Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES最新文献

{"title":"A randomized prospective clinical study comparing wide-awake local anesthesia no tourniquet (WALANT) and spinal anesthesia in the surgical treatment of ankle fractures.","authors":"Taha Kızılkurt, Mustafa Ozkaya, Berk Nimetoglu, Muhammed Oguzhan Albayrak, Mehmet Demirel, Nur Canbolat, Halil İbrahim Balcı","doi":"10.14744/tjtes.2025.82593","DOIUrl":"https://doi.org/10.14744/tjtes.2025.82593","url":null,"abstract":"<p><strong>Background: </strong>Ankle fractures are common injuries that often require surgical intervention to restore proper alignment and stability. Traditional anesthesia methods, such as general and spinal anesthesia, may not be suitable for patients with significant comorbidities. The wide-awake local anesthesia no tourniquet (WALANT) technique has emerged as a viable alternative, particularly for patients with cardiovascular or pulmonary conditions. This study aimed to compare the clinical outcomes of WALANT and spinal anesthesia in the surgical treatment of ankle fractures.</p><p><strong>Methods: </strong>This prospective, randomized study included patients with bimalleolar fractures who underwent surgery between June 2022 and November 2023. Patients were randomly assigned to one of two groups: the WALANT group (n=16) or the spinal anesthesia group (n=19). Preoperative demographic data, intraoperative parameters (including surgical time), and postoperative outcomes, such as pain scores assessed using the Visual Analogue Scale (VAS), patient-controlled analgesia (PCA) morphine consumption, and American Orthopaedic Foot and Ankle Society (AOFAS) scores at 12 months postoperatively, were evaluated.</p><p><strong>Results: </strong>Both groups had similar demographic characteristics (p>0.05). There was no significant difference in operating room time between the groups (WALANT: 180.47 minutes vs. Spinal: 190.94 minutes, p=0.30). Postoperative pain, assessed using VAS scores at 12 and 24 hours, did not significantly differ between groups. Morphine consumption via PCA was also similar (WALANT: 19.57 mg vs. Spinal: 22.8 mg, p=0.291). At the 12-month follow-up, AOFAS scores were similar between groups (WALANT: 80 vs. Spinal: 83.1, p=0.388). However, preoperative anxiety levels were higher in the WALANT group (p=0.001).</p><p><strong>Conclusion: </strong>The WALANT technique provides comparable postoperative pain control and functional outcomes to spinal anesthesia in ankle fracture surgery. Although preoperative anxiety was higher in the WALANT group, no significant differences were observed in postoperative pain or long-term recovery. WALANT represents a feasible and cost-effective alternative to traditional methods, especially in settings with limited access to anesthesiologists, such as during natural disasters or pandemics. It may be particularly advantageous for patients with cardiovascular or pulmonary comorbidities, helping to avoid the risks associated with systemic anesthesia.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":"31 6","pages":"570-576"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144287646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical outcomes and management strategies in intraperitoneal rupture of hydatid cysts: A retrospective analysis.","authors":"Bilal Turan, Nurullah Bilen, Emre Teke, Serdar Acar, İsa Karaca, Sibel Yaman","doi":"10.14744/tjtes.2025.15691","DOIUrl":"https://doi.org/10.14744/tjtes.2025.15691","url":null,"abstract":"<p><strong>Background: </strong>Hydatid cyst disease, a parasitic infection caused by Echinococcus species, primarily affects the liver and lungs, with potential for spontaneous or traumatic rupture into the peritoneal cavity. Although hydatid cyst perforation is rare, it necessitates urgent surgical intervention to prevent severe complications such as anaphylaxis, bile leakage, and secondary infection.</p><p><strong>Methods: </strong>This retrospective study analyzed 13 patients with hydatid cyst perforation who were treated in a general surgery clinic between 2017 and 2022. Data regarding clinical presentation, diagnostic methods, surgical approaches, postoperative outcomes, and follow-up were reviewed. All patients underwent emergency surgery involving cyst evacuation, peritoneal lavage with scolicidal agents, and postoperative albendazole therapy.