Yıl: 2019 Cilt: 9 Sayı: 2 Sayfa Aralığı: 97 - 102 Metin Dili: İngilizce DOI: 10.5505/kjms.2019.02223 İndeks Tarihi: 13-06-2022

Thoracic Trauma: Analysis of 440 Cases

Öz:
Aim: Trauma still has a significant place among the reasons for death before the age of 40. This study analyzed the cases with thoracic trauma that were monitored at our center in a period of eight years. Material and Method: The study was conducted with 440 patients over the age of 16 (385 male, 55 female, mean age of 43.2 with a range of 17-89) who were treated at our center due to thoracic trauma in the period of 2011-2017. The patients were examined in terms of their age, sex, trauma etiology, clinical signs, accompanying injuries, surgery indications, applied surgical interventions, complications that occurred and mortality. Results: Three hundred and eighty five (87.5%) of our cases were male, 55 (12.5%) were female, and their mean age was 43.7 (17- 89). While 202 (58.6%) of our cases with blunt thoracic trauma had isolated trauma, 143 (41.4%) had multiple traumas. 88 (92.6%) of our cases with penetrating thoracic trauma had isolated trauma, whereas there were multiple injuries in seven (7.4%). The reasons for blunt thoracic traumas were motor vehicle accidents, falling from a height, battery and injuries caused by cattle. Penetrating thoracic traumas were caused by firearms and injuries by sharp and pointed objects. Single and multiple rib fractures were the most frequent among bone structure injuries in the thorax. Pneumothorax had the first place among intrathoracic injuries. The most frequently applied surgical method for treatment was tube thoracostomy, while sternotomy was the least frequently applied method. Conclusion: The most significant accompanying problem that increases mortality in thoracic traumas are organ injuries. A patient with trauma should be systematically examined very fast, and unnecessary tests should be avoided.
Anahtar Kelime:

Toraks Travması: 440 Olgunun Değerlendirilmes

Öz:
Amaç: Günümüzde halen 40 yaş altı ölüm nedenleri arasında travma önemli bir yer tutmaktadır. Bu çalışmada sekiz yıllık süre içerisinde merkezimizde izlenen toraks travmalı olgular değerlendirildi. Materyal ve Metot: Çalışmaya 2011-2017 tarihleri arasında toraks travması nedeniyle merkezimizde tedavi edilen 16 yaş üzerindeki 440 hasta ( 385 erkek, 55 kadın; ortalama yaş 43.2 dağılım 17-89) alındı. Hastalar yaş, cinsiyet, travma etyolojisi, klinik bulgular, eşlik eden yaralanmalar, ameliyat endikasyonları, uygulanan cerrahi girişimler, gelişen komplikasyonlar ve mortalite açısından incelendi. Bulgular: Olgularımızın 385’i (%87.5) erkek, 55’i (%12.5) kadın olup, yaş ortalaması 43.2 (17-89) yıl idi. Künt toraks travmalı olgularımızın 202’si (%58.6) izole travma iken, 143’ü (%41.4) multipl travmaydı. Penetran toraks travmalı olgularımızın 88’i (%92.6) izole toraks travması iken, yedi (%7.4) olguda ise multipl yaralanma mevcuttu. Künt toraks travmalarının nedenleri motorlu araç kazaları, yüksekten düşme, darp, büyük baş hayvanların sebeb olduğu yaralanmalar idi. Penetran toraks travmalarını ise ateşli silah yaralanması ve delici kesici alet yaralanması oluşturuyordu. Toraksın kemik yapı yaralanmalarında en çok tek veya çoklu kosta kırığı tespit edildi. İntratorasik yaralanmalarda ise pnömotoraks ilk sırayı aliyordu. Tedavide en fazla uygulanan cerrahi yöntem tüp torakostomi iken en az uygulanan yöntem ise sternotomi idi. Sonuç: Toraks travmalarında mortaliteyi artıran en önemli neden eşlik eden organ yaralanmalarıdır. Travmalı bir hasta hızlı bir şekilde sistematik olarak değerlendirilmeli ve gereksiz tetkiklerden kaçınılmalıdır.
