Investigation of risk factors affecting surgical decision in traumatic colon injuries

Management of colon injuries in trauma surgery has not yet been standardized. Our aim is to present our findings in patients with colon injury retrospectively in order to contribute to the selection of a surgical algorithm. Patients were evaluated with regard to age, sex, type of trauma, hemodynamic state, the time period between trauma and surgery, amount of transfusion; additional organ injury, localization and severity of colon injury, fecal contamination, surgical procedures, postoperative complications, and mortality, and then the factors affecting morbidity and mortality were investigated. Mean Abdominal Trauma Index [ATI] of 34 cases was 18.9; ATI was over 25 in 6 [18%] cases. The time period between trauma and surgery was over 8 hours in 2 [6%] cases. Mean Colonic Injury Severity Scale [CISS] was 3. Severe fecal contamination was detected in 4 [12%] cases. Primary repair and colostomy were performed in 26 [76.5%] and 8 [23.5%] cases, respectively. Mortality occurred in 2 cases who had received colostomy procedure. Decision of performing either primary repair or resection anastomosis should depend particularly on CISS [which should be equal to or less than III] accompanied by low ATI, prompt admittance [i.e. within the first 8 hours], and little or no fecal contamination

Comparison of serum CA 19.9, CA 125 and CEA levels with severity of chronic obstructive pulmonary disease

To investigate serum levels of CA 19.9, CA 125 and carcinoembryonic antigen [CEA] in patients with different stages of chronic obstructive pulmonary disease [COPD]. Fifty-three consecutive patients [50 males, 3 females, mean age 67.6 +/- 10.1 years] with COPD were included in this study. Serum levels of CA 19.9, CA 25 and CEA were determined by the chemiluminescent immunometric method. Based on values obtained from pulmonary function tests, the patients were divided into 3 groups: moderate [21], severe [18] and very severe [14]. Data were analyzed with a Kruskal-Wallis one-way analysis of variance test and Mann-Whitney U test The mean serum levels of CA 125 and CA 19.9 were significantly higher in patients with very severe COPD [p = 0.013 and p = 0.017, respectively] than in patients with severe and moderate COPD [p < 0.05]. Patients with cor pulmonale had significantly high mean serum levels of CEA, CA 19.9 and CA 125 [p < 0.05]. Patients using a long-acting -agonist and theophylline showed significantly higher mean serum levels of CA 125 than patients who were not [p < 0.05]. Data showed that the increased serum tumor markers in patients with COPD might be due to the severity of COPD, medication and cor pulmonale