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KOLON PERFORASYONU İLE SONUÇLANAN GEÇ TANI KONMUŞ TRAVMATİK DİYAFRAGMA YARALANMASI: BİR VAKA TAKDİMİ

Yıl 2017, Cilt 24, Sayı 4, 173 - 177, 01.12.2017
https://doi.org/10.17343/sdutfd.295606

Öz

ÖZET

Giriş: Travmatik diafragma yaralanmaları sık görülmeyen ancak yüksek morbidite ve mortaliteye neden olabilen bir durumdur. Künt travmatik diyafragma rüptürü en sık motorlu taşıt kazaları sonucu olmaktadır. Asemptomatik seyreden Travmatik diyafragma yaralanmaları yıllar sonra diafragma hernisine bağlı gastrointestinal yada pulmoner sistem semptomları ile karşımıza çıkabilmektedir.

Vaka: 65 yaşında, geçirilmiş trafik kazası hikayesi olan kadın hasta, ciddi nefes darlığı ve karın ağrısı şikayeti ile hastanemize başvurdu. Sol hidropnömotoraks saptandı ve tüp torakostomi uygulandıktan sonra, kapalı sualtı drenaj sistemine bir hafta sonunda bağırsak içeriğinin gelmesi üzerine, acil sol torakotomi ve laparotomi yapıldı. Transvers kolon batın içine alınıp nekroze olan kısım rezeke edildi ve kolostomi açıldı. Hastaya postoperatif dönemde yoğun bakım ünitesinde 9 gün  sepsis durumu ile takip ve tedavi edildi. Ardından servisteki 20 günlük izlemin ardından sorunsuz taburcu edildi.

Sonuç: Torakoabdominal yaralanma geçiren hastalarda yapılan tüm radyolojik incelemelerde bulgu saptanmasa bile, hastalar diafragma yaralanması konusunda dikkatlice incelenmelidir. Geçikmiş tanı hayatı tehdit eden durumlara yol açabilir. Dikkatli ve uygun yaklaşımla yüksek morbidite ve mortalite ile seyreden komplikasyonlar açısından erken tanı konabilir.


ABSTRACT

Introduction: Traumatic diaphragmatic injuries are uncommon injuries but cause high mortality and morbidity. Motor vehicle accidents are the most common cause of blunt traumatic diaphragmatic rupture. After years, asymptomatic patients with Traumatic diaphragmatic injuries may be presented with gastrointestinal and pulmonary symptoms due to diaphragmatic hernia.

Case:  65 year-old female patient with a history of traffic accident was admitted to our hospital with severe dyspnea and abdominal pain. Left hydropneumothorax was detected. 7 days after the tube thoracostomy procedure, emergency thoracotomy and laparotomy was performed because of intestinal contents coming from closed underwater drainage system. The transverse colon was taken back to abdomen, necrosis area was resected, and colostomy was opened. The patient with sepsis status was treated and followed 9 days in Intensive Care Unit. Then, 20 days after the follow up in the clinic, she was discharged without any problems.

Result: Although there are no findings detected on all radiological examinations in patients with thoracoabdominal injuries, the patients should be carefully examined for diaphragmatic injuries. Delayed diagnosis may lead to life threatening conditions. With careful and appropriate approaches, early diagnosis may be made for complications with high mortality and morbidity

Kaynakça

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Ayrıntılar

Konular Tıp
Bölüm Olgu Sunumları
Yazarlar

Mustafa Soner ÖZCAN>
Servergazi Devlet Hastanesi
0000-0003-0385-2308
Türkiye


Gökhan PEKER Bu kişi benim
Servergazi Devlet Hastanesi


Tarık TÜRK Bu kişi benim
Servergazi Devlet Hastanesi


Mehmet Gürdal ÖZTEKİN Bu kişi benim
Servergazi Devlet Hastanesi

Yayımlanma Tarihi 1 Aralık 2017
Başvuru Tarihi 1 Mart 2017
Kabul Tarihi
Yayınlandığı Sayı Yıl 2017, Cilt 24, Sayı 4

Kaynak Göster

Vancouver Özcan M. S. , Peker G. , Türk T. , Öztekin M. G. KOLON PERFORASYONU İLE SONUÇLANAN GEÇ TANI KONMUŞ TRAVMATİK DİYAFRAGMA YARALANMASI: BİR VAKA TAKDİMİ. SDÜ Tıp Fakültesi Dergisi. 2017; 24(4): 173-177.

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Süleyman Demirel Üniversitesi Tıp Fakültesi Dergisi/ Medical Journal of Süleyman Demirel Universty Creative Commons Atıf-Gayriticari-Türetilemez 4.0 Uluslararası Lisansı ile lisanslanmıştır.