Selim SÖZEN, Metin PİRİ, Ömer TOPUZ, Mustafa KEÇELİ, Halil Mert BAHADIR, Oğuz IŞIK, Ahmet Feran AĞAÇHAN

Künt Abdominal Travmaya Bağlı Rektum Perferasyonu

Travmatik rektum yaralanmaları nadir görülen, morbidite ve mortalitesi yüksek, cerrahi tedavisi halen tartışmalı bir klinik antitedir. Travmatik rektum yaralanmalarında erken tanı konulan hastalarda primer tamir, generalize peritonitin eşlik ettiği hastalarda primer tamir ve saptırıcı stoma uygulanması mortalitesi ve morbiditesi düşük yaklaşımlardır. Biz bu makalede, rektum perforasyonu ile sonuçlanan künt batın travmalı bir olguyu sunmaktayız. Perforasyon primer sütür ile onarıldı. Postoperatif dönemde yara yeri enfeksiyonu veya intraabdominal sepsis ile karşılaşılmadı.

Anahtar Kelimeler:

Travma, yaralanma, rektum

Rectum Perforation Due To Blunt Abdominal Trauma

Traumatic rectal injuries are rare entities with increased morbidity and mortality. In traumatic rectal injuries, primary repair is preferred in patients with early diagnosis, whereas inclusion of fecal diversion could reduce the morbidity and mortality in patients with generalized peritonitis. In this article we report a case of rectum perforation that occured due to blunt abdominal trauma. This perforation had been primarily sutured. Postoperative course was favorable without any wound infection or intraabdominal sepsis

Keywords:

Trauma, injury, rectum,

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Seamon WB, Wells J. Complication of the barıum enema. Gastro- enterology 1965:48:728.
Fielding J, Lumsden K. Large bowel perforations in patients un- dergoing sigmoidoscopy and barıum enema. Br Med 1973:1:471.
Gonzalez RP, Phelan H, Hassan M, et al. Is fecal diversion neces- sary for nondestructive penetrating extraperitoneal rectal injuries? J Trauma 2006;61:815-9.
Gedebou TM, Wong RA, Rappaport WD, et al. Clinical presenta- tion and management of iatrogenic colon perforations. Am J Surg 1996;172:454-458.
Suh HH, Kim YJ, Kim SK. Colorectal injury by compressed air - a report of two cases. J Korean Med Sci 1996;11:179-82.
Grosberg RC, Hirsch EH. A retrospective analysis and guidelines for therapy. Rectal Trauma. Am J Surg 1983;145;795-9.
Morken JJ, Kraatz JJ, Balcos EG, et al. Civilian rectal trauma: a changing perspective. Surgery 1999;126:693-8.
Robertson HD, Ray JE, Ferrari BT,Gathright JB: Management of rectal trauma. Sur. Gynecol Obstet 1982;154;161-164
Adesanya AA, Ekanem EE. A ten-year study of penetrating inju- ries of the colon. Dis Colon Rectum 2004; 47: 2169-77.
Stone HH, Fabian TC. Management of perforating colon trauma: randomization between primary closure and exteriorization. Ann Surg 1979;190:430-6.
Demetriades D, Murray JA, Chan L, Ordonez C, Bowley D, Nagy KK, et al. Committee on Multicenter Clinical Trials. American Association for the Surgery of Trauma. Penetrating colon injuries requiring resection: diversion or primary anastomosis? An AAST prospective multicenter study. J Trauma 2001;50:765-75.
Biondo S. Jaurrieta E, Marti Ragué J, et al. Role of resection and primary anastomosis of the left colon in the presence of peritonitis. Br J Surg 2000; 87: 1580-1584.
George SM, Fabian TC, Voeller GR, et al. Primary repair of colon wounds. Ann Surg 1989; 209:728-734. Özgönül ve ark.