๋ฉ”์ธ ์ฝ˜ํ…์ธ ๋กœ ๊ฑด๋„ˆ๋›ฐ๊ธฐ
์ฆ๋ก€ #31

PRO ํ”Œ๋žœ ํ•„์š”

PRO ๋ฉค๋ฒ„์‹ญ์œผ๋กœ ์ด ์ผ€์ด์Šค ์ž ๊ธˆ ํ•ด์ œ

ํ”Œ๋žœ ๋ณด๊ธฐ ๋กœ๊ทธ์ธ
์ธ๊ตฌ ํ†ต๊ณ„ํ•™: Male
์ง€์‹œ์‚ฌํ•ญ: ์™ธ์ƒ

์ฆ๋ก€ #31

๊ฒฐ๊ณผ

ํ‰๋ถ€ ๋ฐฉ์‚ฌ์„  ์‚ฌ์ง„

  • ์ƒ์ข…๊ฒฉ๋™์˜ ๊ฒฝ๋ฏธํ•œ ํ™•์žฅ
  • ๊ธฐ๊ด€๋ถ„๊ธฐ๋ถ€ ์ƒ๋ฐฉ 4 cm์— ํˆฌ์˜๋˜๋Š” ๊ธฐ๊ด€๋‚ด๊ด€ ์„ ๋‹จ
  • ์œ„-์‹๋„ ์ ‘ํ•ฉ๋ถ€์— ์ธก๊ณต์ด ์œ„์น˜ํ•˜๊ณ  ์„ ๋‹จ์ด ๋ฐฉ์‚ฌ์„  ์‚ฌ์ง„์˜ ํ•˜๋ถ€ ๊ฒฝ๊ณ„๋ฅผ ๋„˜์–ด ์œ„์น˜ํ•˜๋Š” ์œ„ ํก์ธ ์นดํ…Œํ„ฐ
  • ์–‘์ธก ๊ธฐ์ €๋ถ€ ์ค„๋ฌด๋Šฌ ํ˜ผํƒ๊ณผ ํ•จ๊ป˜ ์šฐ์ธก ์ค‘๊ฐ„ ํ์•ผ์˜ ํ๋ฆฟํ•œ ํ๊ฒฝํ™”

CT

ํ‰๋ถ€

  • ๋™๋งฅ๊ด€ ์ธ๋Œ€ ๋ถ€์ฐฉ๋ถ€์—์„œ์˜ ๊ธ‰์„ฑ ์™ธ์ƒ์„ฑ ๋Œ€๋™๋งฅ ๋‚ด๋ง‰ ํŒŒ์—ด๊ณผ ๊ด€๋ จ ๋Œ€๋™๋งฅ ์™ธ์ธก ์œค๊ณฝ์˜ ๊ตญ์†Œ์  ๋ถˆ๊ทœ์น™ ๋Œ์ถœ
  • ์†Œ๋Ÿ‰์˜ ์ฃผ๋ณ€ ์ข…๊ฒฉ๋™ ํ˜ˆ์ข…
  • ์šฐ์ธก์ด ์ขŒ์ธก๋ณด๋‹ค ์‹ฌํ•œ ์–‘์ธก ํ•˜์ˆ˜ ํ๊ฒฝํ™” ๋ฐ ๋ฐ˜์ ์ƒ ๊ฐ„์œ ๋ฆฌ ์Œ์˜
  • ๊ธฐ๊ด€๋ถ„๊ธฐ๋ถ€ ์ƒ๋ฐฉ์— ์ข…๋ฃŒ๋˜๋Š” ๊ธฐ๊ด€๋‚ด๊ด€, ๊ธฐ๊ด€ ๋‚ด ์†Œ๋Ÿ‰์˜ ์ด๋ฌผ์งˆ ์ธต