</p><p><strong>Results: </strong>The cohort included eight male and five female patients, with a mean age of 33 years. Spontaneous perforation occurred in 12 cases, and one case was due to trauma. The liver was the most commonly affected organ (92.3%). Surgical interventions consisted of partial cystectomy with omentopexy in 12 patients. The recurrence rate was 8%. Postoperative complications were minimal, including two bile fistulas that resolved spontaneously and one case of wound infection. The average hospital stay was 9.2 days, and the mean follow-up duration was 18.8 months. One patient with cirrhosis died due to complications from portal hypertension.</p><p><strong>Conclusion: </strong>Hydatid cyst rupture is a rare but potentially life-threatening condition, particularly in endemic regions. Prompt surgical intervention, combined with postoperative albendazole therapy, is essential to reduce morbidity, mortality, and recurrence. Lifelong monitoring is recommended for patients with intraperitoneal perforations to manage potential complications of hydatidosis.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":"31 6","pages":"562-569"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144287701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rotational problems and clinical reflections after locked intramedullary nailing in diaphyseal femur fractures: A minimum follow-up of 5 years.","authors":"Onur Süer, Anıl Murat Ozturk, Ipek Tamsel, Kemal Aktuglu","doi":"10.14744/tjtes.2025.69886","DOIUrl":"https://doi.org/10.14744/tjtes.2025.69886","url":null,"abstract":"<p><strong>Background: </strong>Rotational malalignment following intramedullary nailing (IMN) of femoral shaft fractures remains a clinically significant concern, with previous studies reporting variable incidence rates and inconsistent risk factors. This study aimed to determine the incidence of rotational malalignment after closed static-locked intramedullary nailing for adult diaphyseal femoral fractures, identify contributing etiological factors, and evaluate its clinical impact on functional capacity and quality-of-life metrics.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted involving 54 adults treated with closed static-locked IMN for diaphyseal femur fractures between 2014 and 2019. Rotational alignment was assessed using computed tomography (CT)-measured femoral anteversion (FAV) differences, with a threshold of ≥15° defined as malalignment. Multivariate logistic regression was employed to examine associations with fracture pattern, nail entry site, surgical timing (day vs. night), and coronal alignment. Functional outcomes were assessed using the WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index) knee, Harris hip, Lower Extremity Functional Scale, and Kujala patellofemoral scores. Receiver operating characteristic (ROC) analysis was used to determine optimal FAV thresholds.</p><p><strong>Results: </strong>Rotational malalignment (≥15° FAV difference) was observed in 33.3% of cases, with 94.4% involving internal rotation. Multivariate analysis identified no independent predictors among the following factors: fracture location (proximal 44.4% vs. middle 29.2%, p=0.625), AO classification (Type A 34.3% vs. Type C 33.3%, p=0.914), nail entry site (lateral trochanteric 40% vs. piriformis 16.6%, *p*=0.574), and surgical timing (night 26.1% vs. day 38.7%, p=0.228). Patients with malalignment demonstrated significantly poorer functional outcomes, as evidenced by higher WOMAC knee scores (12.7+-4.8 vs. 6.4+-4.8, p<0.001). ROC curve analysis identified 13.5° as the optimal FAV threshold (area under the curve, AUC: 0.78), although the 15° cutoff maintained strong clinical utility with a specificity of 83%.</p><p><strong>Conclusion: </strong>Rotational malalignment following IMN occurs in one-third of cases and has a significant negative impact on functional outcomes. However, it appears to be independent of commonly considered surgical variables such as entry site and timing. These findings support technical flexibility in IMN procedures while highlighting the need for improved intraoperative techniques to assess rotational alignment.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":"31 6","pages":"577-586"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144287700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effects of rose oil on liver damage in an experimental model of obstructive jaundice.","authors":"Serdar Acar, Recep Cetin, Ismail Zihni, Ozlem Ozmen, Mehmet Zafer Sabuncuoglu, Isa Sozen, Girayhan Celik, Isa Karaca, Ece Ozkan Acar, Ceren Yaman","doi":"10.14744/tjtes.2025.96613","DOIUrl":"https://doi.org/10.14744/tjtes.2025.96613","url":null,"abstract":"<p><strong>Background: </strong>This study investigates the effects of Turkish rose oil (Rosa damascena) on liver damage in rats with experimentally induced obstructive jaundice.