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. Dakak M. The role of vats in thoracic trauma (our initial clinical experience). Gulhane Med J 2003;45:218–220.
  • 2. Jones KW. Thoracic trauma. Surg Clin North Am 1980;60:957–81.
  • 3. Basoğlu A, Akdag AO, Calik B, Demircan S. Thoracic trauma: an analysis of 521 patients. Ulus Travma Acil Cerrahi Derg 2004;10:42–6.
  • 4. Current problems in surgery. Cardiothoracic Trauma. Volume 35;Number 8;August 1998.
  • 5. Kaewlai R, Avery LL, Asrani AV, Novelline RA. Multidetector CT of blund thoracic trauma. Radiographics 2008;28(6):1555–1570.
  • 6. Er M, Işık AF, Kurnaz M, Çobanoğlu U, Sağay S, Yalçınkaya İ. Göğüs travmalı 424 olgunun sonuçları. Ulus Travma Acil Cerrahi Derg 2003;9:267–274.
  • 7. Eren MN, Balcı AE. Toraks travmaları. In: Ökten İ, Güngör A, editörler. Göğüs cerrahisi. Ankara: Sim Matbaacılık; 2003;661–88.
  • 8. Ho ML, Gutierrez FR. Chest radiography in thoracic polytrauma. AJR Am J Roentgenol 2009;192:599–612.
  • 9. Elkhayat H, Nousseir H. Fixing a traumatic sternal fracture using stainless steel wires. Trauma Mon 2016;21: e27231.
  • 10. Simon B, Ebert J, Bokhari F, Capella J, Emhoff T, Hayward T, et al. Management of pulmonary contusion and flail chest: An Eastern Association fort he surgery of trauma practice management guideline. J Trauma Acute Care Surg 2012;73:351–61.
  • 11. Kamil Naidoo, Layth Hanbali, Peter Bates. The natural history of flail chest injuries. Chin J Traumatol 2017 oct 20(5):293– 296.
  • 12. Pieracci FM, Majercik S, Ali-osman F, Ang D, Doben A, Edwards JG, et al. Consensus statement: Surgical stabilization of rib fractures colloquium clinical practice guidelines. Injury 2017;48(2):307–321.
  • 13. Von GarrelT, İnce A, Junge A, Schnabel M, Bahrs C. The sternal fracture: radiographic analysis of 200 fractures with special reference to concomitant injuries. J Trauma 2004;57:837–844.
  • 14. Brookes J, Dunn R, Rogers I. Sternal fractures: a retrospective analysis of 272 cases. J Trauma 1993;35:46–54.
  • 15. Velissaris T, Tang AT, Patel A, Khallifa K, Weeden DF. Traumatic sternal fracture: outcome following admission to a thoracic surgical unit. Injury 2003;34:924–7.
  • 16. İmamoğlu OU, Öncel M, Erginel T, Tunçay E, Dalkılıç G, Acar H, et al. Toraks travmalarında yaklaşım:110 olgunun değerlendirilmesi. Türk Göğüs Kalp Damar Cer Derg 1999;7:450–3.
  • 17. Altunkaya A, Aktunc E, Kutluk AC ve Ark. Göğüs travmalı 282 olgunun analizi. Turk J Thorac Cardiovasc Surg 2007;15:127–132.
  • 18. Grene R. Lung alterations in thoracic trauma. J Thorac Imaging 1987;2:1–11.
  • 19. Battistelle F, Benfield JR. Blunt and penetrating injuries of the chest wall, pleura and lungs. In: shields TW, ed. General Thoracic Surgery 4th ed. USA. Williams and wilkons company; 2002:825–831.
  • 20. Ruf G, Mappes HJ, Kohlberger E, Baumgartner U, Farthmann EH. Diagnosis and therapy of diaphragmatic rupture after blunt thoracic and abdominal trauma. Zentralbl Chir 1996;121:24–9.
  • 21. Kologlu MB, Fedakar M, Yagmurlu A. Tracheobronchial Rupture due to Blunt Chest Trauma: Report of a Case. Surg Today, 2006, 36:823–6.
  • 22. Yörük Y, Sunar H, Köse S, Mehmed R, Akkuş M. Toraks travmaları. Ulus Travma Derg 1996;2:189–93.
