Computed tomographic findings of splenic injury and correlation with treatment

복부전산화단층촬영의 비장손상 소견과 치료와의 관계 연세대학교 원주의파대학 진단방사선과학교실 김 동진·고주열·김 명 순·흥인 수·조휘 율·성 기 준 Computed Tomographic Findings of Splenic injury and Correlation with Treatment Dong Jin Kim, M.D. , Joo Yaul Koh, M.D. , Myung Soon Kim, M.D. , In Soo Hong, M.D. , Whi Youl Cho, M.D. , Ki Joon Sung M.D. Department o[ Radiology, WDI낀u College o[ Medicine, Yonsei University According to recently reported classification , 46 patients with blunt splenic trauma were evaluated preoperatively with computed tomography(CT). Injuries were graded 1 through IV and described as capsular or subcapsular disruptions without parenchymal injury(3 patients); capsular and parenchymal injuries(23 patients); in juries involving hiluml3 patients) ; and fragmentation( 17 patients). Nineteen patients were managed conservatively and 27 patients were managed surgically. Twelve patients(47 %) out of those with 1γpe 1 or 1γpe 11 were managed surgically incJuding five hemodynamically unstable patients and seven hemodynamically stable patients with associated injuries and unknown surgical criteria. On the other hand five hemodynamically stable patients(25 %) out of those with 1γpe III or Tγpe IV were managed surgicalJy The amount of hemoperitoneum was graded into small , moderate and large ; small in three patients , moderate in 39 patients. and large in two patients. The amount of hemoperitoneum in patients with conservative treatment was moderate in 16 patients and large in one patient. And the amount of hemoperitoneum in patients with operative treatment was small in three patients. moderate in 23 patients and large in one patient. We concJuded that CT was accurate method of determining the extent of splenic injury and evaluation of hemoperitoneum. but treatment choice should be based on the hemodynamic status of patients rather than the type of injury or the amount of hemoperitoneum by CT Index Words: Spleen. CT 775.1211 Splenic Injury 775 .4 1 Splenic Injury. Treatment 이 논문은 1 990년 7월 20일 접수하여 1 990년 1 0월 31 일에 채 택되었읍