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Öğe Abdominal stab wounds in children: An 18-year experience(2002) Öztürk, Hayrettin; Önen, Abdurrahman; Otçu, Selçuk; Dokucu, Ali İhsan; Yaǧmur, Yusuf; Gedik, ŞenolObjective: Evaluation of the diagnosis, management, and the role of selective treatment in children with abdominal stab wounds. Patients and Methods: 59 children (56 male and three female) were included in the study. The patients' median age was 11.8 years (range, 5-14 years). Time between injury and admission was about 3 h. Laparotomy was performed in 44 patients (74%). Solid organ injury was detected in 32 of these patients (73%) and could not be observed in twelve (27%). 15 patients (26%) were treated conservatively, and only one (6.6%) underwent laparotomy during the follow-up. The stomach was the most frequently injured organ (ten patients), followed by the intestines (nine patients). Types of surgical treatment were as follows: primary suture in 28 patients, resection-anastomosis in three, and osteotomy in two. Results: Some prognostic factors such as presence of abdominal organ evisceration and pneumoperitoneum were not significantly correlated with intraabdominal organ injury, whereas some other risk factors such as acute abdomen on admission (p < 0.002) or abnormal clinical and hemodynamic finding (p < 0.001) showed significant correlation with intraabdominal organ injury. The relative risk (odds ratio) of developing an intraabdominal organ injury was > 2 for patients with signs of an acute abdomen on admission. Postoperative complications were observed in five patients with organ injuries. None of our patients died. Conclusions: Conservative treatment can be safely performed in most children with abdominal stab injuries. Signs of major internal hemorrhage or generalized peritonitis are an absolute indication for emergency operation for abdominal stab wounds. Peritoneal penetrations, free air on the abdominal X-ray, and omental or intestinal evisceration are poor indicators of significant organ injuries, and patients presenting these signs should be closely followed up for developing acute abdominal symptoms.Öğe A continuing problem of tetanus in the southeast of Turkey(Blackwell Publishing Ltd, 1997) Hoşoǧlu, Salih; Ayaz, Celal; Geyik, Mehmet Faruk; Yaǧmur, Yusuf; Kökoǧlu, Ömer Faruk; 0000-0002-0906-0902Tetanus continues to represent a serious health problem in developing countries [1,2]. Although tetanus is a rare disease in the developed countries [3], it is still common enough to cause concern in Turkey. During the years 1992-3, 75 deaths caused by tetanus were reported from Turkey [4]. Clinical details of 88 adult patients with tetanus who received treatment at our hospital are summarized in this report.Öğe Management of anorectal injuries in children: An eighteen-year experience(2003) Öztürk, Hayrettin; Önen, Abdurrahman; Dokucu, Ali İhsan; Otçu, Selçuk; Yaǧmur, Yusuf; Yücesan, SelçukAnorectal injuries (ARI) are rare in childhood and yet occur due to sexual abuse and firearm injuries in developed countries. The labeling of ARI remains controversial in spite of a number of divergent reports over the past decade. We evaluated the surgical indications for primary repair of ARI without stoma, and also the potential risk factors affecting morbidity and mortality in children with ARI. Between 1983 and 2001, 41 children were diagnosed as ARI in our institution due to blunt or penetrating trauma. There were 17 male and 24 female patients. Causes of anorectal injury were blunt injuries in the majority of cases (56%). Vagina and extremity fractures were the organs most frequently associated with ARI. There was isolated ARI in 49% of cases. Intraperitoneal organ injury was found in 3 patients (7%). The distribution of injury location according to the classification of ARI in our children was as follows: 10% in G I, 32% in G II, 51% in G III, and 10% in G V. Primary repair without colostomy was performed in 51% of cases. Primary repair and diversion of faecal stream by loop colostomy was required in 20 (49%) patients. Postoperative septic complications occurred in 29% of cases. Some potential risk factors such as trauma mechanism and associated organ injury were not significantly correlated to postoperative septic complications, while other risk factors such as mode of treatment, time of operative intervention and contamination were significantly related to postoperative septic complications (p < 0.05). The sensitivity of trauma scoring systems for the estimation of postoperative complication occurrence was significant for ISS (p < 0.05) and ARI score (p < 0.05). The relative risk of developing a postoperative septic complication was higher than 2 for patients with ARI grade III, ISS > 15, primary repair + colostomy group, and time of operative intervention > 8 hours. A child in the colostomy + primary repair group died on the first postoperative day from rapidly progressing septicaemia and multiple organ failure (2.4%). The management of ARI can be carried out by primary repair procedure without colostomy in the majority of cases if the needed selectivity is established.Öğe Myofibroblastoma in the irradiated breast(1999) Yaǧmur, Yusuf; Prasad, Manju L.; Osborne, Michael P.Myofibroblastoma after wide excision and radiation therapy for intraductal (duct carcinoma in situ) carcinoma is reported. Myofibroblastoma is a benign tumor, largely composed of myofibroblasts arranged in fascicular clusters with interspersed bands of hyalinized collagen, which is well circumscribed and occurs predominantly in men. This is the first documented instance of a postradiation myofibroblastoma of the breast.