๋ณต๋ถ€/๊ณจ๋ฐ˜

  • ์ฃผ๋กœ ์ œ5๋ถ„์ ˆ ๋ฐ ์ œ6๋ถ„์ ˆ์„ ์นจ๋ฒ”ํ•˜์ง€๋งŒ ์ œ7๋ถ„์ ˆ ๋ฐ ์ œ8๋ถ„์ ˆ๋กœ ํ™•์žฅ๋˜์–ด ํ•˜๋Œ€์ •๋งฅ์— ์ธ์ ‘ํ•œ ๊ฐ„๋ฌธ๋ถ€๊นŒ์ง€ ํ™•์žฅ๋˜๋Š” ์šฐ๊ฐ„์—ฝ์˜ ๋ณต์žก ๊ฐ„ ์—ด์ƒ. ํ™œ๋™์„ฑ ์ถœํ˜ˆ์˜ ์ฆ๊ฑฐ ์—†์Œ
  • ์šฐ์ธก ๊ฒฐ์žฅ์ฃผ์œ„๊ตฌ ๋ฐ ํ•ด๋ถ€ํ•™์  ๊ณจ๋ฐ˜๊นŒ์ง€ ์ถ”์ ๋˜๋Š” ์†Œ๋Ÿ‰์˜ ๊ฐ„ ์ฃผ์œ„ ํ˜ˆ๋ณต๊ฐ•
  • ์†Œ๋Ÿ‰์˜ ๋น„์žฅ ์ฃผ์œ„ ์ถœํ˜ˆ๊ณผ ํ•จ๊ป˜ ๋น„์žฅ ์ƒ๋ถ€ ๋ณ€์—ฐ์„ ๋”ฐ๋ฅธ 1 cm ๋ฏธ๋งŒ์˜ ์ž‘์€ ์—ด์ƒ
  • ์šฐ์ธก ๋ถ€์‹ ์„ ์˜ ์ €์กฐ์˜์ฆ๊ฐ•์„ ๋™๋ฐ˜ํ•œ ์šฐ์ธก ๋ถ€์‹  ํ˜ˆ์ข…
  • ์šฐ์ธก ํ”ผ๋ง‰ํ•˜ ๋ฐ ์‹ ์žฅ ์ฃผ์œ„ ํ˜ˆ์ข…์„ ๋™๋ฐ˜ํ•œ ์šฐ์ธก ์‹ ์žฅ ๋‚ดํ•˜๋ฐฉ ์—ด์ƒ, ๊นŠ์ด 1.5 cm. ํ™œ๋™์„ฑ ์ถœํ˜ˆ์˜ ์ฆ๊ฑฐ ์—†์Œ. ์ง€์—ฐ ์˜์ƒ์—์„œ ์†Œ๋ณ€ ์œ ์ถœ์˜ ์ฆ๊ฑฐ ์—†์Œ
  • ๊ฐ„๋‚ด ํ•˜๋Œ€์ •๋งฅ์„ ๋”ฐ๋ฅธ ์†Œ๋Ÿ‰์˜ ์ค„๋ฌด๋Šฌ ๋ฐ ์‹ ์ •๋งฅ ๋ ˆ๋ฒจ์—์„œ ์Šฌ๋ฆฟ ์–‘์ƒ์˜ ํ•˜๋Œ€์ •๋งฅ
  • ์‹ญ์ด์ง€์žฅ ์ œ2๋ถ€์— ์ธ์ ‘ํ•œ ์ค„๋ฌด๋Šฌ
  • ์œ„์ฒด๋ถ€์— ์ข…๋ฃŒ๋˜๋Š” ์œ„ ํก์ธ ์นดํ…Œํ„ฐ
  • ๋„๋‡จ๊ด€ ์ฃผ์œ„๋กœ ํ—ˆํƒˆ๋œ ๋ฐฉ๊ด‘, ์‚ฝ๊ด€๊ณผ ๊ด€๋ จ๋  ์ˆ˜ ์žˆ๋Š” ๊ด€๋‚ด ๊ฐ€์Šค

