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Kahramanmaraş merkezli depremlerde karın ezilme travması geçiren hastalarda multidetektörlü bilgisayarlı tomografi bulguları

Year 2023, Volume: 48 Issue: 3, 993 - 999, 30.09.2023
https://doi.org/10.17826/cumj.1342828

Abstract

Amaç: Bu çalışmanın amacı, Kahramanmaraş merkezli depremler sonrası abdominal crush gelişen hastaların multidetektörlü bilgisayarlı tomografi (MDBT) bulguların araştırmaktır.
Gereç ve Yöntem: Bu çalışmada, Kahramanmaraş merkezli deprem nedeniyle yaralanan ve hastanemizde tedavi edilen 255 hasta retrospektif olarak değerlendirildi. Klinik olarak abdominal crush travması şüphesi olan hastalara MDBT ile tetkik yapıldı. Hastalar karın duvarı yaralanması, solid organ yaralanması, karın içinde serbest sıvı, pnömoperitoneum ve deri altı amfizemi bulguları açısından incelendi.
Bulgular: Yaralanma ile MDBT tetkiki arasındaki ortalama süre 3 gün olup, 4 saat ile 8 gün arasında değişmekteydi. Pediatrik ve yetişkin hastaların sırasıyla, %42,6'sı (52/122) ve %47,4'ü (63/133) erkek, %57,4'ü (70/122) ve %52,6'sı (70/133) ise kadın idi. Pediatrik ve yetişkin yaş gruplarında ölüm oranları sırasıyla, %0,4 (1/122) ve %4,3 (11/133) idi. Ölüm gerçekleşen hastalarda akut böbrek hasarı, deri altı amfizemi, dalak yaralanmaları, renal/perirenal yaralanmaları sırasıyla %8,3 (1/12), karaciğer ve karın duvarı yaralanmaları %16,7 (2/12), ve karın içinde serbest sıvı %33,3 (4/12) oranlarında gözlendi.
Sonuç: Karın duvarı yaralanması, karın ezilmesinin en yaygın görülen belirtisi iken katı organlar arasında renal/perirenal yaralanma en sık görüleni ve intraperitoneal organlar arasında ise karaciğer yaralanması sıkça görülmektedir. Bu bulgular, depremle ilişkili karın ezilme travasının önemli özelliklerini vurgulamaktadır.

