1
|
Dugar D, Mohanty D, Muhammed S. Combined Rupture of the Diaphragm and Urinary Bladder in Blunt Trauma Abdomen. Perm J 2024; 28:109-115. [PMID: 38629878 PMCID: PMC11249275 DOI: 10.7812/tpp/23.156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/10/2024]
Abstract
The authors examined a 25-year-old man with a combined rupture of the diaphragm and urinary bladder following blunt trauma to the abdomen. The presence of hematuria, suprapubic tenderness, and elevated serum urea and creatinine levels in this patient raised suspicion of urinary bladder rupture. Documentation of bowel gas shadows on the chest x-ray suggested underlying diaphragm injury. A computed tomogram of the thorax and abdomen confirmed the tear in the left hemidiaphragm with intrathoracic herniation of abdominal contents; however, it failed to detect the intraperitoneal urinary bladder rupture. Both the defects were identified and repaired during laparotomy. The sudden increase in intraabdominal pressure in blunt trauma to the abdomen often resulted in full-thickness tears of the diaphragm and the urinary bladder. Although radiological investigations were pivotal for assessing the damage to the internal organs, a methodical and thorough exploratory laparotomy was invaluable for successfully managing patients with blunt abdominal trauma.
Collapse
Affiliation(s)
- Dharmendra Dugar
- Department of General Surgery, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
| | - Debajyoti Mohanty
- Department of General Surgery, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
| | - Suhail Muhammed
- Department of General Surgery, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
| |
Collapse
|
2
|
Tonkaz G, Sengul D, Bekci T, Sengul I, Cakir IM, Onder RO, Tonkaz DE, Eryuruk U, Aksoy I, Veiga ECDA, Aslan S. A needful, unique, and in-place evaluation of the injuries in earthquake victims with computed tomography, in catastrophic disasters! The 2023 Turkey-Syria earthquakes: part II. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2023; 69:e20230550. [PMID: 37585998 PMCID: PMC10427186 DOI: 10.1590/1806-9282.20230550] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Accepted: 05/14/2023] [Indexed: 08/18/2023]
Abstract
OBJECTIVE This study aimed to determine the computed tomography findings associated with very recent catastrophic 2023 Turkey-Syria earthquake-related injuries and their anatomotopographic distribution in the adult population. METHODS The incorporated computed tomography scans of 768 adult cases who had been admitted to the hospital and had undergone computed tomography imaging after these tragic disasters had been examined on the Teleradiology Reporting System of the Turkish Ministry of Health. To this end, the injuries were classified into six categories: head, thoracic, spinal, pelvic, extremity, and abdominal injury, with three age groups (18-34, 35-64, and ³65 years) and four different imaging intervals (<24, 24-48, 49-72, and >72 h). RESULTS This study incorporated 316 (41.1%) cases on the first day, 57 (7.5%) on the second day, 219 (28.5%) on the third day, and 176 (22.9%) on the fourth day after the earthquake or later. Of the 768 cases, 109 (14.2%) had a head injury, 100 (13.0%) had a thoracic injury, 99 (12.9%) had a spinal injury, 51 (6.6%) had a pelvic injury, 41 (5.4%) had an extremity injury, and 11 (1.4%) had an abdominal injury. CONCLUSION In these regrettable earthquake disasters, we determined a high ratio of head injuries, which was closely followed by thoracic and spinal injuries, in our preliminary outcomes for the pediatric population, Part I. The frequency of abdominal injuries was low among individuals who experienced the earthquake. Last but not least, we have noticed a higher likelihood of spinal injury in individuals older than 65 years in the studied population.
