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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Insertion of chest drain is always a life saving procedure in emergent conditions. Especially in crowded traffic accidents more than one patient has brought to the emergency service. ⋯ We have no complications related to use of this technique. We concluded that use of laparoscopic trocars in chest tube insertion in emergency conditions is an safe and rapid procedure.
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This study was designed to determine the values of C-Reactive Protein measurements (an acute phase reactant, CRP) and leucocyte counts in prevention of negative appendectomies. Despite improvements in diagnostic methods, negative appendectomy rates still remain between 10-30% in acute appendicitis. Cost-effective and easily applicable diagnostic methods with prompt results are required to reduce negative appendectomy rates. ⋯ Although CRP increases with inflammation, it increases markedly after the occurrence of complication. The increase in leucocyte count is early sign of appendix inflammation. CRP measurements or leucocyte counts are not effective alone to prevent negative appendectomies.