Ulus Travma Acil Cerrahi Derg. 2009; 15(2): 191-193

Yakýn mesafeden kurusýký tabanca atýþýna baðlý karýna nafiz yaralanma: Olgu sunumu

Zafer Teke, Ali Özgür Atalay, Koray Tekin
Pamukkale Üniversitesi Týp Fakültesi, Genel Cerrahi Ana Bilim Dalý, Denizli

Kiþilerin kendini savunma gerekliliði için üretilen ve zararsýz olduðu düþünülen kurusýký tabancalar ilgili yasal kurallarýn bulunmamasý nedeniyle eriþkinler tarafýndan kolayca satýn alýnabilmektedir. Kurusýký tabancalarýn neden olduðu yaralanmalar ölümcül olduðu ve nadiren acil servise geldiði için bu olguyu sunuyoruz. Kurusýký tabanca atýþý ile karnýndan yaralanan 15 yaþýndaki bir erkek çocuðu acil servise getirildi. Fiziksel incelemede, sol kot kavsinin hemen 2 cm altýnda ön koltuk altý çizgisi üzerinde 1 cm çapýnda giriþ yarasý ve bu yaranýn çevresinde 4 cm çapýnda halka þeklinde abrazyon ve kontüzyon alaný olduðu görüldü. Karnýn tüm kadranlarýnda defans muskuler ve ribaund hassasiyeti vardý. Hastaya eksploratif laparotomi yapýldý. Ameliyatta, proksimal jejunumda antimezenterik kenarda yaklaþýk 1 cm çapýnda perforasyon ve sol tarafta büyük omentumda hematom saptandý. Perfore jejunum ansýna kama rezeksiyon ve uç uca anastomoz ve parsiyel sol omentektomi yapýldý. Bu tip silahlarýn tehlike ve zararlarýna iliþkin kitle eðitimi ve kullanýmýnýn kýsýtlanmasýna iliþkin yasal kurallarýn gerekli olduðu görünmektedir. Doktorlarýn kurusýký tabancalarýn ölümcül yaralanmalara neden olabildiðini unutmamalarý gerekir.

Anahtar Kelimeler: Kurusýký tabanca, baðýrsak perforasyonu; karýna nafiz yaralanma.

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Penetrating abdominal wound caused by a close-distance blank cartridge pistol shot: a case report

Zafer Teke, Ali Özgür Atalay, Koray Tekin
Pamukkale University, School of Medicine, Department of General Surgery, Denizli

Blank cartridge pistols, which are produced for self-defense needs and considered harmless, can be easily purchased by adults due to lack of legal regulations. We present this case because injuries caused by blank cartridge pistol shots may be fatal and are rarely encountered in emergency departments. A 15-year-old boy was brought to the emergency department with a wound on his abdomen caused by a blank cartridge pistol shot. Physical examination revealed an entrance wound, 1 cm in diameter, with a ring-shaped abrasion, 4 cm in diameter, and a surrounding area of contusion, just 2 cm caudal to the left arcus costarum on the anterior axillary line. Muscular defense and rebound tenderness were present in all quadrants of the abdomen. The patient underwent an exploratory laparotomy. At the time of surgery, a proximal jejunal perforation on the antimesenteric side, approximately 1 cm in diameter, and left-sided hematoma of the greater omentum were identified. A wedge resection of the perforated jejunal loop with end-to-end anastomosis and partial left-sided omentectomy were performed. A mass education on the dangers of these guns and the harm they can cause as well as legal regulations for their restricted use seem to be necessary. Physicians should keep in mind that blank cartridge guns can cause fatal injuries.

Keywords: Blank cartridge pistol, intestinal perforation; penetrating abdominal injury.

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