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

{"title":"Pediatric methamphetamine poisoning: Case report of a one-year-old child.","authors":"Esat Barut, Kemal Barut","doi":"10.14744/tjtes.2025.73576","DOIUrl":"https://doi.org/10.14744/tjtes.2025.73576","url":null,"abstract":"<p><p>Methamphetamine is a derivative of amphetamine and is widely abused across the globe. It is highly addictive and acts as a potent stimulant of the central nervous system (CNS). Due to its lipophilic nature, methamphetamine easily crosses the blood-brain barrier, leading to significant neurological dysfunctions and even neuronal degeneration. The clinical signs and symptoms of methamphetamine intoxication can vary considerably depending on factors such as the dose ingested, route of administration, duration of exposure (acute and/or chronic), and method of use. Common clinical manifestations include euphoria, increased energy, insomnia, anxiety, substance-induced psychosis, decreased appetite, weight loss, heightened self-confidence, increased libido, fever, tachycardia, sweating, hypertension, tremors, mydriasis, blurred vision, and seizures. Children are particularly vulnerable, as their metabolism and nervous systems are more sensitive compared to adults, making the toxic effects more pronounced. Accidental ingestion of drugs and other substances is a frequent occurrence in pediatric populations and can lead to severe health complications. Therefore, it is crucial for healthcare professionals to promptly and accurately evaluate and manage such poisoning cases. This case report presents the clinical findings, diagnostic process, and treatment management of a one-year-old male child who accidentally ingested crystal methamphetamine orally. Additionally, the report highlights key aspects of effective case management, emphasizes preventive measures to reduce the risk of accidental drug and substance ingestion in children, and aims to raise awareness on this issue.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":"31 6","pages":"600-602"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144287721","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":"Experimental wounding models of different bullet types and diameters on extremities.","authors":"Ilknur Arslan, Gökhan İbrahim Öğünç, Özhan Pazarcı, Ahmet Hilal, Mehmet Eryılmaz","doi":"10.14744/tjtes.2025.12472","DOIUrl":"https://doi.org/10.14744/tjtes.2025.12472","url":null,"abstract":"<p><strong>Background: </strong>Gunshot wounds are the second leading cause of life-threatening injuries and frequently affect the extremities, accounting for 63% of combat-related cases over the past 50 years. Although extremity injuries have lower mortality rates, they still require urgent treatment to reduce complications. Wound ballistics studies often use tissue surrogates like ballistic wax and gelatin, which have limitations due to their dissimilarity to living tissues. There is insufficient data on the effects of gunshots on extremities composed of bone and muscle, which differ in resistance and elasticity. This study aims to analyze the damage caused by commonly used ammunition in living tissue and provide healthcare professionals with critical insights to improve emergency care.</p><p><strong>Methods: </strong>The study involved six Adana-breed sheep, aged 3-4 years, previously used in another study and showing no vital signs. Ethical approval was obtained from the local ethics committee. Test shots were conducted using 9×19 mm (M822), 5.56×45 mm (SS109), and 7.62×51 mm (M80) bullets from a distance of 300 cm, targeting the front legs of sheep positioned laterally. Following the shots, entry and exit wounds were photographed, and anteroposterior and lateral X-ray images of the extremities were taken for analysis. The aim was to examine the effects of different types of ammunition on extremities and provide insights into the characteristics of gunshot wounds.</p><p><strong>Results: </strong>In the first test group (subjects A and B), X-ray imaging revealed joint integrity loss, multi-part fractures, and cavitation in the soft tissue, with bone fragments distributed along the exit trajectory. No bullet fragments were found within the wound cavity. The M822 bullet produced a typical entry wound and a smaller, more defined exit wound. In the second group (subjects C and D), SS109 bullets caused fragmentation of bone, muscle, tendon, and skin. Bullet fragments created a shrapnel-like effect. The exit wounds were larger and had irregular edges. In the third group (subjects E and F), M80 bullets caused extensive tissue disruption due to their high kinetic energy. The resulting exit wounds were wide and irregular.</p><p><strong>Conclusion: </strong>This study found that M80 bullets caused the most severe bone and soft tissue damage compared to M822 and SS109 bullets, primarily due to their higher kinetic energy density and structural characteristics. Unlike prior research using synthetic tissue models, this study demonstrates the real-tissue effects of different ammunition types. Radiologists, forensic medicine experts, and other healthcare professionals should be aware that firearm injuries vary depending on the bullet's characteristics. Applying this understanding can lead to appropriate diagnoses and improved treatment strategies, ultimately enhancing patient outcomes.