Collapse
Affiliation(s)
- Gokhan Tonkaz
- Giresun University, Faculty of Medicine, Department of Radiology – Giresun, Turkey
| | - Demet Sengul
- Giresun University, Faculty of Medicine, Department of Pathology – Giresun, Turkey
| | - Tumay Bekci
- Giresun University, Faculty of Medicine, Department of Radiology – Giresun, Turkey
| | - Ilker Sengul
- Giresun University, Faculty of Medicine, Division of Endocrine Surgery – Giresun, Turkey
- Giresun University, Faculty of Medicine, Department of General Surgery – Giresun, Turkey
| | - Ismet Mirac Cakir
- Giresun University, Faculty of Medicine, Department of Radiology – Giresun, Turkey
| | - Ramazan Orkun Onder
- Giresun University, Faculty of Medicine, Department of Radiology – Giresun, Turkey
| | | | - Uluhan Eryuruk
- Giresun University, Faculty of Medicine, Department of Radiology – Giresun, Turkey
| | - Iskender Aksoy
- Giresun University, Faculty of Medicine, Department of Emergency Medicine – Giresun, Turkey
| | - Eduardo Carvalho de Arruda Veiga
- Universidade de São Paulo, Faculty of Medicine of Ribeirão Preto, Department of Gynecology and Obstetrics – São Paulo (SP), Brazil
| | - Serdar Aslan
- Giresun University, Faculty of Medicine, Department of Radiology – Giresun, Turkey
| |
Collapse
|
3
|
Cakir IM, Sengul I, Bekci T, Tonkaz G, Eryuruk U, Onder RO, Aksoy I, Bayar AE, Tonkaz M, Sengul D, Aslan S. A needful, unique, and in-place evaluation of the injuries in earthquake victims with computed tomography, in catastrophic disasters! The 2023 Turkey-Syria earthquakes: part I. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2023; 69:e20230399. [PMID: 37585997 PMCID: PMC10427183 DOI: 10.1590/1806-9282.20230399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 04/04/2023] [Indexed: 08/18/2023]
Abstract
OBJECTIVE This study was carried out to evaluate the injuries in pediatric earthquake victims due to the 2023 Turkey-Syria earthquakes with computed tomography and determine the anatomotopographic distribution of injuries. METHODS The material of this retrospective study consisted of the computed tomography findings of 257 pediatric cases injured in the 2023 Turkey-Syria earthquakes, and those were divided into subgroups based on their age group, i.e., 0-4, 5-9, 10-14, and 15-18 years, and the type of injury, i.e., head, maxillofacial, thoracic, abdominal, pelvic, and spinal injuries. RESULTS Earthquake-related injuries had been detected in 102 (39.6%) patients. Of the 29 patients with multiple injuries, 17, 10, and 2 had injuries in two, three, and four topographic regions, respectively. The most common injury was a head injury, which was detected in 48 (18.7%) cases, followed by thoracic injury, spinal injury, pelvic fracture, abdominal injury, and maxillofacial fracture, which were detected in 40 (15.6%), 22 (8.5%), 19 (7.4%), 10 (3.9%), and 6 (2.3%) patients, respectively. The cranial bone fractures and intracranial injuries were significantly more frequent in the 0-4 years age group compared with other age groups (p=0.028 and p=0.024, respectively). The rib fractures with spinal and pleural injuries were significantly more common in the 15-18 years age group compared with others (p=0.016, p=0.004, and p=0.002, respectively). CONCLUSION The head injury was the most common earthquake-related injury in pediatric cases. Herein, it was more common in younger children compared with other age groups, whereas rib, spine, and pleural injuries were more common in older children.
Collapse
Affiliation(s)
- Ismet Mirac Cakir
- Giresun University, Faculty of Medicine, Department of Radiology – Giresun, Turkey
| | - Ilker Sengul
- Giresun University, Faculty of Medicine, Division of Endocrine Surgery – Giresun, Turkey
- Giresun University, Faculty of Medicine, Department of General Surgery – Giresun, Turkey
| | - Tumay Bekci
- Giresun University, Faculty of Medicine, Department of Radiology – Giresun, Turkey
| | - Gokhan Tonkaz
- Giresun University, Faculty of Medicine, Department of Radiology – Giresun, Turkey
| | - Uluhan Eryuruk
- Giresun University, Faculty of Medicine, Department of Radiology – Giresun, Turkey
| | - Ramazan Orkun Onder
- Giresun University, Faculty of Medicine, Department of Radiology – Giresun, Turkey
| | - Iskender Aksoy
- Giresun University, Faculty of Medicine, Department of Emergency Medicine – Giresun, Turkey
| | - Ayse Elif Bayar
- Giresun University, Faculty of Medicine, Department of Emergency Medicine – Giresun, Turkey
| | - Mehmet Tonkaz
- Gumushane State Hospital, Department of Radiology – Gumushane, Turkey
| | - Demet Sengul
- Giresun University, Faculty of Medicine, Department of Pathology – Giresun, Turkey
| | - Serdar Aslan
- Giresun University, Faculty of Medicine, Department of Radiology – Giresun, Turkey
| |
Collapse
|
4
|
Muacevic A, Adler JR. Laparoscopic Repair Modality of Perforated Peptic Ulcer: Less Is More? Cureus 2022; 14:e30926. [PMID: 36337818 PMCID: PMC9621601 DOI: 10.7759/cureus.30926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2022] [Indexed: 11/05/2022] Open
Abstract
Perforation, per se, presents the most serious complication of peptic ulcer disease with a mortality rate that cannot be underestimated. Surgery is the only treatment option, which can be performed laparoscopically or via conventional laparotomy. The present study aimed to compare the short-term outcomes of laparoscopy and laparotomy techniques in the surgical treatment of peptic ulcer perforation. A retrospective study design was structured to compare the perioperative and short-term postoperative outcomes of 102 patients who had undergone laparoscopic and conventional repair of the perforated peptic ulcer over a six-year interval (January 1, 2016, to December 31, 2021). Of these, 44 (43.1%) had undergone laparoscopic repair while 58 (56.9%) had surgical repair via conventional laparotomy. The operative time and length of hospital stay were comparable in both subgroups (p=0.984 and p =0.585). Nevertheless, 30-day postoperative morbidity was significantly higher in the open surgery subgroup (75.9% vs. 59.1%, p= 0.032). The risk of relaparotomy was similar in both study subgroups; however, suture dehiscence as a reason for surgical revision was significantly more frequent in the laparoscopic subgroup (13.6% vs 3.4%). Of note, the mortality rate in the laparoscopic group of patients was 13.6%, and in the laparotomy group 41.4%. The laparoscopic approach to peptic ulcer perforation is the procedure of choice for low-risk patients. Conventional surgery seems to be associated with a significantly higher incidence of severe postoperative complications and mortality. However, the higher mortality in these patients is probably related to their worse initial clinical condition.
