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Öğe Blunt trauma - related isolated pancreatic injury(Comenius Univ, 2013) Onder, A.; Kapan, M.; Tekbas, G.; Arikanoglu, Z.; Aliosmanoglu, I; Taskesen, F.; Girgin, S.Background: Pancreatic injuries arising from blunt trauma are rarely seen. Diagnosis and treatment are difficult because of retroperitoneal localization of the organ. We present four pancreatic cases with isolated pancreatic injury due to blunt abdominal trauma. Methods: This retrospective study included four pancreatic patients who were operated on due to isolated injury caused by blunt abdominal trauma at our department between January 2004 and October 2010. Results: The patients consisted of three males and one female. One of them was in stage IV and the rest were in stage III. All underwent pancreaticojejunostomy, distal pancreatectomy, distal pancreatectomy + splenectomy and drainage, respectively. Fistula developed in two of them, and abscess developed in one, while the other one died. Conclusion: Diagnosis may be delayed since the clinical condition is initially stable. Tomography remains one of the most important diagnostic tools. Common risk factors for morbidity and mortality are the presence of ductal injury and delayed laparotomy (Tab. 1, Fig. 4, Ref. 22). Full Text in PDF www.elis.sk.Öğe The comparison of the effects of hot milk and hot water scald burns and factors effective for morbidity and mortality in preschool children(Springer Heidelberg, 2013) Aliosmanoglu, I.; Aliosmanoglu, C.; Gul, M.; Arikanoglu, Z.; Taskesen, F.; Kapan, M.; Onder, A.Scald burns are the leading cause of burns in children, especially in those younger than 5 years of age, however, they are easily preventable. Our aim in this study was to emphasise the importance and impact of scald burns caused by hot milk. A total of 334 patients below seven years of age were included in this study. Of these, 252 were admitted with acquired hot water scald burns (Group 1) and 82 with hot milk scald burns (Group 2) between August 2009 and September 2010. Demographic data of the patients were retrospectively investigated. The depth of the burns was determined to be higher in Group 2 (p < 0.001). The total burnt body surface area in Group 1 and Group 2 were 17.1 +/- A 12.3 and 16.3 +/- A 10.9 (p = 0.99), respectively. Skin grafting was performed in 23 patients in Group 1 and 16 patients in Group 2 (p = 0.01) and complications developed in three patients in Group 1 and in five patients in Group 2 (p = 0.01). The mean length of hospital stay was 9.1 +/- A 7.4 days in Group 1 and 14.9 +/- A 9.8 days in Group 2 (p < 0.001) and the mortality rates were similar between the two groups. More emphasis should be placed on the effects of hot milk scalding due to its ominous clinical course and the high healthcare costs associated with this type of scalding. We believe that taking simple precautions would help reduce the physical, psychological effects and financial consequences of hot milk scalds.Öğe The effective risk factors on mortality in patients undergoing damage control surgery(Verduci Publisher, 2013) Kapan, M.; Onder, A.; Oguz, A.; Taskesen, F.; Aliosmanoglu, I.; Gul, M.; Tacyildiz, I.BACKGROUND: Damage control surgery is a life-saving procedure used in fatal injuries. Morbidity and mortality rate are high in these patients due to massive trauma. The aim of this study was to analyze the risk factors associated with mortality in abdominal traumas that underwent damage control surgery. PATIENTS AND METHODS: The retrospective study included 24 patients that underwent damage control surgery between January 2004 and September 2010. Age, gender, type of injury, period of time before admission, hemodynamic parameters, associated organ injury, injury severity score, surgical procedures performed, length of hospital stay, and complication and mortality rates were recorded. RESULTS: The study included 16 (66.7%) men and 8 (33.3%) women, with a mean age of 32.3 years. Median period of time before admission was 30.83 minutes. All the patients were present with hypothermia and acidosis at admission, while only 5 of them were hemodynamically stable. Mean 6.75 units of blood were transfused in all of them. Common etiological factors included gunshot (50%) and motor vehicle accident (25%). Hepatic injury (83.3%) was the most common organ injury. Mean injury severity score (ISS) was 28.88. Damage control surgery was performed in all the patients. Skin-only closure was applied in 17 (70.8%), while 7 (29.2%) patients received Bogota bag application. Definitive surgery was achieved through de-packing over 36-48 hours in average. Total mortality occurred in 11 (45.8%) patients. Period of time before admission, core temperature at admission, pH levels and amount of blood transfusion were statistically different in the mortality group. A total of 16 complications occurred in 10 patients. Among these, intraabdominal abscess (46.2%) was the most common. CONCLUSION: Hypothermia (< 35 degrees C), acidosis (pH < 7.2), instability related to systolic blood pressure, massive blood transfusion, and delayed admission are predictive factors for mortality.