Öz
Giriş: Travmatik diafram yaralanmaları künt ve delici aletle yaralanmalar sonrasında ortaya çıkan ve sıklıkla gözden kaçan bir sorun- dur. Biz çalışmamızda; kliniğimize sol torakoabdominal bölgeden olan yaralanma ile başvuran hastalar için uygulanan tanı yöntem- lerini karşılaştırdık. Metod: Kliniğimize sol delici kesici alet yaralanması ile konsulte edilen ve tetkik ve tedavisi yapılan 62 hasta ça- lışmaya dahil edildi. Hastalar akciğer grafisi, USG, tomografi ve laparoskopi yapılarak sonuçları incelendi. Sonuçlar: Hastaların 11’i inceleme dışı bırakıldı. Kalan 51 hastanın 26 tanesinde %50.98 diafram yaralanması mevcuttu 25 tanesinde %49.02 ise herhangi bir patoloji rastlanmadı. Tartışma: Sol torakoabdominal bölgeden olan delici kesici alet lezyonları sol tarafta diafram yaralanmasına sebep olması ve sağdaki gibi diafram karaciğer tarafından kapatılmadığından acil tanı almalı ve tedavi edilmelidir. Tanı için hastalara diagnostik laparaskopi yapılmalıdır
Anahtar Kelimeler
Kaynakça
- Yetkin G, Uludag M, Citgez B. Traumatic diaphragmatic hernia re- sulting in intestinal obstruction. BMJ case reports 2009;2009 doi: 10.1136/bcr.06.2008.0258[published Online First: Epub Date].
- Shah R, Sabanathan S, Mearns AJ, et al. Traumatic rupture of di- aphragm. Ann Thorac Surg 1995;60:1444–9.
- Trunkey DD, Lewis FR. Diaphragmatic Injury: Current Therapy of Trauma. St Louis, Mo Mosby–Year Book Inc1999; 144-50.
- Vyhnanek, F., et al., [Penetrating thoracic and abdominal injuries: diagnostic and therapeutic approach]. Rozhl Chir 2011;90:642-6.
- McQuay N Jr, Britt LD. Laparoscopy in the evaluation of penetra- ting thoracoabdominal trauma. Am Surg 2003;69:788-91.
- Hanna WC, Ferri LE. Acute traumatic diaphragmatic injury. Tho- rac Surg Clin 2009;19:485-9.
- Zierold D, Perlstein J, Weidman ER, et al. Penetrating trauma to the diaphragm: natural history and ultrasonographic characteristics of untreated injury in a pig model. Archives of surgery 2001;136:32-7.
- Adegboye VO, Ladipo JK, Adebo OA, Brimmo AI. Diaphragmatic injuries. Afr J Med Med Sci 2002;31:149-53.
- Vyhnanek F, Novak L, Jirava D, et al. [Penetrating thoracic and abdominal injuries: diagnostic and therapeutic approach]. Rozh- ledy v chirurgii : mesicnik Ceskoslovenske chirurgicke spolecnosti 2011;90:642-6.
- Murray JA, Demetriades D, Cornwell EE, 3rd, et al. Penetrating left thoracoabdominal trauma: the incidence and clinical presentation of diaphragm injuries. J Trauma 1997;43:624-6.
- Uribe RA, Pachon CE, Frame SB, Enderson BL, Escobar F, Garcia GA. A prospective evaluation of thoracoscopy for the diagnosis of penetrating thoracoabdominal trauma. J Trauma 1994;37:650-4.
Öz
Introduction: Traumatic diaphragm injury is the problem resulted from blunt and penetrating injuries and it is often overlooked. In our study we compared the diagnotic methods for patients who applied with left thoracoabdominal injury to our clinic. Method: Sixty-two patients consultated for left side penetrating and incisory trauma, were included in our study. After chest radiography, ultrasound, computed tomography and laparoscopy performed, the results were evaluated. Results: 11 of the patients were excluded from the study. Twentysix of the remaning 51 patients 50.8% has diaphragm injury. 25 patients 49.02% has no diaphragm injury. Conclusion: As the liver does not contact the undersurface of the diaphragm on the left side, penetrating and incisory lesions in the left thoracoabdominal area can cause diapragma injury more often than the right side. Therefore emergency diagnosis and treatment is required. Diagnostic laparoscopy should be performed for accurate diagnosis
Anahtar Kelimeler
Kaynakça
- Yetkin G, Uludag M, Citgez B. Traumatic diaphragmatic hernia re- sulting in intestinal obstruction. BMJ case reports 2009;2009 doi: 10.1136/bcr.06.2008.0258[published Online First: Epub Date].
- Shah R, Sabanathan S, Mearns AJ, et al. Traumatic rupture of di- aphragm. Ann Thorac Surg 1995;60:1444–9.
- Trunkey DD, Lewis FR. Diaphragmatic Injury: Current Therapy of Trauma. St Louis, Mo Mosby–Year Book Inc1999; 144-50.
- Vyhnanek, F., et al., [Penetrating thoracic and abdominal injuries: diagnostic and therapeutic approach]. Rozhl Chir 2011;90:642-6.
- McQuay N Jr, Britt LD. Laparoscopy in the evaluation of penetra- ting thoracoabdominal trauma. Am Surg 2003;69:788-91.
- Hanna WC, Ferri LE. Acute traumatic diaphragmatic injury. Tho- rac Surg Clin 2009;19:485-9.
- Zierold D, Perlstein J, Weidman ER, et al. Penetrating trauma to the diaphragm: natural history and ultrasonographic characteristics of untreated injury in a pig model. Archives of surgery 2001;136:32-7.
- Adegboye VO, Ladipo JK, Adebo OA, Brimmo AI. Diaphragmatic injuries. Afr J Med Med Sci 2002;31:149-53.
- Vyhnanek F, Novak L, Jirava D, et al. [Penetrating thoracic and abdominal injuries: diagnostic and therapeutic approach]. Rozh- ledy v chirurgii : mesicnik Ceskoslovenske chirurgicke spolecnosti 2011;90:642-6.
- Murray JA, Demetriades D, Cornwell EE, 3rd, et al. Penetrating left thoracoabdominal trauma: the incidence and clinical presentation of diaphragm injuries. J Trauma 1997;43:624-6.
- Uribe RA, Pachon CE, Frame SB, Enderson BL, Escobar F, Garcia GA. A prospective evaluation of thoracoscopy for the diagnosis of penetrating thoracoabdominal trauma. J Trauma 1994;37:650-4.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Bölüm | Original Article |
| Yazarlar | |
| Yayımlanma Tarihi | 1 Ocak 2012 |
| Yayımlandığı Sayı | Yıl 2012 Cilt: 22 Sayı: 4 |
Genel Tıp Dergisi Creative Commons Atıf-GayriTicari 4.0 Uluslararası Lisansı (CC BY NC) ile lisanslanmıştır.