Ulus Travma Acil Cer
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Ulus Travma Acil Cer · Mar 2022
Case ReportsEmergency surgical gastrostomy in an esophageal cancer patient unable to receive COVID-19 treatment due to obstruction, and operating room measures as per pandemic guidelines: Case report.
We present here a gastrostomy procedure performed on a patient diagnosed with COVID-19 with no oral intake due to esophageal cancer in order to permit the initiation of COVID-19 treatment, and the COVID-19 protocols followed as per the pandemic guidelines. A 55-year-old female patient diagnosed recently with esophageal squamous-cell carcinoma was consulted for a surgical gastrostomy in the absence of oral intake due to complete esophageal obstruction prior to neoadjuvant chemotherapy. The patient had a new-onset cough and elevated body temperature (38°C) on admission to our clinic, and so was tested for COVID-19, with the final diagnosis established with PCR. ⋯ The patient is clinically stable on day 7 of treatment. A COVID-19 patient may require emergency surgical intervention during the fight against pandemic. When a surgical procedure is performed, all guidelines defined to protect healthcare workers from COVID-19 infection should be followed.
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Sigmoid volvulus (SV), the wrapping of the sigmoid colon around itself, is a rare intestinal obstruction form world-wide. For this reason, the physiopathology of SV, particularly the precipitating factors, are not clearly identified. The aim of this study is to evaluate the precipitating factors in SV. ⋯ Although there are few studies about the precipitating factors of SV in the literature, increased bowel motility, excessive body motions, and overeating following a prolonged starvation look like the precipitating factors in the development of SV.
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Ulus Travma Acil Cer · Mar 2022
ReviewIsolated recto-vaginal septum injury during parturition: Single-center experience.
Traumatic rectal injuries are uncommon and can originate due to various causes. Rectal injuries have a high mor-bidity, regardless of cause, and detection at the time of occurrence is important to prevent fistula formation and/or stoma. In this article, treatment approaches in patients with isolated rectovaginal septum injury without perineal and sphincter injury during sponta-neous vaginal delivery are presented and the current literature is reviewed. ⋯ Rectal examination should be performed simultaneously with a detailed perineal examination after vaginal delivery. For birth-related rectal injuries detected early in appropriate patients, a primary repair without diversion stoma may be the best option.
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Ulus Travma Acil Cer · Mar 2022
Randomized Controlled TrialDoes anterolateral ligament internal bracing improve the outcomes of anterior cruciate ligament reconstruction in patients with generalized joint hypermobility?
Generalized joint hypermobility (GJH) is a risk factor for anterior cruciate ligament (ACL) injury and ACL graft failure and is considered an indication for anterolateral ligament (ALL) reconstruction. The aim of this retrospective study was to compare functional outcomes, rupture rates, and residual instability in patients with GJH undergoing isolated ACL reconstruction or combined ACL reconstruction and ALL augmentation with internal bracing (ALL-IB). ⋯ The functional outcomes were similar between the groups. The stability outcomes after combined ACL and ALL-IB were better than those after isolated ACL reconstruction in patients with GJH. However, the technique and its results need to be validated in larger patient series and prospective randomized controlled trials.
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Ulus Travma Acil Cer · Mar 2022
Predictive ability of shock index in survival of ICU admitted emergency surgery patients: A retrospective cohort study.
Shock index (SI) is defined as the ratio of heart rate to systolic blood pressure and is a feasible and reliable tool to assess patients' circulatory status in emergency conditions. Its efficiency was shown in hemorrhagic shock, sepsis, trauma, and emergency triages. This study was planned to evaluate predictive ability of SI on 28-day survival of intensive care unit (ICU) admitted emergency surgery (eSurg) patients. ⋯ This study presented that SI scores successfully predicted patients' survival in ICU admitted eSurg patients. We believe that the SI forgotten in the dusty shelves of the literature does not get the importance it deserves. SI is a simplistic, reliable, and highly cost-effective assessment tool. Larger prospective RCTs should be planned to assess feasibility and reliability of SI in different patient populations.