YUMUÞAK DOKU ÝÇÝNDEKÝ RADYOOPAK YABANCI CÝSÝMLERÝN STEREOTAKSÝK YÖNTEMLE ÇIKARILMASI

Yumuþak doku içindeki yabancý cisimler özellikle radyoopak deðilse oldukça zor çýkarýlýrlar. Radyoopak olanlarda bile lokalizasyon oldukça zor olur. Ýyi lokalize edilmeden yapýlan insizyonlar uzun süren baþarýsýz müdahalelerle sonuçlanabilir. Acil servise yabancý cisim batmasý þikayetiyle baþvuran 53 hasta incelendi. Bunlardan yabancý cisimleri radyoopak olan 15'i çalýþmamýzý oluþturdu. Hastalara iki yönlü direk radyografi çekildi. Yabancý cisim olduðu ve bunun da radyoopak olduðu tespit edildikten sonra yabancý cismi en iyi lokalize edecek þekilde enjektör ucu ile iþaretleme yapýldý. Tekrar iki yönlü radyografi alýndý. Grafiler eþliðinde yabancý cisim arandý ve çýkarýldý. Daha sonra dokular anatomik katlara uygun olarak kapatýldý. Tekrar kontrol grafisi çekildi. Hasta bir hafta sonra kontrole çaðrýldý. Yöntemi uyguladýðýmýz 15 vakanýn 13'ündeyabancý cisim iðne idi. Yabancý cisimlerin 7'si el, 4'ü ayakta idi. Diðerleri vücudun çeþitli yerlerinde idi. 14 vakada yabancý cisimler baþarý ile çýkarýldý. Sonuç olarak; Özellikle skopi imkanlarýnýn olmadýðý yerlerde ve acil servis þartlarýnda stereotaksik yöntemle yabancý cisim çýkarýlmasý ekonomik ve kolay bir yöntemdir. Ýþlemi yapan doktorun radyasyona maruz kalmamasý bir diðer önemli avantajýdýr. Ameliyathane þartlarýna, özel ekip ve ekipmana gerek kalmadan radyoopak yabancý cisimler bu yöntemle çýkarýlabilir.

REMOVAL OF RADIOPAQUE FOREIGN BODIES AMBEDDED IN SOFT TISSUES BYSTEREOTAXIC APPROACH

Removal of foreign bodies in soft tissue is not an easy process. Those which are not radiopaque may make the removal procedure more difficult. Incisions which are made without determining the site of the foreign body properly may result in unsuccessful interventions. In this study we used 'Stereotaxy' method to remove radiopaque foreign bodies from the soft tissues. This approach does not require any specialised team or equipment. 53 patients who visited our emergency department for the foreign bodies embedded in the soft tissues were investigated. 15 patients who had radiopaque foreign bodies in the soft tissues were included in the study. Two-view plain radiographies were obtained first. An injector needle was used to mark the site of the foreign body considering the x-ray appearance of the radiopaque foreign body. After marking the site, x-rays were obtained again. The foreign bodies were removed using the guideness of these radiographs. Control radiographies were obtained following the removal procedure. The patients were asked to apply to the hospital one week later for control examination. This method was applied in the 15 cases. The foreign body was pin in the 13 cases. 7 of the foreign bodies were embedded in the soft tissues of the hand, 4 in the soft tissues of the foot. The remaining ones were in the other parts of the body. The foreign bodies were successfully removed in the 14 cases. Foreign bodies embedded in the soft tissues may cause inflammation, infection and toxic and allergic reactions. The accurate determination of the site of a foreign body embedded in the soft tissue is difficult. Superficial markers, multidimensioned radiographies, grills, fluoroscopy and stereotaxic instruments can be used in determining the localisation of the foreign body. As a result, stereotaxy is a cheap and easy method especially in emergency departments and in clinics where scopy is not present. The foreign bodies can be removed using this method without needing specialised team and equipment and operating-room conditions.