Künt batın travmalarına bağlı damar yaralanmaları
Küçük Resim Yok
Tarih
1999
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Ulusal Travma ve Acil Cerrahi Derneği
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Karın içi damar yaralanmaları sıklıkla delici ve kesici aletlerle olmakta,;nadir de olsa kunt travmaları takibinde yaralanmalar meydana gelmektedir. Kunt travmalar sonucu oluşmuş damar yaralanmalarına ait az sayıda yayın vardır. Geniş bir yelpazeyi dağılan kunt travmalar da oluşan damar yaralanmalarının sıklığı bilinmemektedir, Beş yıjı aşkın süre içinde kunt travmalar sonucu karın içi damarlarda yaralanma oluşmuş 27 hastanın geriye dönük olarak tıbbı dosyaları tarandı. Bu yaralanmaların %93'ü (25/27) motorlu araç kazasıydı. Hastaların acil merkezimize gelişteki ortalama kim basınçları 88/26 mm Hg'idi. Yaralanma ciddiyet skorları ortalaması (ISS) 28 ±8.2 puan olan hastaların, 19'sundaarterial, f T sinde venöz yaralanma mevcuttu. 26 hastada (%96) damar yaralanmalarına, diğer karın içi organ yaralanmaları eşlikediyontufArter yaralanmaları için primer onarım ve ligasyon, venöz yaralanmalar için ise kompresyon, ligasyonive/Vefa primer onarım uygulandı. Kaba mortalite oranı % 19 olarak bulundu. Arter yaralanmalarının tek başına bulunduğu grupta ölüm yokken, mortalite venöz yaralanmaları olan grupta 33% (5 hasta) olarak bulundu (p<0.05). Nadir de olsa kunt batın travmaları sonucu batın içi damar yaralanmaları oluşmaktadır. Eşlik eden organ yaralanmalarını takiben henı0dinaııük değişikler oluşmakta ve tüm müdahalelere rağmen yüksek mortalite ve morbiditiye neden olmaktadır. Büyük ven yaralanmaları ise yüksek olan mortaliteyi daha da arttırmaktadır. Bu nedenle hemodinamik olarak stabil olmayan hastalar resüsitasyon uygulandıktan sonra acil operasyona alınmalı ve damar yaralanması yönünden dikkatli olunmalıdır..
Abdominal vascular trauma is predominantly penetrating in nature with blunt injuries occurring less frequently. The various specific types of blunt abdominal vascular trauma have been individually reported, however, the wide spectrum of vascular pathology possible with blunt injury is relatively unknown.Over a five year period, 27 patients who sustained blunt abdominal vascular injury were identified. The injury was motor vehicle related in 25/27 (93%). Mean blood pressure on admission was 88/26 mm Hg and mean Injury Severity Score (ISS) was 28±8.2. İn 27patients, there was 19 arterial and 17 venous injuries diagnosed. Significant associated injuries were present in 26/27 (96%) patients. When arterial and venous injuriei'were compared, surgical treatment of arterial injuries more frequently required grafting or ligation, in contrast to venous injuries usually required ligation, packing, or primary repair. Overall morbidity (56%) was significantly greater in the group with venous injury (92% vs 46%, p<0.05). The overall mortality rate was 19%. There was no death in the group with major arterial injuries, while five patients (33%) with major venous injuries died (p<0.05). Blunt abdominal vascular trauma is a rare entity with a wide spectrum of vascular injuries possible. Hypotension and associated visceral injuries are often present. Major venous injuries present acutely and despite heroic measures, continue to have a higher morbidity and mortality. Aggressive resuscitation should be followed by early surgical intervention keyed by a high index of suspicion.
Abdominal vascular trauma is predominantly penetrating in nature with blunt injuries occurring less frequently. The various specific types of blunt abdominal vascular trauma have been individually reported, however, the wide spectrum of vascular pathology possible with blunt injury is relatively unknown.Over a five year period, 27 patients who sustained blunt abdominal vascular injury were identified. The injury was motor vehicle related in 25/27 (93%). Mean blood pressure on admission was 88/26 mm Hg and mean Injury Severity Score (ISS) was 28±8.2. İn 27patients, there was 19 arterial and 17 venous injuries diagnosed. Significant associated injuries were present in 26/27 (96%) patients. When arterial and venous injuriei'were compared, surgical treatment of arterial injuries more frequently required grafting or ligation, in contrast to venous injuries usually required ligation, packing, or primary repair. Overall morbidity (56%) was significantly greater in the group with venous injury (92% vs 46%, p<0.05). The overall mortality rate was 19%. There was no death in the group with major arterial injuries, while five patients (33%) with major venous injuries died (p<0.05). Blunt abdominal vascular trauma is a rare entity with a wide spectrum of vascular injuries possible. Hypotension and associated visceral injuries are often present. Major venous injuries present acutely and despite heroic measures, continue to have a higher morbidity and mortality. Aggressive resuscitation should be followed by early surgical intervention keyed by a high index of suspicion.
Açıklama
Anahtar Kelimeler
Batın yaralanmaları, Yaralar, delici olmayan, Kan damarları, Damar yaralanmaları, Künt abdominal travmalar, Karın, Ölüm oranı, Wounds, Nonpenetrating, Abdominal vascular injuries, Mortality, Abdominal Injuries, Abdomen, Blunt abdominal trauma, Blood Vessels
Kaynak
Ulusal Travma ve Acil Cerrahi Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
5
Sayı
3
Künye
Işıklar, M.H., Allen, R.C., Hunter, G., Mclntyre, K. ve Lumsden, A. B. (1999). Künt batın travmalarına bağlı damar yaralanmaları / Vascular injuries due to blunt abdominal trauma. Ulusal Travma ve Acil Cerrahi Dergisi, Ulusal Travma ve Acil Cerrahi Derneği. 5(3), s. 170-174.
