Çocuklarda anorektal travma sonucu gelişen rektum perforasyonu : İki olgu sunumu
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Tarih
2011
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info:eu-repo/semantics/openAccess
Özet
Anorektal yaralanma çocuklarda nadir görülen bir klinik tablodur. Rektum ve diğer intrapelvik organların yaralanmaya eşlik etmesi açısından da önemlidir. Olgu 1: Karın ağrısı ve kusma şikayetleri ile başvuran 9 yaşındaki erkek hastada, karında yaygın hassasiyet ve defans tespit edildi. Ayakta karın grafisinde diyafragma altında serbest hava izlendi. Ameliyatta rektum ve mesane perforasyonu tespit edildi. Yara onarımı ve sigmoid kolostomi yapıldı. Olgu 2: Altı yaşında kız hasta, ağaçtan düşme sonrası gelişen perineal yaralanma nedeniyle kliniğimize başvurdu. Fizik muayenesinde perinede anal kanaldan yaklaşık 4 cm uzaklıkta, 2 cm çaplı, derin planda ilerleyen perineal yara tespit edildi. Ayakta karın grafisinde diyafragma altında serbest hava gözlendi. Ameliyatta rektum perforasyonu tespit edilen hastada, perforasyon onarımı ve sigmoid kolostomi yapıldı. Anorektal yaralanmalarda morbidite ve mortalitenin azaltılması için erken ve doğru tanı, yaralanmanın şekli ve tipinin doğru belirlenmesi, ek organ yaralanmaların tespiti ve uygun yöntemle tedavisi gereklidir. Tedavide gereken olgularda kolostomiden kaçınılmaması gerektiğini düşünüyoruz.
Anorectal injury is a rare clinical condition in children. Since it may be an initial sign of concomitant rectal and other intrapelvic structural injuries, this clinical condition is important to declare. Case 1: A nine-year-old boy was admitted to the hospital with complaints of abdominal pain and vomiting. Diffuse abdominal tenderness and defense were remarkable. Abdominal X-ray showed pneumoperitoneum. In operation rectum and bladder perforation were detected. Perforation was repaired and sigmoid colostomy was performed. Case 2: A six-year-old girl was admitted tot he hospital with perineal injury after a fall from height. A perineal wound which was 2 cm in diameter was detected at a localization 4 cm from the anal canal. Abdominal X-ray showed pneumoperitoneum. Rectal perforation was detected. Perforation was repaired and sigmoid colostomy was performed. To decrease the morbidity and the mortality of the patients, early and correct diagnosis, defining the type and extent of the injury including intrapelvic structures should be accurately determined and appropriate treatment should be performed. We think that colostomy should be done necessarily in cases when needed.
Anorectal injury is a rare clinical condition in children. Since it may be an initial sign of concomitant rectal and other intrapelvic structural injuries, this clinical condition is important to declare. Case 1: A nine-year-old boy was admitted to the hospital with complaints of abdominal pain and vomiting. Diffuse abdominal tenderness and defense were remarkable. Abdominal X-ray showed pneumoperitoneum. In operation rectum and bladder perforation were detected. Perforation was repaired and sigmoid colostomy was performed. Case 2: A six-year-old girl was admitted tot he hospital with perineal injury after a fall from height. A perineal wound which was 2 cm in diameter was detected at a localization 4 cm from the anal canal. Abdominal X-ray showed pneumoperitoneum. Rectal perforation was detected. Perforation was repaired and sigmoid colostomy was performed. To decrease the morbidity and the mortality of the patients, early and correct diagnosis, defining the type and extent of the injury including intrapelvic structures should be accurately determined and appropriate treatment should be performed. We think that colostomy should be done necessarily in cases when needed.
Açıklama
Anahtar Kelimeler
Cerrahi
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Bakırköy Tıp Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
7
Sayı
1
