Introduction: Clot retention in the urinary bladder is a very common health problem in surgical and nonsurgical cases and clot retention treatment is quite costly. Objectives: The aim of this retrospective study was to describe an alternative technique for removing tenacious and chronic clots by using a thoracic catheter technique. Materials and methods: Between January 2011 and June 2018, a total of 27 patients of clot retention were treated under local anesthesia with the thoracic catheter technique. Results: Twenty-seven patients with a mean age of 58 years (range 45-70) were included. The etiologies of bladder clots included surgical causes and nonsurgical causes. Of the surgical causes, the most common cause was post-transurethral resection of the prostate (TURP). The nonsurgical causes were upper tract bleeding, drug-induced bleeding, post-traumatic bleeding, and haematochyluria. It was found that the thoracic catheter technique was simple and easily adoptable, with no training required. Conclusions: Clot retention in the urinary bladder is a very common problem in surgical and nonsurgical cases. Our technique is a simple, safe, fast, and effective option of clot removal from the urinary bladder and it doesn’t require any added cost.
Kliniğimizde gerçekleştirilen ürolojik laparoskopik cerrahi olguların sonuçları ve komplikasyonlarını geriye dönük olarak değerlendirmek. Yöntemler: Ocak 2012 -Ocak 2015 tarihleri arasında laparoskopik operasyon geçiren toplam 115 hasta geriye dönük incelendi. Hastaların demografik özellikleri, preoperatif tanıları, laparoskopik yaklaşım şekli, ameliyat ve yatış süreleri, cerrahi işlem esnasında ve sonrasında gelişen komplikasyonlar ve açık cerrahiye geçilen hastalar açısından incelendi. Bulgular: Hastaların 61'i kadın, 54'ü erkek ve ortalama yaşları 52,4±11,7 yıl idi. Altmış sekiz olguda transperitoneal, 47 olguda ise retroperitoneal girişim uygulandı. Toplam 29 hastaya basit böbrek kisti eksizyonu, 25 hastaya basit nefrektomi, 22 hastaya üreterolitotomi, 19 hastaya radikal nefrektomi, 15 hastaya piyelolitotomi ve 5 hastaya da piyeloplasti yapıldı. Toplam 115 vakanın 4'ünde (%3,4) açık operasyona geçildi. Bu hastalar dışında majör komplikasyon ve mortalite görülmedi. En sık yapılan ameliyatların ortalama süreleri ise; böbrek kist eksizyonu 62 (50-110) dk, basit nefrektomi 125 (95-140) dk, üreterolitotomi 108 (90-130) dk, radikal nefrektomi 141 (105-175) dk, piyelolitotomi 116 (95-140) dk ve pyeloplasti 166 (150-190) dk idi. Ortalama yatış süresi 3,7±2,8 gün (2-11) idi.Sonuç: Uyguladığımız laparoskopik cerrahilerin sonuçları, başarı ve komplikasyon oranları literatürle uyumlu bulundu. Laparoskopik cerrahi, teknolojinin gelişmesi, deneyimlerin artmasıyla ayrıca hastalar tarafından daha iyi tolere edilmesi nedeniyle açık cerrahiye alternatif, güvenli ve minimal invaziv bir tedavi yöntemi olduğunu düşünmekteyiz.
Objectives: We aimed to evaluate the findings of whole-body computed tomography (WBCT) in pediatric high-energy trauma patients and to determine the distribution of injuries. Materials and Methods: The WBCT images of 1132 pediatric patients who were admitted to emergency department between 2013 and 2018 for high-energy trauma were evaluated retrospectively. Six hundred and twenty patients with abdominal, chest, head, and skeletal injuries were included. Results: Using the WBCT images, we detected skeletal injuries in 557 pediatric patients; spinal, rib, extremity, and pelvic fractures were detected in 113, 57, 51, and 37 patients, respectively. Craniofacial fractures were viewed in 299 patients. We detected intracranial hemorrhage, pulmonary contusion, pneumothorax, and solid organ injuries in 102, 115, 45, and 55 pediatric patients, respectively. Conclusion: The frequency and distribution of injuries in trauma cases vary between adults and children. While there are many studies about whole-body CT findings of adult trauma, there are only a few studies about pediatric high-energy trauma patients. The traumatic injury types also differ in pediatric age groups. WBCT scan (with pediatric radiation dose) is the fast and accurate diagnostic tool in high-energy trauma cases and therefore is associated with low mortality rates.
Purpose: Our aim was to determine the diagnostic performance of the combined usage of diffusion-weighted imaging (DWI), magnetic resonance spectroscopy (MRS) and perfusion MR (MRP) imaging for the differential diagnosis of benign and malignant intracranial lesions. Materials and methods: A total of 30 patients with intracranial lesions who were prospectively evaluated with contrast-enhanced magnetic resonance imaging (MRI), DWI, MRS, and MRP were included in this study. The lesions were classified as benign and malignant according to the radiologic findings. All imaging data were compared with the histopathologic results and follow-up of the patients. We used the Pearson chi-square test and Fischer's exact t-test for statistical analysis. Results: For the differentiation of benign and malignant brain lesions, CBV and choline/creatine (Cho/Cr) ratio at short echo time (TE) had the highest sensitivity (87%-88%), Cho/N-acetyl aspartate (NAA) at short TE had the highest specificity (86%). DWI predicted 77% sensitivity, 75% specificity; MRP presented 91% sensitivity, 88% specificity; MRS yielded 77% sensitivity, 63% specificity. The combination of either DWI and MRS, MRP and MRS or DWI+MRS+MRP revealed 100% sensitivity, 100% specificity. Conclusion: For the differentiation of benign and malignant brain lesions, the combination of DWI, MRS, and MRP predicted 100% sensitivity. Invasive procedures like transcranial biopsy were not required via the usage of these advanced MRI techniques.
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