O. Akpınar, Ayça Açikalin, Nezihat Rana Dişel, Ç. Çağlıyan
Clinical statements and guidelines dynamically regenerate with rapidly growing new evidence and regulate our daily clinical practice. On the other hand, our obedience on traditional experiences might lead us to manage patients inappropriately. Recently published guidelines on ST elevation myocardial infarction (STEMI) by the European Society of Cardiology (ESC) and American College of Cardiology (ACC) have altered and changed many previously accurate managements. The aim of this review is to evaluate the recommendations of the new STEMI guidelines and the inappropriate management practices we perform in our daily practice. (JAEM 2014; 13: 199-203)
{"title":"What Do Guidelines Say We Should Do in Patients with ST Elevation Myocardial Infarction","authors":"O. Akpınar, Ayça Açikalin, Nezihat Rana Dişel, Ç. Çağlıyan","doi":"10.5152/JAEM.2014.46548","DOIUrl":"https://doi.org/10.5152/JAEM.2014.46548","url":null,"abstract":"Clinical statements and guidelines dynamically regenerate with rapidly growing new evidence and regulate our daily clinical practice. On the other hand, our obedience on traditional experiences might lead us to manage patients inappropriately. Recently published guidelines on ST elevation myocardial infarction (STEMI) by the European Society of Cardiology (ESC) and American College of Cardiology (ACC) have altered and changed many previously accurate managements. The aim of this review is to evaluate the recommendations of the new STEMI guidelines and the inappropriate management practices we perform in our daily practice. (JAEM 2014; 13: 199-203)","PeriodicalId":14780,"journal":{"name":"Journal of Academic Emergency Medicine Case Reports","volume":"29 1","pages":"199-203"},"PeriodicalIF":0.0,"publicationDate":"2014-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81506707","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, Merve Guven, M. Ergin, B. Cander, Sadık Girişgin
Giris: Tromboz riski hiperkoagulabilite durumlarinda artar. Hiperkoagulabilite, kalitsal veya kazanilmis olabilir. Burada; acil servise yuruyerek giren, kalitsal hiperkoagulabilitesi olan ve acil serviste total abdominal aort okluzyonu ile akut renal arter trombozu tanisi konan bir olgu sunacagiz. Olgu Sunumu: 48 yasinda bayan hasta, 30 dakika once baslayan sag yan agrisi sikayetiyle acil servise basvurdu. Agri aniden baslamisti ve surekli karakterdeydi. Hasta acil servise acil servise yuruyerek girdi. Kontrastli batin bilgisayarli tomografisinde; sag renal enfarkt, sag renal arter trombusu ve iliak arter bifurkasyonu seviyesinde abdominal aortta trombus tespit edildi. Sonuc: Abdominal aort okluzyonu, hiperkoagulabilitenin nadir gorulen komplikasyonlarindan biridir. Abdominal aortanin total okluzyonu, genellikle alt ekstremitelerde iskeminin kardinal bulgulari ile kendini gosterir. Bizim vakamizda, gelismis kollateral akim sayesinde alt ekstremitelerde kan akiminin azalmasina bagli bulgu tespit edilmemistir. Acil servise yuruyerek giren bir hastanin, total aort okluzyonu tanisi almasi acil servis hekimleri acisindan ilginc bir durumdur.
