Erhan Hafız, M. Geyik, V. Sarıçiçek, H. Deniz, Meliha Hafiz, M. Aşam
During lumbar disc hernia operations, large intra-abdominal injuries may develop, even though they are rare. Massive bleeding and hypotension are precursors of this complication, which often has a mortal prognosis. In this circumstance, emergent operation should be performed by laparotomy. We present a case in whom an abdominal aortic injury developed during lumbar disc surgery. (JAEM 2014; 13: 149-50)
{"title":"Abdominal Aorta Injury due to Lumbar Disc Hernia Operation: A Case Report","authors":"Erhan Hafız, M. Geyik, V. Sarıçiçek, H. Deniz, Meliha Hafiz, M. Aşam","doi":"10.5152/JAEM.2014.195","DOIUrl":"https://doi.org/10.5152/JAEM.2014.195","url":null,"abstract":"During lumbar disc hernia operations, large intra-abdominal injuries may develop, even though they are rare. Massive bleeding and hypotension are precursors of this complication, which often has a mortal prognosis. In this circumstance, emergent operation should be performed by laparotomy. We present a case in whom an abdominal aortic injury developed during lumbar disc surgery. (JAEM 2014; 13: 149-50)","PeriodicalId":14780,"journal":{"name":"Journal of Academic Emergency Medicine Case Reports","volume":"161 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2014-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83995338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ahsen Kaya, B. Karadayı, Melek Ozlem Kolusayın, N. Aslan, G. Oral
Objective: In our country, violence has been spreading to every part of society, especially in the health sector in recent years. In this study, we aimed to determine the properties of violence that physicians working in the emergency departments are exposed to and witness and also to present the process after the violence. Material and Methods: This study was held with participants of the 4th Emergency Medicine School Meeting organized by the Emergency Medicine Physicians Association of Turkey on January 11-12, 2013 in Istanbul. Answers given to the questionnaire titled “Violence in the health sector and its properties” by volunteer participants were evaluated with a statistical program. Results: Of the 73 physicians, 60.3% was male and 39.7% was female. The mean age was 31.9±5.8 years; 91.8% stated that they were exposed to violence at least once in their professional lives. The most common type of violence exposed and witnessed was verbal violence. Conclusion: Emergency departments are places where violence is experienced extremely often. Doing legal arrangements, taking security precautions, and solving patient-healthcare communication problems are important steps for preventing violence. But, it is thought that the main step is to provide social synergy in the perception of violence. (JAEM 2014; 13: 124-30)
{"title":"Violence in the Health Sector and Its Properties: A Questionnaire toward Physician Working in the Emergency Departments","authors":"Ahsen Kaya, B. Karadayı, Melek Ozlem Kolusayın, N. Aslan, G. Oral","doi":"10.5152/JAEM.2014.66587","DOIUrl":"https://doi.org/10.5152/JAEM.2014.66587","url":null,"abstract":"Objective: In our country, violence has been spreading to every part of society, especially in the health sector in recent years. In this study, we aimed to determine the properties of violence that physicians working in the emergency departments are exposed to and witness and also to present the process after the violence. Material and Methods: This study was held with participants of the 4th Emergency Medicine School Meeting organized by the Emergency Medicine Physicians Association of Turkey on January 11-12, 2013 in Istanbul. Answers given to the questionnaire titled “Violence in the health sector and its properties” by volunteer participants were evaluated with a statistical program. Results: Of the 73 physicians, 60.3% was male and 39.7% was female. The mean age was 31.9±5.8 years; 91.8% stated that they were exposed to violence at least once in their professional lives. The most common type of violence exposed and witnessed was verbal violence. Conclusion: Emergency departments are places where violence is experienced extremely often. Doing legal arrangements, taking security precautions, and solving patient-healthcare communication problems are important steps for preventing violence. But, it is thought that the main step is to provide social synergy in the perception of violence. (JAEM 2014; 13: 124-30)","PeriodicalId":14780,"journal":{"name":"Journal of Academic Emergency Medicine Case Reports","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2014-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82858568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Faruk Ozsahin, M. Gunaydin, H. Vardar, Gamze Tuten, I. Eraydin, Yunus Karaca, U. Eryigit, A. Gunduz, S. Yurtsever
Objective: This study aimed to determine the factors affecting patients' satisfaction levels treated in yellow, red, and green areas who applied to the emergency department of an education and research hospital.
