ABDOMÝNAL TRAVMALARDA PREOPERATÝF ALT VE AST DEÐERLERÝNÝN KARACÝÐERDEKÝ YARALANMANIN CÝDDÝYETÝNÝ GÖSTERMEDEKÝ ÖNEMÝ

Akdeniz Üniversitesi Týp Fakültesi Genel Cerrahi Anabilim Dalý'nda tedavi edilen 41 karaciðer travmalý olgu Moore klasifikasyonuna göre karaciðer yaralanmasýnýn derecesi, mortalite, preoperatif çalýþýlan ALT (Alanine aminotransferaz) ve AST (Aspartate aminotransferaz) deðerleri açýsýndan retrospektif olarak incelendi. Olgularýn 35'i erkek (Yaþlarý ort: 34.48±15.62), 6'sý kadýn (yaþlarý ort: 26.16±12.01) idi. Bu olgulardan 32'si künt (%78.05), 9'u penetran (%21.95) travmalýydý. Bu çalýþma sonunda, grade III-V karaciðer yaralanmalarý ile grade I-II yaralanmalar arasýnda AST ve ALT deðerleri açýsýndan istatistiksel anlamlý farklýlýk saptandý (p<0.005). Bu nedenle preoperatif dönemde ALT ve AST deðerlerindeki normalden 4 kat artýþ saptandýðýnda karaciðerdeki yaralanmanýn ciddi nitelikte olabileceðinin düþünülmesi gerektiði kanýsýna varýldý.

THE IMPORTANCE OF PREOPERATIVE ALT AND AST VALUES IN THE EVALUATION OF THE SEVERITY OF LIVER INJURY IN ABDOMINAL TRAUMA

Fortyone patients with liver trauma, who were admitted to the General Surgery Department of Akdeniz University Medical Faculty, were evaluated for the severity of liver injury according to the Moore classification, mechanism of trauma, Injury severity score (ISS), mortality and alanine aminotransferase (ALT) values and aspartate aminotransferase (AST) values retrospectively. Among the 41 patients, 32 (78.05%) had a blunt and 9 (21.95%) had a penetrating trauma. The difference between the ALT and AST values of patients with grade I-II injury and grade III-V injury was statistically significant (p<0.005). Our results show that, a four fold rise than normal in the preoperative AST and ALT values should suggest a severe liver injury in these patients.