Atıf BAYRAMOĞLU, Abdullah KISAOĞLU, Selçuk Sabri ATAMANALP, Şükrü ASLAN, Bülent AYDINLI, Gürkan ÖZTÜRK, Bünyami ÖZOĞUL, Ayhan AKÖZ

Künt Batın travmalarında Kolon Yaralanmaları -43 Olguluk Seri

AMAÇ: Bu çalışmada kliniğimizde opere ettiğimiz künt kolon yaralanması olan hastalarda kolon hasar skoru, peritoneal fekal kontaminasyon derecesi, ameliyata kadar geçen süre ve uygulanan tedavi seçeneği gibi faktörlerin morbidite ve mortalite üzerindeki etkileri incelendi.YÖNTEMLER: Çalışmaya Ocak 2006-Aralık 2012 tarihleri arasında künt batın travmasına maruz kalan ve Atatürk Üniversitesi Tıp Fakültesi Hastanesi Genel Cerrahi Kliniğinde ameliyat edilen künt kolon yaralanması olan hastalar dahil edildi. Hastaların yaş, cinsiyet, yaralanma şekli, başvuru süresi, fizik muayene bulguları, görüntüleme yöntemleri, ameliyatın zamanlaması, yandaş organ yaralanmalarının varlığı, yaralanan kalın barsak segmenti, kalın bağırsak yaralanma skalası CIS sonuçları, yapılan operasyon çeşidi, hastanede yatış süresi, morbidite ve mortalite oranları değerlendirildi.BULGULAR: Çalışmaya 43 hasta katıldı. Kolon yaralanmalarında en sık etyolojik faktör trafik kazası idi 23 hasta %53,4 . Hastalardan 38'inde kolonda yalnızca bir alanda perforasyon varken 5 hastada 2 veya daha fazla alanda perforasyon vardı. Hastalarda en sık sol kolon veya sigmoid kolon yaralanması 24 hasta %55,8 mevcuttu. Hastalarda kolon yaralanmasına en sık ince barsak yaralanması 7 hasta eşlik etmekteydi. Hastaların tedavisinde 19 hastada tek aşamalı cerrahi yöntemler seçilirken 24 hastada çift aşamalı yöntemler seçildi. En sık postoperatif komplikasyon yara enfeksiyonu 7 hasta idi. Hastaların mortalite oranları %9,3 4 hasta olarak belirlendi.SONUÇ: Kolon yaralanma skoru Evre-3'ten büyük ve orta-ağır şiddette peritoneal kontaminasyonu olan hastalarda iki aşamalı cerrahi tedavi seçeneklerinin uygulanmasının daha uygun olduğu sonucuna varıldı.

Anahtar Kelimeler:

Künt travma, Kolon, Abdominal, Mortalite

Colon Injuries Due to Blunt Abdominal Trauma - A Case Series of 43 Patients

OBJECTIVE: The aim of this study was to investigate the effects of factors such as colonic damage score, degree of peritoneal fecal contamination, time before surgery and treatment options on morbidity and mortality. METHODS: Patients with colon injury due to blunt abdominal trauma who were operated in General Surgery Clinic of Ataturk University Medical Faculty between January 2006 and December 2012 were enrolled to the study. The age, gender, type of injury, admission time and physical examination findings of patients, used imaging modalities, time of surgery, presence of concomitant organ injuries, injured segment of the colon, results of colon injury scale CIS , the type of operation, length of hospitalization, morbidity and mortality rates were evaluated.RESULTS: A total of 43 patients were included to the study. The most common etiologic factor in colon injuries were traffic accidents n=23; 53.4% . While 38 patients had perforation of the colon in one area, 5 patients had perforation in two or more areas. Patients most commonly had left colon or sigmoid colon injuries n=24; 55.8% . The most common concomitant injury was small bowel injury n=7; 16.3% . In the management of patients, single-stage surgical procedures were prefered in 19 patients, while two-stage surgical procedures prefered in 24 patients. The most common postoperative complication was wound infection n=7; 16.3% . Mortality rate was 9.3% n=4 .CONCLUSION: We concluded that two-stage surgical treatment options were more suitable in patients with colon injury score greater than stage 3 and moderate-to-severe peritoneal contamination.

Keywords:

Blunt Trauma, Colon, Abdominal, Mortality,

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