둔상성 간손상 환자의 손상 통제술 후 발생한 심낭압전

• Published in: Daehan oe'sang haghoeji Vol. 28; no. 3; pp. 211 - 214
• Main Authors: 예진봉, 설영훈, 고승제, 권오상, 김중석, 박상순, 구관우, 이민구, 김영철, Ye, Jin Bong, Sul, Young Hoon, Go, Seung Je, Kwon, Oh Sang, Kim, Joong Suck, Park, ang Soon, Ku, Gwan Woo, Lee, Min Koo, Kim, Yeong Cheol
• Format: Journal Article
• Language: Korean
• Published: 23.09.2015
• Subjects: Blunt hepatic injury; Pericardial tamponade; Primary survey; Secondary survey; Missed injury
• ISSN: 2799-4317; 2287-1683

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.