目的:探讨某教研型医院急诊科黄、红、绿三色区域对患者满意度的影响因素。
{"title":"Satisfaction Level of Patients after Treatment Admitted to Emergency Department","authors":"Faruk Ozsahin, M. Gunaydin, H. Vardar, Gamze Tuten, I. Eraydin, Yunus Karaca, U. Eryigit, A. Gunduz, S. Yurtsever","doi":"10.5152/JAEM.2014.63497","DOIUrl":"https://doi.org/10.5152/JAEM.2014.63497","url":null,"abstract":"Objective: This study aimed to determine the factors affecting patients' satisfaction levels treated in yellow, red, and green areas who applied to the emergency department of an education and research hospital.","PeriodicalId":14780,"journal":{"name":"Journal of Academic Emergency Medicine Case Reports","volume":"66 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2014-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74676310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ç. Can, U. Gulacti, E. Kurtoğlu, A. Çelik, Ugur Lok, H. Topacoglu
3 , Ugur Lok 2 , Hakan Topacoglu 4 Abstract Objective: Alterations in serum levels of sodium may lead to cardiac arrhythmia by affecting the membrane potentials of cardiac cells. Previous studies have documented the association between postoperative atrial fibrillation and reduction in serum magnesium level after cardiovascular surgery well. However, there is no study assessing the relationship between serum sodium concentration and atrial fibrillation. Therefore, we aimed to investigate the relationship between serum sodium concentration and atrial fibrillation. Material and Methods: The present study had a cross-sectional design. The study population included 240 cases (120 patients with atrial fibrillation and 120 controls). Patients with atrial fibrillation were compared with the control group in terms of serum sodium level. Results: The mean serum sodium level in the atrial fibrillation group was 136.0±18.3 mEq/l, while it was found to be 142.0±23.9 mEq/l (p=0.04) in the control group. The mean serum sodium level in patients with permanent atrial fibrillation was 139±14 mEq/l, whereas it was 132.0±22.5 mEq/l in patients with parox - ysmal atrial fibrillation (p=0.03). Conclusion: This study indicates that low serum sodium level might be associated with atrial fibrillation. However, to obtain accurate results, new prospective studies with more patients are needed. (JAEM 2014; 13: 131-4)
{"title":"The Relationship between Serum Sodium Concentration and Atrial Fibrillation among Adult Patients in Emergency Department Settings","authors":"Ç. Can, U. Gulacti, E. Kurtoğlu, A. Çelik, Ugur Lok, H. Topacoglu","doi":"10.5152/JAEM.2014.172","DOIUrl":"https://doi.org/10.5152/JAEM.2014.172","url":null,"abstract":"3 , Ugur Lok 2 , Hakan Topacoglu 4 Abstract Objective: Alterations in serum levels of sodium may lead to cardiac arrhythmia by affecting the membrane potentials of cardiac cells. Previous studies have documented the association between postoperative atrial fibrillation and reduction in serum magnesium level after cardiovascular surgery well. However, there is no study assessing the relationship between serum sodium concentration and atrial fibrillation. Therefore, we aimed to investigate the relationship between serum sodium concentration and atrial fibrillation. Material and Methods: The present study had a cross-sectional design. The study population included 240 cases (120 patients with atrial fibrillation and 120 controls). Patients with atrial fibrillation were compared with the control group in terms of serum sodium level. Results: The mean serum sodium level in the atrial fibrillation group was 136.0±18.3 mEq/l, while it was found to be 142.0±23.9 mEq/l (p=0.04) in the control group. The mean serum sodium level in patients with permanent atrial fibrillation was 139±14 mEq/l, whereas it was 132.0±22.5 mEq/l in