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":"31 6","pages":"516-524"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144287717","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":"Firearm injuries in pediatric surgery: Pediatric trauma center experiences.","authors":"Elif Emel Erten, Can Ihsan Öztorun, Ahmet Ertürk, Suleyman Arif Bostancı, Sabri Demir, Vildan Selin Şahin, Bekir Dincer, Sait Özsoy, Mujdem Nur Azılı, Emrah Şenel","doi":"10.14744/tjtes.2024.25224","DOIUrl":"https://doi.org/10.14744/tjtes.2024.25224","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to evaluate the epidemiological data on thoracic and abdominal firearm injuries in children treated by pediatric surgeons at a pediatric trauma center.</p><p><strong>Methods: </strong>Children hospitalized with firearm injuries from 2015 to 2022 were retrospectively analyzed. Patient demographics, affected organs, treatment, and length of hospital stay were analyzed retrospectively.</p><p><strong>Results: </strong>The mean age of the patients was 12.43+-2.31 years; 27 (84.4%) were male and five (15.6%) were female. Bullet injuries were associated with higher severity and often required major surgical intervention, whereas pellet injuries were generally managed conservatively. For thoracic injuries, conservative management was considered effective for stable cases without immediate life-threatening complications, whereas abdominal injuries more often required invasive surgical approaches. Notably, unintentional firearm injuries were more common in younger children, whereas intentional injuries were more common in older adolescents. This age-related pattern highlights a statistically significant correlation between age and type of firearm injury (p = 0.002). Also, the majority of patients with thoracic injuries underwent minor surgeries, whereas those with abdominal injuries mostly underwent major surgeries Conclusion: Our study indicates that accidental firearm injuries are more common among younger age groups, whereas intentional firearm injuries tend to occur more frequently among older children.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":"31 6","pages":"540-547"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144287718","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":"Management of complicated hepatic hydatid cysts: Our single-center experience.","authors":"Yiğit İskurt, Aysegul Yabaci Tak, Sabahattin Destek, Adem Akcakaya, Ertan Bulbuloglu, Kamuran Cumhur Deger","doi":"10.14744/tjtes.2025.50748","DOIUrl":"https://doi.org/10.14744/tjtes.2025.50748","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;This study aims to evaluate preoperative laboratory and radiological findings in patients with hydatid cysts to predict the severity of postoperative complications and identify markers of clinical deterioration. The goal is to refine treatment strategies, optimize clinical decision-making, and improve postoperative quality of life in the management of complicated hydatid disease.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This retrospective study included 74 patients who underwent surgical treatment for hydatid disease at our institution between September 2016 and September 2021. Patients with high American Society of Anesthesiologists (ASA) scores or hepatic lesions other than hydatid cysts were excluded. Based on the Clavien-Dindo classification, patients were categorized into two groups: Group 1 (mild complications) and Group 2 (severe complications). All patients received preoperative and postoperative albendazole therapy (15 mg/kg/day). Clinical, demographic, laboratory, and imaging data, along with cyst characteristics, surgical approach, complications, and postoperative morbidity, were analyzed to identify predictive factors for outcomes and complications.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Data from 74 patients who underwent surgery for hydatid disease were analyzed, with a median age of 43 years. The cohort was divided into two groups based on the Clavien-Dindo classification: Group 1 (mild complications, 81%) and Group 2 (severe complications, 19%). Statistically significant differences were observed in preoperative alkaline phosphatase (ALP) and hemoglobin (HGB) levels between the two groups (p&lt;0.05). Most patients in Group 1 had simple cysts, while Group 2 showed a higher incidence of complicated cysts (p=0.023) and biliary fistulas (p=0.01). Postoperative complications, including percutaneous drainage, readmissions, and the need for endoscopic retrograde cholangiopancreatography (ERCP), were more frequent in Group 2 (p&lt;0.001). Imaging modalities such as ultrasonography, computed tomography (CT), and magnetic resonance imaging (MRI) identified biliary involvement as a significant predictor of severe morbidity. Additionally, elevated preoperative ALP levels (≥133 U/L) were found to be a significant risk factor for postoperative morbidity. Receiver operating characteristic (ROC) analysis showed that an ALP level ≥133 U/L had a sensitivity of 64.29% and a specificity of 86.67%, with an area under the curve (AUC) of 0.805. These findings underscore the importance of specific clinical and laboratory markers in predicting postoperative outcomes in hydatid disease surgery.