Portal hipertansiyon ve splenomegali olan bir hastada dalak travması: Olgu sunumu

Öz

Dalak, künt abdominal travma vakalarının en sık yaralanan organıdır. Son zamanlarda künt dalak yaralanmaları olan yetişkinlerin %50-80'i ameliyatsız olarak tedavi edilmektedir. Bu raporda, portal hipertansiyon ve splenomegali öyküsü olan künt bir abdominal travma hastası sunuyoruz. Grade 3 ve hatta grade 4 dalak yaralanmalarında, mevcut literatürde non-operatif tedavi tavsiye edilmektedir. Splenomegali ve portal hipertansiyon öyküsüne sahip bir hasta ile dalak travması yönetimi literatürde yeterince tartışılmamaktadır. Sunulan olguda, hipersplenizm ve portal hipertansiyon hemostaz üzerindeki etkileri görülmektedir. Masif resusitasyon ile bile, beş saat sonra trombosit seviyesi 40.000/mm³’e azalmıştır. Ancak, bu durumda non-operatif tedavide ısrar etmek ölümcül olabilir.

Anahtar Kelimeler

• Dalak travması,Splenomegali

Splenic trauma in a patient with portal hypertension and splenomegaly: A case report

Abstract

The spleen is the most commonly injured organ in cases of blunt abdominal trauma. Currently, 50-80% of adults with blunt splenic injuries are treated nonoperatively. In this report, we present a blunt abdominal trauma patient having a history of portal hypertension and splenomegaly. In grade 3 and even grade 4 splenic injuries non-operative treatment is recommended in current literature. Management of splenic trauma with a patient with history of splenomegaly and portal hypertension is insufficiently discussed in literature. In presented case, hypersplenism and portal hypertension were burden on hemostasis. Even with massive resuscitation, thrombocyte level decreased to 40.000/mm³ after five hours. But, insistence on non-operative treatment in this situation could be fatal.  

Keywords

• Splenic trauma,Splenomegaly

Kaynakça

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