patients with parox - ysmal atrial fibrillation (p=0.03). Conclusion: This study indicates that low serum sodium level might be associated with atrial fibrillation. However, to obtain accurate results, new prospective studies with more patients are needed. (JAEM 2014; 13: 131-4)","PeriodicalId":14780,"journal":{"name":"Journal of Academic Emergency Medicine Case Reports","volume":"64 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2014-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78965188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Z. Dundar, M. Ergin, M. Karamercan, S. Satar, A. S. Girişgin, M. Yıldız, B. Cander
{"title":"Meeting Report of 10th National Emergency Medicine Congress & 1st Intercontinental Emergency Medicine Congress","authors":"Z. Dundar, M. Ergin, M. Karamercan, S. Satar, A. S. Girişgin, M. Yıldız, B. Cander","doi":"10.5152/JAEM.2014.379","DOIUrl":"https://doi.org/10.5152/JAEM.2014.379","url":null,"abstract":"","PeriodicalId":14780,"journal":{"name":"Journal of Academic Emergency Medicine Case Reports","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2014-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89173887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
V. Çakmak, A. Gunduz, Yunus Karaca, Z. Ali̇oğlu, A. Menteşe, M. Topbaş
Objective: Use of biochemical markers of cerebral ischemia is a newly favored approach for early diagnosis of ischemic stroke. Our aim was to establish the sensitivity and specificity of ischemia-modified albumin (IMA) in acute ischemic stroke and to compare it with S100b and neuron-specific enolase (NSE). We also intended to investigate the usefulness of a panel composed of these three biomarkers in acute ischemic stroke. Material and Methods: Consecutive adult patients who were admitted to the emergency department with focal neurological deficits were enrolled. Serum samples were obtained at the initial examination, and IMA, S100b, and NSE were measured. Receiver operating characteristics (ROC) curve analysis was used to determine the cut-off values of the biomarker and biomarker groups. Results: Serum IMA, NSE, and S100b levels were significantly higher in ischemic stroke patients (p<0.001, p=0.005, p=0.001, respectively). The optimum diag nostic cutoff point for IMA was 0.31 ABSU with 90% sensitivity and 57% specificity; 18 µg/L for NSE with 61% sensitivity and 53% specificity; and 65 pcg/l for S100b with 87% sensitivity and 72% specificity. With a combination of IMA with either S100b or NSE, instead of IMA alone, the best results were obtained with IMA and S100b, at 97% sensitivity and 37% specificity. Conclusion: This study indicates that IMA was a sensitive diagnostic biomarker in the acute phase of ischemic stroke, although its specificity is low. The combi nation of IMA with S100b and NSE did not add any beneficial effect to the specificity of IMA alone. (JAEM 2014; 13: 112-7)
{"title":"Diagnostic Significance of Ischemia-Modified Albumin, S100b, and Neuron-Specific Enolase in Acute Ischemic Stroke","authors":"V. Çakmak, A. Gunduz, Yunus Karaca, Z. Ali̇oğlu, A. Menteşe, M. Topbaş","doi":"10.5152/JAEM.2014.37980","DOIUrl":"https://doi.org/10.5152/JAEM.2014.37980","url":null,"abstract":"Objective: Use of biochemical markers of cerebral ischemia is a newly favored approach for early diagnosis of ischemic stroke. Our aim was to establish the sensitivity and specificity of ischemia-modified albumin (IMA) in acute ischemic stroke and to compare it with S100b and neuron-specific enolase (NSE). We also intended to investigate the usefulness of a panel composed of these three biomarkers in acute ischemic stroke. Material and Methods: Consecutive adult patients who were admitted to the emergency department with focal neurological deficits