Künt Karın Travmasına Bağlı Solid Organ Yaralanmalarında Non operatif Tedavi-Dalak Yaralanmaları

Mehmet Aykut Yıldırım; Ahmet Tekin; Mehmet Sinan İyisoy; Murat Çakır; Cengiz Kadıyoran; Tevfik Küçükkartallar; Celalettin Vatansev; Faruk Aksoy; Metin Belviranlı; Adil Kartal

doi:10.15321/GenelTipDer.2021.294

EN TR

Non-operative Management In Solid Organ Injuries After Blunt Abdominal Trauma-Splenic Injuries

Abstract

Introduction: Non-operative management (NOM) is the current approach in patients with solid organ injury caused by blunt abdominal trauma. In recent years, conservative treatment is successfully employed by advances in imaging modalities, interventional radiology and intensive care management. However, there is no consensus on follow-up of trauma patients undergoing NOM. In this study, we aimed to highlight controversial issues in trauma patients undergoing NOM. Materials and methods: In this study, we retrospectively assessed with splenic injury after blunt abdominal trauma. Criteria for conversion to laparotomy include hemodynamic instability despite adequate resuscitation and presence of peritoneal irritation findings. The patients were classified as those with NOM success and those with NOM failure requiring laparotomy. Groups were compared regarding demographic characteristics, mechanism of injury, additional trauma, hemodynamic status at admission, severity of injury on CT scan, transfusion need for blood and blood products, need for laparotomy, length of hospital stay, need for ICU admission, change in hemoglobin/hematocrit value and leukocyte count, and initiation time of oral intake Results: In 72 cases with splenic injury after blunt abdominal trauma that was managed by NOM. In 10 patients, NOM was failed and the patients underwent laparotomy. All patients underwent CT scan during initial diagnostic workshop. Conclusion: Imaging modalities should be used in the follow-up of patients with ≥grade 3 injury. Higher grades of injury result in increased costs and prolonged hospitalization. NOM failure is increased in high grade injuries. Another factor in NOM failure is perforation of non-solid organs. Close hemodynamic monitorization, frequent physical examination and effective fluid resuscitation are essential in patients undergoing NOM. It should be kept in mind that complications such as re-bleeding and splenic abscess may occur at early period after discharge.

Keywords

Non-operative management, splenic injury, blunt trauma

Künt Karın Travmasına Bağlı Solid Organ Yaralanmalarında Non operatif Tedavi-Dalak Yaralanmaları

Abstract

Amaç: Künt karın travmasına bağlı solid organ yaralanması olan hastalarda nonoperatif tedavi (NOT) uygulaması güncel yaklaşımdır.NOT uygulanan travmalı hastaların takibinde halen birliktelik yoktur. Çalışmamızda literatürde NOT uygulama aşamasında bazı aydınlatılmayan alanlara ışık tutmayı amaçladık. Materyal-Metod: Çalışmamızda künt karın travmasına bağlı dalak yaralanması tespit edilen hastalar değerlendirildi. NOT başarılı olan hastalar ve NOT başarısız olup laparatomi yapılan hastalar tasnif edildi. Laparotomiye dönüş kriterlerimiz ise yeterli resusitasyona rağmen hemodinaminin instabil olması ve peritoneal irritasyon bulgularının varlığıydı.Yaralanma derecesine göre kendi içlerinde karşılaştırılarak analiz edildi.Gruplar karşılaştırılırken demografik bilgiler, travmanın oluş şekli,girişteki hemodinamik durum, BT’de yaralanmanın derecesi, yatış süresi boyunca kan ve kan ürünleri transfüzyonu gereksinimi, laparatomi gereksinimi, hastanede kalış süreleri, yoğun bakım ihtiyacı, ilk başvurudaki hemoglobin/hematokrit/lökosit sayısı değişimi ve oral beslenme zamanının tayini parametreleri kullanıldı. Bulgular: NOT uygulanan 72 vaka retrospektif olarak değerlendirildi. 10 hastada NOT uygulanırken başarısızlıkla sonuçlandı ve laparatomi uygulandı. Sonuç: Grade 3 ve üzeri yaralanmaların takibinde görüntüleme tetkikleri gerekebilir. NOT uygulanan hastalara hastaneye girişten itibaren yakın hemodinamik izlem, sık tekrarlayan fizik muayene ve etkin sıvı resusitasyonu yapılmalıdır. NOT uygulanan dalak travmalı hastalarda taburculuk sonrası erken dönemde yeniden kanama ve splenik abse gibi komplikasyonların olabileceği akılda tutulmalıdır.