Öğe Laparoscopic salvage for malfunctioning of peritoneal dialysis catheters(Edizioni Minerva Medica, 2012) Taskesen, F.; Arikanoglu, Z.; Uslukaya, O.; Aliosmanoglu, I.; Oguz, A.; Guzel, A.; Tas, I.Aim. The aim of this study was to emphasize the efficacy of the laparoscopic surgical method performed for elimination of catheter-induced mechanical complications developing in CAPD patients. Methods. Medical records of 31 patients who had undergone CAPD catheter implantation at the Dicle University Medical Faculty Hemodialysis Unit between January 2001 and June 2012 were examined retrospectively. Double-felted spiral Tenckhoff catheters were used in all patients for peritoneal access. Results. We performed a retrospective review of 31 patients who, over an 11-year period, underwent revision of a peritoneal dialysis catheter using laparoscopy. Chronic renal failure requiring dialysis occurred in 31 patients (12 males and 19 female). Ages ranged from 13 to 77 years (mean age 35.8 years). Conclusion. As a conclusion, CAPD is currently a choice to be frequently used in patients with ESRD. In the treatment of CAPD-associated mechanical catheter complications laparoscopic method may be preferred because of patient comfort, short hospital stay, and lesser postoperative complications.Öğe Sigmoid volvulus treated by resection and primary anastomosis: urgent and elective conditions as risk factors for postoperative morbidity and mortality(Springer Heidelberg, 2012) Kapan, M.; Onder, A.; Arikanoglu, Z.; Boyuk, A.; Taskesen, F.; Gul, M.; Keles, C.Sigmoid volvulus is a major cause of intestinal obstruction. The aim of this study is to analyze urgent and elective conditions as risk factors for morbidity and mortality regarding sigmoid colon resection and primary anastomosis in patients with sigmoid volvulus. This retrospective study included 63 patients diagnosed with sigmoid volvulus, who underwent sigmoid colon resection plus primary anastomosis under urgent or elective conditions between January 1994 and December 2010. Sigmoid colon resection plus anastomosis was performed in 63 patients; 31 (49.2 %) under urgent conditions, while 32 (50.8 %) were performed electively. The mean age of the patients was 65.2 +/- A 15.2 (18-95) years. The patients consisted of 50 (79.4 %) men and 13 (20.6 %) women. There were no statistical significances between groups in terms of age, gender, associated diseases, and hospital stay. Postoperative morbidity occurred in 30.2 % of patients. The morbidity rates for the urgent group and the elective group were 35.5 and 25.0 %, respectively (p = 0.419). Wound infection, pneumonia, and evisceration were the most common postoperative complications. Wound infection was higher in the urgent group (p = 0.026). In terms of other complications, the groups were similar. Total mortality occurred in 19.4 % of the urgent group and 15.6 % of the elective group (p = 0.750). Sigmoid colon resection plus primary anastomosis-related morbidity and mortality rates were similar in patients who were operated on under urgent and elective conditions, and who maintained good general condition.Öğe Splenic injuries: factors affecting the outcome of non-operative management(Springer Heidelberg, 2012) Boyuk, A.; Gumus, M.; Onder, A.; Kapan, M.; Aliosmanoglu, I.; Taskesen, F.; Arikanoglu, Z.The aim of this study was to evaluate the outcome of non-operative management (NOM) in patients with splenic injuries and to determine the predictive factors of NOM failure. Two hundred and six patients with splenic injury were admitted between January 2005 and April 2011. Of the 206 patients with splenic injury, 47 patients met the inclusion criteria of NOM. The mechanism of injury, grade of splenic injury, other intra- and extra-abdominal injuries, systolic blood pressure on admission, hemoglobin levels, number of transfusions, Injury Severity Score (ISS), Glasgow Coma Scale score, and hospitalization period were recorded. The patients were divided into two groups: those with NOM and those in whom the failure of NOM led to laparotomy. The patients were monitored for vital signs, abdominal findings, and laboratory data. NOM was abandoned in cases of hemodynamic instability, ongoing bleeding, or development of peritonitis. Independent predictive factors of NOM failure were identified. The patients managed non-operatively were compared with the patients for whom NOM failed. NOM was successful in 40 of 47 patients. There were differences between the two groups for ISS, hemoglobin levels, need for blood transfusion, and the number of associated extra-abdominal injuries. The grade of splenic injury was determined to be an important and significant independent predictive factor for the success of NOM of splenic injuries. The grade of splenic injury is an important and significant independent predictor factor for the success of NOM. NOM is not recommended in patients with high-grade splenic injury.Öğe Unusual extraperitoneal rectal injuries: a retrospective study(Springer Heidelberg, 2012) Gumus, M.; Boyuk, A.; Kapan, M.; Onder, A.; Taskesen, F.; Aliosmanoglu, I.; Tufek, A.Rectal injuries, which are rarely encountered because of the anatomic characteristics, occur due to penetrating traumas. In the current study, we aimed to present experiences gleaned from our clinic concerning rarely encountered unusual rectal injuries, including those cases presented for the first time. Eleven patients who had been treated for unusual rectal injuries in the General Surgery Clinic of Dicle University between 2004 and 2011 were retrospectively reviewed. The reasons for rectal injuries included foreign bodies in four cases, sexual intercourse in three cases, iatrogenic injuries in two cases, electric shock in one case, and animal horns in one case. All cases had extraperitoneal rectal injuries and all injuries were grade 2 injuries, except for the electrical burn. Primary repair was adequate for the treatment of six patients. Four patients underwent primary repair and ostomy, whereas one of the patients underwent debridement and an ostomy. The patients recovered without complications, except for one patient with sphincter insufficiency. The results of the current study suggested that primary repair is adequate in the patients with low-energy injuries and early presentation, whereas an ostomy is required for those with late presentation and for those with high-energy and destructive injuries.
