Koroziv Madde İçimine Bağlı Mide Nekrozu ve Perforasyonu
Yükleniyor...
Dosyalar
Tarih
2008
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Koroziv madde içimi sonrası mide nekrozuna bağlı perforasyon oluşabilir. Mide nekrozu ve perforasyonunun ortaya konmasında en hızlı yöntem üst GİS’in endoskopik incelemesidir. Bu tür hastalarda erken dönemde endoskopik inceleme yapılmasının önemini vurgulamayı amaçladık. Olgu sunumu: Koroziv maddeler çocukluk çağında kazara, ergenlik döneminde ise genellikle intihar amacıyla içilmektedir. 33 yaşında bir kadın intihar amacıyla % 15 hidroklorik asit içeren sıvı kireç çözücü içmiş ve yakınları tarafından acil servise getirilmiş. Hasta reanimasyon servisinde gözleme alındı. İlk 24 saat içinde üst gastrointestinal sistem endoskopisi yapıldı. Özofagusta hemoraji ve yer yer nekrotik alanlar saptandı. Mide bol hemorajik sıvı ile doluydu. Ayrıca mide mukozası tamamen soluk görünümdeydi ve kanama odakları vardı. Hastaya medikal tedavi başlandı. Hastaneye yatışından 24 saat sonra akut batın tanısı konularak ameliyata alındı ve midenin antrum kısmında nekroza bağlı perforasyon tespit edildi. Ayrıca peritonit ve karın içi organlarda belirgin yapışıklıklar gözlendi. Hastaya total gastrektomi ve Roux en Y özofagojejunostomi ameliyatı yapıldı. Hasta postoperatif 2. gün zehirlenmeye bağlı multiorgan yetmezliği nedeniyle kaybedildi. Sonuç: Koroziv madde içimi sonrası erken dönemde yapılan endoskopik inceleme hastanın seyri açısından önemli bilgiler vermektedir. Oluşabilecek komplikasyonlar bu sayede erkenden teşhis edilebilecektir.
Aim: After ingestion of corrosive substances gastric perforation may occur due to gastric necrosis. The most appropriate way of detecting perforation and necrosis is gastrointestinal endoscopic examination. We aimed to emphasize the importance of early endoscopic examination for these patients. Case report: Corrosive substances are ingested accidentally at childhood and for suicidal purposes at adolescence. A 33-years old woman ingested liquid lime dissolver containing 15% hydrochloric acid, with purpose of suicide and she was brought to the emergency service by her relatives. She had been kept under observation at ICU. Upper gastrointestinal tract endoscopy was performed at the first 24 hours and medical treatment had been started. At endoscopy we observed hemorragic and necrotic areas at the esophagus and stomach was full with the hemorrhagic fluid. Also gastric mucosa was pale and hemorrhagic. After twenty-four hours of her hospitalization, she was diagnosed as an acute abdomen and taken to operation room. At the operation we detected stomach perforation at the antrum. Prominent adhesions at intraabdominal organs were observed. Total gastrectomy and Roux en Y esophagojejunostomy were performed. Postoperative second day we passed away the patient due to multiorgan failure caused by toxication. Conclusion: Early endoscopic examination after corrosive substance ingestion gives important information about the course of the patient. So that the possible complications may be diagnosed early.
Aim: After ingestion of corrosive substances gastric perforation may occur due to gastric necrosis. The most appropriate way of detecting perforation and necrosis is gastrointestinal endoscopic examination. We aimed to emphasize the importance of early endoscopic examination for these patients. Case report: Corrosive substances are ingested accidentally at childhood and for suicidal purposes at adolescence. A 33-years old woman ingested liquid lime dissolver containing 15% hydrochloric acid, with purpose of suicide and she was brought to the emergency service by her relatives. She had been kept under observation at ICU. Upper gastrointestinal tract endoscopy was performed at the first 24 hours and medical treatment had been started. At endoscopy we observed hemorragic and necrotic areas at the esophagus and stomach was full with the hemorrhagic fluid. Also gastric mucosa was pale and hemorrhagic. After twenty-four hours of her hospitalization, she was diagnosed as an acute abdomen and taken to operation room. At the operation we detected stomach perforation at the antrum. Prominent adhesions at intraabdominal organs were observed. Total gastrectomy and Roux en Y esophagojejunostomy were performed. Postoperative second day we passed away the patient due to multiorgan failure caused by toxication. Conclusion: Early endoscopic examination after corrosive substance ingestion gives important information about the course of the patient. So that the possible complications may be diagnosed early.
Açıklama
Anahtar Kelimeler
Genel ve Dahili Tıp, Koroziv madde, mide nekrozu, perforasyon, Corrosive substance, gastric necrosis, perforation
Kaynak
Genel Tıp Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
18
Sayı
4
Künye
Küçükkartallar, T., Aksoy, F., Tekin, A., Esen, H. H., Belviranlı, M. M., (2008). Koroziv Madde İçimine Bağlı Mide Nekrozu ve Perforasyonu. Genel Tıp Dergisi, 18(4), 165-168.