</p><p><strong>Methods: </strong>A total of 40 Wistar-Albino rats were divided into three groups: Sham (control), Obstructive Jaundice (OJ), and Rose Oil treatment (RO). Obstructive jaundice was induced by bile duct ligation in the OJ and RO groups. The RO group received 100 mg/kg of oral Turkish rose oil daily for seven days.</p><p><strong>Results: </strong>Biochemical analysis showed significantly elevated levels of liver and biliary injury markers, including aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), and gamma-glutamyl transferase (GGT), in the OJ group. These markers were significantly reduced in the RO group. Additionally, oxidative stress markers such as malondialdehyde (MDA) and myeloperoxidase (MPO) were lower in the RO group compared to the OJ group. Although levels of antioxidant enzymes, including glutathione peroxidase (GSH-Px) and superoxide dismutase (SOD), were higher in the RO group, the differences were not statistically significant. Interestingly, C-reactive protein (CRP) levels were unexpectedly higher in the RO group than in the OJ group, possibly due to the study duration or dosing protocol. Histopathological examination revealed significant portal inflammation, bile duct proliferation, polymorphonuclear leukocyte (PMNL) infiltration, necrosis, and fibrosis in the OJ group. Conversely, the RO group showed substantial reductions in these pathological features, including milder bile duct proliferation and necrosis (p<0.001). Additionally, connective tissue expansion and collagen deposition were significantly lower in the RO group compared to the OJ group.</p><p><strong>Conclusion: </strong>The anti-inflammatory and hepatoprotective effects of Turkish rose oil, previously reported in the literature, were demonstrated in this study for the first time through oral administration. The findings highlight its potential in mitigating acute liver damage caused by obstructive jaundice. However, some unexpected biochemical results (e.g., elevated CRP and MDA levels) may be attributed to the short study duration, limited sample size, and lack of dose variation. Overall, Turkish rose oil emerges as a promising natural agent with significant hepatoprotective and anti-inflammatory properties. These results suggest that it may serve as a potential therapeutic option for liver damage associated with obstructive jaundice. Further studies are warranted to investigate varying dosages, longer treatment durations, and larger sample sizes to better understand its therapeutic potential.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":"31 6","pages":"495-504"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144287703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of acute traumatic coagulopathy in pediatric trauma patients.","authors":"Yavuz Selim Ayhan, Ali Korulmaz, Ali Ertuğ Arslankoylu","doi":"10.14744/tjtes.2025.28787","DOIUrl":"https://doi.org/10.14744/tjtes.2025.28787","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to evaluate acute traumatic coagulopathy in pediatric trauma patients and to assess the effectiveness of coagulopathy-related findings in predicting prognosis.</p><p><strong>Methods: </strong>Patients aged between one month and 18 years who were admitted to our hospital due to trauma between October 2016 and January 2021 were included in the study. Demographic data, type of trauma, presence of acute bleeding, history of blood product transfusion, coagulation and hemogram parameters, as well as Glasgow Coma Scale (GCS), Injury Severity Score (ISS), Pediatric Trauma Score (PTS), Pediatric Index of Mortality 2 (PIM2), and Pediatric Logistic Organ Dysfunction (PELOD) scores were recorded. The relationship of each variable with acute traumatic coagulopathy (ATC) was statistically analyzed.