27 research outputs found
An interesting journey of an ingested needle: a case report and review of the literature on extra-abdominal migration of ingested Foreign bodies
Swallowed foreign bodies encounter a major problem especially in children, but fortunately they mostly do not cause any related complication and are easily passed with the stool. In this paper, an interesting journey of a needle is presented. A 20-year old female admitted to our emergency service after she had swallowed a sewing machine needle, which is initially observed in the stomach in the plain abdominal radiography. During the follow-up period, the needle traveled through bowels, and surprisingly was observed in the left lung on 10th day of the follow-up. It was removed with a thoracotomy and pneumotomy under the fluoroscopic guidance. The postoperative period was uneventful and the patient was discharged from the hospital on the day 5. We also review the literature on interesting extra-abdominal migrations of swallowing foreign bodies
Off-pump coronary artery bypass grafting surgery in early stage myocardial infarction treatment
We evaluated the surgical results of off-pump coronary artery bypass grafting (OPCAB) performed within the first 12 h of infarction in patients with acute myocardial infarction. From January 2005 to January 2007, emergency coronary artery bypass grafting without cardiopulmonary bypass was performed in 56 patients with acute coronary syndromes. The mean age was 62.9 (range, 51-86) years. All patients underwent OPCAB via sternotomy
Influence of intracoronary shunt on myocardial damage: a prospective randomized study
Objective: We aimed to evaluate whether surgical intracoronary shunt protects myocardium in patients with moderate left ventricular dysfunction (MLVD). Methods: Thirty-nine patients consisted the shunt group and 43 patients consisted the shuntless group. Troponin I, CK, and CK-MB were measured preoperatively, and at 6 and 24 h postoperatively. Cardiac enzymes, rate of postoperative atrial fibrillation (AF) and third month ejection fraction (EF) were compared between the groups. Results: There were no significant differences between the groups for preoperative troponin I, CK, CK-MB, and postoperative CK levels (at 6 and 24 h). Postoperative troponin I and CK-MB levels were significantly lower in the shunt group (p < 0.001). Although preoperative EF of the patients were not significantly different between groups, the third month EF were significantly increased in both groups, and this increment was significantly higher in the shunt group than the shuntless group. One patient (2.3%) died in the shuntless group whereas there was no death in the shunt group. Conclusion: Intracoronary shunt has protective effects on myocardium in patients with moderate left ventricular dysfunction. (c) 2008 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved
Cardiac tamponade caused by an ingested sewing needle - A case report
Ingested sharp-pointed foreign bodies can cause serious complications. A case of a 16-year-old girl with cardiac tamponade due to ingestion of a sewing needle is presented. Ingested needles have often been reported as a cause of gastrointestinal injuries but in this rare case the sewing needle actually migrated into the myocardium
Repair of the Inferior Vena Cava With Autogenous Peritoneo-Fascial Patch Graft Following Abdominal Trauma: A Case Report
Abdominal vascular injuries are among the most challenging and lethal injuries in traumatized patients. Inferior vena cava is the most frequently injured vein during the blunt or penetrating trauma. The primary repair, end to end anastomosis, endovascular stenting, or graft interposition with autogenous or synthetic materials should be considered in selected cases. However, in cases the synthetic graft was preferred, intestinal contaminations due to small or large bowel perforation accompanying the trauma have been cited as a limiting factor for the use of such grafts as in the current case. However, a previous history of lower leg variceal surgery prevents the use of great saphenous vein as a graft. So in the present case, the authors report a patient with inferior vena cava injury repaired with autogenous peritoneo-fascial graft. The authors have used APF graft in traumatic inferior vena cava injury for the first time
The inpatient costs related to revascularization of lower extremity artery disease in terms of amputation and mortality rates
© The Author(s) 2023.Objective: With the initial utilization of endovascular treatment options in 1970s, the number of procedures performed for lower extremity artery disease (LEAD) both with open surgical (OS) and endovascular (EV) treatment increased, but this did not result in a decrease in the number of amputations. The burden of LEAD still constitutes a huge proportion among the health care costs over the world. Methods: The patients who admitted to our clinic between October 2014 and December 2019 with LEAD and required revascularization were enrolled. The total hospitalization costs related to LEAD were registered and divided into two groups as care costs and medical supplies costs. Results: 181 procedures were performed to 133 patients. Mean age was 63.98 ± 11.65 and 115 (86.5%) patients were male. Mean follow-up period was 31.19 ± 17.99 months (95% CI). The most frequent comorbidities were diabetes mellitus (DM) (n = 86, 66.2%) and active smoking (n = 59, 44.4%). Total costs and medical supplies costs were increased in EV group when compared with OS group (3339.28 ± 3459.53 p =.005 v.s. 904.42 ± 1209.97 p <.001, respectively). Care costs were increased in OS group when compared with EV group (1028.56 ± 1397.77 p <.001). The highest total, medical supplies, and care costs were determined in EV + OS group (6784.91 ± 8332.04; $6286.41 ± 7652.12, respectively).Graft/wound infection related and amputation related costs were 21% of all costs. Amputation-free survival was 71.42% (95% CI) with 21 total amputations. There were linear correlations between mortality and amputation (p =.002); also between mortality and cost (p =.001). Conclusions: In mid-long-term period, the care costs are increased with OS; however, EV treatment significantly increases the medical supplies and total costs. The increase in cost is correlated with poor outcome. Although the comorbidities and risk factors of these patients lead the clinicians to perform more challenging endovascular approaches, in mid-long-term period, particularly failed endovascular procedures are not promising in terms of outcomes and costs. We consider that the best-fit therapy on time is cost-effective, life and extremity-saving either, by avoiding deleterious effects of severe ischemia, such as severe pain, tissue loss, and related major adverse cardiaovascular events