  • 23. Emircan S, Ozgüç H, Akköse Aydın S, Ozdemir F, Köksal O, Bulut M. Factors affecting mortality in patients with thorax trauma. Ulus Travma Acil Cerrahi Derg 2011 Jul; 17(4):329–33.
  • 24. Jones R, Gage A, Watchel P. Abdominal trauma. In: Pausada L, Osborn H, David L. Emergency medicine. Williams & Wilkins; 1997;134–72.
  • 25. Orhan Yücel, Ersin Sapmaz, Hasan Çaylak, Alper Gözübüyük, Sedat Gürkök, Mehmet Dakak, et al. Hastaneye yatırılmayı gerektiren toraks travmalı 748 olgunun analizi. Gülhane Tıp Dergisi 2009;51:86–90.
APA Haberal M, SENGOREN DİKİS Ö, Akar E (2019). Thoracic Trauma: Analysis of 440 Cases. , 97 - 102. 10.5505/kjms.2019.02223
Chicago Haberal Miktat Arif,SENGOREN DİKİS ÖZLEM,Akar Erkan Thoracic Trauma: Analysis of 440 Cases. (2019): 97 - 102. 10.5505/kjms.2019.02223
MLA Haberal Miktat Arif,SENGOREN DİKİS ÖZLEM,Akar Erkan Thoracic Trauma: Analysis of 440 Cases. , 2019, ss.97 - 102. 10.5505/kjms.2019.02223
AMA Haberal M,SENGOREN DİKİS Ö,Akar E Thoracic Trauma: Analysis of 440 Cases. . 2019; 97 - 102. 10.5505/kjms.2019.02223
Vancouver Haberal M,SENGOREN DİKİS Ö,Akar E Thoracic Trauma: Analysis of 440 Cases. . 2019; 97 - 102. 10.5505/kjms.2019.02223
IEEE Haberal M,SENGOREN DİKİS Ö,Akar E "Thoracic Trauma: Analysis of 440 Cases." , ss.97 - 102, 2019. 10.5505/kjms.2019.02223
ISNAD Haberal, Miktat Arif vd. "Thoracic Trauma: Analysis of 440 Cases". (2019), 97-102. https://doi.org/10.5505/kjms.2019.02223
APA Haberal M, SENGOREN DİKİS Ö, Akar E (2019). Thoracic Trauma: Analysis of 440 Cases. Kafkas Tıp Bilimleri Dergisi, 9(2), 97 - 102. 10.5505/kjms.2019.02223
Chicago Haberal Miktat Arif,SENGOREN DİKİS ÖZLEM,Akar Erkan Thoracic Trauma: Analysis of 440 Cases. Kafkas Tıp Bilimleri Dergisi 9, no.2 (2019): 97 - 102. 10.5505/kjms.2019.02223
MLA Haberal Miktat Arif,SENGOREN DİKİS ÖZLEM,Akar Erkan Thoracic Trauma: Analysis of 440 Cases. Kafkas Tıp Bilimleri Dergisi, vol.9, no.2, 2019, ss.97 - 102. 10.5505/kjms.2019.02223
AMA Haberal M,SENGOREN DİKİS Ö,Akar E Thoracic Trauma: Analysis of 440 Cases. Kafkas Tıp Bilimleri Dergisi. 2019; 9(2): 97 - 102. 10.5505/kjms.2019.02223
Vancouver Haberal M,SENGOREN DİKİS Ö,Akar E Thoracic Trauma: Analysis of 440 Cases. Kafkas Tıp Bilimleri Dergisi. 2019; 9(2): 97 - 102. 10.5505/kjms.2019.02223
IEEE Haberal M,SENGOREN DİKİS Ö,Akar E "Thoracic Trauma: Analysis of 440 Cases." Kafkas Tıp Bilimleri Dergisi, 9, ss.97 - 102, 2019. 10.5505/kjms.2019.02223
ISNAD Haberal, Miktat Arif vd. "Thoracic Trauma: Analysis of 440 Cases". Kafkas Tıp Bilimleri Dergisi 9/2 (2019), 97-102. https://doi.org/10.5505/kjms.2019.02223