were enrolled. Serum samples were obtained at the initial examination, and IMA, S100b, and NSE were measured. Receiver operating characteristics (ROC) curve analysis was used to determine the cut-off values of the biomarker and biomarker groups. Results: Serum IMA, NSE, and S100b levels were significantly higher in ischemic stroke patients (p<0.001, p=0.005, p=0.001, respectively). The optimum diag nostic cutoff point for IMA was 0.31 ABSU with 90% sensitivity and 57% specificity; 18 µg/L for NSE with 61% sensitivity and 53% specificity; and 65 pcg/l for S100b with 87% sensitivity and 72% specificity. With a combination of IMA with either S100b or NSE, instead of IMA alone, the best results were obtained with IMA and S100b, at 97% sensitivity and 37% specificity. Conclusion: This study indicates that IMA was a sensitive diagnostic biomarker in the acute phase of ischemic stroke, although its specificity is low. The combi nation of IMA with S100b and NSE did not add any beneficial effect to the specificity of IMA alone. (JAEM 2014; 13: 112-7)","PeriodicalId":14780,"journal":{"name":"Journal of Academic Emergency Medicine Case Reports","volume":"55 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2014-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86404362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Y. Demir, S. Akay, S. Yolcu, Ali Savas Miran, Tugba Cicek Durak, I. Parlak
Objective: In our study, we aimed to investigate the accuracy of Focused Assessment Sonography for Trauma (FAST) findings of multitrauma patients in com parison with abdominal CT results. Material and Methods: Age, gender, demographic properties, trauma type, arrival method to the emergency service, abdominal USG results, abdominal CT results, results of other CT scans, hospitalization data, and hemoglobin (Hb) and white blood cell count (WBC) values of the patients were recorded. Results: One hundred eighty (79.6%) males and 46 (20.4%) females (total 226 patients) were included to our study. Mean age was 38.74±17.18; 203 (89.8%) patients were traffic accidents, and 23 (10.2%) patients were falls from heights. The sensitivity of FAST was 50% and specificity was 93.7%. The positive predictive value (PPV) was 60 and negative predictive value was 90.8%. Conclusion: Multiple trauma patients with positive USG findings according to their hemodynamic situations and multitrauma patients with suspicious USG findings should undergo abdominal CT scan in the emergency service. (JAEM 2014; 13: 104-7)
{"title":"Investigation of Accuracy of FAST Findings of Multitrauma Patients in Comparison with Abdominal CT Results","authors":"Y. Demir, S. Akay, S. Yolcu, Ali Savas Miran, Tugba Cicek Durak, I. Parlak","doi":"10.5152/JAEM.2014.70037","DOIUrl":"https://doi.org/10.5152/JAEM.2014.70037","url":null,"abstract":"Objective: In our study, we aimed to investigate the accuracy of Focused Assessment Sonography for Trauma (FAST) findings of multitrauma patients in com parison with abdominal CT results. Material and Methods: Age, gender, demographic properties, trauma type, arrival method to the emergency service, abdominal USG results, abdominal CT results, results of other CT scans, hospitalization data, and hemoglobin (Hb) and white blood cell count (WBC) values of the patients were recorded. Results: One hundred eighty (79.6%) males and 46 (20.4%) females (total 226 patients) were included to our study. Mean age was 38.74±17.18; 203 (89.8%) patients were traffic accidents, and 23 (10.2%) patients were falls from heights. The sensitivity of FAST was 50% and specificity was 93.7%. The positive predictive value (PPV) was 60 and negative predictive value was 90.8%. Conclusion: Multiple trauma patients with positive USG findings according to their hemodynamic