References

  • USGS. Fault Rupture Mapping of the 6 February 2023 Kahramanmaras, Turkiye, Earthquake Sequence from Satellite Data. 2023. DOI:10.5066/P985I7U2.
  • 1.5 million now homeless in Türkiye after quake disaster, warn UN development experts. UN GENEVA. 2023; published online Feb 21. https://www.ungeneva.org/en/news-media/news/2023/02/78128/15-million-now-homeless-turkiye-after-quake-disaster-warn-un.
  • Hussain E, Kalaycıoğlu S, Milliner CWD, Çakir Z. Preconditioning the 2023 Kahramanmaraş (Türkiye) earthquake disaster. Nat Rev Earth Environ. 2023;4:287-289.
  • Fabian TC, Bee TK, Cagianos C, Miller PR, Croce MA, Stewart RM et al. Current issues in trauma. Curr Probl Surg 2002;39:1160–244.
  • Hughes TMD, Elton C. The pathophysiology and management of bowel and mesenteric injuries due to blunt trauma. Injury 2002;33:295–302.
  • Soto JA, Anderson SW. Multidetector CT of blunt abdominal trauma. Radiology 2012;265:678–93.
  • Kowal-Vern A, Sharp-Pucci MM, Walenga JM, Dries DJ, Gamelli RL. Trauma and thermal injury: comparison of hemostatic and cytokine changes in the acute phase of injury. J Trauma Acute Care Surg 1998;44:325–9.
  • Daly KP, Ho CP, Persson DL, Gay SB. Traumatic retroperitoneal injuries: review of multidetector CT findings. Radiographics 2008;28:1571–90.
  • Chen T-W, Yang Z-G, Dong Z-H, Shao H, Chu Z-G, Tang S-S. Abdominal crush injury in the Sichuan earthquake evaluated by multidetector computed tomography. World J Radiol 2011;3:135.
  • Chen T, Yang Z, Dong Z, Chu Z, Tang S, Deng W. Earthquake-related crush injury versus non-earthquake injury in abdominal trauma patients on emergency multidetector computed tomography: a comparative study. J Korean Med Sci 2011;26:438–43.
  • Mulvey JM, Awan SU, Qadri AA, Maqsood MA. Profile of injuries arising from the 2005 Kashmir earthquake: the first 72 h. Injury 2008;39:554–60.
  • Oda J, Tanaka H, Yoshioka T, Iwai A, Yamamura H, Ishikawa K, et al. Analysis of 372 patients with Crush syndrome caused by the Hanshin-Awaji earthquake. J Trauma. 1997;42:470-5.
  • Federle MP, Goldberg HI, Kaiser JA, Moss AA, Jeffrey Jr RB, Mall JC. Evaluation of abdominal trauma by computed tomography. Radiology 1981;138:637–44.
  • Sever MS, Erek E, Vanholder R, Akoglu E, Yavuz M, Ergin H, et al. Clinical findings in the renal victims of a catastrophic disaster: the Marmara earthquake. Nephrol Dial Transplant. 2002;17:1942-9.
  • Erek E, Sever MS, Serdengeçti K, Vanholder R, Akoğlu E, Yavuz M et al. Turkish Study Group of Disaster. An overview of morbidity and mortality in patients with acute renal failure due to crush syndrome: the Marmara earthquake experience. Nephrol Dial Transplant. 2002;17:33-40.

Multidetector computed tomography findings in patients with abdominal crush trauma due to Kahramanmaraş centered earthquakes

Year 2023, Volume: 48 Issue: 3, 993 - 999, 30.09.2023
https://doi.org/10.17826/cumj.1342828

Abstract

Purpose: This study aimed to investigate the characteristics of abdominal crush injuries using multidetector computed tomography (MDCT) in survivors of earthquakes centered in Kahramanmaraş.
Materials and Methods: Retrospective evaluation was conducted on 255 patients who sustained injuries due to an earthquake centered in Kahramanmaraş and were treated at our hospital. Patients clinically suspected of having abdominal crush trauma underwent MDCT examinations. The presence of abdominal wall injuries, solid organ injuries, free fluid in the abdomen, pneumoperitoneum, and subcutaneous emphysema findings were examined.
Results: The median time between injury and MDCT examination was 3 days, ranging from 4 hours to 8 days. Among pediatric and adult age groups, males constituted 42.6% (52/122) and 47.4% (63/133), while females were 57.4% (70/122) and 52.6% (70/133), respectively. The mortality rates for pediatric and adult age groups were 0.4% (1/122) and 4.3% (11/133), respectively. Among patients with fatal outcomes, rates of acute kidney injury, subcutaneous emphysema, spleen injuries, and renal/perirenal injuries were 8.3% (1/12), liver and abdominal wall injuries were 16.7% (2/12), and free fluid in the abdomen was observed at a rate of 33.3% (4/12).
Conclusion: Abdominal wall injuries were the most frequently observed manifestations of crush injuries, with renal/perirenal injuries being the most common among solid organs, and liver injuries being commonly seen among intraperitoneal organs. These findings underscore important characteristics of abdominal crush trauma related to earthquakes.