{"title":"A Diagnosis of Total Abdominal Aortic Occlusion in a Patient Who Entered the Emergency Department by Walking","authors":"Z. Dundar, Merve Guven, M. Ergin, B. Cander, Sadık Girişgin","doi":"10.5152/jaemcr.2014.569","DOIUrl":"https://doi.org/10.5152/jaemcr.2014.569","url":null,"abstract":"Giris: Tromboz riski hiperkoagulabilite durumlarinda artar. Hiperkoagulabilite, kalitsal veya kazanilmis olabilir. Burada; acil servise yuruyerek giren, kalitsal hiperkoagulabilitesi olan ve acil serviste total abdominal aort okluzyonu ile akut renal arter trombozu tanisi konan bir olgu sunacagiz. Olgu Sunumu: 48 yasinda bayan hasta, 30 dakika once baslayan sag yan agrisi sikayetiyle acil servise basvurdu. Agri aniden baslamisti ve surekli karakterdeydi. Hasta acil servise acil servise yuruyerek girdi. Kontrastli batin bilgisayarli tomografisinde; sag renal enfarkt, sag renal arter trombusu ve iliak arter bifurkasyonu seviyesinde abdominal aortta trombus tespit edildi. Sonuc: Abdominal aort okluzyonu, hiperkoagulabilitenin nadir gorulen komplikasyonlarindan biridir. Abdominal aortanin total okluzyonu, genellikle alt ekstremitelerde iskeminin kardinal bulgulari ile kendini gosterir. Bizim vakamizda, gelismis kollateral akim sayesinde alt ekstremitelerde kan akiminin azalmasina bagli bulgu tespit edilmemistir. Acil servise yuruyerek giren bir hastanin, total aort okluzyonu tanisi almasi acil servis hekimleri acisindan ilginc bir durumdur.","PeriodicalId":14780,"journal":{"name":"Journal of Academic Emergency Medicine Case Reports","volume":"123 1","pages":"235-255"},"PeriodicalIF":0.0,"publicationDate":"2014-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80195876","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 : 2014-11-01DOI: 10.5152/jaemcr.2014.25348
I. Beydilli, N. Kozaci, F. Gungor, Asım Arı
Giris: Trombofili hemostatik mekanizmalardaki bozukluk olup trombozise egilim olarak tanimlanir. Herediter ve akkiz nedenli olabilir. Tum tromboz olaylarinin yaklasik %40'inda herediter trombofililer sorumlu tutulmaktadir. Olgu Sunumu: Tromboembolik olgularda en sik gorulen herediter bozukluk faktor V Leiden mutasyonudur. Sik gorulen diger kalitsal risk faktorleri ise protrombin G20210A mutasyonu, protein C eksikligi, protein S eksikligi, antitrombin III eksikligi, hiperhomosistinemidir. Kalitsal trombofilisi olan hastalar venoz tromboza yatkindir oysaki edinsel bozuklugu olan hastalarda arteryal ve venoz pihtinin her ikisi de gorulur. Sonuc: Biz bu makalede hem arterial sistemde hem de venoz sistemde es zamanli emboli tespit edilen ve edinsel protein C ve S eksikligi saptanan bir olguyu tartistik.
{"title":"Thrombosis in Arterial and Venous System Simultaneously; What is the Reason?","authors":"I. Beydilli, N. Kozaci, F. Gungor, Asım Arı","doi":"10.5152/jaemcr.2014.25348","DOIUrl":"https://doi.org/10.5152/jaemcr.2014.25348","url":null,"abstract":"Giris: Trombofili hemostatik mekanizmalardaki bozukluk olup trombozise egilim olarak tanimlanir. Herediter ve akkiz nedenli olabilir. Tum tromboz olaylarinin yaklasik %40'inda herediter trombofililer sorumlu tutulmaktadir. Olgu Sunumu: Tromboembolik olgularda en sik gorulen herediter bozukluk faktor V Leiden mutasyonudur. Sik gorulen diger kalitsal risk faktorleri ise protrombin G20210A mutasyonu, protein C eksikligi, protein S eksikligi, antitrombin III eksikligi, hiperhomosistinemidir. Kalitsal trombofilisi olan hastalar venoz tromboza yatkindir oysaki edinsel bozuklugu olan hastalarda arteryal ve venoz pihtinin her ikisi de gorulur. Sonuc: Biz bu makalede hem arterial sistemde hem de venoz sistemde es zamanli emboli tespit edilen ve edinsel protein C ve S eksikligi saptanan bir olguyu tartistik.","PeriodicalId":14780,"journal":{"name":"Journal of Academic Emergency Medicine Case Reports","volume":"1 1","pages":"256-259"},"PeriodicalIF":0.0,"publicationDate":"2014-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83040720","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}
