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Penetran toraks travması sonrası torakotomi gerektiren şok kliniği: Olgu sunumu

Year 2020, Volume: 4 Issue: 8, 704 - 706, 01.08.2020
https://doi.org/10.28982/josam.697034

Abstract

Toraks travması tüm travmatik yaralanmaların %25-50'sinin ve tüm yaş grubunda ölümün önde gelen sebeplerinden biridir. Toraks travmalarında ana sorun, solunumun ve hemodinamik fonksiyonların bozulmasıdır. Biz bu çalışmada acil servise ulaştığında yaşamsal değerleri bozulmuş ve resüsitasyona cevap vermeyen bir toraks yaralanmasında yapılan acil torakotomiyi sunmayı amaçladık. Bu vakada toraksa penetre multipl yaralanmaları olan 41 yaşında bir kadın olgunun hastaneye gelişinden acil torakotomi kararı alınmasına kadar olan süreyi inceledik. Şok yaklaşımının ve resüsitasyon protokollerinin uygun biçimde uygulanmasına rağmen hastanın klinik durumunda iyileşme olmaması ve yapılan FAST ultrasonografisinde aktif kanama görülmesi üzerine hastaya acil torakotomi kararı alındı. Torakotomi sonrası yaşamsal değerlerinde düzelme görülen hasta 1 haftalık yoğun bakım ve servis takibinin ardından ayaktan taburcu edildi. Şok yaklaşımı doğru bir şekilde uygulanmış olmasına rağmen, toraks içi penetran yaralanmalara acil torakotomi endikasyonu kararının alınmasının ve uygulanmasının hastanın mortalitesinde kilit bir nokta olduğu unutulmamalıdır.

References

  • 1. Haberal MA, Dikiş ÖŞ, Lewis Jakar E. Thoracic Trauma: Analysis of 440 Cases. Kafkas J Med Sci. 2019;9(2):97–102. doi: 10.5505/kjms.2019.02223
  • 2. Emircan Ş, Özgüç H, Aydın ŞA, Özdemir F, Köksal Ö. Factors affecting mortality in patients with thorax trauma. Ulus Travma Acil Cerrahi Derg. 2011;17(4):329-33. doi: 10.5505/tjtes.2011.76158.
  • 3. Demetriades D, Murray J, Charalambides K, Alo K, Velmahos G, Rhee P, et al. Trauma fatalities: time and location of hospital deaths. J Am Coll Surg. 2004;198(1):20-6. doi:10.1016/j.jamcollsurg.2003.09.003.
  • 4. Baumgartner FJ, Thoracic Trauma. In: Baumgartner FJ, editors. Cardiothoracic Surgery, 3rd ed. Texas: Landes Bioscience, 2004:245-262.
  • 5. Brock MV, Mason DP, Yang SC, Thoracic trauma. In: del Nido PJ, Swanson SJ, editors. Sabiston, Spencer Surgery of the Chest, 7th ed. Philadelphia: Elsevier Saunders, 2005:79-102.
  • 6. Çobanoğlu U, Kara V, Yalçınkaya İ, Er M, Işık AF, Sayır F, et al. traumatic diaphragmatic ruptures: diagnostic and therapeutic approaches. Türk Göğüs Kalp Dama. 2012;20(1):85-93. doi: 10.5606/tgkdc.dergisi.2012.014.

Shock requiring thoracotomy after penetrating thoracic trauma: A case report

Year 2020, Volume: 4 Issue: 8, 704 - 706, 01.08.2020
https://doi.org/10.28982/josam.697034

Abstract

Thoracic trauma is one of the leading causes of 25-50% of all traumatic injuries and death in the entire population. The main problem in thoracic traumas is the disruption of respiratory and hemodynamic functions. We aimed to investigate emergency thoracotomy performed in thoracic injury and its effect on patient mortality. In this case, we examined the time from the arrival of a 41-year-old woman with penetrating multiple injuries to the thorax to the decision to perform an emergency thoracotomy. Although the shock approach and resuscitation protocols were properly applied, an emergency thoracotomy was decided on, since there was no improvement in the patient's clinical condition and active bleeding was observed in FAST ultrasonography. The patient, whose vital values improved after thoracotomy, was discharged from the hospital after 1 week of intensive care and service follow-up. It should not be forgotten that performing an emergency thoracotomy in intrathoracic penetrating injuries is a key point in the patient’s survival.

