Künt Göğüs Travmalarında Pnömotoraks Araştırılması

Yıl 1996, Cilt: 12 Sayı: 1, 23 - 30, 30.04.1996

Sermet Koç

https://izlik.org/JA28CY69NT

Öz

KUnt gog tis travmalannda geli~en hemotoraks ve pnomotoraks slkltkla oltime yol acmaktadlr. Olopside, oltime yol acan kan miktann!l1 kolayllkla belirlenebilmesine karS!l1, otopsi baslanglclIlda pnbmoloraks
araslinlmasl yapllmayan olgularda bliimtin meydana gelmesindeki roW belirsiz kalmaktadlr. Bu durum. bzellikle ie organ YlrtJlmasl ve kanaman!l1 s!l1ITh kaldlgl olgularda bliim mekanizmaslllm ayd!l1latllmaSI
ae;:lslndan onem ta:)lmaktadlr. Kiint gbgtis travmalannda pnbmotorakslll varhgl ctirtime gelismeyen olgularda otopside kalilatif olarak degerlendirilebilir. Kalitatif pnbmotoraks arastHmasl yapJlan nonpenetran nitelikteki 100 ktint gbgiis travmaSI olgusunun 35'inde pozitif, 65'inde negatif sonue;: ahnd!. Olgulann cogunu trafik kazalan ve ytiksekten dtismel er olusturmakta olup, test trafik kazalannda % 34.28, ytiksekten dti~mel rde % 48,57 oranmda pozitif olarak sonucland!. Pnbmotoraks testi (+) 35 olguda slraslyla 29'unda (% 82,85) kosta frakttirU, 26'smda (% 74,28) hemoloraks, yine 26's!l1da (% 74,28) akciger laserasyonu ve 5'inde (% 14,28) sternum klTlgI saptand!. Oliimtin tizerinden 48 saatten fazla stire gee;:mis ve ileri e;: tiriime bulunan olgular arastlrma grubu alll1madl: konlrol grubu olarak kullantlan bu tip 10 olgunun 4'tinde testin pozitif sonuc;: almasl dikkat c;:ekici bulundu.

Anahtar Kelimeler

hemotoraks , pnömotoraks , künt göğüs

Kaynakça

• Rezek, P. R. , Millard, M., Klemperer, P. (1963) Autopsy Pathology A Guide for Pathologists and Clinicians. Charles e. Thomas Publisher, Springfield, illinois, 167: 331-2.
• Knight, B. Forensic Parhology. First Edition, Edward Arnold, London, 199-202.
• Reifferscheid, M. , Weller, S. (1983) Chirurgie. 6., durchgesehene Auflage, George Thieme Verlag, Stuttgart, New York. 77, 365.
• Thomas. e. (1983) Makropathologie, Lehrbuch und Atlas fur Studierende und Aerzte Sechste, Verbesserte Aullage, F.K. Schattauer Verlag, Stuttgart New York, 57.
• Williams, O. (1976) Unexpected Death Due to Natural Disease (In Gradwohl"s Legal Medicine, Third Edition, By Ed. Camps, F.E., Robinson. A.E .. Lucas, B.G.B .. Thomas, f.e.), Bristol: John Wright and Sons Ltd, 236.
• Di Maio. 0 .. 01 Maio, V.J. Forensic Pathology. CRC Press, Boca Raton-Ann Arbor-London-Tokyo, 118-121.
• Lee, M.e., Wong, S.S., Chu, JJ, Chang, J.P .. Lin. P.l, Shieh, M.J., Chang, e.H. (1991 ) Traumatic Asphyxia. Ann. Thome. Surg .. 51(1): 86-8.
• Garramone, R.R., Jr, Jacobs, L.M .. Sandev, P. (1991) An objective method to measure and manage occult pneumothorax. Surg. Gynecol. Ohstet., 173(4): 257-61.
• Spencer, J.A .. Rogers, e.E .. Westaby, S. (1991 ) Clinico-radiological correlates in rupture of the major airways. Ciill. Radiol., 43(6): 371 -6.
• Collms, J.e. , Levine, G., Waxman, K. (1992) Occult traumatic pneumothorax: immediate tube thoracostomy versus expectant. Am. Surg., 58(12): 743-6.
• Wolfman, N.T., Gilpin, J.W., Bechtold, R.E., Meredith, J.W .. Ditesheim, J.A. (J 993) Occult pneumothorax in patients with abdominal trauma. CT studies. 1. Comput. Assist. Tomogr., 17(1): 56-9.
• Ganong, W.P. (1979) Lehrbuch der Medizinischen Physiologie. Ubersetzt, bearbeitet und ergaentz von W. Auerswald in Zusammen-arbeit mit B. Binder und J. Miczoch. Vierte. Uberarbeitere AuJlage, Springer-Verlag, Berlin, Heideberg, New York, 631, 674.
• Ludwing. J. (1972) Current Methods of Autopsy Practie. W.B. Saunders Company , Philadelphia-London-Toronto, 7,8.