S. Yaylaci, T. Ozturk, M. Serinken, C. Eken, O. Karcioglu
Takotsubo syndrome (TS) has been described as an acute cardiac condition precipitated by a stressful mental or physical condition. A majority of patients are presented with acute substernal chest pain. It is often difficult to differentiate TS from acute ST-elevation myocardial infarction (STEMI) on initial presentation. The electrocardiograph classically mimics STEMI and is generally accompanied by elevation of myocardial enzymes that warrants immediate cardiac catheterization. The present article reports a patient with TS referred to the emergency department because of symptoms suggestive of acute coronary syndrome. (JAEM 2015; 14: 41-3)
{"title":"Takotsubo Syndrome and Acute Coronary Syndrome: Case Report and Literature Review","authors":"S. Yaylaci, T. Ozturk, M. Serinken, C. Eken, O. Karcioglu","doi":"10.5152/JAEM.2015.93446","DOIUrl":"https://doi.org/10.5152/JAEM.2015.93446","url":null,"abstract":"Takotsubo syndrome (TS) has been described as an acute cardiac condition precipitated by a stressful mental or physical condition. A majority of patients are presented with acute substernal chest pain. It is often difficult to differentiate TS from acute ST-elevation myocardial infarction (STEMI) on initial presentation. The electrocardiograph classically mimics STEMI and is generally accompanied by elevation of myocardial enzymes that warrants immediate cardiac catheterization. The present article reports a patient with TS referred to the emergency department because of symptoms suggestive of acute coronary syndrome. (JAEM 2015; 14: 41-3)","PeriodicalId":14780,"journal":{"name":"Journal of Academic Emergency Medicine Case Reports","volume":"101 1","pages":"41-43"},"PeriodicalIF":0.0,"publicationDate":"2014-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80788325","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}
Aim: The aim of this retrospective study was to investigate the prognostic value of red cell distribution width (RDW) and other hematological parameters measured on admission to the emergency department in patients with organophosphate poisoning. Materials and Methods: All patients aged ≥15 years who were admitted to the emergency department from 2008 to 2013 on account of organophosphate poisoning were included in the study. The written and electronic medical charts of the patients were reviewed. Hematological parameters were recorded. Mechanical ventilation requirement was used as the primary endpoint. Results: A total of 72 patients were included in the study for evaluation. Mechanically ventilated patients had significantly higher leukocyte counts and RDW levels than non-ventilated patients (p=0.004 and p<0.001, respectively). The area under the receiver-operating characteristic curve of RDW levels for predicting mechanical ventilation requirement was 0.716 (95% CI: 0.581-0.852, p=0.010). RDW had a sensitivity of 73%, specificity of 70%, and negative predictive value of 91% with a cut-off value of 14.5% in predicting mechanical ventilation requirement in patients with organophosphate poisoning. Conclusion: RDW can be a valuable and easy-to-use parameter in estimating prognosis in the follow-up of patients with organophosphate poisoning. (JAEM 2015; 14: 65-9)
