A planned delayed laparoscopy in a gunshot injury case with spleen and diaphragmatic damage

Yıl 2014, Cilt: 41 Sayı: 4, - , 01.12.2014

Ahmet Türkoğlu Metehan Gümüş Zübeyir Bozdağ Hekim Kuzu Yılmaz Zengin

https://doi.org/10.5798/diclemedj.0921.2014.04.0515

Öz

The basic treatment of thoracoabdominal gunshot injury is surgery. However, a conservative approach is increasingly becoming widespread in selected cases. In this study, the management of a patient with a spleen and diaphragm damage due to a gunshot injury who treated with delayed surgery was presented. A 37-year-old man was admitted with a gunshot injury and a computed tomography showed splenic and left diaphragmatic injury. His vital signs were stable and after a 3 days of conservative treatment, laparoscopic repair of the diaphragm was performed and the patient was discharged uneventfully. When a diaphragmatic injury is accompanied by splenic injury in the case of the patient is stable and there is no need for emergency surgery, the repair of the diaphragm may be delayed to prevent unnecessary splenectomy.

Anahtar Kelimeler

Gunshot injury, laparoscopic repair, spleen, diaphragm, delayed

Ateşli silahla oluşmuş dalak ve diyafram yaralanması olgusunda planlanmış geç laparoskopi

Öz

Torakoabdominal ateşli silah yaralanması (ASY)\'nda temel tedavi eksplorasyondur. Ancak seçilmiş olgularda konservatif yaklaşımlar giderek yaygınlaşmaktadır. Bu çalışmada geciktirilmiş cerrahi ile tedavi edilen ateşli silahla oluşmuş dalak ve diyafram yaralanmalı hastanın yönetimi sunuldu. ASY nedeniyle başvuran 37 yaşında erkek hastaya yapılan bilgisayarlı tomografide dalak üst polde yaralanma ve sol diyaframda yaralanma gözlendi. Vital bulguları stabil olan hastaya 3 günlük konservatif tedavi sonrası laparoskopik diyafram tamiri yapıldı ve hasta sorunsuz taburcu edildi. Diyafram yaralanmasına dalak yaralanması eşlik ettiği durumlarda acil cerrahi gerekmiyorsa ve hasta stabilse diyafram onarımı ertelenerek gereksiz splenektomi önlenebilir.

Anahtar Kelimeler

Ateşli silah yaralanması, geciktirilmiş, laparoskopik onarım, dalak, diyafram

Kaynakça

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