</p><p><strong>Results: </strong>A total of 282 patients, including 196 males and 86 females, were included in the study. The most common injury mechanism was motor vehicle accidents (47.5%), and the most frequent type of injury was head trauma (41.8%). Acute traumatic coagulopathy was detected in 141 patients (66.8%). There were statistically significant differences between the groups with and without acute traumatic coagulopathy in terms of admission body temperature, blood product transfusion, length of stay in the pediatric intensive care unit, GCS, PTS, ISS, PIM2, and PELOD scores (p<0.05). Additionally, creatinine, aspartate aminotransferase (AST), alanine aminotransferase (ALT), pH, and HCO3 levels in blood gas analyses were significantly different between the groups (p<0.05). However, systolic and diastolic blood pressure, heart rate, urea, platelet count, and lactate levels showed no statistically significant differences between the groups (p>0.05). The mortality rate and frequency of blood product transfusion were found to be statistically significantly higher in the group with acute traumatic coagulopathy (p<0.05) Exitus was observed in 14 (19.4%) transfused patients, while no deaths were recorded among non-transfused patients.</p><p><strong>Conclusion: </strong>Trauma patients admitted to pediatric intensive care units should be closely monitored due to the risk of developing coagulopathy. The international normalized ratio (INR) can be used independently to predict the prognosis of these patients. Mortality rates are higher in patients who receive transfusions.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":"31 6","pages":"548-555"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144287715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of chrysin on ischemia-reperfusion injury in the rat epigastric artery skin island flap.","authors":"Simay Ersahin, Nesrin Tan Baser, Narin Karagoz, Gulcin Simsek","doi":"10.14744/tjtes.2025.87041","DOIUrl":"https://doi.org/10.14744/tjtes.2025.87041","url":null,"abstract":"<p><strong>Background: </strong>The return of oxygenated blood by reperfusion after ischemia triggers paradoxical tissue damage known as ischemia-reperfusion (I/R) injury. This study aims to investigate the effect of chrysin (C) on I/R injury in epigastric island flaps in rats.</p><p><strong>Methods: </strong>Thirty male Wistar albino rats were randomly divided into five groups (n=6): the sham control group (Group I), the flap I/R-untreated group (Group II), the I/R + C 10 mg/kg/day group (Group III), the I/R + C 50 mg/kg/day group (Group IV), and the I/R + C 100 mg/kg/day (Group V). Chrysin was administered orally for seven days before and after surgery. Flap elevation was performed on the eighth day, followed by eight hours of induced ischemia. Flap survival rate, as well as biochemical and histopathological parameters, were evaluated.</p><p><strong>Results: </strong>Oral administration of chrysin significantly reduced fibroblast activity at all treatment doses in rats subjected to I/R injury. Although improvements were observed in flap survival rate, oxidative stress index (OSI), and vascular proliferation at 10 mg/kg/day and 50 mg/kg/day doses, as well as in total oxidant status (TOS), tumor necrosis factor-alpha (TNF-α), active inflammation, chronic inflammation and ulceration across all treatment doses, these changes did not reach statistical significance. Total antioxidant capacity (TAC) values, consistent with existing literature, did not appear to influence the positive outcomes.</p><p><strong>Conclusion: </strong>This study examined the effects of chrysin treatment on ischemia-reperfusion injury using a rat inferior epigastric artery skin island flap model. Although favorable molecular changes were observed, these did not translate into significant improvements in clinical outcomes.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":"31 6","pages":"505-515"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144287702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of Achilles tendon thickness and Kager's fat pad thickness on clinical and functional outcomes following open surgical repair of acute Achilles tendon rupture.","authors":"Bilge Kagan Yılmaz, Caglar Tuna Issı, Murat Yesıl, Furkan Kaya, Ozal Ozcan","doi":"10.14744/tjtes.2025.92998","DOIUrl":"https://doi.org/10.14744/tjtes.2025.92998","url":null,"abstract":"<p><strong>Background: </strong>Acute Achilles tendon ruptures (ATR) are among the most common sports-related injuries. The aim of this study was to evaluate the correlation between Achilles tendon (AT) and Kager's fat pad (KFP) thickness with clinical and functional outcomes, measured using the Achilles Tendon Rupture Score (ATRS) and the Foot and Ankle Outcome Score (FAOS), in patients treated with open surgical repair for acute ATR.</p><p><strong>Methods: </strong>This retrospective study included 42 patients who underwent surgery for ATR at our institution between January 2017 and December 2021. All patients were treated using the open surgical Krackow suture technique. ATRS, FAOS, and Visual Analogue Scale (VAS) scores were recorded one year postoperatively. AT and KFP thicknesses were measured via ultrasonography by an independent radiologist at one-year follow-up.