situations and multitrauma patients with suspicious USG findings should undergo abdominal CT scan in the emergency service. (JAEM 2014; 13: 104-7)","PeriodicalId":14780,"journal":{"name":"Journal of Academic Emergency Medicine Case Reports","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2014-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76853691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Thrombolysis is a rapidly available but semi-effective treatment, whereas percutaneous coronary intervention is a potentially delayed but highly effective therapy. What about thrombolysis in the prehospital setting for ST-elevated myocardial infarction? Does scientific evidence support or oppose? Which patient group is more eligible for prehospital thrombolysis? Is there any skirmish between emergency medicine and cardiovascular professionals? You can find a history of prehospital thrombolysis on the basis of scientific evidence in this writing. (JAEM 2014; 13: 143-5)
{"title":"Thrombolysis in STEMI at Prehospital Settings","authors":"M. Ergin, Z. Dundar, B. Cander","doi":"10.5152/JAEM.2014.81567","DOIUrl":"https://doi.org/10.5152/JAEM.2014.81567","url":null,"abstract":"Thrombolysis is a rapidly available but semi-effective treatment, whereas percutaneous coronary intervention is a potentially delayed but highly effective therapy. What about thrombolysis in the prehospital setting for ST-elevated myocardial infarction? Does scientific evidence support or oppose? Which patient group is more eligible for prehospital thrombolysis? Is there any skirmish between emergency medicine and cardiovascular professionals? You can find a history of prehospital thrombolysis on the basis of scientific evidence in this writing. (JAEM 2014; 13: 143-5)","PeriodicalId":14780,"journal":{"name":"Journal of Academic Emergency Medicine Case Reports","volume":"73 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2014-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90839143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Giris: Endometriozis, uterus disinda fonksiyonel endometrial doku varligi ile karakterize bir klinik antitedir. Bu lezyon genellikle overler, rektovaginal bolge ve pelvik taban peritonunda gorulur. Karin duvari endometriozisi, oldukca nadirdir ve genellikle tek olgu sunumlari ya da kucuk seriler olarak bildirilmektedir. Olgu Sunumu: Bu yazida, bogulmus kesi fitigini taklit eden karin duvari endometriozisi olgusu bildirildi. Vakalarin cogu, ozellikle sezaryen gibi cesitli obstetrik ve jinekolojik operasyonlarin ardindan olusur. Karin duvari endometriozisi bazen akut karin bulgularina neden olabilir ve kolayca deri alti apsesi, rektus kilifi hematomu ya da bizim olgumuzda oldugu gibi bogulmus kesi fitigi ile karisabilir. Sonuc: Karin duvari endometriozisinin dogru tanisi genellikle zordur ama ozellikle siklik agrisi olan menstruasyon goren bir kadinda dusunulmelidir. Ayrica, obstetrik ve jinekolojik ameliyat oykusu de sorgulanmalidir. Tedavisi total eksizyondur.
{"title":"A Case of Abdominal Wall Endometriosis Mimicking Strangulated Incisional Hernia","authors":"M. Kılıç, G. Değirmencioğlu, C. Dener","doi":"10.5152/JAEMCR.2014.436","DOIUrl":"https://doi.org/10.5152/JAEMCR.2014.436","url":null,"abstract":"Giris: Endometriozis, uterus disinda fonksiyonel endometrial doku varligi ile karakterize bir klinik antitedir. Bu lezyon genellikle overler, rektovaginal bolge ve pelvik taban peritonunda gorulur. Karin duvari endometriozisi, oldukca nadirdir ve genellikle tek olgu sunumlari ya da kucuk seriler olarak bildirilmektedir. Olgu Sunumu: Bu yazida, bogulmus kesi fitigini taklit eden karin duvari endometriozisi olgusu bildirildi. Vakalarin cogu, ozellikle sezaryen gibi cesitli obstetrik ve jinekolojik operasyonlarin