Abdominal Ateşli Silah Yaralanması Nedeniyle Opere Edilen Çocuk Hastaların Klinik Özellikleri: Bir Somali Deneyimi

Abstract

Amaç: Ateşli silah yaralanmaları dünya genelinde önemli bir morbidite ve mortalite nedenidir. Bu çalışmada Somali'deki tek çocuk cerrahisi kliniğinde abdominal ateşli silah yaralanması nedeniyle opere edilen hastaların klinik özellikleri incelendi. Gereç ve Yöntemler: Bu çalışmada,Somali'deki tek çocuk cerrahisi kliniğine Mayıs 2019 - Temmuz 2021 tarihleri arasında abdominal ateşli silah yaralanması ile getirilen ve opere edilen 42 çocuk hastanınkayıtları retrospektif olarak incelendi. Hastalar yaş, cinsiyet, yaralanma nedeni (ateşli silah veya bombalanma), tedavi, ameliyat bulguları, yaralanan organlar, hastanede kalış süresi ve komplikasyonlar açısından değerlendirildi. Bulgular: Yaşları 3 - 16 arasında değişen (ortanca 10 yıl), 28 (%67) erkek ve 14 (%33) kadın hastaların 30’u (%71) bombalanma, 12’si ise (%29) kurşunlanma sonucu yaralanmıştı. Vakaların 21’inde (%50) tek, 21’inde (%50) birden fazla organ yaralanması saptandı. En sık hasar gören organlar sırasıyla ince bağırsak (n=24), kolon (n=14), karaciğer (n=10) ve böbrekti (n=7). Ortanca yatış süresi yedi gün olarak saptandı. Vakaların 36’sı (%86) serviste, altısı (%14) yoğun bakım ünitesinde takip edildi. Yoğun bakımda takip edilen iki hastanın seyri mortalite ile sonuçlandı. Sonuç: Çalışmamızın sonuçları, Somali’de tek bir çocuk cerrahisi kliniğinde kısa bir zaman dilimi içinde elde ettiğimiz verilerin, çocukların ciddi oranda abdominal ateşli silah yaralanmalarına maruz kaldıklarını ve önemli bir morbidite ve mortalite ile karşı karşıya olduklarını ortaya koymaktadır.

Keywords

• Ateşli silah yaralanması
• çocuk
• cerrrahi tedavi
• mortalite
• komplikasyonlar

Clinical Characteristics of Child Patients Operated for Abdominal Gunshot Injury: A Somali Experience

Abstract

Aim: Gunshot injuries are an important cause of morbidity and mortality worldwide. We investigated the clinical characteristics of the abdominal gunshot wound patients operated at the only pediatric surgery clinic in Somalia. Materials and Methods: In this study, the records of 42 pediatric patients who were admitted to the only pediatric surgery clinic in Somalia with abdominal gunshot wounds and operated between May 2019 and July 2021 were retrospectively reviewed. Patients were evaluated in terms of age, gender, cause of injury (firearm or bombing), treatment, surgical findings, injured organs, length of hospital stay, and complications. Results: A total of 42 children aged 3 - 16 years (median 10 years), 28 (67%) male and 14 (33%) women, wounded by bombs (30, 71%) or bullets (12, 29%) were included in the study. Twenty one (50%) had single and the other 21 (50%) had multiple intra abdominal organ injury. Most commonly injured organs were small intestines (n=24), large intestines (n=4), liver (n=10) and kidneys (n=7). Median duration of hospitalization was seven days. Thirty six (86%) patients were followed up in the clinic and 6 (14%) in the intensive care unit (ICU). Two of the patients in the ICU did not survive. Conclusion: The results of our study reveal that the data we obtained in a short period of time in a single pediatric surgery clinic in Somalia show that children are exposed to severe abdominal gunshot wounds and face significant morbidity and mortality.

Keywords

• Child
• complications
• gunshot wounds
• mortality
• treatment

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