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- MakaleYalnız künye2013A rare cause of acute respiratory failure: spontaneous pneumomediastinum due to cocaine use
Memetoglu, Mehmet Erdem; Kalkan, Asim; Tutar, Nuri; Kurtcan, Serpil; Gündüz, Abdulkadir
Spontaneous pneumomediastinum is defined as free air in mediastinum without any underlying pulmonary pathology. Although spontaneous pneumomediastinum is a rarely seen clinical entity, it is one of the most common reasons of sudden pleuritic chest pain in healthy young individuals. Cocaine inhalation is also associated with the development of spontaneous pneumomediastinum. Our case having spontaneous pneumomediastinum was referred to our emergency service with the complaint of acute respiratory failure due to cocaine abuse, and the etiology, clinical presentation and the treatment of the disease were evaluated in our study.
- MakaleAçık Erişim2012Traumatic diaphragmatic ruptures: diagnostic and therapeutic approaches
Çobanoglu, Ufuk; Kara, Volkan; Yalçinkaya, Irfan; Er, Metin; Isik, Ahmet Feridun; Sayir, Fuat; Mergan, Duygu
Background: This study aims to evaluate the characteristics of patients with traumatic rupture of diaphragm (TDR), the diagnostic and therapeutic approaches used in these cases and and the outcomes of the patients. Methods: Forty-one patients (31 males, 10 females; mean age 41.9 years; range 7 to 71 years) with thoracoabdominal trauma and diagnosis of TDR who were treated in our clinic between January 2000 and January 2010 were analyzed retrospectively. The patients were statistically compared in terms of age, gender, the time of diagnosis (early or late), the diagnostic procedures that were performed, whether the diagnosis of rupture was made during or after the operation, the localization of the rupture, the diameter of the rupture, accompanying injuries, the surgery performed, mortality and morbidity and the trauma injury severity score. Results: The etiology for the diaphragmatic rupture was blunt trauma in 43.9% and penetrating trauma in 56.10% of the patients. 85.36% of the patients were diagnosed in early stage and 14.64% in late stage. Herniation dignosis was made radiologically in 118 (43.9%) patients and diaphragmatic rupture was detected during the operation in 23 patients (56.1%). Twenty-nine (70.73%) patients had thoracotomy, seven (17.02%) patients had laparatomy and five (12.19%) patients had thoracotomy plus laparatomy. The overall mortality rate was 14.63% (n=6). Conclusion: Traumatic diaphragmatic ruptures may have a fatal course depending on the strangulation of the herniating abdominal viscera. Traumatic diaphgram rupture should be suspected in all multitraumatic patients and these cases shuld be seriously evaluated for the definitive diagnosis and treatment plan.