Künt Karın Travmasında Non-Operatif İzlem: Olgu Sunumu
Künt karın travmalarında diffüz bir yaralanma olduğundan tüm abdominal organlar risk altındadır. Hasar, kompresy- on, gerilme ve kesilme gibi mekanizmalarla ve organların yer değiştirmesiyle oluşur. Künt travma sonrası hasarlan- malarda kanama yavaş olabileceğinden erken bulgu vermeyebilir. Ameliyat öncesi ve sonrası oluşabilecek mortaliteve morbiditenin önlenmesi amacıyla uygun hastalar özenli bir şekilde non-operatif izlenebilir. Bu çalışmamızda darpnedeniyle intraabdominal uzanımı olan rektus kası hematomu olan ve konservatif olarak izlenip taburcu edilen birolgu sunulmuş ve güncel literatür eşliğinde tartışılmıştır.
Non-Operative Observation of Blunt Abdominal Traumas: A Case Report
Since it s a diffuse injury,in blunt abdominal traumas all abdominal organs are at risk.The damage occurs due tomechanisms like compression,distantion and disruption or shift of the organs.In blunt trauma injuries,clinical presen- tation may be delayed because the bleeding may occur slowly.In order to prevent the morbidity or mortality that mayoccur in the pre- or post-operative period,some well chosen non-operated patients may be carefully observed. In thisstudy a case of rectus hematoma with intraabdominal relation due to beating who was conservatively observed anddischarged is presented and discussed according to the current literature.
___
- 1. Stassen NA, Bhullar I, Cheng JD, Crandall M, Friese R, Guilla- mondegui O, Jawa R, Maung A, Rohs TJ Jr, Sangosanya A, Schus- ter K, Seamon M, Tchorz KM, Zarzuar BL, Kerwin A; Eastern As- sociation for the Surgery of Trauma. Nonoperative management of blunt hepatic injury: an Eastern Association for the Surgery of Tra- uma practice management guideline. J Trauma Acute Care Surg. 2012 Nov;73(5 Suppl 4):S288-93
- 2. Haan JM, Bochicchio GV, Kramer N, Scalea TM. Nonoperative management of blunt splenic injury: a 5-year experience. J Trau- ma. 2005 Mar;58(3):492-8.
- 3. National Center for Health Statistics, US Department of Health and Human Service monthly vital statistics report, advance report of final mortality statistics. 43:1-76, 1992
- 4. Anadol AZ, Topgül K, Güngör B, Bilgin M, Kesim M. Künt kara- ciğer travmalarına konservatif yaklaşım. Ulus Travma Acil Cerra- hi Derg 2007;13:222-6.
- 5. Fischer RP, Beverghin BC, Engrav LH diagnostic peritoneal lava- ge : Fourteen years and 2586 patients later. Am Surg. 136:701,1978
- 6. McLoughlin E, McGuire A. Injury preventation. In: Trunkey DD, Lewis FR, Current Therapy of Trauma, 4th ed. Mosby, St Lou- is, 1999
- 7. Kennith H. Sartorelli, Carmine Frumiento, Frederick B. Rogers: Nonoperative management in hepatic,splenic and renal injuries in adults with multipl injuries. J Trauma. 49:56-62, 2000
- 8. Brasel KH, DeLisle CM, Olson CH,et al: Splenic injury: Trends in evaluation and management. J Trauma. 44:283,1998
- 9. Pachter HL, Knudson MM, Esrig BB, et al: Status of nonoperative management of blunt hepatic injuries in 1995. A multicenter expe- rience with 404 patients. J Trauma. 140:31,1996
- 10. Buchman RF, Prano G, Dunham CM, et al : Major bowel and di- afragmatic injuries associated with blunt spleen or liver rupture. J Trauma. 28:1317,1988
- 11. Fisher RP, Miller-Crockett P, Reed RL II:Gastrointestinal disrup- tion :The hazard of nonoperative management in adults with blunt abdominal injury. J Trauma. 28:1445,1998