Ulus Travma Acil Cer
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Spontaneous rectus sheath hematoma (RSH) is an uncommon and frequently misdiagnosed cause of acute abdominal pain. The purpose of this study is to present our experiences in the diagnosis and treatment of spontaneous RSH. ⋯ Spontaneous RSH must be suspected in patients with advanced age who are using anticoagulation medications and present with acute abdominal pain. Early diagnosis permits conservative management and avoids unnecessary surgical interventions.
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We aimed to identify different methods of treating late perforation of the cervical esophagus. ⋯ The conservative management of removal of foreign body, prohibition of oral food and administration of broad-spectrum antibiotics is supported. Perforations with the presence of abscess can be surgically treated by debridement closure combined with strip muscle flap repair and irrigation drainage. Granuloma can be removed by lateral cervical incision and vacuum sealing drainage.
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Ulus Travma Acil Cer · Nov 2010
Randomized Controlled TrialThe effect of nursing-implemented sedation on the duration of mechanical ventilation in the ICU.
We aimed to compare the effects of nursing-implemented sedation protocol and daily interruption of sedative infusion on the duration of mechanical ventilation. ⋯ Daily interruption of sedative infusions provided shorter duration of sedation and mechanical ventilation than nursing-implemented sedation with protocol. Although nurse-implemented sedation protocol has been found acceptable, if the number of nurses is lacking, we believe the nurse-implemented sedation protocol should not be applied.
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Ulus Travma Acil Cer · Nov 2010
Case ReportsComplex lumbosacral fracture-dislocation with pelvic ring disruption and vertical shear sacral fracture: a case report of late presentation and review of the literature.
Combination of lumbosacral junction injury with closed vertical shear sacral fracture and disruption of the symphysis pubis is a very rare pattern of injury, particularly with a late presentation. To our knowledge, the complexity of such a lumbosacral injury with pelvic fractures, which was presented with a chronic condition, has never been addressed or identified in the previous literature. We aimed to demonstrate a case with a late presentation of a complex lumbosacral fracture-dislocation, pelvic ring disruption and a vertical shear sacral fracture with neurological deficits and to emphasize the difficulties in the management in this case and the operative technique used for the definitive treatment. ⋯ At one year after surgery, the clinical result was satisfactory with almost complete correction of a deformity and solid posterolateral fusion. The patient had partial recovery from the preoperative neurological deficit. We report herein a patient with a very unusual complex spondylo-pelvic injury pattern with late presentation, which required meticulous planning of management, imaging, and surgical technique before definitive treatment.
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Primary epiploic appendagitis is a rare, self-limiting inflammatory disease of epiploic appendices of the colon. Although treatment options do not include surgery, it sometimes mimics acute abdominal diseases for which surgery is required for treatment. We present the computed tomography findings of this rare disease in our case report. ⋯ Abdominal computed tomography workup showed a mass lesion with fat density in the anterior neighborhood of the descending colon, with a hyperdense rim. Antibiotic treatment was started after radiological assessment as primary epiploic appendagitis. Clinical healing was seen on the ninth day from the onset of symptoms.