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

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Evaluation of intestinal necrosis with laser Doppler in experimental mesenteric ischemia model. 用激光多普勒评估实验性肠系膜缺血模型中的肠坏死情况
Nurullah Aksoy, Davut Sinan Kaplan, Mustafa Orkmez, Ömer Eronat
{"title":"Evaluation of intestinal necrosis with laser Doppler in experimental mesenteric ischemia model.","authors":"Nurullah Aksoy, Davut Sinan Kaplan, Mustafa Orkmez, Ömer Eronat","doi":"10.14744/tjtes.2024.38399","DOIUrl":"10.14744/tjtes.2024.38399","url":null,"abstract":"<p><strong>Background: </strong>Acute mesenteric ischemia (AMI) is responsible for one in a thousand emergency hospital admissions in America and Europe and is associated with high morbidity and mortality rates. Current diagnostic and treatment methods fall short of desired outcomes, often resulting in delayed diagnoses and difficulties in detecting ischemic bowel tissue during treatment. This study evaluates the diagnostic value of commonly used biochemical markers in clinical practice-creatine kinase, C-reactive protein (CRP), and lactate dehydrogenase (LDH)-alongside blood flow measurements using laser Doppler in a rat model of experimental mesenteric ischemia. We also compare these markers with pathological ischemia scoring.</p><p><strong>Methods: </strong>Rats were divided into five groups: control, 1 hour, 2 hours, 3 hours, and 4 hours. Mesenteric ischemia was induced for the respective durations in each group. After these periods, we measured blood flow using laser Doppler. We also collected blood samples and intestinal biopsies for biochemical parameter analysis. These values were assessed in relation to intestinal viability using the Chiu ischemia scoring system.</p><p><strong>Results: </strong>Blood flow measurement with laser Doppler correlated with both the duration and severity of bowel ischemia. No significant relationship was found between CRP levels and the duration of ischemia. However, creatine kinase and lactate dehydrogenase (LDH) levels were significantly higher in ischemia lasting into the third and fourth hours.</p><p><strong>Conclusion: </strong>Creatine kinase and lactate dehydrogenase (LDH) levels may be useful biomarkers in patients with suspected acute mesenteric ischemia (AMI). Blood flow measurements using laser Doppler can accurately identify intestinal loops for resection during surgery.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10977481/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139473167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Medical and legal evaluation of injuries due to dog bites: a Türkiye study. 狗咬伤的医疗和法律评估:土耳其研究。
Talip Vural, Melike Erbaş, Işıl Karaca Baysal
{"title":"Medical and legal evaluation of injuries due to dog bites: a Türkiye study.","authors":"Talip Vural, Melike Erbaş, Işıl Karaca Baysal","doi":"10.14744/tjtes.2024.77550","DOIUrl":"10.14744/tjtes.2024.77550","url":null,"abstract":"<p><strong>Background: </strong>Dog bites are the most common type of injury related to animal bites in our country and worldwide. Dog bite wounds pose significant public health concerns and have medicolegal implications. In this study, we aimed to assess the problems associated with dog bites and propose potential solutions.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of 149 cases submitted by judicial authorities to our institution, the Istanbul Council of Forensic Medicine, between 2015 and 2021, to obtain medicolegal expert opinion reports. Information regarding the cases included in the study was obtained from our archives and the National Judicial Network Project (UYAP) system. Data were recorded using Microsoft Excel 2016, and statistical analysis was performed using SPSS 25.0 for Windows (SPSS Inc., Chicago, IL).</p><p><strong>Results: </strong>The mean age of the cases was 33.7 years, with 57% being male. 56.4% of the incidents occurred in the city center, and 30.9% took place during the summer months. 65.8% (n=98) of the cases were attributed to stray dogs. Superficial injuries without muscle tissue involvement were observed in 54.4% (n=81) of all cases, while 22.8% (n=34) had deep tissue defects or flap injuries, 4.7% (n=7) involved vascularnerve injuries, 16.1% (n=24) included bone fractures, and 2% (n=3) featured visceral injuries. Surgical treatment was performed on 37.5% (n=56) of the cases. Impairments were reported in 22.1% of the cases, with permanent facial scars affecting 16.7% of them. Psychiatric evaluations were required for 48.9% (n=89) of the cases, and 57.5% of them received a diagnosis of post-traumatic stress disorder.