Erişkin Karın Travma Hastalarının ve Karın İçi Solid Organ Yaralanmalarının Değerlendirilmesi

Abstract

Amaç: Çalışmamızda acil serviste karın yaralanması düşünülüp batın tomografisi çekilen erişkin olguların; demografik özelliklerini, karın yaralanmalarının klinik ve laboratuar bulgularını, travmanın şiddetini, mortalite oranlarını, karın içi solid organ yaralanma oranlarını ve organların yaralanma derecelerini incelemeyi ve literatüre katkıda bulunmayı amaçladık.

Yöntem: Bu çalışma acil servise gelen çoklu travma hastalarından batın yaralanması düşünülüp tomografi çekilen 18 yaş üzerindeki 335 hastanın geriye dönük incelenmesi sonucu gerçekleştirildi. Olguların yaşı, cinsiyeti, yaralanma mekanizması, eşlik eden diğer sistem yaralanmaları, vital bulguları, fizik muayene bulguları, laboratuar değerleri, solid organ yaralanma derecesi, olguların yaralanma şiddet skorları, tedavileri ve son durumları kaydedildi. Elde edilen veriler istatistiksel olarak incelendi. 

Bulgular: Olguların % 76.2 erkekti ve hastaların yaş ortalaması 41±18.4 idi. Batın yaralanması şüphesi olan hastaların %92.8’inde künt yaralanma ve %7.2’sinde ise penetran yaralanma tespit edildi. Tüm hastaların mortalite oranı %1.2 tespit edildi. Hastaların % 12.8’inde solid organ yaralanması mevcuttu. Solid organ yaralanması olan hastaların %95.3’ü künt yaralanma idi. Solid organ yaralanması olan olguların %55.8’inde karaciğer, %41.9’sında dalak, %18.6’sında böbrek yaralanması tespit edildi. Solid organ yaralanması tespit edilen hastaların %79.1’i konservatif tedavi edilirken %20.9’una cerrahi tedavi uygulandı. Solid organ yaralanması olan hastaların yaralanma şiddet skorları (ISS ve NISS) ve transaminaz değerleri anlamlı derecede yüksek bulundu (p<0.05). 

Sonuç: Sonuç olarak; karın travma olgularında birden fazla karın içi organın yaralanması, eşlik eden karın dışı yaralanmalar, etkilenen solid organın yaralanma derecesi, yüksek travma indeksi mortalite ve morbiditeyi etkileyen faktörler arasında yer almaktadır.

Keywords

• Travma,karın,mortalite,tomografi,morbidite

Evaluation of Adult Abdominal Trauma Patients and Intra Abdominal Solid Organ Injuries

Abstract

Objectives: In our study, adult patients who underwent abdominal trauma in the emergency department and received abdominal tomography; We aimed to examine demographic features, clinical and laboratory findings of abdominal trauma, severity of trauma, mortality rates, intra-abdominal solid organ injury rates, and degree of injury to organs and contribute to the literature.

Methods: This study was carried out as a result of retrospective examination of 335 patients over the age of 18 who underwent tomography, considering abdominal injury from multiple trauma patients admitted to the emergency department. Age, gender, mechanism of injury, accompanying system injuries, vital signs, physical examination findings, laboratory values, solid organ injury degree, injury severity scores, treatments, and final status of the cases were recorded. The data obtained were analyzed statistically.

Results: 76.2% of the cases were male and the mean age of the patients was 41±18.4 years. Blunt injury was detected in 92.8% and penetrating injury in 7.2% of patients with suspected abdominal injury. The mortality rate of all patients was 1.2%. 12.8% of the patients had solid organ injuries. 95.3% of patients with solid organ injuries were blunt injuries. Liver injury was detected in 55.8%, spleen injury in 41.9% and kidney injury in 18.6% of cases with solid organ injury. While 79.1% of patients with solid organ injuries were treated conservatively, 20.9% were treated surgically. Injury severity scores and transaminase values of patients with solid organ injuries were significantly higher (p <0.05).

Conclusion: As a result; multiple intra-abdominal organ injuries, accompanying extra-abdominal injuries, degree of injury of the affected solid organ, high trauma index are among the factors affecting mortality and morbidity in abdominal injuries.

Keywords

• Trauma,abdomen,tomography,mortality,morbidite

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