Forensic Medical Evaluation of Trauma Cases with Whole-Body Computed Tomography Examination

Öz

Objective: Radiological imaging plays a crucial role in diagnosing trauma in modern emergency care. The use of medical imaging techniques, particularly whole-body computed tomography (Pan-CT), has increased significantly in recent years. This study aimed to determine the number of negative Pan-CT results (absence of trauma-related findings) and findings that could influence forensic reports and legal proceedings in trauma cases. The results were also compared with existing literature. Methods: This retrospective study analyzed cases referred to Bandırma Training and Research Hospital Forensic Medicine Polyclinic for forensic medical assessment between January 1, 2023, and December 31, 2023, who underwent Pan-CT as part of their posttraumatic emergency care. Results: The study included 261 cases, of whom 74.3% (n = 194) were male and 25.7% (n = 67) were female. The mean age was 37 years (±17.54). Motorcycle accidents were the most common cause of trauma (n = 84, 32.2%). Pan-CT findings showed that 63.2% (n = 165) of cases had negative results (normal findings), while 5.0% (n = 13) exhibited only traumatic soft tissue injuries. Conclusion: Performing Pan-CT in trauma patients based on established indications and clinical decision-making guidelines can help avoid unnecessary imaging. Physicians should have appropriate conditions to assess indications thoroughly and implement proper evaluation algorithms based on clinical data. Adhering to these principles will enhance the accuracy of medical findings and improve the quality of medical documentation, ultimately strengthening forensic assessments and contributing positively to legal proceedings.ekçelerini irdelemeleri, klinik verileri değerlendirerek uygun algoritmaları uygulamaları için uygun çalışma ve saha şartlarına sahip olmaları gerekmektedir. Bu şartların sağlanmasıyla elde edilecek tıbbi bulgular ve düzenlenecek tıbbi belgeler, sonraki süreçte yapılacak adli tıbbi değerlendirmeler için de çok daha etkin olacak, adli sürece olumlu katkı sağlayacaktır.

Anahtar Kelimeler

• Trauma
• Computed tomography
• Forensic medicine
• Pan-CT

Tüm Vücut Bilgisayarlı Tomografi Tetkiki Yapılan Travma Olgularının Adli Tıbbi Değerlendirilmesi

Öz

Amaç: Modern acil travma bakımında radyolojik görüntüleme, tanıya götüren yolda oldukça önemli bir basamaktır. Son yıllarda başta tüm vücut bilgisayarlı tomografi (Pan-CT) olmak üzere medikal görüntüleme yöntemlerinin kullanımı oldukça artmıştır. Çalışmamızda travma sonrası Pan-CT çekilen olgularda, sonuçların ne kadarında negatif sonuç (herhangi bir travma bulgusu olmaması), ne kadarında teşhisi, bunun yanında adli rapor ve adli süreci etkileyecek bulgular elde edildiğinin saptanması, literatür verileri ile karşılaştırılması amaçlanmıştır. Yöntem: Çalışmada 01/01/2023-31/12/2023 tarihleri arasında Bandırma Eğitim ve Araştırma HastanesiAdli Tıp Polikliniği’ne adli rapor düzenlenmesi amacıyla başvurmuş ve posttravmatik acil servis sürecinde Pan-CT tetkiki yapılan olgular retrospektif olarak incelenmiştir. Bulgular: Çalışmaya dahil edilen 261 olgunun %74,3’ü (n=194) erkek, %25,7’si (n=67) kadındı. Olguların yaş ortalaması 37 (±17,54) olarak tespit edildi. Olay türüne baktığımızda motosiklet kazası (n=84, %32,2)’nın ilk sırada olduğu tespit edildi. Pan-CT çekilen olguların sonuçları incelendiğinde, olguların %63,2’sinde (n=165) negatif BT sonucu (normal bulgular), %5,0’inde (n=13) sadece travmatik yumuşak doku bulguları saptandı. Sonuç: Acil servislerde travma hastalarına çekilen Pan-CT’lerin belirlenmiş endikasyonlarla ve klinik karar verme kılavuzları eşliğinde istenmesi gereksiz görüntüleme tetkiklerinin önüne geçecektir. Bununla birlikte hekimlerin endikasyon gerekçelerini irdelemeleri, klinik verileri değerlendirerek uygun algoritmaları uygulamaları için uygun çalışma ve saha şartlarına sahip olmaları gerekmektedir. Bu şartların sağlanmasıyla elde edilecek tıbbi bulgular ve düzenlenecek tıbbi belgeler, sonraki süreçte yapılacak adli tıbbi değerlendirmeler için de çok daha etkin olacak, adli sürece olumlu katkı sağlayacaktır.

Anahtar Kelimeler

• Travma
• Bilgisayarlı tomografi
• Adli tıp
• Pan-BT

Kaynakça

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