{"title":"Prognostic Value of Red Cell Distribution Width in Patients with Organophosphate Poisoning","authors":"Z. Dundar, M. Ergin, N. Erbakan","doi":"10.5152/JAEM.2014.90692","DOIUrl":"https://doi.org/10.5152/JAEM.2014.90692","url":null,"abstract":"Aim: The aim of this retrospective study was to investigate the prognostic value of red cell distribution width (RDW) and other hematological parameters measured on admission to the emergency department in patients with organophosphate poisoning. Materials and Methods: All patients aged ≥15 years who were admitted to the emergency department from 2008 to 2013 on account of organophosphate poisoning were included in the study. The written and electronic medical charts of the patients were reviewed. Hematological parameters were recorded. Mechanical ventilation requirement was used as the primary endpoint. Results: A total of 72 patients were included in the study for evaluation. Mechanically ventilated patients had significantly higher leukocyte counts and RDW levels than non-ventilated patients (p=0.004 and p<0.001, respectively). The area under the receiver-operating characteristic curve of RDW levels for predicting mechanical ventilation requirement was 0.716 (95% CI: 0.581-0.852, p=0.010). RDW had a sensitivity of 73%, specificity of 70%, and negative predictive value of 91% with a cut-off value of 14.5% in predicting mechanical ventilation requirement in patients with organophosphate poisoning. Conclusion: RDW can be a valuable and easy-to-use parameter in estimating prognosis in the follow-up of patients with organophosphate poisoning. (JAEM 2015; 14: 65-9)","PeriodicalId":14780,"journal":{"name":"Journal of Academic Emergency Medicine Case Reports","volume":"5 1","pages":"65-69"},"PeriodicalIF":0.0,"publicationDate":"2014-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89278182","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}
S. Sezgin, G. Aksel, Hande Akbal, O. Guneysel, Ş. E. Çevik
Giris: Spontan subklavyen arter yaralanmalari nadir rastlanir. Hapsirma sonrasi spontan subklavyen arter transeksiyonunu gelisen bir olguyu sunmayi amacladik. Olgu Sunumu: 18 yasinda erkek hasta acil servise hapsirma sonrasi sag omuz agrisi sikayeti ile basvurdu. Hastanin vital bulgulari ve fizik muayenesi normaldi. Akciger grafisinde mediasten genisligi 7 cm idi. Hasta taburcu edildi. Hasta taburculugundan bes saat sonra acil servise nefes darligi ve gogus agrisi sikayeti ile basvurdu. Hipotansif ve tasikardik olan hastanin sag brakial ve radial nabizlar palpe edilemedi. Masif hemotoraks tespit edildi. Tup torakostomi yapildi, hemodimisinin hizla bozulmasi uzerine acil torakotomi yapilan hastada kanama kontrolu esnasinda kardiyak arrest gelisti. Postmortem yapilan eksplorasyonda sag subklavyen arterin arcus aorta birlesme noktasindan sirkuler olarak tam kat yirtilmaya bagli olarak tamamen ayrildigi (komplet transeksiyon) goruldu. Sonuc: Hapsirma, spontan arter diseksiyonunu tetikleyen minor travmalar arasinda yer almaktadir. 6 cm ve uzerindeki mediasten genisligi uc kat artmis mortalite ile iliskili bulunmustur. Acil servise ozellikle ani hareket sonrasi baslayan gogus, sirt, omuz ve kol agrisi gibi yakinmalarla basvuran ve akciger grafisinde ≥6 cm mediastinal genislik tespit edilen hastalarda ileri goruntuleme yapilmasinin bu olgudaki gibi nadir ancak mortalitesi yuksek hastaliklarin taninmasinda faydali olabilecegini dusunmekteyiz.
{"title":"Spontaneous Subclavian Artery Transection after Sneezing","authors":"S. Sezgin, G. Aksel, Hande Akbal, O. Guneysel, Ş. E. Çevik","doi":"10.5152/jaemcr.2014.646","DOIUrl":"https://doi.org/10.5152/jaemcr.2014.646","url":null,"abstract":"Giris: Spontan subklavyen arter yaralanmalari nadir rastlanir. Hapsirma sonrasi spontan subklavyen arter transeksiyonunu gelisen bir olguyu sunmayi amacladik. Olgu Sunumu: 18 yasinda erkek hasta acil servise hapsirma sonrasi sag omuz agrisi sikayeti ile basvurdu. Hastanin vital bulgulari ve fizik muayenesi normaldi. Akciger grafisinde mediasten genisligi 7 cm idi. Hasta taburcu edildi. Hasta taburculugundan bes saat sonra acil servise nefes darligi ve gogus agrisi sikayeti ile basvurdu. Hipotansif ve tasikardik olan hastanin sag brakial ve radial nabizlar palpe edilemedi. Masif hemotoraks tespit edildi. Tup torakostomi yapildi, hemodimisinin hizla bozulmasi uzerine acil torakotomi yapilan hastada kanama kontrolu esnasinda kardiyak arrest gelisti. Postmortem yapilan eksplorasyonda sag subklavyen arterin arcus aorta birlesme noktasindan sirkuler olarak tam kat yirtilmaya bagli olarak tamamen ayrildigi (komplet transeksiyon) goruldu. Sonuc: Hapsirma, spontan arter diseksiyonunu tetikleyen minor travmalar arasinda yer almaktadir. 