Karaciğer yaralanmaları

Abstract

1 Ocak 1984 · 31 Eylül 1987 tarihleri arasında (45 ay) Uludağ Üniversitesi Tıp Fakültesi Genel Cerrahi Ana Bilim Dalı'nda karaciğer yaralanması nedeniyle cerrahi girişim uygulanan 73 olgu retrospektif olarak incelendi. Olguların 56 'sı erkek , 17'si kadın olup yaşları 4 ·75 arasındadır (Ortalama yaş 36). Yaralanma şekli 51 olguda künt, 22 olguda penetran olup en sık görülen etken trafik kazalarıdır (% 62). Olguların 11'inde izole karaciğer yaralanması saptanmıştır. Cerrahi tedavi yöntemleri olarak 64 olguda primer sütür onarımı, drenaj, 7 olguda Mikulicz tamponad, 1 olguda eksizyonel debridman ve 1 olguda parsiyel hepatektomi uygulandı. Mortalile oranı % 17.8 (izole karaciğer yaralanmalarında % 5.9, yandaş organ yaralanması da bulunanlarda % 11.9), morbidite oranı % 22 (izole karaciğer yaralanmalarında % 6. 7, yandaş organ yaralanmalı olgularda % 15. 3) olmuştur. Hastanede ortalama kalış süresi 11.3 gün olmuştur.73 patients with liver trauma had been analysed retrospectively between January the 1 st. 1984 and Septembre the 31 st. 1987 (54 months) at the Department of Surgery, University of Uludağ School of Medicine. Among the cases, 56 were males and 17 were females. The average age was 36 (4-75 years). 51 patients (70 %) had blunt and 22 patients (30 %) had penetrated abdominal trauma. The most comman cause of injuries was traffic accidents (62 %). Isolated liver injury was seen only in 11 cases. Surgical treatments were simple suture and drainage (64 cases), Mikulicz's tamponade (7 cases), excisional debridement (1 case) and partial hepatectomy (1 case).The overall mortality rate was 17.8 percent (in isolated liver injuries it was 5.9 percent and in associated injuries 11.9 percent). The mean hospitalisition period was 11.3 days. The management of isolated liver injury is a fairly simple matter in the majority of cases. But in associated injuries and in high grade liver injuries it is difficult matter and their morbidity and mortality rate is high.