Ulus Travma Acil Cerrahi Derg. 2012; 18(6): 542-544 | DOI: 10.5505/tjtes.2012.02603

Balistik yaralanmaya baðlý karotiko-juguler fistül

Recep Oktay Peker¹, Mustafa Etli¹, Ulaþ Saðlam¹, Zafer Erk¹, Tülay Tunçer Peker², Mehmet Özaydýn³, Ahmet Yeþildað^4
1Süleyman Demirel Üniversitesi Týp Fakültesi Kalp Damar Cerrahi Ana Bilim Dalý, Isparta
²Süleyman Demirel Üniversitesi Týp Fakültesi Anesteziyoloji Ve Reanimasyon Anabilim Dalý, Isparta
³Süleyman Demirel Üniversitesi Týp Fakültesi Kardiyoloji Anabilim Dalý, Isparta
⁴Selçuk Üniversitesi Meram Týp Fakültesi Radyoloji Anabilim Dalý, Konya

Karotiko-juguler fistüller ateþli silah, kesici alet yaralanmasý sonucu veya iatrojenik olabilir. Geç dönemde kalp yetmezliði, endokardit, serebral embolizasyon gibi komplikasyonlarla ortaya çýkabilir.Bu yazýda nadir görülen karotiko-juguler fistülde BT-anjionun tedaviyi planlamaya katkýsý ve görüntüleme bulgusu sunuldu. 35 yaþýnda erkek hasta sað servikal bölgeden ateþli silah yaralanmasýyla merkezimize 2.saatte sevk edildi. Fiziksel incelemede sað sternokleidomastoid adalesi yakýnýnda hematom ve çýkýþ deliði, þiddetli üfürüm ve trill tespit edildi. Doppler ultrason ve BT-anjio ile taný konuldu. Cerrahi yaklaþým ile 6mm PTFE kullanýlarak karotis artere, 12mm dacron greft ile de juguler vene interpozisyon yapýldý.Fistül traktý kapatýldý. Postoperatif 6.ayda USG yapýlan hasta antiagregan tedavi ile sorunsuz izlenmektedir.

Anahtar Kelimeler: Balistik yaralanma, karotiko-juguler fistül, BT- anjio

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Carotico-jugular fistula following a ballistic injury

Recep Oktay Peker¹, Mustafa Etli¹, Ulaþ Saðlam¹, Zafer Erk¹, Tülay Tunçer Peker², Mehmet Özaydýn³, Ahmet Yeþildað^4
1Department Of Cardiovascular Surgery, Suleyman Demirel University, Isparta, Turkey
²Department Of Anesthesiology And Reanimation, Suleyman Demirel University, Isparta, Turkey
³Department Of Cardiology, Suleyman Demirel University, Isparta, Turkey
⁴Department Of Radiology, Selçuk University, Meram Medical School, Konya, Turkey

Carotico-jugular fistulae are known complications of gunshot injuries and stab wounds, but they can be iatrogenic. Untreated, these lesions may lead to heart failure, endocarditis, cerebral embolization. We present the CT-angiographic view and its value for treatment strategy in carotico-jugular fistula. 35 year old man was referred in the second hour of a ballistic injury on the right side of the neck. Physical examination revealed hematoma, exit hole and thrill on the right sternocleidomatoid muscle. Diagnosis was confirmed with doppler ultrasound and CT-angiography. Surgical interposition with 6 mm PTFE for carotid artery and with 12 mm dacron for internal jugular vein was performed. Fistulous tract was ligated. In the postoperative 6th month doppler ultrasound was normal and the patient was on antiaggregant therapy and healthy.

Keywords: Ballistic injury, carotico-jugular fistula, CT-angiography

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