出版社：International Medical Journal Management and Indexing System
摘要：Mine blasts typically cause multiple injury of the body with minute particles, which may be a combination of plastic or metallic particles, gunpowder, sand, dust, and organic debris. Because clinical examination is often unreliable in this population, Focused assessment with sonography for trauma FAST and diagnostic peritoneal lavage (DPL) are currently the only remaining diagnostic tools available to identify major intra-abdominal bleeding. We present a case who had injury of right foot wounded by antipersonnel mines. A 21-year-old male was admitted to the emergency room with with complaints of injury of the right foot by antipersonnel mines. Physical examination revealed mild general condition, conscious but he has no orientation and cooperation. A comminuted fracture of the right tibia was found. Patient was enrolled in the operating room for surgery due to the hipovemik shock, without other diagnostic tools used. After the blood sample was taken for cross matching, the opreation was begun by orthopedist for fracture of the right tibia. We applied DPL for advance diagnosis. We found minimal hemorrhagic fluid and multiple perforation on the small bowel segments. All perforation on the small bowel were repaired with 3/0 vicryl as primer. The patient had an uneventful postoperative course and was discharged in good general condition on 10 th postoperative day. On conclusion, DPL is more sensitive FAST and should be used to find hollow organ injury on penetrating inguries patients with hypotension. Albeit laparatomy have used in gunshoots injury in 90% of patients, physical examination, FAST and DPL should be help for laparatomy decision in mines injuries. In patients presenting with lower extremity injuries should be kept in mind that injured the other systems such as abdomen, which may be determined by repeated physical examinations.
