[Lateral esophagostomy with thoracic drainage in treatment of esophageal perforation]

Esophageal perforation is a true emergency caused by instrumentation, spontaneous rupture known as Boerhaave syndrome, foreign bodies, and trauma. For patients with an early diagnosis [less than 24 hours], the primary repair is performed and in case of delayed diagnosis the end esophagostomy with thoracic drainage and tube jujunostomy is the treatment of choice. The aim of this study was to evaluate the surgical technique of lateral esophagostomy with thoracic drainage in treatment of esophageal perforation. This cross-sectional study was performed based on information derived from three patients admitted to the emergency ward of Shahid Rajaei hospital in Qazvin with the diagnosis of esophageal perforation who underwent lateral esophagostomy with thoracic drainage and tube jujunostomy. Three patients with esophageal perforation caused by foreign bodies or Boerhaave syndrome underwent surgery with lateral esophagostomy, thoracic drainage, and tube jujunostomy technique. Following surgery, the patients were transferred to ICU and all recovered. This study confirms that patients with esophageal perforation, who undergo lateral esophagostomy, thoracic drainage, and tube jujunostomy, make a good recovery soon after a simple and short duration surgery without invasive surgical procedure

Transfusion audit of blood products using the World Health Organization Basic Information Sheet in Qazvin, Islamic Republic of Iran

We assessed the practicality of using the transfusion basic Information Sheet [BIS] for data collection, to determine the overall adequacy of physician documentation of Blood product transfusion, and to make an audit of the appropriateness of blood product transfusion. The transfusion process and clinical indications for transfusions administered to adult hospitalized patients in 3 tertiary care teaching hospitals in Qazvin were prospectively reviewed. Adequate documentation was achieved in transfusion episodes, range 41%-73%, depending on the medical specialty; 15.7% of red blood cells and whole blood requests, 40.8% of platelet requests and 34.1% of fresh frozen plasma requests were inappropriate. BIS-based information along with data collection can be used to provide feedback regarding the effectiveness of and compliance with local and national transfusion guidelines

Management of asymptomatic patients following stab wound to the chest

Background: Asymptomotic stab wounds in the chest may be complicated if there is a delay

Objective: Determining the incidence of delayed complications and time required to discover. In This follow-up study, 92 patients,admitted to Shahid Rajaee hospital between September 2000 and april 2001, were studied. They were observed in hospital for 24 hours. Clinical examination and chest radiography were performed at the time of admission, 6 hours and finally 24 hours later

Findings: Of 92 patients with 98 thoracic wounds,six [6.1%] were complicated by pneumothorax, hemothorax or pneumothorax. All of these complications showed themselves in the first 6 hours period. No additional complications were revealed after that time

Conclusion: To reveal the delayed complications, 6 hours observation in hospital seems to be sufficient