Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES
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Ulus Travma Acil Cerrahi Derg · Nov 2024
Case ReportsShoulder disarticulation after clavicle fracture: a case report.
In this case report, we presented to a 90-year-old female with multiple comorbidities presented to the emergency department of our hospital three weeks following a fall from standing height. Upon arrival, the patient exhibited a Glasgow Coma Scale (GCS) 12, blood pressure of 100/60 mmHg, heart rate of 117 beats/min, respiratory rate of 24 breaths/min. Examination revealed atrophy, skin color change, sensory disturbance, or motor palsy in the left upper extremity. ⋯ No other symptoms of circulatory dysfunction were observed at the 3 months follow-up. This case report emphasizes that delayed clavicle fracture can lead to catastrophic consequences. Trauma surgeons should also consider surgical treatment of clavicle fractures, depending on the patient's condition.
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Ulus Travma Acil Cerrahi Derg · Nov 2024
Case ReportsA case of mistaken identity: Gallstone-induced hepatic abscess mimicking metastasis.
We present a challenging case at our facility involving a 70-year-old female with a history of hypertension who was diagnosed with malignant ovarian neoplasia. Preoperative imaging revealed a 6 x 6 x 2.5 cm mass in liver segment 6, initially suspected to be metastatic disease. The patient had undergone a laparoscopic cholecystectomy 11 years prior. ⋯ However, during a total abdominal hysterectomy and bilateral salpingo-oophorectomy, an excisional biopsy of the liver lesion identified it as an abscess formed around a gallstone, presumably spilled during the previous cholecystectomy. This case highlights a rare but significant diagnostic challenge, wherein a gallstone shed during gallbladder surgery mimicked a metastatic liver mass. It underscores the importance of considering a patient's surgical history in differential diagnoses, especially when encountering atypical abdominal masses.
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Ulus Travma Acil Cerrahi Derg · Nov 2024
Computed tomography and clinical outcomes in the diagnosis of acute appendicitis: Significance of periappendiceal fat tissue.
This study aimed to elucidate the diagnostic significance of changes in periappendiceal fat density observed on computed tomography (CT) in patients with acute appendicitis (AA). ⋯ In cases where the diagnosis is uncertain, the hyperechogenicity in periappendiceal tissue observed on CT strengthens the diagnosis of AA. Additionally, cases of AA become increasingly complex as echogenicity in periappendiceal tissue increases.
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Ulus Travma Acil Cerrahi Derg · Nov 2024
The evaluation of secondary pneumomediastinum in children: the experience of a pediatric surgery clinic.
Pneumomediastinum, defined as mediastinal emphysema, is the term coined for the presence of air in the mediastinum. It is a rare condition that can occur in children due to various etiologies, especially trauma, and may appear without any underlying injury. We investigated the causes of secondary pneumomediastinum and the treatment approaches in children treated at our clinic. ⋯ Although pneumomediastinum is a self-limiting pathology, ventilation difficulties alongside pneumomediastinum should raise suspicion of esophageal and tracheal injuries, necessitating further investigations. Since the etiologies are very different, each patient should be evaluated separately. In most patients, pneumomediastinum regresses on its own. However, patients with complications should be carefully evaluated for accompanying diseases and injuries.
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Ulus Travma Acil Cerrahi Derg · Nov 2024
Observational StudyChallenges and predictive radiological findings in the diagnosis of neuroendocrine tumors in patients with acute appendicitis.
Acute appendicitis is one of the most common surgical emergencies. With antibiotic-first treatment strategies gaining importance, the risk of an appendiceal tumor as an incidental finding or as the cause of appendicitis presents an obstacle to a conservative approach. Neuroendocrine tumors, the most frequent type of appendiceal tumors, are difficult to diagnose preopera-tively due to their small size. This study aims to identify predictive factors for neuroendocrine tumors in patients undergoing surgery for acute appendicitis by analyzing imaging and clinical characteristics, thereby enhancing preoperative diagnostic accuracy and guiding surgical interventions. ⋯ This study identifies mural nodules and intraluminal air as significant predictors of neuroendocrine tumors in patients with acute appendicitis, emphasizing the importance of meticulous preoperative imaging evaluations. Incorporating these predictors into diagnostic protocols could improve the preoperative identification of neuroendocrine tumors, enabling more appropriate surgical interventions. Future research should validate these findings through prospective studies and explore advanced imaging techniques to further enhance the detection of appendiceal neoplasms, ultimately improving patient outcomes and reducing overlooked malignancies.