References

  • USGS. Fault Rupture Mapping of the 6 February 2023 Kahramanmaras, Turkiye, Earthquake Sequence from Satellite Data. 2023. DOI:10.5066/P985I7U2.
  • 1.5 million now homeless in Türkiye after quake disaster, warn UN development experts. UN GENEVA. 2023; published online Feb 21. https://www.ungeneva.org/en/news-media/news/2023/02/78128/15-million-now-homeless-turkiye-after-quake-disaster-warn-un.
  • Hussain E, Kalaycıoğlu S, Milliner CWD, Çakir Z. Preconditioning the 2023 Kahramanmaraş (Türkiye) earthquake disaster. Nat Rev Earth Environ. 2023;4:287-289.
  • Fabian TC, Bee TK, Cagianos C, Miller PR, Croce MA, Stewart RM et al. Current issues in trauma. Curr Probl Surg 2002;39:1160–244.
  • Hughes TMD, Elton C. The pathophysiology and management of bowel and mesenteric injuries due to blunt trauma. Injury 2002;33:295–302.
  • Soto JA, Anderson SW. Multidetector CT of blunt abdominal trauma. Radiology 2012;265:678–93.
  • Kowal-Vern A, Sharp-Pucci MM, Walenga JM, Dries DJ, Gamelli RL. Trauma and thermal injury: comparison of hemostatic and cytokine changes in the acute phase of injury. J Trauma Acute Care Surg 1998;44:325–9.
  • Daly KP, Ho CP, Persson DL, Gay SB. Traumatic retroperitoneal injuries: review of multidetector CT findings. Radiographics 2008;28:1571–90.
  • Chen T-W, Yang Z-G, Dong Z-H, Shao H, Chu Z-G, Tang S-S. Abdominal crush injury in the Sichuan earthquake evaluated by multidetector computed tomography. World J Radiol 2011;3:135.
  • Chen T, Yang Z, Dong Z, Chu Z, Tang S, Deng W. Earthquake-related crush injury versus non-earthquake injury in abdominal trauma patients on emergency multidetector computed tomography: a comparative study. J Korean Med Sci 2011;26:438–43.
  • Mulvey JM, Awan SU, Qadri AA, Maqsood MA. Profile of injuries arising from the 2005 Kashmir earthquake: the first 72 h. Injury 2008;39:554–60.
  • Oda J, Tanaka H, Yoshioka T, Iwai A, Yamamura H, Ishikawa K, et al. Analysis of 372 patients with Crush syndrome caused by the Hanshin-Awaji earthquake. J Trauma. 1997;42:470-5.
  • Federle MP, Goldberg HI, Kaiser JA, Moss AA, Jeffrey Jr RB, Mall JC. Evaluation of abdominal trauma by computed tomography. Radiology 1981;138:637–44.
  • Sever MS, Erek E, Vanholder R, Akoglu E, Yavuz M, Ergin H, et al. Clinical findings in the renal victims of a catastrophic disaster: the Marmara earthquake. Nephrol Dial Transplant. 2002;17:1942-9.
  • Erek E, Sever MS, Serdengeçti K, Vanholder R, Akoğlu E, Yavuz M et al. Turkish Study Group of Disaster. An overview of morbidity and mortality in patients with acute renal failure due to crush syndrome: the Marmara earthquake experience. Nephrol Dial Transplant. 2002;17:33-40.
There are 15 citations in total.

Details

Primary Language English
Subjects Radiology and Organ Imaging
Journal Section Research
Authors

Ferhat Can Pişkin 0000-0003-4092-1077

Bişar Akbaş 0000-0002-3098-7294

Ömer Kaya 0000-0001-7998-0686

Hasan Doğru 0009-0006-0404-8492

Bilen Onan 0000-0002-1486-2782

Early Pub Date September 25, 2023
Publication Date September 30, 2023
Acceptance Date September 11, 2023
Published in Issue Year 2023 Volume: 48 Issue: 3

Cite

MLA Pişkin, Ferhat Can et al. “Multidetector Computed Tomography Findings in Patients With Abdominal Crush Trauma Due to Kahramanmaraş Centered Earthquakes”. Cukurova Medical Journal, vol. 48, no. 3, 2023, pp. 993-9, doi:10.17826/cumj.1342828.