Ulus Travma Acil Cer
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Ulus Travma Acil Cer · Mar 2021
Case ReportsRenal autotransplantation due to iatrogenic ureter injury: A case report.
Hardy and colleagues carried out 'Renal autotransplantation' for the first time in 1963 to treat severe ureter injury and it has evolved as a method used for complex treatment of trauma, renal artery diseases or ureteral stenosis. In case of proximal ureter injury, approximately 2/3 of which is iatrogenic, if the end-to-end anastomosis is not possible, renal autotransplantation, ileal ureter interposition or nephrectomy are alternative treatments. ⋯ These types of injuries are generally in form of simple perforations (2-6%), but from time to time ureter avulsions are also observed (0.3%). In this article, a case is presented where renal autotransplantation is made following development of ureter avulsion during ureterorenoscopy process carried out due to right ureteral calculi and treatment options are discussed in the light of literatures.
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Ulus Travma Acil Cer · Mar 2021
Treatment of rectus sheath hematomas: Eight years of single-center experience with a review of literature.
Rectus sheath hematoma is a rare and frequently misdiagnosed cause of acute abdominal pain. In the management of the patients with rectus sheath hematoma, which are mostly with advanced age and comorbid diseases, positive results can be obtained by avoiding unnecessary surgical procedures with correct diagnosis and treatment approaches. The presented study aims to contribute to the lack of algorithms and optimal treatment strategies in the management of rectus sheath hematoma patients with the description of our experience in their management. ⋯ Rectus sheath hematoma should be suspected in elderly patients using anticoagulants with acute abdominal pain, severe cough attacks and an umbilical palpable or radiologically supported mass. Computed Tomography and Ultrasonography should be performed in case of clinical suspicion. Early and correct diagnosis ensures successful conservative treatment and prevents unneces-sary surgical procedures. In the management of cases where clinician experience is at the forefront, we are hopeful that a new effective algorithm system and guidelines for the diagnosis will be identified after increasing the presentations of case series and experiences.
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Ulus Travma Acil Cer · Mar 2021
External validation of the AppendistatTM score and comparison with CRP levels for the prediction of complicated appendicitis.
In acute appendicitis, the treatment approach may vary depending on the age and comorbidities of the patient and whether the appendix is complicated. In this study, we validated the appendistatTM score, including the logistic regression model of complicated appendicitis, and compared the efficacy of this scoring with C-reactive protein in predicting complicated appendicitis. ⋯ AppendistatTM is a successful scoring system that contains appropriate parameters. However, C-reactive protein detecting or excluding complicated appendicitis at a similar rate to AppendistatTM suggests that the latter does not have a significant advantage in clinical practice.
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Ulus Travma Acil Cer · Mar 2021
Practice GuidelineUrgent and elective proctologic/anorectal interventions in the COVID-19 pandemic: A practical guideline for treatment safety.
This article aims to give practical information and concrete suggestions on what should be considered in emergency, semi-urgent and elective settings for common anorectal diseases in the hectic period of the COVID-19 pandemic, based on early results of a series of anorectal interventions. ⋯ By adhering to the principles outlined in this practical guide, it was possible to treat most of the benign anorectal diseases safely in the initial, hectic period of the COVID-19 pandemic.
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Ulus Travma Acil Cer · Mar 2021
Case ReportsAll in one: Multiple coronary stents, history of stent thrombosis, pancreatic carcinoma, postoperative bleeding and thrombocytosis.
Although the management of a stent patient may appear in the guidelines, some patients may be unique and out of class. In this presentation, the patient had multiple thrombotic risk factors for perioperative myocardial injury. These factors included coronary artery disease with multiple implantations of drug-eluting stent (DES), stent thrombosis history, implantation of a new stent 11months ago and hypercoagulability (due to malignancy and surgical procedure). The patient's history of DES presented a dilemma for the anesthesiology, surgery, and cardiology teams in considering the optimal method to minimize the risk of perioperative bleeding and stent re-thrombosis.