Nuray Kılıç, Dilek Atik
Acil servise pelvik travması ile gelen hastanın hemodinamik olarak stabilitesi belirlenmeli, mortalite ve morbilidite açısından risk oluşturacak yaralanmalar uygun ve hızlı bir şekilde değerlen-dirilmelidir. Ciddi pelvis yaralanmaları multidisipliner yaklaşım gerektirir ve genellikle multisistem travmaları ile birlikte görülür. Şiddetli pelvik travmalarında hemoraji en önemli ölüm nedenidir. Risk altında hastalar acil hekimi tarafından hızlıca tanımlanmalı ve vakit kaybetmeden ilk müdahaleye başlanıp ilgili branşlarca ileri tetkik ve tedavi başlanmalıdır.
Anahtar Kelimeler: Pelvik travması, hemoraji, Open book pelvik kırıkları
Ramazan Ünal, İsmail Yeşiltaş, Mert Ruşen Gülşen, Sevgi Özen, Nurşen Saraçbaşı, Ramazan Güven, Başar Cander
Among all the trauma cases, thoracic trauma is the third most common after head-neck and extremity trauma. Pneumomediastinum is defined as the presence of air in the mediastinum and it can occur spontaneously, iatrogenic or due to trauma. A case of pneumothorax with accompanying pneumomediastinum developed after blunt thorax trauma who had the complaint of chest pain is being presented in this case report.
A 27-year-old male was admitted to the Emergency Room with complaints of chest pain and shortness of breath. Decreased lung sounds were heard on the left hemithorax with auscultation. The patient’s learned from the anamnesis of the patient that a ball hit his chest during a football match one week before the admission and that he had chest pain and respiratory distress that gradually increased since then. Computed Tomography image of the thorax had an appearance compatible with pneumothorax in the left lung as well as diffuse images of air at the anterior mediastinum. Tube thoracostomy was applied under emergency conditions and was admitted to Thoracic Surgery for follow-up and treatment.
Traumatic pneumothorax and pneumomediastinum should be kept in mind in patients admitted to the emergency department with the complaint of chest pain who also has a history of minor chest trauma.
Keywords; Traumatic pneumothorax, traumatic pneumomediastinum, chest pain, football match
Ramazan Ünal, Mert Ruşen Gülşen
Splenic infarct is a rare pathology of the spleen which is most commonly observed as a complication of another disease. A case of splenic infarct which is diagnosed after admission to the emergency room with symptoms mimicking renal colic and exacerbation of peptic ulcer is being presented in this case report.
A 59-year-old male patient with unremarkable medical history was admitted to our Emergency Room (ER) with the complaint of pain in the epigastric area and left flank. There were significant findings in terms of spleen infarction in the contrast-enhanced abdominal computed tomography of the patient. The patient, who was hospitalized in the General Surgery Department with the diagnosis of splenic infarct, was taken to the emergency operation and underwent a total splenectomy.
The presence of well-circumscribed, non-enhancing, hypodense area on contrast-enhanced abdominal computed tomography is diagnostic at a rate of 75% for splenic infarct. While conservative treatment is sufficient in the early period, surgical intervention may be required in complicated cases such as ours.
Keywords: Splenic infarct, total splenectomy, pain in the epigastric area.
Ramazan Ünal, Ahmet Erdur, Hasan Çam, Ramazan Güven, Başar Cander
Pott's Puffy Tumor (PPT) is a rare clinical entity characterized by subperiosteal abscess accompanied by osteomyelitis due to frontal sinusitis. It is a rare complication in the adult age group. A systematic review of literature in 2020 reported 128 cases of PPT identified in adults.
In this case report, a 19-year-old male patient who was admitted to the emergency service with a complaint of swelling and headache on his forehead for the past month and was diagnosed with PPT due to complicated frontal sinusitis is described. PPT was storage as a result of the physical examination and anamnesis of the patient who admitted to the emergency department with complaints of swelling in the forehead, headache and fever. Computed tomography was preferred as the imaging method in our patient and radiological images consistent with clinical suspicion were observed. The patient was consulted with an Otorhinolaryngology and Neurosurgery specialist. Abscess drainage was performed with Functional Endoscopic Sinus Surgery (FESS) by the Otorhinolaryngology department. The patient was called for control 3 months later. It was observed that the abscess did not recur.
In conclusion, PPT should be kept in mind in the differential diagnosis of patients with a history of swelling in the forehead and sinusitis, and low socio-cultural level.
Keywords: Frontal Sinusitis, Complication, Pott's Puffy Tumor, Functional Endoscopic Sinus Surgery
Hasan Burak Kaya, Dilek Atik
İntrahepatik gebelik kolestazı genellikle gebeliğin son trimesterinda ortaya çıkan karaciğer fonk-siyonlarında anormallik gösteren gebelik kaşıntısı olarak karşımıza çıkmaktadır. Hem maternal hem de fetal komplikasyonları göz önüne alındığında akılda tutulması gereken bir tablodur. Biz yazımızda acil servise kaşıntı ile başvuran ve gebelik kolestazı düşünülen 29 haftalık bir gebe olgusundan bahsedeceğiz. Acil servise kaşıntı ile başvuran gebe hastalarda intrahepatik gebelik kolestazı acil servis hekimi için gözden kaçmaması gereken bir tanıdır.
Anahtar Kelimeler: Gebelik, Kolestaz, Kaşıntı.
