Forensic medical evaluation of penetrating abdominal injuries

BACKGROUND: This study aims to discuss the characteristics, origins, degree of injury, results, reporting, and forensic medical aspects of penetrating abdominal injuries.
METHODS: In this study, 28,619 cases who applied to the emergency department of Kutahya Health Sciences University Evliya Celebi Training and Research Hospital between January 1, 2016 and December 31, 2020 were reviewed. The forensic reports and medical documents of 85 cases with penetrating abdominal injuries were evaluated retrospectively, with the approval of the ethics committee.
RESULTS: Among the patients included in the study, 87.1% were male and 12.9% were female. The mean age was found to be 31±13 years. When the origins of the cases were analyzed, 87.1% were found to have developed as a result of intentional injury. The incidents predominantly occurred between 20: 00 and 04: 00 hours. As a result of the examinations performed at the hospital after the incident, alcohol was detected in 36.5% of the cases, while 30.6% of the individuals did not consume alcohol. It was observed that 32.9% of the cases were not tested for alcohol. The most common injuries identified were sharp injuries, accounting for 69.4% of cases, and firearm injuries, comprising 27.1%. Organ damage was noted in 68.2% of the cases, with the small intestine being the most frequently damaged organ. The average number of wounds present was 3.6. Intra-abdominal hemorrhage was detected in 61.2% of the cases, and intra-abdominal artery injuries were found in 8.2%. The mortality rate for penetrating abdominal injuries was 8.2%.
CONCLUSION: In forensic traumatology, penetrating abdominal injuries commonly lead to life-threatening conditions and loss of organ function, which represent the most severe category in trauma severity assessment. Penetrating abdominal injuries most often result from violent incidents, as observed in our study and in the literature.

Penetran batýn bölgesi yaralanmalarýnýn adli týp yönünden deðerlendirilmesi

AMAÇ: Çalýþmamýzda penetran batýn yaralanmalarýnýn özellikleri, orjinleri, yaralanma derecesi, sonuçlarý, raporlanmasý, adli týbbi boyutunun tartýþýlmasý amaçlanmýþtýr.
GEREÇ VE YÖNTEM: Bu çalýþmada 01.01.2016-31.12.2020 tarihleri arasýnda Kütahya Saðlýk Bilimleri Üniversitesi Evliya Çelebi Eðitim ve Araþtýrma Hastanesi acil sevisine baþvurusu bulunan 28619 vaka taranarak penetran batýn yaralanmasý bulunan 85 olgunun adli raporlarý ve týbbi evraklarý etik kurul onayý alýnarak retrospektif olarak deðerlendirilmiþtir.
BULGULAR: Çalýþmaya dahil edilen olgularýn %87.1’i erkek, %12.9’u kadýnlardan oluþmaktadýr. Ortalama yaþ 31±13 yýl olarak bulunmuþtur. Orjinleri incelediðinde %87.1’i kasten yaralama neticesinde geliþmiþ olduðu görülmüþtür. Olgularýn maruz kaldýðý olaylarýn gerçekleþme saati 20.00-04.00 saatleri arasýnda yoðunlaþmýþtýr. %36.5’inde alkol saptanmýþ olup, %30.6’sýnda alkol saptanmamýþtýr. Olgularýn %32.9’unda alkol testi istenmediði anlaþýlmýþtýr. Olgularda en sýk görülen yaralanmanýn %69.4 oranýnda kesici delici alet yaralanmasý ve %27.1 oranýnda ateþli silah yaralanmasý olduðu belirlenmiþtir. Vakalarýn %68.2'sinde organ hasarý saptanmýþ ve en sýk hasar gören organýn ince baðýrsak olduðu görülmüþtür. Mevcut yaralarýn ortalama sayýsý 3.6 bulunmuþtur. Olgularýn %61.2'sinde batýn içi kanama, %8,2'sinde ise batýn içi arter yaralanmasý tespit edilmiþtir. Penetran batýn yaralanmalarýnýn ölüm oraný %8.2 olarak bulunmuþtur.
SONUÇ: Adli travmatolojide travmanýn aðýrlýk derecesi deðerlendirilmesinde en aðýr grubu oluþturan yaþamsal tehlikenin ve organ iþlev kaybýnýn meydana gelmesi penetran batýn yaralanmalarýnda sýklýkla görülmektedir. Penetran batýn yaralanmalarý bizim çalýþmamýzda ve literatürdeki çalýþmalarda en sýk þiddet olaylarý sonucu meydana gelmektedir.