Injuries to the anatomic structures of the porta hepatisare rare and have high morbidity and mortality rates.The case is here presented of a patient with isolatedleft hepatic artery transection after blunt trauma. A17-year old male was admitted to the EmergencyDepartment of Bitlis State Hospital after a trafficaccident. Pseudoaneurysm and extravasation wasdemonstrated in the left hepatic artery on computedtomography (CT) examinaation. The left hepaticartery could not be detected in the portal vein phaseon CT. Parenchymal hematoma and non-contrastedlaceration areas were observed in the left lobe. Thepatient underwent surgery, and the left hepatic arterywas seen to be transected on exploration. To providedhemostasis, the left hepatic artery was ligated. Isolatedleft hepatic artery transection is rarely seen after blunttrauma. Arterial ligation is the most commonly usedtreatment option in hemodynamically unstablepatients.
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Objective: Ultrasonography (US) is a useful, easy, and accurate screening method for the diagnosis of neonatal developmental dyspla- sia of the hip. The purpose of this prospective and cross-sectional study is to determine the optimal timing of US for the evaluation of the hip joints in newborns. Methods: We enrolled consecutive 27 [18 girls (66.7%) and nine boys (33.3%)] newborns in this study. Two experienced radiologists (S .T. and M.O ̈ .) performed standard hip US examinations at the 1st and 5th weeks of age according to the method described by Graf. We assessed the relationship between femur head and acetabulum and compared the results of evaluation obtained between the 1st and 5th weeks. Additionally, we evaluated the agreement between the two radiologists. Results: None of the babies were found to have subluxation or dislocation by clinical examination. The US measurements regarding the ossification and the diameter of femur head, bony, and cartilaginous roof at the 1st and 5th weeks were similar (for all infants, P > .05). In our series, no hip was defined as Graf’s type IIb or higher. In total, four (14.8%) right hips and six (22.2%) left hips (total 10 hips) were classified as Graf’s type IIa (physiologically immature) at the 1st week of evaluation. A total of seven hips spontaneously returned to their normal positions during the following 4 weeks. However, two (7.4%) right and one (3.7%) left hip joints were still classified as type IIa at the 5th week of evaluation. Graf type of hips was reported as similar in all the infants by the 1st and 5th week of measure- ments (n ¼ 54, P > .05, for each). There was no interobserver variability between the two radiologists with respect to Graf’s classifica- tion (j > 0.81). The blunt/round shape of acetabular rim defined in 10 hips at the 1st week was improved to an angular shape in the eight hips at the 5th week (P ¼ .008). Conclusion: Early US screening along with normal physical examination can diagnose some hip disorders in babies. Most of the abnor- mal findings detected at the 1st week of US screening recovered spontaneously at the 5th week. Infants with normal US measurements at the 1st week may be excluded from the follow-up, and those with suboptimal findings may be monitored by physical examination and repeated US scans.
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Left ventricular assist device outflow graft stenosis is a rare, but a lethal complication. Device replacement or thrombolytic treatments are associated with serious mortality and morbidity. Implantation of covered stents is a less invasive option. Herein, we represent a successful stent placement of two cases with outflow graft stenosis, which we performed by leaving the stents on the aortic side of the anastomosis line 5 to 10 mm. This treatment option can be used reliably in cases of stenosis of the outflow graft with part of the stent leaving the aorta.
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Giriş: Gastrik kanserler altıncı en sık görülen ve üçüncü en çok kansere bağlı ölüm nedenidir. 2018 yılında tüm kanserler içinde 1,033.701 (%5,7) vaka görülürken, tüm kanserler içinde 782,685 (%8,2) kansere bağlı ölüm görülmektedir. Çalışmamızda neoadjuvan kemoterapi alan lokal ileri mide adenokarsinomlu hastalarda primer tümör lokalizasyonunun prognostik önemini değerlendirmeyi amaçladık.Yöntemler: Toplam 90 hasta verisi değerlendirmeye uygun bulundu. Hastalar primer tümör lokalizasyonuna göre kardiya ve kardiya dışı olarak iki gruba ayrıldı. Gruplar hastalıksız sağkalım (HSK) ve genel sağkalım (GSK) açısından değerlendirildi.Bulgular: Medyan HSK, kardiya grubunda 34,9 ay iken kardiya dışı grubunda 11,3 ay olarak saptandı. Bu değer istatistiksel olarak anlamlıydı(34.9 vs 11.3 ay, p=0.008). Medyan GSK’da kardiya grubunda analiz esnasında henüz ulaşılamamışken, kardiya dışı grubunda ise 21.7 ay olarak saptandı. Bu değer de istatistiksel olarak anlamlı idi (NR vs 21.7 ay, p<0.001). Medyan HSK ve GSS kardiya grubunda kardiya dışı grubuna göre belirgin olarak uzundu.Tartışma: Çalışmamızda benzer bazal özelliklere sahip, benzer klinik evreleri olan ve aynı neoadjuvan kemoterapileri alan kardiya tümörlü hastalarda kardiya dışı tümörlü hastalara göre daha kötü sağkalım gözlendi.
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INTRODUCTION: Anastomosis leak after radical gastrectomy is a medical emergency and should be treated without delay. Most of the self-expanding metallic stents used for leaks in the literature are endoscopically placed and application with scopy have been mentioned only in a few studies. The aim of this study is to evaluate ourexperience in management of postoperative esophagojejunostomy (OJ) leaks after radical total gastrectomy, to evaluate the safety, efficacy, technical and clinical success of a scopically placed fully covered selfexpanding metallic stents (FCSEMS) and compare these parameters with endoscopically placed stents in the literature.METHODS: A total of 20 patients who underwent TG withgastric cancer and subsequently developed OJ leak for theremaining period between 2014 and 2017 were screenedretrospectively and added to the study. FCSEMSes wereplaced in the interventional radiology unit with scopy.RESULTS: Technical success was evaluated as 100%. Clinical success was measured as 80%. Stent migration was observed in 2 patients (10%). One patient died of sepsis. Mortality rate was evaluated as 5%. There were no procedural complications in the patients. The relationship between clinical success and mortality related factors could not be determined statistically (P > 0,05).DISCUSSION and CONCLUSION: FCSEMS is a safe and effective treatment method that can be safely used without complications.
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