Ulus Travma Acil Cer
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Ulus Travma Acil Cer · Nov 2012
Case ReportsUnexpected multiple intra-abdominal injuries after projectile fragmentation: report of three cases.
Explosives create and energize particles that act as projectiles prone to further fragmentation or create other secondary missiles in the body. These fragments may result in secondary injuries. This has been repeatedly described in the orthopedic and neurosurgical literature. ⋯ The overall mean number of peritoneal defects was 1.7, and a mean 6.8 intra-abdominal injuries for each peritoneal defect were found when through-and-through injuries were excluded. Despite a single peritoneal defect, there may be multiple intraperitoneal injuries due to further fragmentation of the projectile. Under mass casualties, wound exploration with a full-thickness fascial defect could serve as an indicator of possible intra-abdominal injuries, and consequently indicate exploratory laparotomy.
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Ulus Travma Acil Cer · Nov 2012
Major thoracic vessels and cardiac trauma: case series from a center in a developing country.
Seventy-five percent of all trauma-related deaths are related to thoracic trauma. Very few penetrating cardiac trauma patients arrive to the hospital alive. Due to its high prevalence, an understanding of the pathogenesis, manifestations and management of cardiac trauma by the medical personnel is becoming increasingly important. ⋯ We believe that, in the past, the inevitable delay in diagnosis led to unsuccessful thoracotomies, late transfers to the operating room and physiological deterioration of the patient. As the incidence of trauma is increasing worldwide, it is essential for surgeons to be prepared to handle cardiovascular and cardiac trauma injuries immediately, as delay can adversely affect the outcome in terms of both morbidity and mortality. All patients presenting with trauma to the chest should be assessed with a high index of suspicion for major cardiovascular injuries. Early diagnosis, prompt transfer to the operating room and speedy and perfect surgery influence a favorable outcome.
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Ulus Travma Acil Cer · Nov 2012
Case ReportsUrgent endovascular treatment of iatrogenic subclavian artery rupture: report of three cases.
The increased use of central venous catheters in modern medical practice has brought a proportional increase in the number of cases of iatrogenic vascular injuries. Concerning the subclavian artery, the site of the lesion and the vessel size demand urgent and effective treatment in order to obtain a favorable prognosis. It has been common practice for a long time to consider this type of lesion as a surgical emergency. ⋯ Hypovolemic shock (demonstrated in two patients) as well as brachial plexus palsy due to pseudoaneurysm of the subclavian artery (presented in another patient) were successfully managed by percutaneous brachial (in two patients) or right femoral (in the patient with the pseudoaneurysm) approach and placement of balloon expandable covered stents (4-9 mm x 38 mm). No procedure-related complications were observed. Short-term follow-up results in two of the three patients were quite satisfactory concerning patency.
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Ulus Travma Acil Cer · Nov 2012
Case ReportsRe-formation of acute parietal epidural hematoma following rapid spontaneous resolution in a multitraumatic child: a case report.
Acute epidural hematomas resulting from traumatic brain injury remain among the most common causes of mortality and disability. In the literature, there are cases about the resolution and recurrence of spinal epidural hematomas. This case is characterized by the rapid disappearance and re-formation of an acute cranial epidural hematoma (EDH) associated with no overlying skull fracture. Various authors have reported resolution of EDHs managed conservatively, but rapid resolution and recurrence of cranial EDH was not reported before.
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Ulus Travma Acil Cer · Nov 2012
Case Reports[Conservative approach to isolated cricoid cartilage fracture].
Isolated cricoid fracture is encountered rarely during the clinical follow-up. A 71-year-old female patient was referred to emergency service with complaints of fall from height, and urgent tracheotomy was performed due to dyspnea. During the examination, isolated fractures of the cricoid cartilage were identified. With the conservative approach, the patient remained symptom-free and was discharged after decannulation.