保存的治療で治癒した小児外傷性肝内血腫の1例

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This paper summarizes our experience on patient with traumatic hematoma who was suc-cessfully treated by nonoperative management. This 7-year-old female sustained a blunt injury in the upper abdomen with a hundle-bar of a bicycle. On admission 50 minutes following injury, physical examination disclosed a marked tenderness in the epigastrium with blood pressure of 90/40mmHg. Laboratory data showed Hgb: 12.2mg/dl, GOT: 354u, GPT: 395u, LDH: 700u, s-amylase : 105IU, Because of her stable hemodynamic condition, nonoperative management was attempted. Her blood pressure decreased to 78mmHg systolic 3 hours after injury. As her BP was restored with a rapid infusion of lactated Ringer solution, the nonoperative management was continued. She received 400ml of blood transfusion because of a decresed hemoglobin, 9.2mg/dl 16 hours after injury. An abdominal CT scan disclosed a low density area in the medial segment of the left lobe of the liver, suggesting intrahepatic hematoma. She recovered well without sequelae and was discharged 3 weeks after injury. A CT scan was repeated 2 months after injury, showing a reduced "low density area" in its intensity as well as its area.
1986-02-20