[Nine years of trauma cases]. / Dokuz yillik travma olgularimiz.

Trauma is one of the major cause of death in the young population. The patients treated due to trauma were evaluated retrospectively during the last nine years. 212 cases with trauma were hospitalised in our clinic, between 1.7.1990-11.4.1999. 190 (89.6%) of them were operated and 22 (10.4%) of them were observed selectively. 36 (17%) of the cases were female and 176 (83%) of them were male. The mean age was 32.4 (16-81). 93 (43%) of them were hospitalized following traffic accidents; 56 (26.4%) of them stab wounds, 33 (15.6%) of them gunshots and 30 (14.1%) of them blunt trauma. The diagnosis was done through the diagnostic peritoneal lavage 95.1% of the traffic accident cases. The diagnosis was performed through diagnostic peritoneal lavage 76.9% of the after blunt trauma cases. After gunshots the diagnosis was done by 59.4% of the cases with physical examination. Local lesion exploration helped us to establish the diagnosis 51.4% of the stab wound cases. The most frequent organ injury following traffic accidents is splenic injury and injury of small intestine following penetrating trauma. The amount of our negative laparotomy was more than in literature and 47 (24.7%) cases were accepted as negative exploration. Negative laparotomy was seen mostly by stab wounds (49%). 17 (77.3%) of the 22 cases observed selectively were the cases of the last two years. In the recent two years the amount our negative laparotomy was six and our negative laparotomy ratio is 14%. Our mortality and the morbidity rates were at the acceptable level.

A rare cause of acute abdomen: splenic infarction.

Splenic infarction is a rare disorder. We have treated 4 patients during the last year. Abdominal pain in the left upper quadrant was the common complaint. Other complaints were fever, nausea and vomiting. Computed tomography showed infarcted areas in the spleen in all of the patients. Splenectomy was applied to three of the patients with recurring symptoms. The other patient had the first episode treated medically. Pulmonary embolism in one and surgical wound infection occurred in another patient during postoperative follow-up for nine (range: 4-14) months.

Retroperitoneal localization of hydatid cyst disease.

In this study we discuss a rare case; hydatid cyst disease that is located in the retroperitoneum. Two cases were treated in our department with hydatid cyst disease located in the retroperitoneum; one of the cysts was in the minor pelvis and the other was on the left psoas muscle. Diagnosis was confirmed with blood tests, and radiological examinations. The cyst wall was excised partially and was oversewn. Following the operation both of the patients were given albendasole tablets for 10 weeks with blood count and liver enzyme monitorization. Hydatic cysts located in retroperitoneum were treated successfully. Especially in the endemic areas hydatid cyst should be remembered when evaluating cystic masses in the retroperitoneum. It can be treated successfully with surgery.

The comparison of electron microscopy and scintigraphy in determining the protective effect of dimethylsulphoxide (DMSO) on ischemia/reperfusion injury through Pringle maneuver.

BACKGROUND/AIMS: We investigated the role of the electron microscopy and hepatobiliary scintigraphy in determining the effect of DMSO (dimethysulphoxide) and ischemia/reperfusion injury in the liver after the Pringle maneuver. METHODOLOGY: Twenty-four rabbits were divided into the following groups; A: Control group, B: Pringle, C: 10 mg/kg DMSO, D: 1 g/kg DMSO + Pringle. Group A was considered as a control group and only laparotomy was applied. Group B was exposed to Pringle maneuver only. Group C was given 10 mg/kg of DMSO via the vena cava inferior. Group D was given 1 g/kg of DMSO. A clamp was fastened for the groups of B, C and D in the 30th minute of the Pringle maneuver and a biopsy was applied five minutes later. Fifteen minutes later a dynamic hepatobiliary scintigraphy was applied. From dynamic images, liver peak time and activity half time of the liver were obtained. RESULTS: It was found that liver peak time and liver activity half time values of the group B, C and D were significantly longer than group A. Liver peak time and liver activity half time values of group B was not different from group C. However, some values of group D were found to be significantly shorter than groups B and C. In the electron microscopy examination, only in group B were some specific degenerative changes observed in the sinusoids. We observed less irreversible changes in group C than in group B. On the other hand, the least irreversible changes were in group D. CONCLUSIONS: As a conclusion, while electron microscopy is regarded as the "gold standard", hepatobiliary scintigraphy may be thought of as an easily applicable method in determining the ischemic reperfusion injury in the clinical comparison of the protective agents.

Laparoscopic versus open cholecystectomy: effect on pulmonary function tests.

BACKGROUND/AIMS: Operations often cause impairment in respiration due to pain. This study was designed to compare the changes in pulmonary function tests after open and laparoscopic cholecystectomy. METHODOLOGY: Two groups of 35 patients were randomly set up. Each patient had 3 pulmonary function tests performed and 2 postero-anterior grid chest roentgenograms taken. All of these data were evaluated by the same group of investigators. RESULTS: After taking into consideration the difference between pulmonary function tests, values were not significant (P < or = 0.05). All pulmonary function test values decreased significantly on the 1st postoperative day (P < or = 0.05). When postero-anterior chest roentgenograms were compared no clinically evident atelectasis except 3 lineary was seen in the laparoscopic cholecystectomy group, whereas 5 lineary, 7 focal, and 3 segmentary atelectasia were encountered in the open cholecystectomy group (P < or = 0.05). CONCLUSIONS: We believe that laparoscopic cholecystectomy has more advantages when speaking of postoperative pulmonary function tests and atelectasia.