Keywords

Non-operative management, splenic injury, blunt trauma

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Details

Primary Language

Turkish

Subjects

Clinical Sciences

Journal Section

Research Article

Authors

Mehmet Aykut Yıldırım ^*
Türkiye

Ahmet Tekin This is me
0000-0001-9261-8243
Türkiye

Mehmet Sinan İyisoy
0000-0001-8789-8199
Türkiye

Murat Çakır
0000-0001-8789-8199
Türkiye

Cengiz Kadıyoran
0000-0002-7173-3530
Türkiye

Tevfik Küçükkartallar
Türkiye

Celalettin Vatansev
0000-0002-0094-1703
Türkiye

Faruk Aksoy
0000-0003-1560-3034
Türkiye

Metin Belviranlı This is me
0000-0003-1974-255X
Türkiye

Adil Kartal This is me
0000-0002-5045-3273
Türkiye

Publication Date

June 30, 2021

Submission Date

July 16, 2019

Acceptance Date

May 17, 2020

Published in Issue

Year 2021 Volume: 31 Number: 2

DOI

https://doi.org/10.15321/GenelTipDer.2021.294

IZ

https://izlik.org/JA58GX57NC

APA

Yıldırım, M. A., Tekin, A., İyisoy, M. S., Çakır, M., Kadıyoran, C., Küçükkartallar, T., Vatansev, C., Aksoy, F., Belviranlı, M., & Kartal, A. (2021). Künt Karın Travmasına Bağlı Solid Organ Yaralanmalarında Non operatif Tedavi-Dalak Yaralanmaları. Genel Tıp Dergisi, 31(2), 105-110. https://doi.org/10.15321/GenelTipDer.2021.294

AMA

1.Yıldırım MA, Tekin A, İyisoy MS, et al. Künt Karın Travmasına Bağlı Solid Organ Yaralanmalarında Non operatif Tedavi-Dalak Yaralanmaları. Genel Tıp Derg. 2021;31(2):105-110. doi:10.15321/GenelTipDer.2021.294

Chicago

Yıldırım, Mehmet Aykut, Ahmet Tekin, Mehmet Sinan İyisoy, et al. 2021. “Künt Karın Travmasına Bağlı Solid Organ Yaralanmalarında Non Operatif Tedavi-Dalak Yaralanmaları”. Genel Tıp Dergisi 31 (2): 105-10. https://doi.org/10.15321/GenelTipDer.2021.294.

EndNote

Yıldırım MA, Tekin A, İyisoy MS, Çakır M, Kadıyoran C, Küçükkartallar T, Vatansev C, Aksoy F, Belviranlı M, Kartal A (June 1, 2021) Künt Karın Travmasına Bağlı Solid Organ Yaralanmalarında Non operatif Tedavi-Dalak Yaralanmaları. Genel Tıp Dergisi 31 2 105–110.

IEEE

[1]M. A. Yıldırım et al., “Künt Karın Travmasına Bağlı Solid Organ Yaralanmalarında Non operatif Tedavi-Dalak Yaralanmaları”, Genel Tıp Derg, vol. 31, no. 2, pp. 105–110, June 2021, doi: 10.15321/GenelTipDer.2021.294.

ISNAD

Yıldırım, Mehmet Aykut - Tekin, Ahmet - İyisoy, Mehmet Sinan - Çakır, Murat - Kadıyoran, Cengiz - Küçükkartallar, Tevfik - Vatansev, Celalettin - Aksoy, Faruk - Belviranlı, Metin - Kartal, Adil. “Künt Karın Travmasına Bağlı Solid Organ Yaralanmalarında Non Operatif Tedavi-Dalak Yaralanmaları”. Genel Tıp Dergisi 31/2 (June 1, 2021): 105-110. https://doi.org/10.15321/GenelTipDer.2021.294.

JAMA

1.Yıldırım MA, Tekin A, İyisoy MS, Çakır M, Kadıyoran C, Küçükkartallar T, Vatansev C, Aksoy F, Belviranlı M, Kartal A. Künt Karın Travmasına Bağlı Solid Organ Yaralanmalarında Non operatif Tedavi-Dalak Yaralanmaları. Genel Tıp Derg. 2021;31:105–110.

MLA

Yıldırım, Mehmet Aykut, et al. “Künt Karın Travmasına Bağlı Solid Organ Yaralanmalarında Non Operatif Tedavi-Dalak Yaralanmaları”. Genel Tıp Dergisi, vol. 31, no. 2, June 2021, pp. 105-10, doi:10.15321/GenelTipDer.2021.294.

Vancouver

1.Mehmet Aykut Yıldırım, Ahmet Tekin, Mehmet Sinan İyisoy, Murat Çakır, Cengiz Kadıyoran, Tevfik Küçükkartallar, Celalettin Vatansev, Faruk Aksoy, Metin Belviranlı, Adil Kartal. Künt Karın Travmasına Bağlı Solid Organ Yaralanmalarında Non operatif Tedavi-Dalak Yaralanmaları. Genel Tıp Derg. 2021 Jun. 1;31(2):105-10. doi:10.15321/GenelTipDer.2021.294

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Non-operative Management In Solid Organ Injuries After Blunt Abdominal Trauma-Splenic Injuries

Abstract

Keywords

Künt Karın Travmasına Bağlı Solid Organ Yaralanmalarında Non operatif Tedavi-Dalak Yaralanmaları

Abstract

Keywords

References

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