Ulus Travma Acil Cer
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Ulus Travma Acil Cer · Feb 2023
Evaluation and clinical significance of predictors for strangulation and intestinal resection in emergency anterior abdominal wall hernia surgery.
Emergency anterior abdominal wall hernia surgery plays a pivotal role in emergency general surgery practice. In this study, the predictive value of laboratory and imaging findings as well as demographic information and comorbidities of the patients for the recognition of strangulation and intestinal resection was investigated. ⋯ Indices of systemic inflammation such as lactate dehydrogenase to white blood cell ratio, neutrophil to platelet ratio, and particularly neutrophil to albumin ratio may be potentially beneficial to prevent complications and improve clinical outcomes in emergency hernia surgery.
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Ulus Travma Acil Cer · Feb 2023
Rare causes of acute abdomen and review of literature: Primary/secondary omental torsion, isolated segmental omental necrosis, and epiploic appendagitis.
Primary/secondary omental torsion (POT/SOT), isolated segmental omental necrosis (ISON), and primary epiploic appendagitis (PEA) are rare causes of acute abdominal pain that often lead to misdiagnosis. Although the differential diagnosis may vary according to the localization and severity of the pain, and associated symptoms such as nausea-vomiting and fever, depending on the disease and site of involvement, the character of the pain is generally similar and in a continuous form. Depending on pain localization, it can mimic different clinical pictures such as acute appendicitis, acute diverticulitis, ovarian pathologies, urinary tract stones and acute cholecystitis, and patients are often diagnosed after surgical exploration. With the increased availability of computed tomography and awareness of these diseases, more patients can be diagnosed in the preoperative process and unnecessary operations can be avoided. In particular, PEA is a self-limiting local inflammatory disease and can often be managed conservatively. For all diagnoses, the surgical treatment option is local excision of the relevant epiploic appendix or omental segment, preferably laparoscopically. The most common surgical indication is diagnostic confusion and the second is persistent pain. ⋯ POT, SOT, ISON and PEA should be considered in the differential diagnosis of patients with acute abdominal findings. In patients with PEA diagnosed in the preoperative period, a conservative approach should be considered first. In patients with a diagnosis of POT, SOT, and ISON, a surgical or conservative approach should be evaluated according to the patient's clinical condition.
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Ulus Travma Acil Cer · Feb 2023
The predictive effect of neutrophil-lymphocyte and platelet-lymphocyte ratios in the post-operative recurrence of temporomandibular joint ankylosis.
Reankylosis is a frequent pathology in patients who are operated for post-traumatic temporomandibular joint (TMJ) ankylosis. In the current practice, ankylosing spondylitis attacks are monitored with the increases in neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR). In this study, such a relation between TMJ reankylosis and increase in these ratios was evaluated. ⋯ PLR and NLR may be utilized for predicting reankylosis, respectively, in children and adults who were operated for ankylosis due to TMJ fractures.
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Ulus Travma Acil Cer · Feb 2023
Construction of a nomogram predictive model for patients with liver rupture undergoing surgical intervention.
The incidence of blunt abdominal injury has significantly increased, and the liver is one of the most commonly damaged organs. In this study, we explored and established a nomogram model for patients with liver ruptures undergoing surgical treatment. ⋯ A nomogram model established based on Cr, arterial partial pressure of oxygen, HCO3-, CK-MB, the GCS, and other parameters can accurately predict the surgical treatment of patients with liver rupture.
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Ulus Travma Acil Cer · Feb 2023
Case ReportsOut-of-hospital cardiac arrest due to cervical spine injury by uncertain trauma: A study of two cases.
Cervical spinal cord injury is a well-known cause of cardiac arrest in trauma victims. Unless trauma is definitively suspected, emergency medical services teams perform resuscitation in the pre-hospital stage without cervical spine immobilization. During advanced cardiovascular life support (ACLS), intubation with cervical spinal immobilization causes difficulty in accessing the airway, thus, immobilization tends to not be performed, unless the patient is a clear case of trauma. ⋯ Emergency medical physicians tend to neglect cervical spine injury when the likelihood of trauma is unclear in a patient presenting with OHCA. These cases urge physicians to consider the possibility of cervical spinal injuries, even in cases of minor trauma. If there is a possibility of cervical spinal injury, imaging should not be delayed and should be followed by appropriate treatment.