</p><p><strong>Conclusion: </strong>People attacked by dogs may experience serious physical or psychological sequelae. Therefore, it is crucial to evaluate all victims using a multidisciplinary approach, addressing their physical, social, and psychological needs, and providing rehabilitation when necessary. Non-governmental organizations, such as those dedicated to the prevention of cruelty to animals, in collaboration with local veterinary services, should play a role in national initiatives to provide objective and humane solutions for both victims and animals.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10977485/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139473171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The relationship between prognostic nutritional index and long-term mortality in patients undergoing emergency coronary artery bypass graft surgery for acute-ST elevation myocardial infarction. 因急性ST段抬高型心肌梗死而接受紧急冠状动脉旁路移植手术的患者,其预后营养指数与长期死亡率之间的关系。
Gökhan Demirci, Hakan Hasdemir, Anıl Şahin, Ali Rıza Demir, Ömer Çelik, Fatih Uzun, Mustafa Yildiz
{"title":"The relationship between prognostic nutritional index and long-term mortality in patients undergoing emergency coronary artery bypass graft surgery for acute-ST elevation myocardial infarction.","authors":"Gökhan Demirci, Hakan Hasdemir, Anıl Şahin, Ali Rıza Demir, Ömer Çelik, Fatih Uzun, Mustafa Yildiz","doi":"10.14744/tjtes.2023.44082","DOIUrl":"10.14744/tjtes.2023.44082","url":null,"abstract":"<p><strong>Background: </strong>Malnutrition and the prognosis of coronary artery disease (CAD) are shown to be correlated. The significance of nutritional status has been evaluated in patients with ST elevation myocardial infarction (STEMI), stable CAD, and elective coronary artery bypass graft (CABG) surgery. However, the prognostic impact of poor nutritional status on STEMI patients who underwent emergent CABG is not known. In this study, we aimed to investigate the relationship between nutritional status assessed by the prognostic nutritional index (PNI) and long-term mortality in STEMI patients who underwent emergent CABG. To the best of our knowledge, our study is the first one to evaluate the PNI effect on this specific population.</p><p><strong>Methods: </strong>131 consecutive patients with STEMI who did not qualify for primary percutaneous coronary intervention and required emergent CABG between 2013 and 2018 were included in our study. The study population was divided into two groups: survivors and non-survivors. The PNI was calculated as 10 × serum albumin (g/dL) + 0.005 × total lymphocyte count (per mm3) for both groups, using the preoperative data. The optimal cut-off value was obtained by receiver operating characteristic (ROC) analysis. According to the cut-off value, we investigated the relationship between PNI and long-term mortality.</p><p><strong>Results: </strong>The mean age of the study population was 57.0±10.6. During the median 92.7 (70.0-105.3)-month follow-up, 32 of the 131 patients (24.4%) died. Regression analysis showed a significant association between glucose levels (hazard ratio (HR), 1.007; 95% confidence interval (CI), 1.002-1.012; p=0.011) and PNI (HR, 0.850; 95% CI, 0.787-0.917; p<0.001) and long-term mortality. Accord-ing to the ROC analysis, the cut-off value for PNI to predict all-cause mortality was found to be 44.9, with a sensitivity of 81.3% and a specificity of 89.9%. In addition, age, ejection fraction, glomerular filtration rate, Killip classification, and left anterior descending-left internal mammary artery graft use are significantly associated with long-term all-cause mortality in STEMI patients undergoing emergency CABG.</p><p><strong>Conclusion: </strong>The PNI was significantly associated with long-term mortality in patients with STEMI who underwent emergent CABG. PNI can be used to improve the accuracy of the risk assessment of STEMI patients undergoing emergent CABG.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10977484/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139471495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Endovascular and surgical management of splenic artery aneurysms. 脾动脉瘤的血管内治疗和外科治疗。
Fatih Yanar, Bahar Canbay Torun, Burak Ilhan, Ali Fuat Kaan Gok, İbrahim Fethi Azamat, Berke Sengun, Mehmet Semih Çakır, Fatih Ata Genc
