Travma dışı aort rüptürüne bağlı ölümlerin değerlendirilmesi

Öz

AMAÇ: Bu çalışmanın amacı travma dışı aort rüptürü sonucu öldüğü tespit edilmiş olguların otopsi bulguları, organların histopatolojik özellikleri, anevrizma lokalizasyonu ve risk faktörlerini değerlendirmektir. YÖNTEM: 01.01.2015 - 31.12.2019 tarihleri arasında Adli Tıp Kurumu Morg İhtisas Dairesi tarafından travma dışı aort rüptürü nedeniyle öldüğü tespit edilen 250 vaka çalışmaya dahil edilmiştir. BULGULAR: Vakalardaki erkek kadın oranı 3,03: 1, yaş ortalaması 52,7±15,9’dur. Kadınların yaş ortalaması erkeklere göre anlamlı olarak daha yüksek bulunmuştur. En sık görülen yaş grubu 51-60 yaş grubu %24,4 olarak saptanmıştır. Vakaların vücut kitle indeksi ortalaması 28,9±6,2 olup, kadınlarda erkeklere göre biraz daha yüksek bulunmuştur. Tıbbi özgeçmişlerine erişilebilen vakaların %42,8’inde hipertansiyon olduğu tespit edilmiştir. Ayrıca vakaların %50’sinde ateroskleroz olduğu görülmüştür. Bir vakada Turner Sendromu olduğu öğrenilmiş olup, vakaların %4,4’ünde de biküspit aort kapakçığı tespit edilmiştir. Anevrizmaların lokalizasyonu incelendiğinde vakaların %55,6’sında anevrizmanın assendan aortta olduğu, %10,8’inde assendan aort ve arcus aortta olduğu tespit edilmiştir. Vakaların %78’inde rüptürün assendan aortta olduğu görülmüştür. DeBakey sınıflamasına göre vakaların %56,4’ünün Tip II, %11,6’sinin Tip I olduğu, %27,6’sının sınıflandırma dışında kaldığı tespit edilmiştir. Stanford sınıflamasına göre ise vakaların %88’inin Tip A, %8,9’unun Tip B diseksiyon olduğu, %3,1’inin ise sınıflandırma dışı kaldığı görülmüştür. SONUÇ: Travma dışı aort rüptürüne bağlı ölümlerin gerçek insidansını ve risk grubunda olan hastaları belirleyerek erken teşhis ve tedavi konusunda doğru stratejiler oluşturulması gerekmektedir.

Anahtar Kelimeler

• Aort anevrizması
• rüptür
• otopsi
• ani ölüm
• hipertansiyon

Evaluation of deaths due to non-traumatic aortic rupture

Öz

INTRODUCTION: The aim of this study is to evaluate autopsy findings, histopathological features of organs, aneurysm localization and risk factors in non-traumatic aortic rupture death cases. METHODS: The data of 250 cases which determined to have died due to non-traumatic aortic rupture by the Morgue Department of Council of Forensic Medicine autopsy unit between 01.01.2015 and 12.31.2019 were included. RESULTS: The male-female ratio in the cases was 3.03: 1, and the mean age was 52.7±15.9 years. The mean age of women was found to be significantly higher than men. The most common age group was 51-60 age group 24.4% . The mean body mass index of the cases was 28.9±6.2, and it was found to be slightly higher in women than in men. Hypertension was found in 42.8% of the cases whose medical history could be accessed. In addition, 50% of the cases were found to have atherosclerosis. One case had Turner syndrome, and bicuspid aortic valve was detected in 4.4% of the cases. When the localization of the aneurysms was examined, 55.6% of the cases had the aneurysm in the ascending aorta, and 10.8% of the cases had in both the ascending aorta and arcus aorta. In 78% of the cases, the rupture was seen in the ascending aorta. According to the DeBakey classification, it was determined that 56.4% of the cases were Type II, 11.6% were Type I, and 27.6% were excluded from the classification. According to the Stanford classification, 88% of the cases were Type A, 8.9% were Type B dissection, and 3.1% were not classified. CONCLUSION: It is necessary to establish the right strategies for early diagnosis and treatment by determining the real incidence of deaths due to non-traumatic aortic rupture and the patients in the risk group.

Anahtar Kelimeler

• Aortic aneurysm
• rupture
• autopsy
• sudden death
• hypertension

Kaynakça

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