Künt Travmaya Bağlı İntestinal Yaralanmalar
Yükleniyor...
Dosyalar
Tarih
2012
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
İnönü Üniversitesi Tıp Fakültesi Dergisi
Erişim Hakkı
Attribution 3.0 United States
Özet
Künt travmaya bağlı intraabdominal lümenli organ yaralanmaları sık görülmez fakat genellikle geç tanı konulduğundan mortalite ve morbidite oranları yüksektir. Bu çalışmada, kendi vakalarımızdaki tanı yöntemlerini ve sonuçlarını analiz etmeyi amaçladık.
Gereç ve Yöntem: Aralık 2008- Aralık 2011 arasında, kliniğimize yatırarak tedavi ettiğimiz 8 hasta prospektif olarak incelendi. Hemodinamik instabilite ile hemen ameliyata alınan 2 hasta çalışma dışı bırakıldı.
Bulgular: Künt travmaya bağlı intraabdominal yaralanmaların %9.3’ünü lümenli organ yaralanmaları oluşturuyordu. Hastaların 2’sinde jejunum, 2’sinde ileum, 1’inde çekum ve çıkan kolon, 1’inde ise transvers kolon yaralanması mevcuttu. Evisserasyon nedeniyle hemen ameliyata alınan bir hasta dışındakilerin hepsi peritonit ve BT bulgularıyla 7-24. saat arasında ameliyata alındılar. İki hastaya laparaskopi uygulandı. Hastaların ortalama ISS (Yaralanma Şiddet Skoru) değeri 15.2, PATI(Penetran Abdominal Travma İndeksi) skoru ise 9.8 idi. Çekum ve çıkan kolon yaralanması nedeniyle opere edilen bir hasta sepsis nedeniyle eks oldu (%16.7).
Sonuç: Bu hastaların tanısında, travma mekanizmasının sorgulanması ve tekrar edilen fizik muayeneler önemlidir. BT de intraabdominal solid organ yaralanması bulunmadan serbest sıvı bulunması ve peritonit bulguları tanı koydurucu olabilir.
Abdominal hollow organ injuries due to blunt trauma are uncommon, but as they are usually diagnosed late, mortality and morbidity rates are high. In this study, we aimed to analyze the diagnostic methods and results of patients with hollow organ injury related to blunt trauma. Methods: From December 2008 to December 2011, eight patients with abdominal hollowed organ injury related to blunt trauma were prospectively included in the study. Two patients with hemodynamic instability undergoing emergent laparotomy were excluded from the study. Results: Hollow organ injuries accounted for 9.3% of all cases with abdominal blunt trauma. Injuried organs were jejunum (n=2), ileum (n=2), caecum and ascending colon (n=1) and transverse colon (n=1). Due to the development of peritonitis signs and suspicious computarized tomography findings, five patients underwent surgery during the 7-24 hours of follow-up, while one patient underwent emergent laparotomy because of organ evisceration. Two patients underwent laparoscopy. The mean ISS(Injury Severity Score) and PATI(Penetrating Abdominal Trauma Index) values were 15.2 and was 9.8, respectively. One patient with caecum and ascending colon injury died due to sepsis (16.7%). Conclusion: Mechanism of trauma and serial physical examination are important diagnostic factors. Free intra-abdominal fluid without solid organ injury in computarized tomography and the presence of signs of peritonitis may be diagnostic.
Abdominal hollow organ injuries due to blunt trauma are uncommon, but as they are usually diagnosed late, mortality and morbidity rates are high. In this study, we aimed to analyze the diagnostic methods and results of patients with hollow organ injury related to blunt trauma. Methods: From December 2008 to December 2011, eight patients with abdominal hollowed organ injury related to blunt trauma were prospectively included in the study. Two patients with hemodynamic instability undergoing emergent laparotomy were excluded from the study. Results: Hollow organ injuries accounted for 9.3% of all cases with abdominal blunt trauma. Injuried organs were jejunum (n=2), ileum (n=2), caecum and ascending colon (n=1) and transverse colon (n=1). Due to the development of peritonitis signs and suspicious computarized tomography findings, five patients underwent surgery during the 7-24 hours of follow-up, while one patient underwent emergent laparotomy because of organ evisceration. Two patients underwent laparoscopy. The mean ISS(Injury Severity Score) and PATI(Penetrating Abdominal Trauma Index) values were 15.2 and was 9.8, respectively. One patient with caecum and ascending colon injury died due to sepsis (16.7%). Conclusion: Mechanism of trauma and serial physical examination are important diagnostic factors. Free intra-abdominal fluid without solid organ injury in computarized tomography and the presence of signs of peritonitis may be diagnostic.
Açıklama
Anahtar Kelimeler
Künt, Travma, Lümenli Organ Yaralanması, Blunt, Trauma, Hollow Organ Injury
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Özpek, Adnan;Çalışkan, Müjgan ;Yücel, Metin;Hasbahçeci, Mustafa;Baş, Gürhan;Alimoğlu, Orhan; (2012) Künt Travmaya Bağlı İntestinal Yaralanmalar,İnönü Üniversitesi Tıp Fakültesi Dergisi 2012;19(3):138-41.