</p><p><strong>Results: </strong>The mean age of the patients was 45.38+-9.68 years, with 22 male patients (52.4%). The mean ATRS was 65.17+-24.46, the mean FAOS was 76.14+-16.75, and the mean VAS score was 3.02+-1.44. The mean AT thickness on the operated side was 15.54+-2.89 mm, compared to 14.58+-2.28 mm on the contralateral side (p=0.009). The mean KFP thickness on the operated side was 8.42+-2.99 mm, compared to 6.32+-2.67 mm on the contralateral side (p=0.005). A strong correlation was found between ATRS and FAOS (r=0.742, p<0.001). For AT thickness, there were moderate negative correlations with both ATRS and FAOS (r=-0.544, p=0.013; r=-0.451, p=0.003, respectively). For KFP thickness, a moderate negative correlation was found with ATRS (r=-0.506, p=0.001).</p><p><strong>Conclusion: </strong>AT and KFP thicknesses had no significant direct effect on ATRS and FAOS. However, ATRS and FAOS scores following open surgical repair of acute ATR were correlated with each other and with functional outcomes. Despite its specific complications, open surgical repair of acute ATR is an effective option for patients eligible for surgery.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":"31 6","pages":"587-595"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144287704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bilateral anterior obturator hip dislocation without fracture: A rare case report with unusual etiology.","authors":"Sancar Alp Ovali","doi":"10.14744/tjtes.2025.00772","DOIUrl":"https://doi.org/10.14744/tjtes.2025.00772","url":null,"abstract":"<p><p>Bilateral obturator hip dislocations are quite rare injuries. This case report presents a 27-year-old male patient who experienced bilateral obturator hip dislocation due to a falling concrete electric pole. The unique features of this case include the unusual mechanism of injury and the absence of associated fractures, which differentiate it from other cases reported in the literature. Locked hip position and the presence of head trauma were discussed as factors that could delay treatment. Hip dislocations could be reduced within the first two hours. During a follow-up period of two years, the patient showed no signs of avascular necrosis or osteoarthritis and reported no clinical complaints. Bilateral obturator hip dislocations are quite rare injuries. This case report presents a 27-year-old male patient who experienced bilateral obturator hip dislocation due to a falling concrete electric pole. The unique features of this case include the unusual mechanism of injury and the absence of associated fractures, which differentiate it from other cases reported in the literature. Locked hip position and the presence of head trauma were discussed as factors that could delay treatment. Hip dislocations could be reduced within the first two hours. During a follow-up period of two years, the patient showed no signs of avascular necrosis or osteoarthritis and reported no clinical complaints.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":"31 6","pages":"596-599"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144287714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of peripheral perfusion index in predicting blood product need for trauma patients.","authors":"Ertuğ Dinçer, Ayhan Aköz, Ali Duman, Yunus Emre Özlüer, Ahmet Melih Savaş, Onur Cem Büyüktaş","doi":"10.14744/tjtes.2025.65957","DOIUrl":"https://doi.org/10.14744/tjtes.2025.65957","url":null,"abstract":"<p><strong>Background: </strong>Early detection of hemorrhagic shock and the need for blood product replacement in trauma patients is crucial. The present study aimed to evaluate the effectiveness of peripheral perfusion index (PPI) measurements in determining the severity of hemorrhagic shock and predicting the need for blood product replacement in trauma patients.</p><p><strong>Methods: </strong>A total of 43 patients who presented to the emergency department due to trauma and were diagnosed with hemorrhagic shock according to the Advanced Trauma Life Support (ATLS) guidelines were included in this prospective cross-sectional study. Demographic characteristics, vital signs, laboratory parameters, PPI values, ATLS shock classification, and blood product replacement status were evaluated.