ardindan olusur. Karin duvari endometriozisi bazen akut karin bulgularina neden olabilir ve kolayca deri alti apsesi, rektus kilifi hematomu ya da bizim olgumuzda oldugu gibi bogulmus kesi fitigi ile karisabilir. Sonuc: Karin duvari endometriozisinin dogru tanisi genellikle zordur ama ozellikle siklik agrisi olan menstruasyon goren bir kadinda dusunulmelidir. Ayrica, obstetrik ve jinekolojik ameliyat oykusu de sorgulanmalidir. Tedavisi total eksizyondur.","PeriodicalId":14780,"journal":{"name":"Journal of Academic Emergency Medicine Case Reports","volume":"23 1","pages":"229-231"},"PeriodicalIF":0.0,"publicationDate":"2014-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82176531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-08-29DOI: 10.5152/JAEMCR.2014.15010
D. Öztürk, E. Altınbilek, M. Koyuncu, Ahmet Cevdet Toksoz, F. Çakmak, I. Ikizceli, C. Kavalci
Introduction: Substernal thyroid goiter is defined as extension of the thyroid gland into the mediastinum. Vocal cord paralysis, vena cava superior syndrome due to the compression on major vessels, and Horner syndrome can be rarely seen in patients. Case Report: A 77-year-old female patient presented to our emergency department with complaints of dyspnea, flushing, and edema on her face. Her vital signs were as follows: BP: 140/90 mm Hg, HR: 135 bpm, respiratory rate: 28 per minute, and SpO2: 88%. On her physical examination, there was increased jugular venous distension, both thyroid lobes were palpable, and breath sounds decreased in the right lung. A contrast-enhanced pulmonary computed tomography (CT) was planned, and substernal goiter was seen on CT. Then, 4 L/min supplemental O2, 2 puffs of 200 mcg budenoside 3 times a day and 250 mg IV methylprednisolone therapy were started. Conclusion: In patients presenting with dyspnea, retrosternal (substernal) goiter should also be considered.
胸骨下甲状腺肿的定义是甲状腺延伸到纵隔。声带麻痹、主要血管受压引起的腔静脉上症候群及霍纳症候群在患者中罕见。病例报告:一名77岁女性患者以面部呼吸困难、潮红和水肿就诊于我们的急诊科。生命体征如下:血压:140/90 mm Hg，心率:135 bpm，呼吸频率:28 /分钟，SpO2: 88%。体格检查发现颈静脉扩张增加，可触及双甲状腺叶，右肺呼吸音减弱。计划进行肺部CT增强扫描，发现胸骨下甲状腺肿。然后开始4 L/min补氧，布地诺苷200 mcg 2次，每日3次，静脉注射250 mg甲基强的松龙治疗。结论:出现呼吸困难的患者也应考虑胸骨后(胸骨下)甲状腺肿。
{"title":"An Unusual Case of Dyspnea: Substernal Goiter","authors":"D. Öztürk, E. Altınbilek, M. Koyuncu, Ahmet Cevdet Toksoz, F. Çakmak, I. Ikizceli, C. Kavalci","doi":"10.5152/JAEMCR.2014.15010","DOIUrl":"https://doi.org/10.5152/JAEMCR.2014.15010","url":null,"abstract":"Introduction: Substernal thyroid goiter is defined as extension of the thyroid gland into the mediastinum. Vocal cord paralysis, vena cava superior syndrome due to the compression on major vessels, and Horner syndrome can be rarely seen in patients. Case Report: A 77-year-old female patient presented to our emergency department with complaints of dyspnea, flushing, and edema on her face. Her vital signs were as follows: BP: 140/90 mm Hg, HR: 135 bpm, respiratory rate: 28 per minute, and SpO2: 88%. On her physical examination, there was increased jugular venous distension, both thyroid lobes were palpable, and breath sounds decreased in the right lung. A contrast-enhanced pulmonary computed tomography (CT) was planned, and substernal goiter was seen on CT. Then, 4 L/min supplemental O2, 2 puffs of 200 mcg budenoside 3 times a day and 250 mg IV methylprednisolone therapy were started. Conclusion: In patients presenting with dyspnea, retrosternal (substernal) goiter should also be considered.","PeriodicalId":14780,"journal":{"name":"Journal of Academic Emergency Medicine Case Reports","volume":"28 1","pages":"165-167"},"PeriodicalIF":0.0,"publicationDate":"2014-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89449354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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