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Effective management of liver hydatid cysts requires a multidisciplinary approach, combining surgical expertise, pharmacological treatment, and a comprehensive understanding of disease pathophysiology. Continued research is essential to refine treatment protocols, enhance surgical outcomes, and improve patients' quality ","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":"31 6","pages":"531-539"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144287720","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":"Experimental study comparing the effects of cold and warm applications on oxidative stress markers in a rat extremity ischemia-reperfusion injury model.","authors":"Kubilay Erol, Arman Vahabi, Erdem Er, Eser Yıldırım Sözmen, Levent Küçük","doi":"10.14744/tjtes.2025.82421","DOIUrl":"https://doi.org/10.14744/tjtes.2025.82421","url":null,"abstract":"<p><strong>Background: </strong>After successful restoration of limb perfusion following limb ischemia, a series of secondary damage mechanisms, collectively known as reperfusion injury, is triggered. This study investigated the comparative effects of warming, a technique commonly used in clinical settings after extremity revascularization, and cooling, in a rat model of ischemia-reperfusion injury.</p><p><strong>Methods: </strong>Sprague Dawley rats aged 12 to 14 weeks and weighing between 250-350 g were used. The study included four experimental groups: Sham, Control, Cold Application, and Warm Application. Ischemia was induced by occluding the femoral artery with an atraumatic vascular clamp for three hours. Cold and warm treatments were applied for two hours by immersing the hind limbs in water at specific temperatures. In the cold application group, water temperature was maintained at 12±2°C using ice cubes to lower the temperature as needed. In the warm application group, the water temperature was kept at 38±2°C by adding hot water when necessary. Twenty-four hours after the injury model was established, the animals underwent a second surgical procedure to obtain tissue samples for analyses of malondialdehyde (MDA), myeloperoxidase (MPO), poly(ADP-ribose) polymerase (PARP), catalase, and superoxide dismutase (SOD).</p><p><strong>Results: </strong>Compared to the control group, the warm application group showed no statistically significant differences in levels of MDA (p=0.910), MPO (p=0.527), PARP (p=0.192), catalase (p=0.999), or SOD (p=0.987). In contrast, the cold application group exhibited a significant reduction in MDA, MPO, PARP, catalase, and SOD levels (p<0.001 for all).</p><p><strong>Conclusion: </strong>To minimize reperfusion injury following limb ischemia, cold application may provide greater benefits than warming the extremity. Further studies are necessary to explore the clinical relevance and applications of this finding.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":"31 5","pages":"425-430"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051318","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":"Management of vertebral artery injuries in civilian cervical gunshot wounds: A case series and literature review.","authors":"Duygu Dolen, Cafer İkbal Gülsever, Pulat Akın Sabancı","doi":"10.14744/tjtes.2025.74401","DOIUrl":"10.14744/tjtes.2025.74401","url":null,"abstract":"<p><p>Cervical gunshot injuries, although rare, carry a significant risk of vertebral artery injuries (VAIs), which can lead to complex neurological and vascular complications. Effective management requires individualized strategies tailored to the clinical presentation and associated injuries. This study presents three cases of civilian cervical gunshot wounds involving VAIs and reviews the literature to highlight optimal management approaches. Three male patients, aged 24, 41, and 44, presented with cervical gunshot wounds and varying degrees of spinal cord and vertebral artery injuries. Two patients were managed conservatively with close monitoring, broad-spectrum antibiotics, and supportive care due to the absence of progressive neurological deficits or active bleeding. The third patient underwent emergency surgical decompression and vertebral artery clipping to control massive hemorrhage and prevent further neurological deterioration. Where feasible, endovascular treatment was prioritized due to its lower complication rates compared to open surgery. Follow-up revealed diverse outcomes, ranging from paraplegia to quadriparesis, highlighting the variable presentations and long-term consequences associated with these injuries. The third patient developed a delayed arteriovenous fistula (AVF) two years post-injury, which was successfully treated with endovascular embolization. Civilian cervical gunshot injuries involving the vertebral artery require individualized treatment plans. Conservative management may be appropriate for clinically stable cases, while surgical or endovascular interventions are crucial for managing vascular instability or progressive neurological deficits. Long-term follow-up is essential to detect and address delayed complications such as pseudoaneurysms or AVFs. This case series underscores the importance of a multidisciplinary approach, involving neurosurgery, vascular surgery, otolaryngology, and interventional radiology, to optimize outcomes and deliver comprehensive care.