Dergiler / Ulusal Travma Dergisi / 1999 / Cilt: 5 - Sayı: 2
Batın nafiz delici kesici alet yaralanalarında gecikmiş ince barsak ve kolon tamiri olgularının değerlendirilmesi
- Sayfa
- 102–105
- DOI
- —
Özet
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 Tsinde tedavi en az£ saat gecikirken geriye kalan hastalarilk 6 saat içinde ameliyat edildiler. Tedavide gecikilen 7hastanın 2 (%28.8fsindeilfum, 2 (%28.8)'sindekolonve jejunum, 2(% 28.8 f sinde kolon ve 1 (% 14.4 finde 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 hastalardapostoperatifdönem'sörunsuzifseyretti. Batma penetre DKAYlannda, olguların PL ile takip edilmeleri içi boş organ yaralanmalarının tam ve tedavisinde getıkn\elere neden olabilir. Ancak tedavide belirli bir süre gecikmenin morbidite ve mortaliteyiarttırmadığı gözlendi.
Abstract
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 (DPI) 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 andjejunal ruptures in 2patients (%28.8), in 2patients (%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.