Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES
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Ulus Travma Acil Cerrahi Derg · May 2023
Intra-abdominal packing does not increase infection risk or mandate longer presumptive antibiotic therapy.
Damage control laparotomy allows for resuscitation and reversal of coagulopathy with improved mortality. In-tra-abdominal packing is often used to limit hemorrhage. Temporary abdominal closure is associated with increased rates of subse-quent intra-abdominal infection. The effect of increased duration of antibiotics is unknown on these infection rates. We sought to determine the role of antibiotics in damage control surgery. ⋯ Two-hundred and thirty-nine patients underwent DCS during the study period. A majority were packed (141/239, 59.0%). No differences existed in demographics or injury severity between groups, and infection rates were similar (30.5% vs. 38.8%, P=0.18). Patients with infection were more likely to have suffered gastric injury (23.3% vs. 6.1%, P=0.003) than those without complication. There was no significant association between gram negative and anaerobic (Odds Radio [OR] 0.96, 95% confidence interval [CI] 0.87-1.05) or antifungal therapy (OR 0.98, 95% CI 0.74-1.31) and infection rate, regardless of duration on multivariate regression CONCLUSION: Our study offers the first review of the effect of antibiotic duration on intra-abdominal complications following DCS. Gastric injury was more commonly identified in patients who developed intra-abdominal infection. Duration of antimicrobial therapy does not affect infection rate in patients who are packed following DCS.
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Ulus Travma Acil Cerrahi Derg · May 2023
Esophageal dilation through bouginage or balloon catheters in children, as the treatment of benign esophageal strictures: results, considering the etiology, and the methods.
Corrosive substance ingestion, history of esophageal surgery, and reflux esophagitis are the main causes of benign esophageal strictures in children. Esophageal dilation is the first treatment option. Bougies and balloons are the most frequently used dilation tools. The literature record on esophageal dilation methods and their results is mostly composed of data gathered from adults, who differ from children in many terms, including etiology, indications, and results. This study aims to evaluate esophagial dilation in children; comparing the two mentioned modalities; and considering the impact of different diseases on dilation success. ⋯ Savary-Gilliard bougies have advantages over balloon catheters with less need of fluoroscopy, shorter duration of sessions, and lower cost. Both methods are equivalently safe with close complication rates.
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Ulus Travma Acil Cerrahi Derg · May 2023
Comparison of percutaneous gallbladder aspiration with percutaneous cholecystostomy in acute cholecystostomy patients. Can gall bladder aspiration alone be sufficient?
The aim of this study is to compare the efficacy and complication rates of percutaneous gallbladder aspiration (PA) and percutaneous cholecystostomy (PC) in the management of AC and present the experiences of a single third-line center. ⋯ In this pandemic period, PA and PC procedures are effective, reliable, and successful treatment method that can be applied at the bedside for critical patients with AC who are not compatible with surgery, which are safe for health workers and low-risk minimal invasive procedures for patients. In uncomplicated AC patients, PA should be performed, and if there is no response to treatment, PC should be reserved as a salvage procedure. The PC procedure should be performed in patients with AC who have developed complications and are not suitable for surgery.
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Ulus Travma Acil Cerrahi Derg · May 2023
Predictive value of sphericity index and other multidetector computed tomography findings in perforated acute appendicitis.
Early radiological prediction and diagnosis of perforated acute appendicitis remain controversial. In the current study, it was aimed to examine the predictive value of multidetector computed tomography (MDCT) findings in perforated acute appendicitis. ⋯ MDCT findings, namely, appendicolith, free fluid, wall defect, abscess, free air, and RPS involvement are significant findings for perforated appendicitis. With a high sensitivity and specificity, the ASI appears to be a key predictive parameter for perfo-rated acute appendicitis.
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Ulus Travma Acil Cerrahi Derg · May 2023
Case ReportsReport of a case mimicking the acute appendicitis; Small bowel perforation due to olive leaf.
Abdominal pain is one of the most frequent causes of emergency room admissions. Acute appendicitis is the most common surgical pathology in these patients. Foreign body ingestion is a quite rare pathology that takes place in list of differential diagnosis of acute appendicitis. We presented a dry olive leaf ingestion case in this paper.