Clinical Analysis of Patients with Multiple Organ Injuries Who Required Open thoracotomy / 대한흉부외과학회지

ABSTRACT

BACKGROUND: Multiple trauma patients have rapidly increased due to traffic accidents, industrial disasters, incidental accidents, and violence. Multiple trauma can involve injuries to the heart, lung, and great vessels and influence the lives, necessitate prompt diagnosis and treatment. Most of the thoracic injuries can be managed with conservative method and simple surgical procedures, such as closed thoracostomy, but in certain cases open thoracotomy is necessary. MATERIALS AND METHODS: The author analyzed the surgical result of 70 cases of open thoracotomy after multiple organ injury including thoracic organ. RESULTS: The most common type of thoracic lesion was hemothorax with or without pneumothorax and diaphragmatic rupture was the second. Sixty percent of the patients were associated with bone fractures, 42.9% with abdominal injuries, and 37.1% with head injuries. The modes of operation were ligations of torn vessels for bleeding control (48.6%), repair of diaphragm (35.7%), and repair of lung laceration (25.7%) in this order of frequency and additional procedures were splenectomy (14.3%), hepatic lobectomy (8.6%) and repair of liver lacerations (5.7%). Postoperative complications were atelectasis (8.6%), wound infection (8.6%), and pneumonia (4.3%). Postoperatively six patients died (The mortality rate was 8.6%) and the causes of death were respiratory failure (2), acute renal failure (2), sepsis (1), and hypovolemic shock (1).