하악골 골절과 동반된 알콜 진전 섬망 : 증례 보고

DELIRIUM TREMENS ASSOCIATED WITH FRACTURE OF MANDIBLE : REPORT OF A CASE

본 증례를 경험후 다음의 결론을 생각할 수 있었다. 1. 구강악안면외상 환자의 초진시 과거력상 자세한 음주력 파악의 중요성 2. 연관된 내과질환의 평가의 중요성 3. 환자의 작은 심신 반응의 변화라도 세심한 주의를 기울여야 함 4. 심한 알콜 음주력을 가진 환자가 외상으로 인한 급작스러운 금주를 경험할 경우 알콜 진전 섬망이 발생될 가능성이 있음을 알고 항상 대비할 것.

Delirium tremens is a severe state of alcohol-related withdrawal syndrome, which is precipitated in the chronic alcoholic who are suddenly deprived of alcohol because of traumatic injury or other diseases. About 5% of alcoholics show evidence of severe withdrawal symptoms. Symptoms begin within 1 to 3 days after stopping ethanol intake. These include a state of confusion sometimes accompanied by visual, tactile, or auditory hallucinations. The diagnosis is made when the course progresses beyond the usual symptoms of withdrawal to include confusion, severe agitation, and generalized seizures. The likelihood of developing severe withdrawal symptoms increases with concomitant infections or medical problems, a prior history of withdrawal seizures of DTs, and higher quantity and frequency of drinking. Most periods of severe withdrawal begin and end abruptly, rarely lasting longer than 3 to 5 days. The mortality risk for DTs is quite low but increases with preexisting medical illnesses or organ system failure. We experienced a case of DTs associated with fracture of mandible. The patient was a 36-years-old male who was admitted to our hospital via emergency room after suffering from a traffic accident. He developed DTs 3 days after admission and eventually expired. The report of a case and review of literatures are as follows.