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

{"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":"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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12183474/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144287714","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}

{"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":"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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12183478/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144287716","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}

{"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":"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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12183479/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144287719","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}

{"title":"Pediatric methamphetamine poisoning: Case report of a one-year-old child.","authors":"Esat Barut, Kemal Barut","doi":"10.14744/tjtes.2025.73576","DOIUrl":"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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12183485/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144287721","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}

{"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":"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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12183475/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144287718","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}

{"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":"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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12183482/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144287717","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}

{"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":"10.14744/tjtes.2025.50748","url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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<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<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.</p><p><strong>Conclusion: </strong>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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12183483/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144287720","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}

{"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}