{"title":"Endovascular and surgical management of splenic artery aneurysms.","authors":"Fatih Yanar, Bahar Canbay Torun, Burak Ilhan, Ali Fuat Kaan Gok, İbrahim Fethi Azamat, Berke Sengun, Mehmet Semih Çakır, Fatih Ata Genc","doi":"10.14744/tjtes.2023.23793","DOIUrl":"10.14744/tjtes.2023.23793","url":null,"abstract":"<p><strong>Background: </strong>Although true splenic artery aneurysms (SAA) are rare, due to advancements in imaging techniques, they are seen more frequently. The aim of this study is to present our strategy of managing patients with SAA.</p><p><strong>Methods: </strong>Retrospectively, 13 patients who were treated in a tertiary university care center between 2012 and 2020 were included. Their demographic, clinical information, and post-operative complications were analyzed.</p><p><strong>Results: </strong>Seven male and six female patients were evaluated between the ages of 27 and 73. The mean age was 49.8±13.2. The diameter of the aneurysm was between 17 and 80 mm with a mean range of 31.5±16 mm. Seven patients were treated with endovascular interventions (EV). Two patients were referred to surgery with failed attempt of EV, but patients refused surgery and were followed up consequently. Patients who had larger aneurysms with an increased risk of rupture underwent aneurysmectomy and splenectomy. Conservative management was decided on two patients initially: A patient who was previously operated on for a sigmoid colon tumor, and had an aneurysm size of 15 mm and another patient with a surgical history of thoracic aortic dissection with an aneurysm size of 18 mm. One patient who underwent surgery had post-operative pancreatic fistula and was treated with percutaneous drainage. The treatment of the remaining 12 patients was completed without any further complications.</p><p><strong>Conclusion: </strong>Splenic artery aneurysm treatment should be individualized. Endovascular treatment can be considered for patients with stable aneurysms larger than 2 cm in the elective setting. Open surgical treatment should be considered in patients with ruptured SAA or hemodynamically unstable, complicated patients.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10977486/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139473165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Management of membranous tracheal rupture due to the endotracheal tube cuff during thyroid surgery. 甲状腺手术中气管导管袖带导致膜性气管破裂的处理方法。
Erman Alçı, Azad Gazi Sahin
{"title":"Management of membranous tracheal rupture due to the endotracheal tube cuff during thyroid surgery.","authors":"Erman Alçı, Azad Gazi Sahin","doi":"10.14744/tjtes.2023.14093","DOIUrl":"10.14744/tjtes.2023.14093","url":null,"abstract":"<p><p>Tracheobronchial ruptures can be extremely dramatic and life threatening and are encountered in approximately 5 out of 100,000 cases after orotracheal intubation. They can occur as a result of intubation, tracheostomy, and bronchoscopy. In this case report, we presented a 56-year-old female patient with a history of thyroid surgery 27 years prior who presented to our clinic with recurrent multinodular goiter. The patient underwent a complementary complication-free thyroidectomy assisted by intermittent intraoperative nerve monitoring. After hemostasis, final controls involving digital palpation of the possible remnants of the thyroid gland and a search for pathological lymph nodes in the central compartments, a mass structure with a rubbery consistency suspicious for residue thyroid tissue was palpated in both posterolateral aspects of the trachea, but more prominently in the left. The anesthesia team was asked to decrease the cuff pressure, assuming that the palpated mass could be the cuff of the endotracheal tube, and the mass was noted to shrink. The membranous tracheal rupture due to the endotracheal tube cuff was closed with sutures running superiorly, and a superiorly based strap muscle flap was placed over during thyroid surgery. The patient was discharged on day 7. A simple routine digital examination by the attending surgeon dealing with the thyroid surgery would contribute favorably to prognosis, as such a precaution would allow early repair in cases where such injuries occur.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10977483/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139473170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Results of combat medic junctional tourniquet training: a prospective, single-blind, randomized, cross-over study. 战医交界处止血带训练的结果:一项前瞻性、单盲、随机、交叉研究。
Şahin Kaymak, Aytekin Ünlü, Rahman Şenocak, Bilgi Karakaş, Gokhan Arslan, Mehmet Eryılmaz, Nazif Zeybek, Ali İhsan Uzar
{"title":"Results of combat medic junctional tourniquet training: a prospective, single-blind, randomized, cross-over study.","authors":"Şahin Kaymak, Aytekin Ünlü, Rahman Şenocak, Bilgi Karakaş, Gokhan Arslan, Mehmet Eryılmaz, Nazif Zeybek, Ali İhsan Uzar","doi":"10.14744/tjtes.2023.13263","DOIUrl":"10.14744/tjtes.2023.13263","url":null,"abstract":"<p><strong>Background: </strong>Bleeding remains the leading cause of potentially preventable deaths both in military and civilian pre-hospital trauma settings. Conventional extremity tourniquets do not control bleeding if an iliac artery or a common femoral artery is injured. Stopping junctional bleeding is particularly challenging and requires the use of specifically designed junctional tourniquets. SAM® Junctional Tourniquet (SJT®, United States of America) and Tactical Abdominal Junctional Tourniquet (T-AJT®, Fora Group Türkiye) have been actively used by Turkish security forces. This study questioned the effect of training on combat medics' successful junctional tourniquet applications and application times (AT).