Management and Morbidity of Major Pelvic Hemorrhage in Complex Abdominopelvic Surgery.

Introduction: Hemorrhage is a challenging complication of pelvic surgery. This study aimed to analyze the causes, management, and factors associated with morbidity in patients experiencing major pelvic hemorrhage during complex abdominopelvic surgery.

Methods: Patients who had major intraoperative pelvic hemorrhage during complex abdominopelvic surgery at 11 tertiary referral centers between 1997 and 2017 were included.

Use of self-expanding covered stent and negative pressure wound therapy to manage late rectal perforation after injury from an improvised explosive device: a case report.

Blast injuries, caused by explosions accompanied by high-pressure waves, produce tissue damage in the acute period, followed in the later period by circulatory disorders due to vascular endothelial damage and related tissue necrosis. Blunt rectal perforation is rare and difficult to diagnose. In the acute period following blast pelvic injuries, the main objectives are to stop bleeding, minimise contamination and preserve the patient's life.

A simple novel technique for enteroatmospheric fistulae: silicone fistula plug.

Enteroatmospheric fistulae (EAFs), a rare condition that develops in patients treated with an open abdomen, present serious problems for the surgeon. There are no fixed algorithms for treatment of EAF, and treatment options are determined based on the experience of the surgeon and status of the patient. We developed a 'suspended silicone fistula plug' for treating a patient who developed an EAF after undergoing multiple operations in a short period of time.

Surgical treatment of caustic esophageal strictures in adults.

Background And Aims: Caustic esophageal injury is a rare clinical condition in adult patients. Although dilatation, or the conservative approach, is the primary treatment method, some patients require surgical intervention. Because of the rarity of such cases, standard surgical treatment algorithms cannot be utilized.

The use of single port surgery for polyps located in the rectum.

Transanal endoscopic microsurgery is a minimally invasive technique for the treatment of rectal lesions which was introduced by Buess. In this report the first clinical experience of transanal endoscopic surgery was performed by a single incision laparoscopic surgical port adapted through the anal canal. In single port surgery, the single incision laparoscopic surgical port has to be stitched around anal orifice.

Constipation as a defecation disorders: what do we expect from the physiologic tests?

Background: Constipation is often associated with some clinical signs as hard stool, incomplete defecation, chronic straining, and abdominal pain and long stays in bathroom. Some diagnostic uncertainties came from functional and structural variations of the anorectum and the assessment from few imaging procedures, which were thought as the best but could not always give the expected result. Then physiologic tests were required to be used.

The effects of amlodipine on the biochemical and histopathological changes in the rabbit ileum subjected to ischemia-reperfusion.

Objective: The aim of this study was to determine the potential, protective effects of amlodipine in an experimental, ischemia-reperfusion (I/R) model in the rabbit small intestine.

Materials And Methods: The rabbits were divided into four groups: sham-operated, amlodipine (10 mg/kg) + sham-operated, I/R, and I/R + amlodipine (10 mg/kg) groups. An intestinal I/R model was applied to the rabbits.

[The disguised face of blast injuries: shock waves].

Background: The increase in terrorist attacks has brought a profound and new knowledge of blast injuries. In order to improve our knowledge regarding the mechanisms of blast injuries, we analyzed the effects of shock waves.

Methods: 100 g TNT and 1000 g C4 were detonated and recorded by high-speed camera.

Comparison of permissive hypotensive resuscitation, low-volume fluid resuscitation, and aggressive fluid resuscitation therapy approaches in an experimental uncontrolled hemorrhagic shock model.

Background: In this study, we aimed to compare the efficacy of aggressive fluid resuscitation, low-volume fluid resuscitation and permissive hypotensive resuscitation in an experimental uncontrolled hemorrhagic shock model.

Methods: Forty-four male Guinea pigs were used in the study in an experimental uncontrolled shock model. Guinea pigs were split into six groups including normovolemic-normotensive fluid treatment group, normovolemic-permissive hypotensive fluid treatment group, low-volume normotensive fluid treatment group, low-volume permissive hypotensive fluid treatment group, no treatment (n=6), and sham-operated groups (n=6).

Synergistic effects of hyperbaric oxygen and granulocytecolony stimulating factor on postoperative adhesion formation in a rat cecal abrasion model.

Purpose: We investigated the synergistic effect of hyperbaric oxygen (HBO) and granulocyte-colony stimulating factor (G-CSF) on adhesion formation in rats.

