ATEÞLÝ SÝLAH YARALANMASINA BAÐLI PENETRAN MESANE YARALANMALARI

Bu çalýþmada; 1990 ile 1996 tarihleri arasýnda ateþli silah yaralanmasýna baðlý penetran mesane yaralanmasý nedeni ile ameliyat edilen 28 olgu; taný ve tedavi yöntemleri, yandaþ organ yaralanmasý, morbidite ve mortalite oranlarý açýsýndan deðerlendirildi. Mesane rüptürü tanýsý olgularýn 16'sýnda retrograt sistografi ile, 12'sinde ise laparotomi sýrasýnda konuldu. Yirmialtý hastada intraperitoneal, 2 hastada ekstrapertoneal mesane rüptürü mevcuttu. Tüm hastalarýn mesane rüptürleri primer sütür ile onarýldý. Hiçbir hastada izole mesane yaralanmasý yoktu. Yandaþ organ yaralanmasý olarak 27 hastada intraabdominal organ yaralanmasý, 12 hastada fraktür, 5 hastada diðer organ yaralanmalarý saptandý. Olgularýn hiçbirinde direkt mesane yaralanmasý ile ilgili mortalite görülmedi. Ancak 2 olgu yandaþ organ yaralanmalarý nedeni ile kaybedildi. Sonuç olarak; ateþli silah yaralanmasýna baðlý mesane rüptürleri primer sütürle güvenli olarak onarýlabilir. Ancak yandaþ yaralanmalar ciddi komplikasyonlara neden olabilir.

PENETRATING INJURIES OF THE BLADDER DUE TO GUNSHOT WOUNDS

In this study; 28 patients underwent surgery secondary to penetrating injury of the bladder due to gunshot wounds between 1990 and 1996 were evaluated retrospectively according to the diagnosis and treatment methods, associated organ injury, morbidity and mortality rates. The bladder rupture was diagnosed with retrograde cystography in 16 patients and with laparotomy in 12 patients. Bladder rupture was intraperitoneal in 26 patients and extraperitoneal in 2 patients. Bladder ruptures were repaired with primary suture in all of patients. No patient had isolated bladder injury, while there were intraabdominal injury in 27 patients, fractures in 12 patients and other organ injuries in 5 patients as associated injuries. There were no mortally directly related with the bladder injury, 2 patients died secondary to associated organ injury. As a result; the bladder ruptures due to gunshot wounds can be repaired primarily with safety. But, associated injuries can cause severe complications.