References

  • 1. Haberal MA, Dikiş ÖŞ, Lewis Jakar E. Thoracic Trauma: Analysis of 440 Cases. Kafkas J Med Sci. 2019;9(2):97–102. doi: 10.5505/kjms.2019.02223
  • 2. Emircan Ş, Özgüç H, Aydın ŞA, Özdemir F, Köksal Ö. Factors affecting mortality in patients with thorax trauma. Ulus Travma Acil Cerrahi Derg. 2011;17(4):329-33. doi: 10.5505/tjtes.2011.76158.
  • 3. Demetriades D, Murray J, Charalambides K, Alo K, Velmahos G, Rhee P, et al. Trauma fatalities: time and location of hospital deaths. J Am Coll Surg. 2004;198(1):20-6. doi:10.1016/j.jamcollsurg.2003.09.003.
  • 4. Baumgartner FJ, Thoracic Trauma. In: Baumgartner FJ, editors. Cardiothoracic Surgery, 3rd ed. Texas: Landes Bioscience, 2004:245-262.
  • 5. Brock MV, Mason DP, Yang SC, Thoracic trauma. In: del Nido PJ, Swanson SJ, editors. Sabiston, Spencer Surgery of the Chest, 7th ed. Philadelphia: Elsevier Saunders, 2005:79-102.
  • 6. Çobanoğlu U, Kara V, Yalçınkaya İ, Er M, Işık AF, Sayır F, et al. traumatic diaphragmatic ruptures: diagnostic and therapeutic approaches. Türk Göğüs Kalp Dama. 2012;20(1):85-93. doi: 10.5606/tgkdc.dergisi.2012.014.
There are 6 citations in total.

Details

Primary Language English
Subjects Emergency Medicine
Journal Section Case report
Authors

Elif Koçkara This is me 0000-0001-8912-172X

Hatice Şeyma Akça 0000-0003-2823-9577

Abdullah Algın 0000-0002-9016-9701

Serdar Özdemir 0000-0002-6186-6110

Serkan Emre Eroğlu 0000-0002-3183-3713

Publication Date August 1, 2020
Published in Issue Year 2020 Volume: 4 Issue: 8

Cite

APA Koçkara, E., Akça, H. Ş., Algın, A., Özdemir, S., et al. (2020). Shock requiring thoracotomy after penetrating thoracic trauma: A case report. Journal of Surgery and Medicine, 4(8), 704-706. https://doi.org/10.28982/josam.697034
AMA Koçkara E, Akça HŞ, Algın A, Özdemir S, Eroğlu SE. Shock requiring thoracotomy after penetrating thoracic trauma: A case report. J Surg Med. August 2020;4(8):704-706. doi:10.28982/josam.697034
Chicago Koçkara, Elif, Hatice Şeyma Akça, Abdullah Algın, Serdar Özdemir, and Serkan Emre Eroğlu. “Shock Requiring Thoracotomy After Penetrating Thoracic Trauma: A Case Report”. Journal of Surgery and Medicine 4, no. 8 (August 2020): 704-6. https://doi.org/10.28982/josam.697034.
EndNote Koçkara E, Akça HŞ, Algın A, Özdemir S, Eroğlu SE (August 1, 2020) Shock requiring thoracotomy after penetrating thoracic trauma: A case report. Journal of Surgery and Medicine 4 8 704–706.
IEEE E. Koçkara, H. Ş. Akça, A. Algın, S. Özdemir, and S. E. Eroğlu, “Shock requiring thoracotomy after penetrating thoracic trauma: A case report”, J Surg Med, vol. 4, no. 8, pp. 704–706, 2020, doi: 10.28982/josam.697034.
ISNAD Koçkara, Elif et al. “Shock Requiring Thoracotomy After Penetrating Thoracic Trauma: A Case Report”. Journal of Surgery and Medicine 4/8 (August 2020), 704-706. https://doi.org/10.28982/josam.697034.
JAMA Koçkara E, Akça HŞ, Algın A, Özdemir S, Eroğlu SE. Shock requiring thoracotomy after penetrating thoracic trauma: A case report. J Surg Med. 2020;4:704–706.
MLA Koçkara, Elif et al. “Shock Requiring Thoracotomy After Penetrating Thoracic Trauma: A Case Report”. Journal of Surgery and Medicine, vol. 4, no. 8, 2020, pp. 704-6, doi:10.28982/josam.697034.
Vancouver Koçkara E, Akça HŞ, Algın A, Özdemir S, Eroğlu SE. Shock requiring thoracotomy after penetrating thoracic trauma: A case report. J Surg Med. 2020;4(8):704-6.