Ulus Travma Acil Cer
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Ulus Travma Acil Cer · Mar 2014
The efficacy of a hemostatic agent in anticoagulant drug-induced rat bleeding model.
Bleeding is a major problem in warfarin pretreated patients who need emergency surgical procedures. APH is a hemostatic agent with ultra-hydrophilic and particulate properties. This study aimed to evaluate the in vivo hemostatic effect of APH in rats pretreated with warfarin. ⋯ APH has an effective hemostatic property in rats pretreated or non-pretreated with anticoagulants. Hemostatic agents can be useful for incidences of external bleedings, which are increasing because of anticoagulation.
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Ulus Travma Acil Cer · Mar 2014
Case ReportsSubcutaneous emphysema, pneumo-orbita and pneumomediastinum following a facial trauma caused by a high-pressure car washer.
Pneumomediastinum is air leakage to mediastinal space from various potential sites, including lung, esophagus, trachea, and neck. It is a rare condition that develops either spontaneously with increased intraalveolar or intrabronchial pressure, or due to trauma. Although cases where face or neck trauma with subcutaneous emphysema that extended to mediastinal cavity via anatomical connections in face and neck have been reported, orbital traumas leading to pneumomediastinum are very rare occurrences that have seldom been reported. This paper documents a 17-year-old male who presented with diffuse subcutaneous emphysema involving paraorbital facial areas, which extended to neck and mediastinal cavity.
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The Alvarado score is utilized to determine the likelihood of appendicitis based on clinical signs, symptoms, and laboratory results. The goal of this study was to determine whether Alvarado scores can be used to aid in the accurate diagnosis of appendicitis. ⋯ Our findings suggest that patients presenting with abdominal pain and Alvarado scores greater than 7 are more likely to have appendicitis. As such, the Alvarado scoring system may be utilized to better predict whether a patient has appendicitis. An Alvarado score that is positive for appendicitis would consist of a score greater than 7, which suggests that the patient has a 93% chance of having appendicitis. A negative Alvarado score is 7 or lower, suggesting a 26% probability of having appendicitis. In all, the Alvarado scoring system is a good rule-in test, but it does not adequately rule-out appendicitis.
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Ulus Travma Acil Cer · Mar 2014
Case ReportsCatastrophic necrotizing fasciitis after blunt abdominal trauma with delayed recognition of the coecal rupture - case report.
Necrotizing fasciitis (NF) is a rare bacterial infection with dramatic course, characterized by widespread necrosis of the skin, subcutaneous tissue, and superficial fascia which can often lead to death. We present a case of a 27-year-old male with NF. One day after experiencing blunt abdominal trauma caused by falling over bike handlebars, the patient was admitted to a regional hospital and treated for diffuse abdominal pain and large hematoma of the anterior abdominal wall. ⋯ Despite all resuscitation measures including fluids, blood transfusions, and parenteral nutrition, lung infection and MODS caused death 42 days after initial operation. Blunt abdominal trauma can cause the rupture of intestine, and if early signs of peritoneal irritation should present, emergency laparotomy should be performed. Disastrous complication are rare but lethal.
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Liver is the most frequently injured organ upon abdominal trauma. We present a group of patients with blunt hepatic trauma who were managed without any invasive diagnostic tools and/or surgical intervention. ⋯ During the last quarter of century, changes in the diagnosis and treatment of liver injury were associated with increased survival. NOM of liver injury in patients with stable hemodynamics and hepatic trauma seems to be the gold standard.