</p><p><strong>Methods: </strong>Our research on two different junctional tourniquet models was designed as a prospective randomized, crossover, single-blinded study. All 40 participants in the study were attendees of a 12-week combat medic training course with updated medical approvals, which were used as an eligibility criterion. Randomization was performed by drawing T-AJT®-SJT cards. The study consisted of pretraining and after-training tourniquet application phases. In each study phase, all participants' AT and the presence or absence of arterial flow were recorded for each group. Finally, the combat medics were presented with a 6-question survey.</p><p><strong>Results: </strong>Although training increased successful T-AJT® application rates, training was not statistically significantly associated with successful applications for any tourniquet types (p>0.05). The pretraining phase ATs for SJT® and T-AJT® were 55±11.8 and 93.8±2.9 seconds, respectively, and the difference was statistically significantly different (p<0.001). Likewise, after-training phase ATs for SJT® and T-AJT® were 49±22.6 and 79.2±17.5 seconds, respectively, and participants' SJT® ATs were significantly shorter (p<0.001). Overall, when participants' applied any of the tourniquet unsuccessfully, the odds of participants' lower Visual Analogue Scale scores were 0.2 (95% CI [0.08, 0.49]. p<0.001).</p><p><strong>Conclusion: </strong>Our study basically investigates the effects of training on effective tourniquet application. Unfortunately, our after-training success rates remained unsatisfactory when compared to other studies. This is also the first study on T-AJT® tourniquet application, and further studies on its efficacy are also required.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10977488/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139471378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Are trauma victims with obesity lucky in penetrating trauma injuries? 肥胖的创伤患者在穿透性创伤中是否幸运?
Talar Vartanoğlu Aktokmakyan, Hasim Furkan Gullu, Erkan Yavuz
{"title":"Are trauma victims with obesity lucky in penetrating trauma injuries?","authors":"Talar Vartanoğlu Aktokmakyan, Hasim Furkan Gullu, Erkan Yavuz","doi":"10.14744/tjtes.2023.26852","DOIUrl":"10.14744/tjtes.2023.26852","url":null,"abstract":"<p><strong>Background: </strong>We aimed to reveal the protective effect of body mass index (BMI) and subcutaneous adipose tissue thickness (SATT), together with scores covering the abdomen, in patients with penetrating abdominal trauma.</p><p><strong>Methods: </strong>The data of 234 abdominal penetrating trauma patients over the age of 16 who applied to the emergency general sur-gery unit of Istanbul Medipol Hospital between 2017 and 2021 were analyzed retrospectively. Sex, age, types of penetrating injuries, BMI, need for blood transfusion and intensive care unit (ICU), mortality, Injury Severity Score (ISS), Penetrating Abdominal Trauma Index (PATI), and Flint Colon Injury Score (FCIS) were recorded.</p><p><strong>Results: </strong>The patients were divided into two groups: Gunshot Wound (GW) and Stab Wound (SW).While there was no significant difference in all parameters examined in all patients and GW patients in terms of BMI, a statistically significant difference was found in terms of blood transfusion need in SW patients (p=0.035). As a result of the Receiver Operating Characteristic curve analysis for the SATT variable, the cutoff value between mortality (p=0.866) and SATT (mm) values in all patients was 11 mm for all patients and 12 mm for GW patients. A significant difference was found in all patients and separately in GW and SW groups in terms of ICU and blood transfusion need, length of stay, ISS, PATI, and FCIS scores in non-operated patients (p<0.05). When all patients were examined, a statistically significant difference was found in terms of mortality (p=0.002).</p><p><strong>Conclusion: </strong>It is the first study to evaluate penetrating abdominal injuries with both BMI and SATT comprehensively and with all abdominal scores. A cutoff value to be determined for SATT with larger and multicenter studies can take its place as a parameter in the penetrating trauma algorithm.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10977477/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139473163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The impact of curfews on emergency departments and orthopedic traumas. 宵禁对急诊室和骨科创伤的影响。