Ramazan UNAL, Mert Rusen GULSEN, Ceren Ovacik KARAFILIK, Nurcan OZASLAN, Vedat AVCIERI
The acute scrotum is a broad definition used for all scrotal swellings with or without pain. The most common differential diagnoses include testicular torsion, testicular appendage torsion, and acute epididymitis or epididymo-orchitis. Testicular torsion usually occurs during adolescence. Testicular torsion accounts for approximately 25% of acute scrotum cases. According to the studies, normal testicular dimensions are preserved and only slight changes in morphology occur if the testes are operated within 8 hours after the onset of torsion symptoms. The early diagnosis together with intervention in testicular torsion prevents irreversible changes in testes. Bedside ultrasonography done by emergency medicine specialists, especially in health institutions that do not have on-duty radiology specialists, is of great importance in the early diagnosis of testicular torsion and in reducing morbidity, as in most emergencies. We will present 2 cases diagnosed with testicular torsion by bedside ultrasound and then operated.
Keywords; Bedside ultrasound, emergency medicine department, testicular torsion.
Dilek Atik, Nuray Kılıç, Fulya Köse
Gabapentin (GBP) has anticonvulsant and analgesic properties and is used in many ailments associated with chronic pain and neuropathic pain, mostly diabetes mellitus. In a study, they stated the incidence of myoclonus as 0.1% in epilepsy patients using Gabapentin. Case Report: A 39-year-old female patient was started by Gabapentin neurosurgery for pain in the legs due to herniated L3-4 disc in the lower back. The first dose of use to relieve paraesthesia was manifested in the form of twitching and subsequent contraction in the nasolabial groove of the left rim of the patient, who started using 300 mg/day gabapentin. In our case, the patient did not have any cerebral disease such as encephalopathy or epilepsy, and his kidney functions were also normal. We think that myoclonus may develop due to GBP in the first dose of treatment, and the severity of myoclonus may increase after dose increase, and it should be kept in mind that care should be taken in treatment arrangements.
Keywords: Gabapentin; myoclonus; Gabapentin side effect
Mert Rusen GULSEN, Fahrunisa Meryem Betul EROL, Feride GUNEC, Ramazan UNAL
Hydatid cyst is a parasitic disease, which is transmitted to humans mostly through dog feces and frequently seen in countries where agriculture and animal husbandry are common, caused by Echinococcus Granulosus. Hydatid cysts are frequently localized in the liver and the lungs. The disease may have different clinical course and cause various complications depending on location and size of the cysts.
In this article, we aimed to present a 72-year-old male, who was newly diagnosed with hepatic hydatid cyst with pulmonary fistulization, which was surgically drained.
Keywords: Hydatid disease, pulmonary fistulization, dyspnea.
Nuray Kılıç, Dilek Atik
The gallbladder is a pear-shaped sac-shaped organ that is 8-10 cm long and 4-5 cm wide in adults. The gallbladder stores bile, which is constantly secreted by the liver. Gallbladder pathologies have an important place in patients experiencing abdominal pain symptoms. Abdominal pain in children requires a multidisciplinary approach and treatment just like adults. However, it is not as common to encounter cholelithiasis in pediatric patients as in adults.
Case report: A 3-year-old boy was brought to the emergency room by his family with complaints of abdominal pain and occasional vomiting for 2-3 days. WBC 12.33, CRP 3.44, ALT 11, AST 31, total bilirubin 0.40, GGT 18, creatinine 0.26, and no obvious pathology was detected in the laboratory tests performed. Computed tomography was performed to detect acute intra-abdominal pathology for the patient who was not relieved by the treatment. A diagnosis of cholelithiasis was made.
Although rare, cholelithiasis should be kept in mind by emergency physicians in children who come to the emergency department with the complaint of abdominal pain, and their approach should be directed towards this. At the same time, more studies are needed to eliminate the deficiencies related to gallbladder stone management and treatment in children.
Keywords: Cholelithiasis; Gallbladder risk factors in children; abdominal pain
Fulya Köse, Dilek Atik, Arife Sezgin
Auriküler perikondrit (aynı zamanda pinna perikondrit olarak da adlandırılır), enfeksiyöz ve inflamatuar bir durumdur. Genellikle travmaya ikincil olarak ortaya çıkan dış kulak (yani, yüksek kulak delme, künt travma, yanıklar, iyatrojenik), apse oluşumu olsun ya da olmasın enfeksiyona yol açar. Klasik olarak kızarıklık ve lobülün korunması ile kulak kepçesinin ağrılı şişmesi. Acil servis ve primer başvurular için önemlidir. Hekiminin perikondriti erken ve doğru bir şekilde tedavi etmesi önemlidir. Olgumuz 58 yaşında dm,ht si olan covid 19 aşısı sonrası önce boyundan başlayan daha sonra kulaklarda ve boyunda şişlik oluşması ile devam eden şikayetleri ağrısının artması nedeniyle servisimize başvurdu. Perikondrit tanısı ile yatırılarak tedavisi yapıldı. Kulak kepçesinin perikondriti, değişen derecelerde dış deformiteye yol açabilir ve tedavisi zor bir durumdur. Bu yüzden hastaların yatırılarak tedavi edilmesi daha ön plandadır. Hastamızın etyolojik neden olarak regüle olmayan diyabet varlığı ile immunsuprese durumu ile birlikte Covid 19 aşının hastanın immun sitemini daha da zayıflatması sonucu ortaya çıktığı düşüncesindeyiz. Hastamızın kulak burun boğaz (KBB) uzmanınca yatış yapılarak tedavisi yapılmış ve şifa ile taburculuğu sağlanmıştır.
Anahtar kelimeler: Perikondrit, Covid 19, Allerji, Diyabetes mellitus.
Web sitesi trafiğini analiz etmek ve web sitesi deneyiminizi optimize etmek amacıyla çerezler kullanıyoruz. Çerez kullanımımızı kabul ettiğinizde, verileriniz tüm diğer kullanıcı verileriyle birlikte derlenir.