Cocuk Istismarina Bagli Adli Olguda Beyin Olumu ve Organ Nakli; Olgu Sunumu/Brain Death and Organ Transplantation in Judicial Case Due to Child Abuse

• Published in: Journal of Pediatric Emergency and Intensive Care Medicine Vol. 6; no. 2; p. 98
• Main Authors: Girgin, Feyza Inceköy, Uyar, Emel, Öztürk, Makbule Nilüfer Yalindag
• Format: Journal Article
• Language: English
• Published: Galenos Yayinevi Tic. Ltd 01-08-2019
• Subjects: Brain death; Child abuse; Criminal investigation; Ethics; Head injuries; Liver; Liver transplantation; Medical ethics; Mortality; Organ transplantation; Pediatric intensive care; Surgery; Tissue donation
• ISSN: 2146-2399
• DOI: 10.4274/cayd.galenos.2018.63644

Çocuk istismari oldukça sik rastlanan ve çocuklarda ciddi morbidite ve mortaliteye yol açan sosyal ve tibbi bir sorundur. Bu durumdan süphelenilmesi ve ölüme kadar giden süreçte bunun önüne geçilebilmesinde çocuk hekiminin rolü çok büyüktür. Beyin ölümü, tüm beyin islevlerinin geri dönüsümsüz olarak kaybedildigi klinik bir durumdur. Beyin ölümü olan ve organ nakline uygun bulunan olgular, ailelerinin onami ile donör olabilmektedir. Adli olgular, organ nakli için donör adayi olduklari zaman; adli tip, etik ve hukuk açisindan farkli sorunlar karsimiza çikmaktadir. Istismar nedeniyle ciddi kafa travmasi gelisen 10 aylik erkek olguya yogun bakim ünitemizde takibinin 56. saatinde beyin ölümü tanisi konulmustur. Ailesi tarafindan beyin ölümü tani ve bilgilendirme sonrasi 4. saatte olgunin organ donörü olmasi kabul edilmistir. Olgu adli tip ve savcilik tarafindan inceleme sonrasinda, tanidan yaklasik 38 saat sonra karaciger, böbrek ve kornea donörü olarak degerlendirilmistir. Olgumuz ile; çocuk istismari tanisinin konulmasinda hekimin dikkat ve farkindaliginin, beyin ölümünün erken taninmasinin organ nakli sürecindeki önemini ve adli olgularin da donör olabilecegini hatirlatmak istedik. Anahtar Kelimeler: Adli olgu, beyin ölümü, çocuk istismari, organ nakli Child abuse is a social and medical problem that causes serious morbidly and mortality in children, is very common in our country. The role of the pediatrician is enormous in suspicion of child abuse and inhibition of the process which can be mortal. Brain death children can be organ donors with the permission of their families. In potential donors who are victims of child abuse various problems concerning forensic medicine, judicial needs and ethics are confronted. Here we present a 10 month old boy with severe abusive head trauma who was diagnosed with brain death on 56nd hour during his stay in our pediatric intensive care unit. 4 hours after the brain death determination, his family consented to organ donation. The medical examiner's office gave a timely response and released the body for organ donation. Within 38 hours of the diagnosis, the patient became a donor for kidney, liver and cornea transplantation. With this case we wanted to emphasize the importance of the awareness in early diagnosis of child abuse, along with early recognition of brain death for organ transplantation. In addition, we pointed out that medical examiners cases due to child abuse could be potential donors as well. Keywords: Judicial case, brain death, child abuse, organ transplantation