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":"31 5","pages":"480-485"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144065526","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":"Effects of oral administration of red ginseng on liver ischemia-reperfusion injury in rats.","authors":"Mert Çöl, Salih Tuncal, Mevlut Recep Pekcici, Koray Koşmaz, Saygın Altıner, Mehmet Şeneş, Gül Kırtıl, Neslihan Durmaz, Mehmet Alpaslan Gönültaş, Sema Hücümenoğlu","doi":"10.14744/tjtes.2025.66228","DOIUrl":"https://doi.org/10.14744/tjtes.2025.66228","url":null,"abstract":"<p><strong>Background: </strong>This study investigated the protective effect of red ginseng (RG) on oxidative stress and pathological changes in an experimental liver ischemia-reperfusion injury (IRI) model, using both biochemical and histopathological evaluations.</p><p><strong>Methods: </strong>Fifty female Wistar-Albino rats were used, with body weights ranging from 174 g to 232 g. The animals were randomly divided into five groups, each consisting of 10 rats. After laparotomy in Group I, the hepatic pedicle was mobilized, no further procedures were performed, and tissue and blood samples were collected. In Group II, ischemia was induced by clamping the hepatic artery and portal vein for 60 minutes following laparotomy. Tissue and blood samples were collected via reoperation at 90 minutes after reperfusion, without any drug administration. In Group III, ischemia was similarly induced by clamping the hepatic artery and portal vein for 60 minutes after laparotomy. Tissue and blood samples were collected via reoperation at the 48th hour after reperfusion, again without any drug administration. In Group IV, RG was administered to the rats at a dose of 5 mg/kg/day via orogastric tube for three days preoperatively. This was followed by laparotomy and induction of ischemia through clamping of the hepatic artery and portal vein for 60 minutes. Tissue and blood samples were collected via reoperation at 90 minutes after reperfusion, with no drug administered postoperatively. In Group V, RG was administered at a dose of 5 mg/kg/day via orogastric tube for three days preoperatively, followed by laparotomy and induction of ischemia by clamping the hepatic artery and portal vein for 60 minutes. After reperfusion, the rats received RG at the same dose for two days postoperatively via orogastric tube, and tissue and blood samples were collected via re-operation at the 48th hour.</p><p><strong>Results: </strong>Red ginseng did not show a significant histopathological effect; however, differences were observed in biochemical parameters.</p><p><strong>Conclusion: </strong>Red ginseng may have protective effects against ischemia-reperfusion injury.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":"31 5","pages":"411-417"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144048126","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":"Hyperchloremia at hospital admission for hip fractures is associated with increased morbidity and mortality rates.","authors":"Serhat Gürbüz, Olcayto Ocak, Mustafa Cağlar Kır, Bülent Karslıoğlu, Serdar Akı","doi":"10.14744/tjtes.2025.33779","DOIUrl":"https://doi.org/10.14744/tjtes.2025.33779","url":null,"abstract":"<p><strong>Background: </strong>Hip fractures in the elderly represent a major public health concern due to their high incidence, associated morbidity and mortality, and rising healthcare costs. This study investigates the impact of initial serum chloride levels, measured upon emergency department admission, on hospital length of stay, revision surgeries, and in-hospital mortality in elderly patients with hip fractures.</p><p><strong>Methods: </strong>Between August 2022 and August 2023, a total of 204 patients over 65 years of age diagnosed with hip fractures in the emergency department were included in the study. Patients were categorized into two groups based on their initial serum chloride levels: normochloremic (96-108 mEq/L) and hyperchloremic (>115 mEq/L). Length of hospital stay and postoperative complications were compared between the groups.</p><p><strong>Results: </strong>The mean chloride level was 102.1 mEq/L in the normochloremic group and 121.3 mEq/L in the hyperchloremic group. The average hospital length of stay was 9.9 days in the normochloremic group and 15.5 days in the hyperchloremic group, a statistically significant difference (p=0.009). Mortality and revision surgery rates did not show statistically significant differences between the groups. However, all six patients who died during the study had serum chloride levels above 115 mEq/L at admission.