Kemal UZUN, Gökhan İLHAN, Hasan YILMAZ, Hakan KARA

Penetran kalp yaralanmalarında toraks bilgisayarlı tomografinin rolü

Kesici delici alet yaralanması nedeniyle acil servise getirilen 39 yaşındaki erkek hastada sol orta klaviküler hat ile altıncı kaburgalar arası aralığın kesiştiği alanda 2.5 cm boyunda kesi vardı. Arka-ön akciğer grafisin- de anlamlı bir bulgu yoktu. Mediastinal ve torakal yaralanmaları ekarte için çekilen toraks bilgisayarlı tomografide perikardiyal boşlukta 1 cm kalınlığa ula- şan plevral efüzyon ve sternum arkasında hematom görüldü. Hastaya acilen medyan sternotomi yapıldı. Perikardiyal boşluktaki hematom temizlendikten sonra sol ventrikül ön yüzde yaklaşık 1.5 cm'lik yaralan- ma görüldü. Sol ventriküle parmak sokularak kana- ma kontrol altına alındı. Yaralanma yeri plejitli 3/0 polipropilen ve 2/0 polietilen polyester dikiş ile tamir edildi. Hasta, komplikasyon olmadan iyileşti. Toraks bilgisayarlı tomografi kalbe yönlenen kesici delici alet yaralanmalarında kesin tanı için oldukça önemli bir tanı aracıdır.

The role of thoracic computed tomography in penetrating cardiac injury

A 39-year-old male who was admitted to emergency department due to cutting and penetrating stab wounds had a 2.5 cm stab wound at the intersection of the left midclavicular line and sixth intercostal space. There was no significant finding on posteroanterior chest X-ray. Thoracic computed tomography which was performed to eliminate thoracic or mediastinal injuries revealed pleural effusion reaching 1 cm in thickness in the pericardial space and a retrosternal hematoma. The patient underwent median sternotomy urgently. After hematoma was removed in the pericardial space, a 1.5 cm laceration along the anterior surface of the left ventricle was seen. Bleeding was managed with finger inserted into the left ventricle. The injury site was repaired primarily with pledgeted 3/0 polypropylene and 2/0 polyethylene polyester sutures. The patient recovered without any complication. Thoracic computed tomography is an important diagnostic tool for cutting and penetrating stab wounds towards the heart.

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