RESUMO
Despite its relatively protected position, the liver is the most frequently injured solid intra-abdominal organ. 1 Most liver injuries can be managed conservatively, but about 5% to 10% require urgent laparotomy, usually when the mechanism of injury involves a vehicle accident and hemodynamic instability persists, in spite of 40 mL/kg of blood transfusion. 2 , 3 In particular, grades IV and V liver injuries may pose a challenge to the surgeon trying to control hemorrhage, the leading cause of mortality. 4 Traumatic injuries to the portal vein are rare but devastating. The mortality rate for portal vein injury ranges from 50% to 70%. A recent study of portal triad injuries has highighted the higher mortality rates associated with combination injuries involving multiple portal triad components, especially those that include portal vein injury. 5 This case study describes a unique case of relatively minor trauma in a child resulting in portal triad injury, sudden demise, and surgical repair.
Assuntos
Traumatismos Abdominais/diagnóstico por imagem , Ciclismo/lesões , Fígado/lesões , Traumatismo Múltiplo/diagnóstico por imagem , Veia Porta/lesões , Traumatismos Abdominais/cirurgia , Ductos Biliares Extra-Hepáticos/diagnóstico por imagem , Ductos Biliares Extra-Hepáticos/lesões , Ductos Biliares Extra-Hepáticos/cirurgia , Transfusão de Sangue/métodos , Criança , Serviço Hospitalar de Emergência , Seguimentos , Escala de Coma de Glasgow , Humanos , Escala de Gravidade do Ferimento , Lacerações/diagnóstico por imagem , Lacerações/cirurgia , Laparotomia/métodos , Fígado/diagnóstico por imagem , Fígado/cirurgia , Masculino , Traumatismo Múltiplo/cirurgia , Veia Porta/diagnóstico por imagem , Veia Porta/cirurgia , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento , Ultrassonografia Doppler , Procedimentos Cirúrgicos Vasculares/métodosRESUMO
BACKGROUND: Cervical cancer is one of the ten most frequent cancers in Turkey. We here examined knowledge about cervical cancer in relation to Papanicolaou (Pap) testing among female primary health care workers in Hatay, a city is located in the south of Turkey. MATERIALS AND METHODS: The study was completed on 261 women healthcare workers who were or had been sexually active and who accepted to participate to the study. The participants gave verbal informed consent and thereafter questionnaires prepared by the investigators were administered by personal interview. RESULTS: Only 30.3% (n=79) of the participants regularly had a gynecologic examination. While 87.4% (n=228) of the participants reported that they had already heard about the Pap smear test, only 45.2% (n=118) had undergone this test. It was determined that had undergone an average of 1.66 ± 0.89 times (1-4) within the last five years. Some 56.0% (n=117) of the participants were well informed about the Pap smear test (p<0,001) and 81.1% (n=63) of the participants who regularly had gynecological examinations (p<0,001) had this test. CONCLUSIONS: For the early diagnosis of the cervical cancer, regularly having a Pap smear test is crucial. Healthcare workers should also demonstrate sensitivity about this issue. We think that the importance of the issue should be re-highlighted by organizing in-service training for female primary healthcare workers. Studies are warranted to determine the psychosociological factors that cause individuals to not have the test.