Ulusal travma dergisi = Turkish journal of trauma & emergency surgery : TJTES
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A 30 year old man is admitted to the emergency section with the complaint of bleeding from the neck after an industrial explosion. A laceration, 5 cm's in length, is seen on 'zone II', near the medial border of the anterior jugular triangle. The patient was hemodynamically stable, but there was active bleeding from the laceration. ⋯ Immediate exploration is indicated in the presence of active bleeding, and diagnostic studies should be reserved for haemodynamically stable patients. Injury of major vessels might be tamponaded by foreign bodies, therefore blind removal of the objects may cause life-threatening hemorrhage. Endotracheal intubation is appropriate in the management of airway, as for convenient surgical approach.
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In our study, we aimed to present our cases with heart wounds and to determine the factors influencing mortality. We retrospectively evaluated 23 cases with cardiac injuries who were treated among years 1986-99 in our clinic. There were 4 female and 19 male cases, and the average age was 32 years (range 12-52). ⋯ Diagnosis with immediate echocardiography and efficient treatment was performed. Mortality rate was 33% with 2 cases. We think that emergent resuscitation and immediately surgical exploration in patients with penetrating heart wounds and immediate diagnosis by echocardiography and prompt treatment in patients with blunt heart injuries may improve overall survival.
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Acute appendicitis is the most common acute surgical condition of the abdomen. The concept of lumen obstruction as the cause has been widely accepted in the pathogenesis of acute appendicitis. ⋯ We represent a case of perforated acute appendicitis after blunt abdominal trauma. Although a causative relationship between trauma and appendicitis cannot be proved in our case, we suggest that appendicitis should be considered in the patients with blunt abdominal trauma for not only medical but also its potential legal implications.
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This study was performed on 200 patients with a prospective method, between July and October 1998. The aim of the study was to analyze the patients who were admitted directly or referred from another hospital, if they were suitable with the transfer criteria to a level I trauma center. One hundred and seven patients (53.5%) were admitted without ambulance and 93 patients (46.5%) by ambulance to our center. 34% of those patients applied directly and 66% of them were sent from other hospitals. ⋯ The Glasgow coma score, revised trauma score and appropriateness to the transfer criteria of the American College of Surgeons were statistically analyzed according to the Fischer Exact test. The results revealed that 96% of the patients with RTS, 86% of the patients with GCS and 60% of the patients with ACS were not appropriate to the transfer criteria to a level I trauma center. In conclusion; we believe that GCS will predict better results in the triage of trauma patients with head trauma in our country.
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Twenty-nine cases, penetrating wounds to the heart, who were operated in the thoracic and cardiovascular surgery department of our University during January 1995-August 2000 were reevaluated. Twenty nine patients were men and the mean age was 22.6 (min 12, max 45). The cause of injury was stab wounds in 28 cases and gunshot wounds in 1 case. ⋯ The most frequent side of injury was right ventricule. Our mortality ratio was 17.2%, morbidity ratio 17.2%. We think that fast transportation, urgent diagnostic study and immediate surgical intervention important parameters which decrease of the mortality.