Abdullah ŞİŞİK, Fatih BAŞAK, Tolga CANBEK, Ali KILIÇ, Aylin ACAR, Metin YÜCEL, Adnan ÖZPEK, Gürhan BAŞ

Künt karın travmasına bağlı mezenterik avulsiyon

Künt travma sonucu mezenter yaralanması oldukça nadirdir, ancak künt batın travması ile gelen hastalarda mutlaka göz önünde bulundurulmalıdır. Bu yaralanmaların tanısı oldukça zordur ve çoğu zaman hemodinamik instabilite sonucu yapılan laparotomilerde saptanır. Elli iki yaşında erkek hasta araç içi trafik kazası nedeniyle Acil Servise başvurdu. Gelişinde Glasgow koma skalası 14, tansiyon arteriyel 70/50 mmHg, nabız 78/dk, hemoglobin 11 g/dL, hematokrit %34 ve lökosit 6500/mm³ saptandı. Bilgisayarlı tomografide batın içinde yaygın hemorajik mayi ve mezenterik yağlı dokuda kirlenme saptandı. Konservatif takibin 2. saatinde hemodinamik instabilite olmasından dolayı yapılan laparotomide ince barsak mezenterinde avulsiyon ve 120 cm ince barsakta nekroz saptandı. Kanama kontrolu, rezeksiyon, anastomoz uygulandı. Hasta postoperatif 9. günde sorunsuz şekilde taburcu edildi

Mesenteric avulsion in a blunt trauma

Mesenteric injuries are uncommon with blunt trauma, however these injuries must be considered in patients which are presented with blunt abdominal trauma. Preoperative diagnose is quite difficult in mesenteric injuries,and mostly they are detected during laparotomies which were performed due to hemodinamic instability. Fifty-two years old male patient was admitted to emergency service with road accident. On admission; glasgow coma scale: 14, blood pressure: 70/50 mmHg, pulse: 78/min, hemoglobin: 11 g/dL, hematocrite: 34% and leukocyte: 6500/ mm³. Abdominal computerized tomography showed diffuse intraabdominal hemorrhagic fluid and mesenteric fat straining. Diagnostic laparotomy was performed due to hemodynamic instability after 2 hours of conservative management. Mesenteric avulsion and 120 cm small bowel necrosis were detected and hemorrhage control and anastomosis were performed after resection of necrotic intestine. Patient was discharged uneventfully on postoperative day 9

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