6 cm ve uzerindeki mediasten genisligi uc kat artmis mortalite ile iliskili bulunmustur. Acil servise ozellikle ani hareket sonrasi baslayan gogus, sirt, omuz ve kol agrisi gibi yakinmalarla basvuran ve akciger grafisinde ≥6 cm mediastinal genislik tespit edilen hastalarda ileri goruntuleme yapilmasinin bu olgudaki gibi nadir ancak mortalitesi yuksek hastaliklarin taninmasinda faydali olabilecegini dusunmekteyiz.","PeriodicalId":14780,"journal":{"name":"Journal of Academic Emergency Medicine Case Reports","volume":"236 1","pages":"29-32"},"PeriodicalIF":0.0,"publicationDate":"2014-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73704089","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: Perkutan karaciger biyopsisine bagli iyatrojenik pnomotoraks cok nadir bir komplikasyondur. Olgu Sunumu: Biz bu vakada kronik hepatit B’li bir hastada yapilan karaciger igne biyopsisi sonucunda gorulen iyatrojenik pnomotoraksli bir olguyu sunduk. Sonuc: Karaciger biyopsileri gunluk pratikte rutin uygulanan kolay islemler olmasina ragmen nadiren de olsa hayati tehdit eden komplikasyonlara neden olabilmektedirler. Islemin bir goruntuleme yontemi kilavuzlugunda yapilmasi mortalite ve morbiditeyi azaltacaktir
{"title":"latrogenic Pneumothorax after Liver Biopsy","authors":"Müge Gülen, M. Ay, D. Kaplan, H. Dizen, F. Icme","doi":"10.5152/jaemcr.2014.577","DOIUrl":"https://doi.org/10.5152/jaemcr.2014.577","url":null,"abstract":"Giris: Perkutan karaciger biyopsisine bagli iyatrojenik pnomotoraks cok nadir bir komplikasyondur. Olgu Sunumu: Biz bu vakada kronik hepatit B’li bir hastada yapilan karaciger igne biyopsisi sonucunda gorulen iyatrojenik pnomotoraksli bir olguyu sunduk. Sonuc: Karaciger biyopsileri gunluk pratikte rutin uygulanan kolay islemler olmasina ragmen nadiren de olsa hayati tehdit eden komplikasyonlara neden olabilmektedirler. Islemin bir goruntuleme yontemi kilavuzlugunda yapilmasi mortalite ve morbiditeyi azaltacaktir","PeriodicalId":14780,"journal":{"name":"Journal of Academic Emergency Medicine Case Reports","volume":"118 1","pages":"247-249"},"PeriodicalIF":0.0,"publicationDate":"2014-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87636754","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}
N. Akilli, R. Koylu, Bekir Opuş, M. Kızmaz, Y. Gunaydin, B. Cander
Introduction: Electrical injuries are important environmental emergencies, ranging from simple skin burns to death. In this case, thalamic infarction, as a rare effect of electrical injury, will be discussed. Case Report: A 38-year-old male patient being multiplied 380 volt industrial electricity was admitted to the emergency department with complaints of numbness and loss of strength on the right side 1 day after the event. In the first examination, the vital signs were stable and the patient was conscious. The lung, heart, and abdominal examination was normal. Whole blood count and blood chemistry were normal. The ECG was normal sinus rhythm. An acute infarct in the left thalamic level was detected in the captured brain CT and diffusion MR. All tests conducted for the etiology were considered normal. The patient was followed and treated for 15 days in the neurology department and then discharged from there. Conclusion: Electrical injuries are common and major environmental emergencies that can be fatal. They can cause a lot of early and late neurologic syndromes. Cerebral infarction within this syndrome is a very rare statement. Although paresthesia due to electrical injuries is transient, imaging methods, such as CT and MR, should be used.
