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

Parasitic appendicitis from past to present in Turkey

Understanding the etiology of appendicitis is important for developing effective treatments the relationship between parasitic appendicitis and various socio-cultural factors were examined, particularly with respect to the incidence of literacy. The aim of the article was to research the relations between parasitic appendicitis and literacy ratio in population. Cases of parasitic appendicitis resulting in surgery performed at Buca Seyfi Demirsoy Large State Hospital Surgery Clinic between 2002 and 2009 were retrospectively reviewed and classified according to age, sex, type of parasite, morbidity, and mortality. Studies conducted in different regions of Turkey as well as in other countries were reviewed to determine if there was a relationship between parasitic appendicitis and literacy. Of the 1,969 appendectomy cases reviewed, nine were classified as parasitic appendicitis [0.45%]. Enterobius vermicularis was observed in seven cases and Taenia spp. in two. The average age was 26.4 yr. No morbidity or mortality was found. The data were compared with a retrospective review of studies conducted in the same regions and a decrease in the rate of parasitic appendicitis was observed during the period between the two re views. It was determined that a low literacy rate was associated with an increase in the incidence of parasitic appendicitis. Observations made between different countries also produced similar results. In countries where the incidence of parasitic appendiciticis was greater than 1.5%, the literacy rate was less than 88%. To avoid appendectomy resulting from parasites, it is important to increase education and literacy. In some areas, individuals with appendicitis undergo surgery due to a lack of education or poor literacy