Ulus Travma Acil Cerrahi Derg. 1999; 5(2): 102-105

BATIN NAFÝZ DELÝCÝ KESÝCÝ ALET YARALANMALARINDA GECÝKMÝÞ ÝNCE BARSAK VE KOLON TAMÝRÝ OLGULARININ DEÐERLENDÝRÝLMESÝ

Feza Ekiz¹, Tayfun Yücel¹, Orhan Yalçýn¹, Kasým Fincan¹, H Fehmi Küçük¹
Taksim Hastanesi I. Cerrahi Kliniði

Batýna penetre delici kesici alet yaralanmalarýnda (DKAY) tedavide gecikmenin morbidite ve mortaliteye etkisini incelemek amacýyla, periton lavajý (PL) yapýlarak takip edilen fakat tedavide 8 saatten fazla gecikilen hastalar retrospektif olarak deðerlendirildi. Batýna penetre DKAY olan ve PL ile takip edilen 66 hastadan 37 (% 55.6) sine konservatif tedavi uygulandý. Geriye kalan 29 (% 44.4) olguda ise içi boþ organ yaralanmasý düþünüldü. Bunlarýn 7sinde tedavi en az 8 saat gecikirken geriye kalan hastalar ilk 6 saat içinde ameliyat edildiler. Tedavide gecikilen 7 hastanýn 2 (% 28.8)'sinde ileum, 2(% 28.8)'sinde kolon ve jejunum, 2 (% 28.8)'sinde kolon ve 1(%1.4.4) inde duodenum yaralanmasý mevcut idi ve hastalarýn hepsinde lezyonlar primer onarým ile tedavi edildi (Duodenum yaralanmasýna primer onarýma ek olarak tüp duodenostomi de eklendi). Bu 7 hastadan birinde yara infeksiyonu geliþti (% 14). Diðer hastalarda postoperatif dönem sorunsuz seyretti. Batýna penetre DKAYlarýnda, olgularýn PL ile takip edilmeleri içi boþ organ yaralanmalarýnýn taný ve tedavisinde gecikmelere neden olabilir. Ancak tedavide belirli bir süre gecikmenin morbidite ve mortaliteyi arttýrmadýðý gözlendi.

Anahtar Kelimeler: BATINA PENETRE DELÝCÝ KESÝCÝ ALET YARALANMASI, ÝNCE VE KALIN BARSAK YARALANMALARI, GECÝKMÝÞ TEDAVÝ

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

Feza Ekiz¹, Tayfun Yücel¹, Orhan Yalçýn¹, Kasým Fincan¹, H Fehmi Küçük¹
Taksim Hastanesi I. Cerrahi Kliniði

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

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ATIF KOPYALA