Collapse
|
5
|
Aydin I, Sengul I, Gungor M, Kesicioglu T, Sengul D, Vural S, Yimaz E. Ambulatory Laparoscopic Appendectomy: Does the Conventional Approach Need a Reappraisal? Cureus 2022; 14:e29215. [PMID: 36128563 PMCID: PMC9478505 DOI: 10.7759/cureus.29215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/15/2022] [Indexed: 11/05/2022] Open
Abstract
A Deucalione, acute abdomen remains significant in abdominal pain. The entity of acute abdomen accounts for up to 10% of all emergency admissions. The differences between countries' income and level of prosperity are pertinent, particularly in terms of severity, radiological modalities, and surgical management of the condition. Of note, surgical modalities have been the most widely used treatment modality, and current evidence indicates that the laparoscopic approach, per se, is the most effective surgical therapy with a lower incidence of wound infection, post-intervention morbidity, shorter hospital stay, and better quality of life scores compared to the conventional method. In light of this, the present study aimed to evaluate ambulatory appendectomy in a series of sequential laparoscopic appendectomies (LApp), which included both complicated and uncomplicated cases.
Collapse
|
6
|
Detanac D, Filipovic N, Sengul I, Zecovic E, Muratovic S, Sengul D. Extraordinarily Rare Isolated Intraperitoneal Urinary Bladder Rupture in Blunt Abdominal Injury Without Pelvic Fracture: An Aide-Mémoire. Cureus 2022; 14:e28576. [PMID: 36158414 PMCID: PMC9495293 DOI: 10.7759/cureus.28576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/30/2022] [Indexed: 11/27/2022] Open
Abstract
Isolated urinary bladder rupture caused by blunt abdominal trauma is an infrequent injury, with less than 2% of all cases. It is most often found in traffic accidents and is usually associated with pelvic fractures. While an extraperitoneal bladder injury is mostly treated conservatively, an intraperitoneal one is mostly treated surgically. We present a 54-year-old obese man injured in a traffic accident, with an intraperitoneal rupture of the bladder after blunt abdominal trauma with no signs of pelvic fracture and without signs of traumatic injury to the abdominal organs. The vignette case constitutes a bladder injury that was treated surgically and sutured in two layers with absorbable thread, with the placement of a urinary catheter. The patient recovered without complications and was discharged from the ward on the seventh postoperative day. Of note, the clinical presentation of a bladder rupture can be manifested as a nonspecific lower abdominal pain or with symptoms of an acute abdomen and that is why imaging plays a major role in the diagnosis and further treatment procedures. Surgical treatment of such injuries can be performed laparoscopically or as open surgery. To this end, rapid diagnosis of bladder rupture is necessary because it can lead to complications that endanger patients if overlooked.
Collapse
|
7
|
Aydin I, Sengul I, Sengul D. Phytobezoar: An Unusual Condition Leading to Small Bowel Obstruction. Cureus 2022; 14:e23885. [PMID: 35402121 PMCID: PMC8985846 DOI: 10.7759/cureus.23885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/06/2022] [Indexed: 11/05/2022] Open
Abstract
Bezoar is described as a swallowed, extraneous, and indigestible mass located in the gastrointestinal system; it accounts for 0.4-4.0% of all cases of mechanical intestinal obstruction. Intestinal obstruction is the most frequent complication of bezoar formation. Apart from intestinal obstructions, bezoars may also exhibit clinical symptoms such as abdominal pain, nausea, vomiting, weight loss, upper gastrointestinal bleeding, and gastric perforation. However, a considerable number of cases tend to be asymptomatic. Of note, its clinical symptoms cannot be differentiated easily from intestinal obstructions caused by other factors. As such, preoperative CT examination can provide invaluable information about the level of obstruction, etiology, and the existence of additional pathology and thereby help plan the type of surgical procedure required. If prompt diagnosis and timely treatment are not carried out, the condition may lead to significant morbidity and mortality.
Collapse
|