Abstract
Some injuries are exacerbated during intensive care in multiple trauma cases. Especially, delay of clinical diagnosis of chest and abdomen injury can be fatal. In our hospital, there were 6 cases requiring emergency surgery for chest and abdomen injury diagnosed after admission during a period from April 2009 to September 2010. The average patient age was 54±22 years old. Injury severity score (ISS) was from 19 to 43. Causes of injury included falling from a high place (2 cases) and traffic injuries (4 cases). The details of the delayed injury were 2 cases of intercostal artery injury, 3 cases of diaphragm injury, and 1 case of mesenteric artery injury. Time until deterioration was 5–95 hours. Two cases died. It is important to prevent delayed injury in multiple trauma cases. Delayed injury to the chest and abdominal organs causes exacerbation of the cardiopulmonary state, and intercostal artery injury and diaphragm injury are the main reasons for delayed injury. In the intensive care of multiple traumas, we should not treat only damage diagnosed at first. We need to recognize the risk of delayed injury (for example, multiple rib fractures) and perform intensive care immediately, as well as gain complete understanding of all injuries in an early stage.