Ortaç Güran, İhsan Ozdamar, Ebubekir Bektas, Salih Ender İbaç, Oğuzhan Gök
{"title":"The impact of curfews on emergency departments and orthopedic traumas.","authors":"Ortaç Güran, İhsan Ozdamar, Ebubekir Bektas, Salih Ender İbaç, Oğuzhan Gök","doi":"10.14744/tjtes.2023.53753","DOIUrl":"10.14744/tjtes.2023.53753","url":null,"abstract":"<p><strong>Background: </strong>The aim of our study was to investigate the impact of curfews imposed due to the COVID-19 pandemic on emergency department visits, orthopedic trauma frequencies, and types of trauma.</p><p><strong>Methods: </strong>In this single-center, retrospective cohort study, a total of 16,242 patients, including 3,020 trauma patients, were admitted to level 1 trauma center emergency department between April-June 2020 and 2021 (curfew group) and between April-June 2018 and 2019 (control group). Patients were separated according to emergency department triage categories and trauma mechanisms, and the changes in the days of curfew were analyzed.</p><p><strong>Results: </strong>With the curfews, there was a 54% decrease in emergency room admissions. This decrease was seen especially in yellow and green area patients, whereas there was no significant decrease in red area patients with the highest urgency. When the effect of curfews on orthopedic traumas was analyzed, a 20% decrease was observed in trauma cases. In particular, there was a significant decrease in traffic accidents in and out of the vehicle, assault, and sports injuries, whereas there was no significant decrease in falls from the same level, motor accidents, and occupational accidents.</p><p><strong>Conclusion: </strong>The impact of curfews on the density of emergency departments and trauma patients will guide the health management policies to be followed in future curfews to be implemented for different reasons. In the light of this information, more effective resource management and better quality health service planning will be ensured.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10977487/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139471382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Surgical management of Stapfer Type 2 ERCP perforations. Stapfer 2 型 ERCP 穿孔的手术治疗。
Ulaş Utku Şekerci, Erdem Barış Cartı, Ogün Aydoğan, Muhammed Çağrı Coşkun, Ahmet Deniz Uçar
{"title":"Surgical management of Stapfer Type 2 ERCP perforations.","authors":"Ulaş Utku Şekerci, Erdem Barış Cartı, Ogün Aydoğan, Muhammed Çağrı Coşkun, Ahmet Deniz Uçar","doi":"10.14744/tjtes.2023.39853","DOIUrl":"10.14744/tjtes.2023.39853","url":null,"abstract":"<p><strong>Background: </strong>While numerous studies have proposed algorithms for the management of Stapfer Type 2 ERCP perforations, there is limited research on surgical treatment options specifically for this patient group. Our aim is not to propose a new algorithm for these patients but to describe our surgical approach and contribute to the literature with our surgical procedure applied in Stapfer Type 2 ERCP perforation cases.</p><p><strong>Methods: </strong>Between 2016 and 2023, a total of 12 patients with Stapfer Type 2 ERCP perforations underwent surgery at our hospital. Duodenal diverticulization is a commonly used method in complex duodenal perforation cases. We performed a procedure that involves the removal of the external biliary pathway, hepaticojejunostomy, and a wide Braun anastomosis in addition to the duodenal diverticulization procedure, which we have termed \"modified duodenal diverticulization.\"</p><p><strong>Results: </strong>Eleven out of the 12 patients were discharged successfully without any complications. One patient, who had a late diagnosis, underwent surgery 5 days after ERCP. This patient had ongoing sepsis before the operation, which continued postoperatively and eventually led to multiple organ failure and death.</p><p><strong>Conclusion: </strong>There are limited alternatives for the surgical treatment of Type 2 ERCP perforations, and the widely preferred triple ostomy method may not address the underlying pathology necessitating ERCP. The modified duodenal diverticulization method, offering a definitive treatment, can be considered a surgical option for Type 2 ERCP perforations.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10977480/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139471466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Analysis of thoracic trauma patients transferred to Türkiye's largest hospital after Kahramanmaraş earthquake. 卡赫拉曼马拉什地震后转入土耳其最大医院的胸部创伤患者分析。
Kadir Baturhan Ciflik, Muhammet Ali Beyoglu, Mehmet Furkan Sahin, Sabri Can Mutlu, Behaeddin Raşid Han Yüce, Erdal Yekeler, Bülent Koçer, Nurettin Karaoglanoglu
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