Ulus Travma Acil Cerrahi Derg. 2000; 6(2): 86-90

SPONTAN ÝNCE BARSAK PERFORASYONLARI

Ekrem Kaya¹, Osman Selçuk¹, Adem Derviþoðlu¹, Zafer Malazgirt¹, Necati Özen¹, Kayhan Özkan¹
Ondokuz Mayýs Üniversitesi, Týp Fakültesi, Genel Cerrahi Ad

1995-1999 yýllarý arasýnda kliniðimize akut karýn nedeni ile baþvuran ve spontan ince barsak perforasyonu saptanan olgular; yaþ, cins, hastaneye baþvuru süresi, etyoloji, mortalite ve morbidite yönünden deðerlendirildi. Akut karýn nedeni ile baþvuran 640 hastanýn 14'ü (%2.1) spontan ince barsak perforasyonu idi. Yaþ ortalamalarý 57 olan olgularýn 3'ü kadýn, 9'u erkekti. Hastaneye baþvuru süreleri ortalama 4.9 gün idi. Mortalite oraný %21.4, morbidite oraný %35.7 idi. Baþvuru anýnda hesaplanan APPACHE II skoru yaþayan hastalarda ortalama 6.5, ölen hastalarda ortalama 13.3 tür 8 olguda perforasyonun sebebi bilinmezken 6 olguda sebep karsinom metastazý (1), crohn hastalýðý (1), divertikülit (1), amiloidozis (1), bezoar (1) ve radyoterapi (1) olarak belirlendi. Beþ olguya ostomi, diðerlerine segmenter rezeksiyon-debridman + anastoýnoz tekniði uygulandý. SÝP kliniðimizde sýk görülmeyen bir tablodur. Bulgular nonspesifik olduðu için taný çoðunlukla ameliyatta konulmaktadýr. Etyoloji genellikle belirsiz olup, uygun olgularda rezeksiyon ve primer anastomoz güvenle uygulanabilmektedir.

Anahtar Kelimeler: ÝNCE BARSAK PERFORASYONU, SPONTAN, MORTALÝTE, MORBÝDÝTE

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SPONTANOUS SMALL BOWEL PERFORATIONS

Ekrem Kaya¹, Osman Selçuk¹, Adem Derviþoðlu¹, Zafer Malazgirt¹, Necati Özen¹, Kayhan Özkan¹
Ondokuz Mayýs Üniversitesi, Týp Fakültesi, Genel Cerrahi Ad

Aim: To analyse the cases admitted to our clinic due to spontaneous small bowel perforation. Material and method: Between 1995-1999, the cases admitted to our clinic for acute abdominal pain and diagnosed as spontanous small bowel perforations were analysed retrospectively. The age, sex, admittance time, etiology mortality and morbidity of these patients were evaluated. Results: 640 patient were admitted in this period and 14 of them were spontanous small bowel perforations (2.1%). Nine of them were male and three were female. Mean age of the patients was 57. Mean admittance time to the hospital was 4.9 days. Mortality rate was 21.4% and morbidity rate was 35.7%. The mean APPACHE II score of the patients died on the admission was 13.3 and survived was 6.5. The causes of the perforation were metastatic carcinoma (1), bezoar (1), radiotherapy (1), crohn disease (1) and amiloidosis (1). The etiology was unknown in 8 patients. Temporary ileostomy was performed in five cases and resection + anastomosis was performed in rest of the remaining cases. Discussion and conclusion -Small bowel perforation is an uncommon condition in the clinical practice. The findings of this entity are nonspecific, and the diagnosis is usully made in the operating room. The etiology is mostly unclear. Resection and primary anastomoses can be useful in the suitable cases.

Keywords: SMALL BOWEL PERFORATION, SPONTANEOUS, MORTALITY, MORBIDITY

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ATIF KOPYALA