Halil İbrahim SERİN, Mustafa Fatih ERKOÇ

TORAKS TRAVMALI ERİŞKİN HASTALARDAKİ KOT FRAKTÜRÜ VE HEMOPNÖMOTORAKS ARASINDAKİ KORELASYON

Amaç: Bu çalışmada amaç travmaya bağlı gelişen kot fraktürü ile hemopnömotoraks ilişkisinin saptanmasıdır.Gereç ve yöntemler: Hastanemiz acil servisine 2014-2017 yılları arasında göğüs travmasıyla gelen ve kotkırığı bulunan 280 hastanın toraks BT filmleri retrospektif olarak taranmıştır.Bulgular: 130 hastada deplase(%46,4) 150 hastada nondeplase (%53,6) kot kırıkları saptandı. Deplase olanların75 tanesinde (%57,6) travmatik pnömotoraks, 25 inde (%19,2) eşlik eden hemotraks vardı. Nondeplasekırıkların 20 tanesinde (%13,3) pnömotoraks, 7 sinde (%4,) eşlik eden hemotoraks vardı. Geri kalanlardapnömotoraks hemotoraks izlenmedi. Tüm kırıkların 35’i (%12,5) alt torakal segmentte (9-12. Kotlar), 205’i(%73,2) ise üst torakal segmentteydi (1-8. Kotlar). 40 hastada (%14,3) ise mix tip fraktürler izlendi. Üst torakalyerleşimli olanların 100’ünde ( %79), alt torakal segmentte olanların 4’ünde ( %3) ve mixt tip olanların23’ünde (%18) hemopnömotoraks saptandı.Sonuç: Kot kırığının lokalizasyonu ve deplase-nondeplase olması eşlik eden olası hemopnömotoraks varlığıile ilişkilidir.

Correlation Between Rib Fracture and Haemopneumothorax in Adult Thoracic Traumatic Patients

Objective: The purpose of this study is to determine the relationship between rib fracture and haemopneumothorax due to trauma. Materials and Methods: Thorax CT films of 280 patients who admitted to our emergency department between 2014 and 2017 years with thoracic trauma and diagnosis of rib fracture were scanned retrospectively. Results: Displaced in 130 patients (46.4%) and nondisplaced (53.6%) rib fractures in 150 patients were detected. Traumatic pneumothorax was present in 75 (57.6%) of the displaced patients, and hemotorax was associated additionally with 25 (19, 2 %) patients. Pneumothorax was present in 20 (13.3%) of the nondisplaced fractures and hemotorax was accompanied in 7 (4%) patients. Pneumothorax and/or hemotorax were not observed in the rest of the group. Thirty-five (12.5%) of all fractures were in the lower thoracic segment (9-12th ribs), and 205 (73.2%) were in the upper thoracic segment (1-8th ribs). Mixed fractures were observed in 40 patients (14.3%). Haemopneumothorax was detected in 100 (79%) of the upper thoracic segment located , in 4 (3%) of the lower thoracic segment located and 23 (18%) of the mixt type. Conclusion: Localization and the type (displaced-nondisplaced) of the rib fractures are associated with the possible presence of haemopneumothorax.

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