trauma patients who were combined with head injury and abdominal injury to assess
the correlation with the status of patients, diagnosis, treatment and prognosis.
Glasgow Coma Scale on admission and lateralizing sign as the predictor for Surgical
intervention of intracranial injury are statistically important, and other factors
such as motor vehicle accident, field intubation, age more than 60 years. sex, anisocoria,
fixed or dilated pupil, abdominal surgery and facial or scalp injury are statistically
unimportant. Only 3 patients required both craniotomy and celiotomy. Even in the
patient with positive paracentesis, head CT shouId be checked if neurologic findings
are abnormal. Paracentesis and peritoneal lavage have been proper methods for detection
of an abdominal injury. At present, abdominal ultrasonography can be substituted
with peritoneal lavage and spiral computed tomography is possible to evaluate head
and abdomen simultaneously without delay of diagnosis and treatment for those two
organ injuries. On the base of objective data in addition to Physical examination,
the management of trauma patient must be done.
Key
Words : Head, Abdomen, injury, CT, Lavage |