Methods: 40 adult male Sprague-Dawley rats (250-350 g) were divided into 4 groups. In group-1, no further management was undertaken.

A new method for hepatic resection and hemostasis: absorbable plaque and suture.

Objective: Blunt and penetrating hepatic injuries are conditions that are frequently encountered in emergency surgeries, and they involve high mortality morbidity. In the handling of such injuries, methods ranging from the application of simple cauterization and suturing for hemostasis to hepatic lobectomies, which might involve the removal of the greater part of the organ, have been defined. Due to the organ's fragility and susceptibility to bleeding, elective hepatic resections necessitate both surgical experience and technological equipment.

Modified blank ammunition injuries.

Blank firing weapons are designed only for discharging blank ammunition cartridges. Because they are cost-effective, are easily accessible and can be modified to live firearms plus their unclear legal situation in Turkish Law makes them very popular in Turkey. 2004 through 2008, a total of 1115 modified blank weapons were seized in Turkey.

Can D-dimer become a new diagnostic parameter for acute appendicitis?

Introduction: In this study, we investigated D-dimer serum level as a diagnostic parameter for acute appendicitis.

Materials And Methods: Forty-nine patients were enrolled in the study. Patients were classified according to age; sex; duration between the beginning of pain and referral to a hospital or clinic; Alvarado scores; and in physical examination, presence of muscular defense, the number of leukocytes, preoperative ultrasonography, and D-dimer levels of histopathologic study groups were analyzed.

[Role of anatomic and physiologic trauma scoring systems in forensic cases].

Background: The Turkish Penalty Law has recently been changed. The novel law asks the practitioner to report if there is any 'Situation Placing a Life in Danger '. Herein, we evaluate the anatomic (ISS, TRISS) and physiologic (RTS) trauma scores assessing mortality.

Is the zeolite hemostatic agent beneficial in reducing blood loss during arterial injury?

Background: Uncontrolled hemorrhage is the leading cause of fatality. The aim of this study was to evaluate the effect of zeolite mineral (QuikClot - Advanced Clotting Sponge [QC-ACS]) on blood loss and physiological variables in a swine extremity arterial injury model.

Methods: Sixteen swine were used.

A novel laparoscopic suction device for applying precise aspiration during laparoscopic surgery: sponge-tip suction tube.

Aspiration of the intra-abdominal fluid and debris is usually needed during different stages of the operation. This is necessary to protect the intra-abdominal space from contamination and/or to remove blood or tissue fluids occurring during the operation. It is also essential for obtaining a clean surgical area.

Prognostic importance of increased cyclooxygenase-2 levels in colorectal carcinomas: a 5-year single-institution study.

Objective: COX-2-selective inhibitors are used in the prevention and management of colorectal carcinogenesis. Our objective was to investigate if COX-2 levels have prognostic value in patients diagnosed with colorectal carcinoma.

Materials And Methods: This is a retrospective study of 112 patients diagnosed with colorectal carcinoma between 2000-2004 from the General Surgery Department at Haydarpasa Training Hospital, Gulhane Military Medical Academy.

The magazine: a major cause of bullet fragmentation.

The fragmentation impact of high-velocity bullets penetrating the body after piercing through the magazines carried by soldiers was investigated experimentally. In this study, 16 pigs and 7.62x51-mm full metal jacket bullets were used.

Increased damage from rifle wounds of the chest caused by bullets striking commonly carried military equipment.

Background: The purpose of this study was to investigate the fragmentation effect of the bullet that passes through the radio or ammunition magazine, which are essential pieces of equipment for a soldier, in thoracic gunshot injuries.

Methods: Twelve adult pigs were used. The pigs were separated into three groups (each group contained four pigs).

[Comparison of soft tissue and bone injuries caused by handgun or rifle bullets: an experimental study].

Objectives: The aim of this study was to investigate the factors that influence the severity of soft tissue and bone injuries occurring in gunshot traumas and to compare the effects of handgun and rifle bullets on these injuries.

Methods: Sixteen tissue simulants which were made of transparent gel candle blocks and calibrated to muscle tissue were targetted by pistol (9 mm parabellum) or military rifle (G-3) bullets. Half of the blocks contained fresh calf humerus bone.

A new ballistic simulant "transparent gel candle" (experimental study).

Background: Inanimate tissue stimulants have been used to show the bullet effects in ballistic studies. Gelatin has been being used as a ballistic stimulant for the last 20 years. It was considered that transparent gel candle (kraton in white paraffin oil) might be used as a soft tissue stimulant that can be an alternative for gelatin.