Ulus Travma Acil Cer
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Ulus Travma Acil Cer · May 2012
Review Case ReportsIntestinal malrotation in an adult: case report.
Intestinal malrotation is a developmental anomaly of the midgut in which the normal fetal rotation of intestines around the superior mesenteric artery and their fixation in the peritoneal cavity fail. Rotational anomalies of the midgut are rare in adults. ⋯ Intestinal malrotation is rarely asymptomatic and generally diagnosed incidentally in adults. In the present report, a case of incidental intestinal malrotation with clinical findings of small bowel obstruction is discussed with a literature review.
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Ulus Travma Acil Cer · Nov 2011
Review Case Reports[Primary omental torsion as a cause of acute abdomen: case report].
Torsion of the omentum is a rare pathology that was described 100 years ago. The characteristic appearance of omental torsion and a review of the literature are presented with respect to a case of primary omental torsion that was causing acute abdomen. Excision of the ischemic omentum is the proper treatment for omental torsion.
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Ulus Travma Acil Cer · Jul 2011
ReviewThe experience of military surgeons from a north Afghanistan deployment and lessons for the future.
A military surgeon is a physician who works in a standard clinical field, but who also has to learn to adapt his skills to exceptional circumstances and must cope with special challenges due to his deployment in crisis regions, a fact that is one of the major factors influencing military medical strategy planning. The only certainty is that these special circumstances differ fundamentally from the routine circumstances at the military hospitals of the mother country. The limitations in personnel, equipment and technical resources, the isolation within the deployment region, the lack of a local healthcare system, the specialized aspects of the patients, and the nature of the injuries and diseases represent the main unique challenges.
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The incidence of abdominal tuberculosis (TB) is increasing in western and developed countries. This pathology has several complications, including free intestinal perforation. The aim of this study was to analytically summarize all the pertinent literature discussing the various treatments for TB-related perforations. ⋯ No clinical evidence has been available for analysis to discern the optimal surgical strategy for treating intestinal perforations induced by TB. The direct closure of the perforation typically correlates with poor morbidity and mortality results. The better treatment seems to be the surgical resection of the perforated part with anastomosis. However, pharmacological therapy remains the essential pillar of treatment.
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Informed consent is a prerequisite for the ethical and legal validity of the emergency intervention in emergency medicine, since it protects the fiduciary relationship between the physician and patient; the principle of honesty that grounds this relationship; the principle of autonomy that necessitates right of self-determination; and the principle of respect for persons. Informed consent in emergency medicine, which is supposed to include the nature, benefits and risks of emergency medical intervention, differentiates with respect to definite groups of patients: (1) conscious patients, (2) unconscious patients, and (3) children and mature minors. ⋯ In addition to the exceptions of life-saving interventions, when a patient can not decide for herself/himself, intervention of the physician in the best interest of the patient or children is based on the "therapeutic privilege" of the physician. As an ethically defensible right, since therapeutic privilege may open a door to hard paternalistic approaches, in those situations, emergency physicians should be cautious not to violate a patient's autonomy.