Acute renal infarction (ARI) is a rarely encountered disease in emergency services, but is of particular importance owing to higher mortality and morbidity rates in the absence of early diagnosis and intervention. On the other hand, urolithiasis cases are admitted to emergency departments very frequently with the complaint of pain. ARI with non-specific symptoms or urolithiasis-like pain would increase the likelihood of being omitted in crowded emergency rooms. Previous studies reported supportive diagnostic role in ARI of increased serum lactate dehydrogenase and C-reactive protein levels and white blood cell count in the presence of hematuria; however, none mentioned D-dimer as a likely diagnostic or prognostic marker. We hereby present 2 case reports where a contrast-enhanced tomographic scan performed on the basis of suspicions raised by high serum D-dimer levels which established the definitive diagnosis ARI. Our aim was to emphasize that serum D-dimer may be used as a criterion for supporting or excluding the thromboembolic events, such as renal and mesenteric infarction.
Introduction: Hip dislocations are extremely rare, but they are orthopedic emergencies that need to be immediately intervened. Traumatic hip dislocations are usually unilateral and occur toward the posterior region. Bilateral traumatic hip dislocations, on the other hand, are rarer. Asymmetric occurrence of bilateral traumatic hip dislocations is even rarer. The possibility of spontaneous hip dislocation in a healthy person is very unlikely. This is because ligaments wrapping the hip joint make it quite stable. Thus, hip dislocation usually occurs due to a high-energy trauma.Case Report: In this paper we report a unique female patient with asymmetric bilateral traumatic hip dislocation accompanied by a segmental fracture of the femur due to a traffic accident. The patient's right hip was reduced under sedoanalgesia at the emergency department and the left hip was reduced under anesthesia at operating room. Avascular necrosis did not develop at her 2-year follow-up; however, she has been re-operated after developing nonunion in the left femoral segmental fracture.
Conclusion:In conclusion, hip dislocations should be treated in first six hours due to the risk of avascular necrosis. Uncomplicated hip dislocations without accompanied fractures can be treated with sedoanalgesia in emergency service settings. However hip dislocations which are complicated with accompanied fractures should be reduced in operation rooms without delay.
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