BATIN NAFİZ DELİCİ KESİCİ ALET YARALANMALARINDA GECİKMİŞ İNCE BARSAK VE KOLON TAMİRİ OLGULARININ DEĞERLENDİRİLMESİ [Ulus Travma Acil Cerrahi Derg]
Ulus Travma Acil Cerrahi Derg. 1999; 5(2): 102-105

BATIN NAFİZ DELİCİ KESİCİ ALET YARALANMALARINDA GECİKMİŞ İNCE BARSAK VE KOLON TAMİRİ OLGULARININ DEĞERLENDİRİLMESİ

Feza Ekiz1, Tayfun Yücel1, Orhan Yalçın1, Kasım Fincan1, H Fehmi Küçük1
Taksim Hastanesi I. Cerrahi Kliniği

Batına penetre delici kesici alet yaralanmalarında (DKAY) tedavide gecikmenin morbidite ve mortaliteye etkisini incelemek amacıyla, periton lavajı (PL) yapılarak takip edilen fakat tedavide 8 saatten fazla gecikilen hastalar retrospektif olarak değerlendirildi. Batına penetre DKAY olan ve PL ile takip edilen 66 hastadan 37 (% 55.6) sine konservatif tedavi uygulandı. Geriye kalan 29 (% 44.4) olguda ise içi boş organ yaralanması düşünüldü. Bunların 7sinde tedavi en az 8 saat gecikirken geriye kalan hastalar ilk 6 saat içinde ameliyat edildiler. Tedavide gecikilen 7 hastanın 2 (% 28.8)'sinde ileum, 2(% 28.8)'sinde kolon ve jejunum, 2 (% 28.8)'sinde kolon ve 1(%1.4.4) inde duodenum yaralanması mevcut idi ve hastaların hepsinde lezyonlar primer onarım ile tedavi edildi (Duodenum yaralanmasına primer onarıma ek olarak tüp duodenostomi de eklendi). Bu 7 hastadan birinde yara infeksiyonu gelişti (% 14). Diğer hastalarda postoperatif dönem sorunsuz seyretti. Batına penetre DKAYlarında, olguların PL ile takip edilmeleri içi boş organ yaralanmalarının tanı ve tedavisinde gecikmelere neden olabilir. Ancak tedavide belirli bir süre gecikmenin morbidite ve mortaliteyi arttırmadığı gözlendi.

Anahtar Kelimeler: BATINA PENETRE DELİCİ KESİCİ ALET YARALANMASI, İNCE VE KALIN BARSAK YARALANMALARI, GECİKMİŞ TEDAVİ


THE EVALUATION OF DELAYED REPAIR IN SMALL BOWEL AND COLONIC RUPTURES IN ABDOMINAL STAB WOUND INJURIES

Feza Ekiz1, Tayfun Yücel1, Orhan Yalçın1, Kasım Fincan1, H Fehmi Küçük1
Taksim Hastanesi I. Cerrahi Kliniği

The effect of delayed therapy in abdominal stab wound injuries and morbidity and mortality rates were evaluated retrospectively in the patients who were followed diagnostic peritoneal lavage (DPL) and if necessary who were operated on with a minimum delay of 8 hours. There were 66 cases with stab wound injuries in our series. In 37 patients (%55.6) conservative treatment was done after DPL. But the others had hollow organ injuries. 29 patients (% 44.4) were assessed after DPL and performed operation immediately. But 7 of these patients (%24.2), the treatment was performed at least 8 hours delay and 2 of them (%28.8) had ileum ruptures. There were colonic and jejunal ruptures in 2 patients (%28.8), in 2 patients (%28.8) colonic ruptures and duodenum rupture in one patient (% 14.4). All of these injuries were managed with primary sutures. Duodenostomy was added in the duodenal injury. Wound infection was presented in only one patient. There was no complication in the other patients. As a result, it has been observed that conservative therapy can cause delay in diagnosis and treatment of patients with hollow viscus injuries in abdominal stab wound injuries. But there will be no effect on mortality and morbidity rates in these patients if the patients are observed by peritoneal lavage closely.

Keywords: PENETRATING ABDOMINAL INJURY, SMALL AND LARGE INTESTINE INJURY, DELAYED THERAPY


Feza Ekiz, Tayfun Yücel, Orhan Yalçın, Kasım Fincan, H Fehmi Küçük. THE EVALUATION OF DELAYED REPAIR IN SMALL BOWEL AND COLONIC RUPTURES IN ABDOMINAL STAB WOUND INJURIES. Ulus Travma Acil Cerrahi Derg. 1999; 5(2): 102-105


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