๊ทผ๊ณจ๊ฒฉ๊ณ„

  • ๊ธ‰์„ฑ ์ตœ์†Œ ์ „์œ„ ์šฐ์ธก ํ›„๋ฐฉ ์ œ1-7๋ฒˆ ๋Š‘๊ณจ ๊ณจ์ ˆ

์ง„๋‹จ

๊ธ‰์„ฑ ์™ธ์ƒ์„ฑ ๋Œ€๋™๋งฅ ์†์ƒ

๊ฐ„ ์—ด์ƒ

๋น„์žฅ ์—ด์ƒ

์‹ ์žฅ ์—ด์ƒ

์ƒ˜ํ”Œ ๋ณด๊ณ ์„œ

๋™๋งฅ๊ด€ ์ธ๋Œ€ ๋ถ€์ฐฉ๋ถ€์—์„œ์˜ ๋Œ€๋™๋งฅ ๋‚ด๋ง‰ ํŒŒ์—ด๋กœ ์†Œ๋Ÿ‰์˜ ์ฃผ๋ณ€ ์ข…๊ฒฉ๋™ ํ˜ˆ์ข… ๋ฐ ๋Œ€๋™๋งฅ ์™ธ์ธก ์œค๊ณฝ์˜ ์ž‘์€ ๊ตญ์†Œ์  ๋ถˆ๊ทœ์น™ ๋Œ์ถœ๊ณผ ํ•จ๊ป˜ ์ž‘์€ ๊ฐ€์„ฑ๋™๋งฅ๋ฅ˜์— ๋ถ€ํ•ฉํ•จ.

์šฐ์ธก ํ›„๋ฐฉ ์ œ1-7๋ฒˆ ๋Š‘๊ณจ์˜ ๊ธ‰์„ฑ ์ตœ์†Œ ์ „์œ„ ๊ณจ์ ˆ๊ณผ ๊ฐ„์œ ๋ฆฌ ๋ฐ ๊ฒฝํ™”์„ฑ ํ ํ˜ผํƒ์€ ์ขŒ์ƒ, ํก์ธ, ๋ฌด๊ธฐํ์˜ ์กฐํ•ฉ์„ ๋‚˜ํƒ€๋‚ผ ๊ฐ€๋Šฅ์„ฑ์ด ๋†’์Œ. ๊ธฐํ‰ ์—†์Œ.

ํ•˜๋Œ€์ •๋งฅ์— ์ธ์ ‘ํ•œ ๊ฐ„๋ฌธ๋ถ€๊นŒ์ง€ ํ™•์žฅ๋˜๋Š” ์šฐ๊ฐ„์—ฝ์˜ ๋ณต์žก ๊ฐ„ ์—ด์ƒ. ๊ด€๋ จ ์†Œ๋Ÿ‰์˜ ๊ฐ„ ์ฃผ์œ„ ํ˜ˆ๋ณต๊ฐ•์ด ์šฐ์ธก ๊ฒฐ์žฅ์ฃผ์œ„๊ตฌ ๋ฐ ํ•ด๋ถ€ํ•™์  ๊ณจ๋ฐ˜๊นŒ์ง€ ์ถ”์ ๋จ. ํ•˜๋Œ€์ •๋งฅ์— ์ธ์ ‘ํ•œ ์†Œ๋Ÿ‰์˜ ์ถœํ˜ˆ์€ ํ˜ˆ๊ด€ ์†์ƒ์„ ๋‚˜ํƒ€๋‚ผ ์ˆ˜ ์žˆ์œผ๋‚˜ ํ™œ๋™์„ฑ ์ถœํ˜ˆ์˜ ์ฆ๊ฑฐ๋Š” ์—†์Œ.

์†Œ๋Ÿ‰์˜ ๋น„์žฅ ์ฃผ์œ„ ์ถœํ˜ˆ๊ณผ ํ•จ๊ป˜ ๋น„์žฅ ์ƒ๋ถ€ ๋ณ€์—ฐ์„ ๋”ฐ๋ฅธ 1 cm ๋ฏธ๋งŒ์˜ ์†Œ์—ด์ƒ.

์šฐ์ธก ๋ถ€์‹  ํ˜ˆ์ข…์œผ๋กœ ์šฐ์ธก ๋ถ€์‹ ์„ ์˜ ์ €์กฐ์˜์ฆ๊ฐ•์€ ์ขŒ์ƒ ๋˜๋Š” ํ˜ˆ๊ด€ ์†์ƒ๊ณผ ๊ด€๋ จ๋  ์ˆ˜ ์žˆ์Œ.

์šฐ์ธก ์‹ ์žฅ ์—ด์ƒ์œผ๋กœ ํ”ผ๋ง‰ํ•˜ ๋ฐ ์‹ ์žฅ ์ฃผ์œ„ ํ˜ˆ์ข…. ์ง€์—ฐ ์˜์ƒ์—์„œ ์†Œ๋ณ€ ์œ ์ถœ์˜ ์ฆ๊ฑฐ ์—†์Œ.

