Penetran Diafragma Yaralanmasý Morbidite ve Mortaliteyi Etkiler mi?

Amaç: Bu çalýþmada penetran abdominal hasar ile birlikte olan diafragma rüptürlerini inceledik.
Gereç ve yöntem: Bu çalýþmaya Ocak 1996- Aralýk 2010 tarihleri arasýnda Genel Cerrahi Kliniði’nde penetran abdominal travmalý 237 hastanýn kayýtlarý retrospektif olarak incelendi. Diafragmatik rüptüre sahip olmayan hastalar Grup 1 ve diafragmatik rüptüre sahip olan hastalar Grup 2 olarak ayrýldý.
Bulgular: 177 hastada diafragmatik hasar yoktu ve 60 hastada ise diafragmatik hasar vardý. Diafragmatik hasar hastalarýn 12’sinde saðda, 7’sinde bilateral ve 41’inde sol tarafta idi. 11 vakada toraksa herniasyon vardý ve en fazla kolon, mide, omentum, ince barsaklar ve dalak torakal kaviteye herniye idi. Postoperatif komplikasyon oranýmýz Grup 1’de %50 (n=89) ve Grup 2’de %47 (n=28) idi. Her iki grup arasýnda istatistiksel olarak anlamlý bir fark yoktu (p˃0.05). Hastanede kalýþ süresi Grup 2’de az miktar fazla olmasýna raðmen anlamlý bir fark yoktu (p˃0.05). Grup 1 ‘de 17 hasta (%9.6) ve Grup 2’de 4 hasta (%6.6) eksitus oldu. Mortalite hýzlarý iki grup arasýnda anlamlý deðil idi (p˃0.05).
Sonuç: Penetran abdominal travmalý hastalarda diafragmatik rüptür yaygýn deðildir. Penetran yaralanmalarda diafragma yaralanmasý olan hastalarla olmayan hastalar arasýnda fark bulunamamýþtýr.

Does a penetrating diaphragm injury have an effect on morbidity and mortality?

Aim: In this study, we investigated the diaphragmatic ruptures that accompanied penetrating abdominal injury.
Material and Methods: Retrospectively 237 patients records with penetrating abdominal trauma in General Surgery Clinics between January 1996 and December 2010 were investigated. Patients with diaphragmatic rupture were designated to Group 1 and those without were designated to Group 2.
Results: There was no diaphragmatic injury in 177 patients, and there was diaphragmatic injury in 60 patients. Diaphragmatic injury was on the right side in 12, on the left side in 41, and bilateral in 7. Eleven had thoracic herniation and the most common hernia contents were colon, stomach, greater omentum, the small bowel and the spleen. The postoperative complication rate was 50% in Group 1 (n=89) and 47% in Group 2 (n=28). There was no significant difference between the two groups (p˃0.05). The length of hospital stay was slightly increased, but not significant in Group 2 (p˃0.05). Seventeen patients (9.6%) in Group 1 and four patients (6.6%) in Group 2 died. The mortality rates between the two groups were not significant (p˃0.05).
Conclusion: Diaphragmatic rupture is not common among patients with penetrating abdominal trauma. There was no difference between patients that had penetrating injuries with or without diaphragmatic injuries in terms of mortality and morbidity.