Penetratıng Stab Wounds To The Abdominal Wall: Retrospective Analysıs Of 131 Cases: Could Unnecessary Laparotomies Be Reduced?

INTRODUCTION: : Penetrating stab wounds (PSW) are among the most frequent causes of
admissions to the emergency department.The current study attempted to
answer the question of whether unnecessary laparotomies could be reduced by
preoperative tests and physical examinations

METHODS: The electronic records of patients admitted to the
Emergency Service of the Ministry of xxxxxxx between 2008 and 2013 with penetrating stab wounds were retrospectively examined

RESULTS: : 29367 (96.7%) of total 30,356 patients were ambulatory patients. Of
these patients, 274 (27.7%) were hospitalized in general surgery clinics. 131
(47.8%) of these patients had abdominal injuries.120 patients who were
operated on were divided into two groups as necessary laparotomy
(therapeutic) in Group A, which consisted of 30 patients (25%) and
unnecessary laparotomy (nontherapeutic+negative laparotomy) in Group B,
which consisted of 90 patients (75%).While a thorax tube was inserted to eight
patients (26.7%) in Group A, a thorax tube was inserted to five (5.6%) patients
in Group B. Accidental mesenteric ischemia was observed in two patients in
which negative laparotomy was conducted, and while in one of them segmental
small intestinal resection and terminal ileostomy was performed, an inflamed
appendix was observed and appendectomy was performed. The histopathology
of appendix was consistent with carcinoid tumor.

DISCUSSION AND CONCLUSION: Conservative treatment should be a strong option
in young patients who have stable hemodynamic conditions and who have no
alcohol intake, or anemia and thoracic trauma, and in which US and CT are
negative.

Batına Nafiz Kesici Delici Alet Yaralanmaları;131 Olgunun Retrospektif Analizi: Gereksiz Laparatomiler Azaltılabilir mi?

GİRİŞ ve AMAÇ: Kesici delici alet yaralanmaları(KDAY) acil servise sık başvuru
nedenlerinden biridir.Biz bu çalışmamızda gereksiz laparatomi oranları pre-
operatif tetkik ve muayenelerle azaltılabilir mi sorusuna cevap aradık.

YÖNTEM ve GEREÇLER: xxxxxx Acil Servis Kliniği’ne 2008-2013 yılları arasında kesici delici alet yaralanması ile başvuran hastaların elektronik kayıtları retrospektif olarak incelendi.
BULGULAR: Toplam 30 356 hastanın 29 367(%96.7)’si ayaktan tedavi
edildi.Bunların 274 (%27.7)’ü Genel Cerrahi Kliniği’ne yatırıldı.Bu hastaların
131(%47.8)’i batına nafiz yaralanmaydı.Opere edilen 120 hasta gerekli
laparatomi(terapötik) 30 hasta (%25)Grup A ve gereksiz laparatomi (non
terapötik+negatif laparatomi) 90 hasta(%75)Grup B olarak ikiye ayrıldı.A
grubunda 8 (%26.7) hastaya torax tüpü takılırken,B grubunda 5 (%5.6)
hastaya torax tüpü takıldı.Negatif laparatomi yapılan 2 hastadan birinde
rastlantısal mezenter iskemi görülüp segmental ince barsak rezeksiyonu+uç
ileostomi uygulanırken,diğerinde enflame apendiks görülerek apendektomi
yapıldı.Apendiksin histopatolojisi karsinoid tümör olarak geldi

TARTIŞMA ve SONUÇ: USG ve BT nin negatif olduğu,alkollü,vitalleri
stabil,anemisi ve torax travması olmayan genç hastalarda konservatif tedavi
güçlü bir seçenek olmalıdır.