Ulus Travma Acil Cer
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Ulus Travma Acil Cer · Nov 2022
Impact of the establishment of a trauma center on blunt traumatic spleen injury treatment: Comparison between pre-traumatic center and trauma center periods.
The spleen is a commonly injured intra-abdominal organ from blunt trauma. In cases of traumatic blunt spleen injury, immediate treatment is often required. This study aimed to investigate the prognostic impact of the establishment of a trauma center on the treatment of patients with blunt trauma injury to the spleen. ⋯ The establishment of a trauma center has led to improvements in the treatment quality and prognosis of patients with blunt trauma injury to the spleen receiving either of the three treatments.
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Ulus Travma Acil Cer · Nov 2022
Case ReportsSpontaneous rectus sheath hematoma in three patients with COVID-19: Computed tomography findings.
The pulmonary symptoms secondary to severe acute respiratory syndrome in coronavirus (COVID-19) infections are the most common presentation for the disease; however, it is now known that in a small portion of patients, severe hemorrhagic complications can also be seen. In this report, three cases of elderly women with known COVID-19 infection, developing spontaneous rectus sheath hematoma on anticoagulation therapy, are presented. Three cases presented above emphasize the need to perform a computed tomography examination after a sudden hemodynamic deterioration and a decrease in hemoglobin count in COVID-19 patients in intensive care units (ICUs). ⋯ If these RSHs rupture into the abdominal cavity, the outcome may be fatal in few hours as represented in two of our cases. Major spontaneous hemorrhage in COVID-19 patients is quite uncommon; therefore, it may cause serious complications as it is rarely taken into consideration. Failure to acknowledge such a risk could significantly worsen the prognosis of the patients especially in ERs and ICUs.
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Ulus Travma Acil Cer · Nov 2022
Investigating the correlation between severe acute pancreatitis and pancreatic necrosis with some serum parameters.
Acute pancreatitis (AP) is a disease related to significant morbidity and even mortality. Various factors are involved in the etiology, especially gallstones and excessive alcohol consumption. Although, the course of the disease in most of the cases is generally mild, in some cases, the disease can be severe and lead to pancreatic or peripancreatic necrosis. Radiologically, 'Balthazar computed tomography severity index' (CTSI) is used to assess the severity and presence of necrosis in pancreatitis. In this study, we classified the severity of AP in patients with Balthazar CTSI and investigated whether there is a correlation between some serum parameters and AP severity and which serum parameters can be used as a safe marker to predict the AP severity and the development of pancreatic necrosis (PN). ⋯ Neutrophil count, serum albumin levels, NLR, LR, and NMR can be used as predictive markers to determine AP severity.
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Ulus Travma Acil Cer · Nov 2022
Case ReportsBurned-out germ cell tumor presenting with acute abdomen.
Acute abdomen is a serious condition frequently encountered in the emergency departments (ED). There are various etiologies causing acute abdomen, most common being acute appendicitis; however, there are rare causes of acute abdomen as well and one should keep them in mind while handling a patient with unusual clinical features. We herein present a 26-year-old male, with no past medical or surgical history, presenting with acute abdominal pain and distension to the ED. ⋯ However, this is the first case in the literature presenting with duodenal perforation and acute abdomen. Sampling of the retroperitoneal tumor for histopathological diagnosis during the immediate surgical intervention facilitates the diagnostic management in these cases. Although scrotal examination combined with testis tumor marker assessments is essential for optimal patient management, the possibility of a burned-out testicular tumor with normal scrotal examination should always be kept in mind.
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The authors present the case of a 9-year-old boy who sustained a gunshot injury to the pericardium by an air gun. The penetrative wound to the pericardium was, according to the performed pre-operative diagnostic methods, initially believed to be a penetrative wound into the cardiophrenic angle of the left pleural cavity. The stabilized patient was indicated for an extraction of the projectile through a left anterior minithoracotomy, during which the projectile was found and successfully removed from the pericardium. The limits of pre-operative assessment, optimal treatment procedures, and surgical approaches in pediatric patients with gunshot injuries to the chest and heart are discussed.