{"title":"Thalamic Infarct due to Electrical Injury","authors":"N. Akilli, R. Koylu, Bekir Opuş, M. Kızmaz, Y. Gunaydin, B. Cander","doi":"10.5152/jaemcr.2014.576","DOIUrl":"https://doi.org/10.5152/jaemcr.2014.576","url":null,"abstract":"Introduction: Electrical injuries are important environmental emergencies, ranging from simple skin burns to death. In this case, thalamic infarction, as a rare effect of electrical injury, will be discussed. Case Report: A 38-year-old male patient being multiplied 380 volt industrial electricity was admitted to the emergency department with complaints of numbness and loss of strength on the right side 1 day after the event. In the first examination, the vital signs were stable and the patient was conscious. The lung, heart, and abdominal examination was normal. Whole blood count and blood chemistry were normal. The ECG was normal sinus rhythm. An acute infarct in the left thalamic level was detected in the captured brain CT and diffusion MR. All tests conducted for the etiology were considered normal. The patient was followed and treated for 15 days in the neurology department and then discharged from there. Conclusion: Electrical injuries are common and major environmental emergencies that can be fatal. They can cause a lot of early and late neurologic syndromes. Cerebral infarction within this syndrome is a very rare statement. Although paresthesia due to electrical injuries is transient, imaging methods, such as CT and MR, should be used.","PeriodicalId":14780,"journal":{"name":"Journal of Academic Emergency Medicine Case Reports","volume":"8 1","pages":"244-246"},"PeriodicalIF":0.0,"publicationDate":"2014-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84785428","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: Gebeligin cok nadir bir komplikasyonu olan spontan uterus rupturu hem fetus hem de anne icin oldukca katastrofiktir. Bu durum, uterus anomalileri, uterin skar dokusu varligi, makrozomik fetus, sefalopelvik uyusmazlik ve dogum esnasinda induksiyon ajanlari kullanilmasi gibi risk faktorleri ile iliskilidir. Bu yazida oldukca nadir gorulen, ilk gebelikte gelisen, travma oykusu olmayan skarsiz bir uterus rupturu vakasini tartismayi amacladik. Olgu Sunumu: 22 yasinda ve 22 haftalik ilk gebeligi olan hasta acil servise bayilma ve hafif dispne sikayetleri ile basvurdu. Hastanin travma oykusu yoktu. Fizik muayenesinde Glasgow koma skoru 15, arteriyel tansiyonu 60/30mmHg ve nabiz sayisi 110/dakika idi. Yapilan ilk abdominal ultrason sonucu normal olarak degerlendirildi. Kadin hastaliklari ve dogum uzmanina toplamda 2 defa konsulte edilen hastada fetal kalp atimlarinin normal oldugu ve obstetrik bir patoloji dusunulmedigi bilgisi alindi. 1000ml normal salin infuzyonuna ragmen hipotansiyonu devam eden hastanin yapilan kontrol ultrasonunda batin icerisinde serbest sivi tespit edildi. Bunun uzerine genel cerrahi tarafindan tanisal amacli acil laparotomy uygulanan hastada batin icerisinde onemli miktarda kanama oldugu ve fetusun peritoneal kavitede oldugu goruldu. Hasta operasyon sonrasinda iyilesip, post operatif 5. gunde taburcu edilirken fetus kaybedildi. Sonuc: Her ne kadar primigravidlerde cok nadir gorulse de, acil servis doktorlari hemodinamik olarak unstabil olan gebe hastalarda spontan uterus rupturunu akla getirmelidirler.
