ABSTRACT
To evaluate clinical findings and surgical interventions and their results in the patients referred to our hospital with cardiac injuries. Penetrating heart injury is potentially a life-threatening condition due to cardiac tamponade or exsanguinating hemorrhage. The data of 20 patients undergoing surgical intervention due to penetrating cardiac injury between 2001 and 2010 were retrospectively evaluated. In this series of 20 patients all were male between the ages of 14-65 years, with a mean age of 33.2 +/- 14.15 years. Age interval of the participating patients was between 14 - 65. Eighteen of these patients were diagnosed with right ventricular injuries while two were diagnosed with left ventricular injuries. All the diagnoses were established with clinical examination, direct radiograph, CT, echocardiography and ECG. Four of the patients admitted in emergency service were in agony, four were in shock, and six presented with hypotensive hemodynamic, and four with stable hemodynamic. Right anterior thoracotomy was applied to four patients in agony in the emergency service. Two of these patients died. None of other patients died. All the postoperative patients were followed with echocardiography. Post - pericardiotomy syndrome was detected in one of the patients. Our experience shows that early diagnosis and immediate surgical intervention are the main factors affecting patient survival after penetrating heart injuries. Penetrating cardiac injuries have high mortality. This rate may be 80% in those patients in agony. Emergent intervention in emergency services for the patients under emergent conditions may be life- saving
ABSTRACT
Carotid body tumors [CBTs], especially familial paragangliomas, are rare benign neoplasm, accounting for < 0.5% of all tumors; and they are the most common extra-adrenal paraganglioma. Because of peripheral vascular and neural invasion or compression of tumors, early diagnosis and treatments are very important, whereas this kind of tumors have got slow progression and low malignity potential. The aim of this study was to review an institutional experience in the management of paragangliomas. In this study, CBTs were clinically suspected in 33 patients but diagnosed by histopathology in between 1999 and 2011 at our department. Three of these patients presented with bilateral tumors. All but one was operated upon. The ages of the 48.3 surgically treated patients ranged 32-58 years. A mass in the neck was the common symptom in all patients. The patients were classified according to the Shamblin classification. There were 17 patients [11 women 6 men] in the first group, 13 patients [9 women, 4 men] in the second group, and 3 patients [2 women 1 man] in the third group. All of these 33 surgically treated patients had confirmed CBT by histopathology. CBTs were resected without a shunt procedure. No mortality occurred, however one patient experienced Horner syndrome post operatively. In the follow up period, no recurrences were observed. Three of the patients was had hoarseness, but improved after six months. No stroke occurred in the patients. CBTs are infrequent neoplasm; their surgical treatment is highly dependent on the ability and experience of the surgeon. The diagnostic and therapeutic relevance reside in making a timely diagnosis to propose a surgical treatment aimed at preventing complications and neurological damage. Surgical resection is usually definitive therapy for these lesions