</p><p><strong>Results: </strong>The median age of the patients was 35 years (range: 18-94), and 12 (27.9%) were female. The median PPI value was 1.30 (range: 0.15-10.00), and 23 (53.5%) patients received blood product replacement. PPI values were found to be statistically significantly lower in patients who received blood product replacement compared to those who did not. The PPI values of ATLS Class I patients were statistically significantly higher than those of ATLS Class III and IV patients. Among patients in the Class II shock group, the PPI value was 0.75 (range: 0.30-4.70) in patients who received blood product replacement and 2.20 (range: 1.10-10.00) in those who did not, indicating a statistically significant difference between the groups. According to the receiver operating characteristic curve analysis performed to determine the effectiveness of PPI measurement in predicting the need for blood product replacement in Class II shock patients, the cut-off value was 1.2.</p><p><strong>Conclusion: </strong>The findings of this study demonstrated that PPI values were lower in patients who required blood product replacement due to traumatic shock compared to those who did not. These results suggest that PPI measurements may serve as an effective assessment method for predicting the need for blood product replacement, particularly in patients in the Class II shock group according to the ATLS shock classification.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":"31 6","pages":"525-530"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144287716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intestinal endometriosis: A rare cause of acute care surgery.","authors":"Fadime Kutluk, Sefa Ergün, Server Sezgin Uludağ","doi":"10.14744/tjtes.2025.85691","DOIUrl":"https://doi.org/10.14744/tjtes.2025.85691","url":null,"abstract":"<p><strong>Background: </strong>Intestinal endometriosis is a rare condition that can cause gastrointestinal symptoms such as abdominal pain, constipation, and diarrhea. It occurs in approximately 5%-15% of women with endometriosis. Although it rarely leads to obstruction or perforation, there is no clear consensus on its optimal management. Hormonal therapy is considered the first-line treatment for endometriosis; however, the best approach for intestinal involvement remains controversial. This study aims to contribute to the literature by evaluating patients with intestinal endometriosis who underwent surgery for acute abdomen.</p><p><strong>Methods: </strong>Sixteen patients who underwent emergency surgery for acute abdomen at the Emergency General Surgery Clinic of İstanbul University-Cerrahpaşa, Cerrahpaşa Medical Faculty of Medicine, between February 2016 and April 2023 were identified. Four patients voluntarily withdrew from the study, and 12 were included in the analysis. Demographic data, laboratory findings, surgical records, length of hospital stay, pathology reports, postoperative complications within the first 30 days, and their management were reviewed. Patients' current health status was assessed through telephone interviews.</p><p><strong>Results: </strong>The mean age of the patients was 39.3+-9.2 years. Nine patients underwent surgery with a preoperative diagnosis of intestinal obstruction, while three were operated on for suspected acute appendicitis. Among the patients with intestinal obstruction, three underwent laparoscopic ileocecal resection, and three had segmental small bowel resection. One patient underwent anterior resection with appendectomy, and another underwent both anterior resection and ileocecal resection with ileocolostomy. One patient underwent a left hemicolectomy. The mean hospital stay was 7.9+-5.9 days. Postoperative complications occurred in three patients (25%). The mean age of patients who experienced complications was significantly higher than that of those who did not (p<0.007). Histopathological examination revealed benign full-thickness endometriosis in all cases. The mean follow-up period was 50.6 months, with no recurrences observed.</p><p><strong>Conclusion: </strong>Acute abdomen due to intestinal endometriosis-related obstruction is extremely rare. In reproductive-aged women presenting with acute abdomen, intestinal endometriosis should be considered in the differential diagnosis. In cases of clinical suspicion, intraoperative consultation with a gynecologist is recommended, and a multidisciplinary approach should be adopted to optimize treatment planning.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":"31 6","pages":"556-561"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144287719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}