{"title":"A Rare Case: Spontaneous Uterine Rupture in First Pregnancy","authors":"G. Aksel, Asli Deniz, O. Guneysel","doi":"10.5152/JAEMCR.2014.502","DOIUrl":"https://doi.org/10.5152/JAEMCR.2014.502","url":null,"abstract":"Giris: Gebeligin cok nadir bir komplikasyonu olan spontan uterus rupturu hem fetus hem de anne icin oldukca katastrofiktir. Bu durum, uterus anomalileri, uterin skar dokusu varligi, makrozomik fetus, sefalopelvik uyusmazlik ve dogum esnasinda induksiyon ajanlari kullanilmasi gibi risk faktorleri ile iliskilidir. Bu yazida oldukca nadir gorulen, ilk gebelikte gelisen, travma oykusu olmayan skarsiz bir uterus rupturu vakasini tartismayi amacladik. Olgu Sunumu: 22 yasinda ve 22 haftalik ilk gebeligi olan hasta acil servise bayilma ve hafif dispne sikayetleri ile basvurdu. Hastanin travma oykusu yoktu. Fizik muayenesinde Glasgow koma skoru 15, arteriyel tansiyonu 60/30mmHg ve nabiz sayisi 110/dakika idi. Yapilan ilk abdominal ultrason sonucu normal olarak degerlendirildi. Kadin hastaliklari ve dogum uzmanina toplamda 2 defa konsulte edilen hastada fetal kalp atimlarinin normal oldugu ve obstetrik bir patoloji dusunulmedigi bilgisi alindi. 1000ml normal salin infuzyonuna ragmen hipotansiyonu devam eden hastanin yapilan kontrol ultrasonunda batin icerisinde serbest sivi tespit edildi. Bunun uzerine genel cerrahi tarafindan tanisal amacli acil laparotomy uygulanan hastada batin icerisinde onemli miktarda kanama oldugu ve fetusun peritoneal kavitede oldugu goruldu. Hasta operasyon sonrasinda iyilesip, post operatif 5. gunde taburcu edilirken fetus kaybedildi. Sonuc: Her ne kadar primigravidlerde cok nadir gorulse de, acil servis doktorlari hemodinamik olarak unstabil olan gebe hastalarda spontan uterus rupturunu akla getirmelidirler.","PeriodicalId":14780,"journal":{"name":"Journal of Academic Emergency Medicine Case Reports","volume":"17 1","pages":"238-240"},"PeriodicalIF":0.0,"publicationDate":"2014-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78759834","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}
Amirhosein Jahanshir, H. Vahedi, J. Hosseini, M. Bahreini
Giris: Şupheli pnomotoraksin ultrasonografi ile degerlendirilmesi acil servis bolumlerinde yapilan rutin bir islemdir. Ultrasonografi pnomotoraksin tespit edilmesinde oldukca duyarlidir, ancak bazi yanlis-pozitif sonuclar vermektedir. Olgu sunumu: Bu olgu sunumunda, rutin yatak basi torasik ultrasonografide pnomotoraks olarak yanlis degerlendirilen akalazyasi olan 60 yasindaki bir erkek hastayi sunmaktayiz. Sonuc: Akalazya, pnomotoraksin yatak basi ultrasonografi ile elde edilen yanlis-pozitif sonuclarinin nadir bir nedenidir.
{"title":"Misinterpretation of Achalasia as a Pneumothorax in Transthoracic Ultrasonography","authors":"Amirhosein Jahanshir, H. Vahedi, J. Hosseini, M. Bahreini","doi":"10.5152/JAEMCR.2014.562","DOIUrl":"https://doi.org/10.5152/JAEMCR.2014.562","url":null,"abstract":"Giris: Şupheli pnomotoraksin ultrasonografi ile degerlendirilmesi acil servis bolumlerinde yapilan rutin bir islemdir. Ultrasonografi pnomotoraksin tespit edilmesinde oldukca duyarlidir, ancak bazi yanlis-pozitif sonuclar vermektedir. Olgu sunumu: Bu olgu sunumunda, rutin yatak basi torasik ultrasonografide pnomotoraks olarak yanlis degerlendirilen akalazyasi olan 60 yasindaki bir erkek hastayi sunmaktayiz. Sonuc: Akalazya, pnomotoraksin yatak basi ultrasonografi ile elde edilen yanlis-pozitif sonuclarinin nadir bir nedenidir.","PeriodicalId":14780,"journal":{"name":"Journal of Academic Emergency Medicine Case Reports","volume":"14 1","pages":"241-243"},"PeriodicalIF":0.0,"publicationDate":"2014-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74867183","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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