Government Liability to Damages Due to Defective Provision of Health Services in Turkey

Health service is one of the basic public services offered by the administration with a very comprehensive and wide staff, and due to the comprehensive nature of the service provided and the fact that the beneficiaries of the service constitute almost every segment of the society, many different appearances of defect that may constitute the compensation responsibility of the administration may arise. The study is mainly about the service defect and the compensation responsibility of the administration in the provision of health services within the scope of the responsibility of the administration based on service defect. In the study, the concept of the responsibility of the administration and the concepts of defect liability and strict liability, which are the types of responsibility of the administration, will be discussed first, and then the conditions of the responsibility of the administration will be examined. Then, the concept of service defect, the different forms of appearance of service defect, such as poor service, late service, non-operational service, and severe service defect will be examined. Finally, the service defects specific to health services, which constitute the main framework of the study, will be examined in the light of the decisions of the Council of State on this issue

Femoral artery occlusion secondary to a spontaneously "migrated" hip prosthesis: case report

A 77-year-old male patient was admitted to the hospital with a worsening acute ischemia of the left lower extremity. The patient, who had a coxarthrosis and was being followed by the orthopedic clinic, had undergone a total hip prosthesis, with a revision performed at the sixth month of its placement. The physical examination revealed the absence of the femoral, popliteal and distal pulses of the left lower extremity. The left hip movements were painful and limited in external rotation posture. Doppler ultrasonography showed an acute occlusion of the left common femoral artery due to the dislocated hip prosthesis, and right-to-left femorofemoral expanded polytetrafluoroethylene graft bypass was carried out. After successful surgery and an uneventful postoperative period with palpable femoral and popliteal pulses, the patient was put on low molecular weight heparin and referred to orthopedics once the ischemia had subsided with the intervention. Case reports regarding occlusions due to migration of total hip prosthesis are rare in the literature. The emphasis of this case report is to describe one such case

Is Cholecystectomy Alone Enough To Prevent Acute Biliary Pancreatitis Attack?

Introduction The main objective of this study is to find out whether laparoscopic cholecystectomy alone is enough to prevent acute biliary pancreatitis attacks. Material and Method We performed a retrospective study with acute biliary pancreatitis patients who previously undergone cholecystectomy at the Istanbul Faculty of Medicine, Department of General Surgery, between January 2012 and December 2015. Acute biliary pancreatitis was diagnosed with elevated serum and urinary amylase levels with biliary pain. All the diagnoses were made with a combination of cholecystectomy history, physical examination, laboratory tests and imaging techniques [ultrasonography, magnetic resonance cholangiopancreaticography, computed tomography]. Ranson and Balthazar scores are assessed for each case. According to revised Atlanta grading system, the cases are classified as mild, moderate and severe pancreatitis. After a careful evaluation non-biliary pancreatitis patients are excluded from the study. Patients' demographic datas, comorbidities, history of cholecystectomy and pancreatitis, laboratory tests, invasive procedures, rates of morbidity and mortality and period of hospital stay were analyzed. Results The mean age was 51.5 (21-73) years. Thirty-one patients were enrolled in the study, 23 of them (74.1%) were female and eight (25.9%) were male. The average Ranson score was calculated as According to revised Atlanta scoring system; 28 cases were assessed as mild, one case was moderate and two cases were in the severe category. Necrosis was seen in both severe cases, and there was no necrosis in the moderate category. Balthazar score for the mild cases were counted as 0, moderate cases were 1, and the severe cases as 7. There was no correlation between C-reactive protein level and necrosis with clinical severity. In 19 (61%) of the cases, biliary stone was spotted in the common bile duct on the radiology. Then, endoscopic retrograde pancreaticography was applied for these 19 patients. Two of the cases had infected-necrotizing pancreatitis. Disease lasted fatal in these two cases due to sepsis and multiple organ failure. Percutaneous drainage was applied under USG by the radiologist for one patient whom had an image of collection in the gall bladder bed. Three patients were excluded from the study as non-biliary pancreatitis. The average length of hospital stay was measured as 4-5 days. Conclusion Early cholecystectomy after first pancreatitis attack together with endoscopic retrograde pancreaticography procedure (for the cases that have indication) decreases rates of complication and recurrence greatly. Laparoscopic cholecystectomy alone does not always prevent acute biliary pancreatitis attacks, in patients with prior endoscopic retrograde pancreaticography traumas and patients with high cholestasis enzymes during pancreatitis. Prospective randomized large studies are needed to reach certain etiologic reasons

Fournier's gangrene: Risk factors and strategies for management

Objective: The prognosis of Fournier's gangrene (FG) depends on early diagnosis and management. In this study, our objective was to identify the distinct features of FG that may influence the clinical outcome

An infrequent cause of upper gastrointestinal tract bleeding: "Dieulafoy's lesion"

Background/Aims: Dieulafoy's lesions are uncommon sources of upper gastrointestinal tract bleeding. Endoscopists must be aware of these lesions when evaluating patients with upper gastrointestinal tract bleeding

TIMING OF LAPAROSCOPIC CHOLECYSTECTOMY IN ELDERLY PATIENTS WITH MILD ACUTE BILIARY PANCREATITIS

Introduction: Age-related diseases have increased with the increase in average life expectancy. Biliary pancreatitis is one such disease, and its incidence increases with age. This study aimed to evaluate treatment outcomes for patients aged >65 years who were hospitalized for biliary pancreatitis and underwent cholecystectomy during initial hospitalization

Planned second-look laparoscopy in the management of acute mesenteric ischemia

AIM: To investigate the role of second-look laparoscopy in patients with acute mesenteric ischemia (AMI)

Falling television related child injuries in Turkey: 10-year experience

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