</p><p><strong>Conclusion: </strong>This study demonstrates that elevated serum chloride levels at admission are associated with prolonged hospital stays and increased morbidity in elderly patients with hip fractures. While hyperchloremia may not directly predict mortality or the need for revision surgery, it may serve as a prognostic marker for extended hospitalization, indicating a higher risk in this vulnerable population.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":"31 5","pages":"465-471"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144013942","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":"A superficial temporal artery pseudoaneurysm following dog bites in a 4-year-old child: The first case reported in the literature.","authors":"Emrah Işıktekin","doi":"10.14744/tjtes.2025.94797","DOIUrl":"10.14744/tjtes.2025.94797","url":null,"abstract":"<p><p>Pseudoaneurysms of the extracranial arterial system are rare, largely due to the small size and thin walls of superficial vessels. This report presents a case of a pseudoaneurysm of the superficial temporal artery (STA) following dog bites in a 4-year-old child, an injury sustained three months prior. The lesion was initially misdiagnosed as an abscess, possibly involving an occult foreign body, and was unsuccessfully drained in the Emergency Department (ED). Physical examination revealed a palpable mass measuring 21 × 18 × 12 mm in the left frontotemporal region above the eyebrow. There were no signs of local inflammation or fluctuation. The child's facial expressions and eyebrow movements were normal, and laboratory tests were within normal limits. Doppler ultrasound demonstrated a partially thrombosed pseudoaneurysm with a well-defined swirl pattern, known as the 'yin and yang' sign. The patient was admitted for surgery, and the frontal branch of the superficial temporal artery was dissected to the neck of the pseudoaneurysm after debride-ment and removal of blood clots. A pseudoaneurysm measuring approximately 1 cm in diameter was observed on the deep side of the lesion, extending up to the eyebrow. The affected artery was ligated using a segmental running locking suture and then excised. Postoperatively, the patient was transferred to the clinic in stable condition without complications. Pathological analysis revealed that the tumor wall consisted of a mixed thrombus with signs of organization. The patient experienced no complications during follow-up. It is of utmost importance to obtain a comprehensive clinical history, conduct a meticulous physical examination, and perform detailed imaging studies, including ultrasound, to avoid overlooking critical pathologies in emergency situations. Such measures are essential for early detection and management of underlying medical conditions, thereby preventing further complications and improving the overall prognosis.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":"31 5","pages":"486-489"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059163","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":"Rare complication of a common procedure: Pneumomediastinum following an endodontic procedure.","authors":"Cemre Ozenbas, Sercan Aydin","doi":"10.14744/tjtes.2025.63531","DOIUrl":"https://doi.org/10.14744/tjtes.2025.63531","url":null,"abstract":"<p><p>Pneumomediastinum is a rare but potentially serious complication characterized by the presence of air within mediastinal structures. Although it is typically associated with thoracic trauma or vigorous coughing, it can also occur following dental procedures involving high-speed air-turbine drills. During these procedures, air can enter the cervical fascial planes and potentially extend to the mediastinum, leading to risks like deep neck infections or mediastinitis. This report presents the case of a 38-year-old woman who developed cervical emphysema and pneumomediastinum on the same day following endodontic treatment. Computed tomography (CT) imaging demonstrated air densities extending from the submandibular region to the mediastinum. There was no evidence of pneumothorax, pleural effusion, or pericardial effusion. The patient was managed conservatively with oxygen therapy and intravenous antibiotics, resulting in complete recovery within one week. This case highlights the importance of recognizing pneumomediastinum in patients presenting with neck swelling and subcutaneous crepitus following dental procedures. Since it can be mistaken for postoperative edema, infection, or allergic reactions, early CT imaging is crucial for accurate diagnosis and timely intervention. Awareness of this rare complication among healthcare professionals plays a critical role in ensuring early detection and effective patient management.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":"31 5","pages":"490-492"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144049188","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}