Traumatic rupture of a splenic cyst hydatid

INTRODUCTION: Hydatid cyst (HC) can be observed in all parts of the body, splenic involvement represents 5% of all cases. Many ruptured HC's cases of a primary organ have been reported in the literature. However, only several splenic HC rupture has reported. A patient with traumatic rupture of splenic hydatic cyst is presented. PRESENTATION OF CASE: 37 year old female sustained traffic accident presented our emergency department. In her physical examination there was hemodynamic instability, peritoneal irritation sign. An ultrasonographic examination of her abdomen showed intraperitoneal free fluid, a splenic rupture. The patient urgently operated; a 11 × 9 × 5 cm ruptured HC in the spleen was treated by splenectomy. During surgery the intraabdominal spaces were washed with povidoniodine and saline. Postoperative course of the patient was uneventful. The spleen was an organ involved with hydatidosis in our patient. Pathologic examination of the specimen revealed a splenic hydatid cyst. The patient is symptom free for 18 months. DISCUSSION: Several traumatic ruptured splenic HC case are encountered in the literature. The cases in the literature almost always are not case report but those are one or more than one case in a case series. This case, an extremely infrequent encountered is reporting. CONCLUSION: Early discovery is important since it is possible to cure viable HCs without dissemination to other organs by conservative surgery. If our patient was examined by ultrasound in a routine check up then her hydatid cyst of spleen would be discovered, the treatment of it would be made so no peritoneal dissemination with cystic fluid will be occur

Laboratory Risk Indicators for Necrotizing Fasciitis and Associations with Mortality

Objectives: Necrotizing fasciitis (NF) is rare but life threatening soft tissue infection characterized by a necrotizing process of the subcutaneous tissues and fascial planes. The Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score has been verified as a useful diagnostic tool for detecting necrotizing fasciitis. A certain LRINEC score might also be associated with mortality. The aims of this study are to determine risk factors affecting the prognosis and to evaluate the prognostic value of the LRINEC score in NF. Methods: Twenty-five patients with necrotizing fasciitis treated in Samsun Education and Research Hospital between January 2008 and April 2013 were enrolled in the study. Surviving and non-surviving patient groups were compared regarding demographic data, co-morbidity, predisposing factors, causative agents, number of debridements and LRINEC score. Results: Mean age was 55.6±16.79 years (min: 17-max: 84), and the female/male ratio was 16/9. Mortality was observed in 6 (24%) patients. The most frequent comorbid diseases were diabetes mellitus (52) and peripheral circulatory disorders (24%), and the most frequent etiologies were cutaneous (32%) and perianal abscess (20%). Pseudomonas aeruginosa infection was higher in the non-surviving group (p=0.006). The mean number of debridements and LRINEC score were higher in the non-surviving group than in the surviving group (p=0.003 and p=0.003, respectively). Conclusions: Pseudomans aeruginosa infection and multiple debridements are related with mortality. The LRINEC score might help predict mortality in NF

Synergistic effect of multiple predisposing risk factors on the development of bezoars

AIM: To describe the clinical characteristics of patients with gastric or intestinal bezoars recently treated in our hospital

Pre-opereative Parathormone Levels are Correlated with Mean Diameter of Parathyroid Adenoma and Pre-operative Serum Calcium and Alkaline Phosphatase Levels

The aim of the present study was to determine the relationship between biochemical parameters, mean diameter of parathyroid adenoma (MDPA) and parathyroid hormone (PTH) levels in patients who underwent parathyroid surgery.Materials and Methods: Data were collected retrospectively from patients with hyperparathyroidism who were operated and followed in our hospital between September 2011 and April 2014. Twenty-nine (male/female = 8/21) patients with a mean age of 58.31 ± 12.59 years were enrolled into the study. The mean pre-operative serum calcium and intact PTH (iPTH) levels were 11.98±1.23 mg/dl and 386.52±374.96 pg/ml, respectively. Serum pre-operative calcium levels were found to be significantly higher in patients who had nephrolithiasis than those who did not, whereas pre-operative serum phosphate levels were lower. Pre-operative iPTH levels were found to be correlated with pre-operative calcium, alkaline phosphatase and MDPA but not with pre-operative serum phosphate. Also, pre-operative calcium levels were found to be significantly correlated with MDPA.Conclusion: Presence of nephrolithiasis is associated with higher pre-operative calcium and lower phosphate levels. Pre-operative iPTH and calcium levels were also found to be significantly correlated with MDPA; this suggests that serum iPTH and calcium levels can be useful in predicting MDPA. [Med-Science 2015; 4(3.000): 2401-13