์‹ ์ •๋งฅ ๋ ˆ๋ฒจ์—์„œ ์Šฌ๋ฆฟ ์–‘์ƒ์˜ ํ•˜๋Œ€์ •๋งฅ์€ ํ˜ˆ๋Ÿ‰์ €ํ•˜๋ฅผ ์‹œ์‚ฌํ•จ.

์‹ญ์ด์ง€์žฅ ์ œ2๋ถ€์— ์ธ์ ‘ํ•œ ์ค„๋ฌด๋Šฌ๋Š” ์ธ์ ‘ ๊ฐ„ ๋ฐ ๋ถ€์‹  ์†์ƒ๊ณผ ๊ด€๋ จ๋  ์ˆ˜ ์žˆ์œผ๋‚˜, ์žฅ ์†์ƒ๋„ ๋ฐฐ์ œํ•  ์ˆ˜ ์—†์Œ. ์žฅ ์†์ƒ์— ๋Œ€ํ•œ ๋†’์€ ์ž„์ƒ์  ์šฐ๋ ค๊ฐ€ ์žˆ์œผ๋ฉด ๋ฐ˜๋ณต ์˜์ƒ์„ ๊ณ ๋ คํ•˜์‹ญ์‹œ์˜ค.

ํ† ๋ก 

PRO ํ”Œ๋žœ ํ•„์š”

PRO ๋ฉค๋ฒ„์‹ญ์œผ๋กœ ํ† ๋ก  ์ž ๊ธˆ ํ•ด์ œ

ํ”Œ๋žœ ๋ณด๊ธฐ

์ฐธ๊ณ ๋ฌธํ—Œ

  • Alonso RC, Nacenta SB, Martinez PD, Guerrero AS, Fuentes CG. Kidney in danger: CT findings of blunt and penetrating renal trauma. Radiographics 2009; 29(7): 2033-2053.
  • Heneghan RE, Aarabi S, Quiroga E, Gunn ML, Singh N, Starnes BW. Call for a new classification system and treatment strategy in blunt aortic injury. J Vasc Surg 2016; 64(1): 171-176.
  • Rana AI,ย Kenney PJ,ย Lockhart ME, McGwin G, Morgan DE, Windham ST, Smith JK.ย Adrenal gland hematomas in trauma patients.ย Radiologyย 2004; 230(3): 669-675.
  • Saksobhavivat N, Shanmuganathan K, Chen HH, DuBose JJ, Richard H, Khan MA, Menaker J, Mirvis SE, Scalea TM. Blunt Splenic Injury: Use of a Multidetector CT-based Splenic Injury Grading System and Clinical Parameters for Triage of Patients at Admission. Radiology 2014; 3: 702-711.
  • Soto JA, Anderson SW. Multidetector CT of blunt abdominal trauma. Radiology 2012; 265: 678-693.
  • Steenburg S, Ravenel J, Ikonomidis J, Schonholz C, Reeves S. Acute traumatic aortic injury: Imaging evaluation and management. Radiology 2008; 248: 748-762.
  • Yoon W,ย Jeong YY,ย Kim JK, Seo JJ, Lim HS, Shin SS, Kim JC, Jeong SW, Park JG, Kang HK.ย CT in blunt liver trauma.ย Radiographicsย 2005; 25(1): 87-104.

    • ์‚ฌ์ดํŠธ ํ”ผ๋“œ๋ฐฑ

    ์—ฌ๋Ÿฌ๋ถ„์˜ ํ”ผ๋“œ๋ฐฑ์€ CaseStacks ๊ฐœ์„ ์— ๋„์›€์ด ๋ฉ๋‹ˆ๋‹ค. ์˜๊ฒฌ, ์ œ์•ˆ ๋˜๋Š” ๋ฐœ์ƒํ•œ ๋ฌธ์ œ๋ฅผ ๊ณต์œ ํ•ด ์ฃผ์„ธ์š”.

    /5
    ํ”ผ๋“œ๋ฐฑ์„ ๋ณด๋‚ด์ฃผ์…”์„œ ๊ฐ์‚ฌํ•ฉ๋‹ˆ๋‹ค. ์†Œ์ค‘ํžˆ ๋ฐ˜์˜ํ•˜๊ฒ ์Šต๋‹ˆ๋‹ค.