Atalay Şahin

Evaluation of patients diagnosed with spontaneous hemopneumothorax

Amac: Spontan hemopnomotoraks (SHP), nadir gorulen bir hastaliktir. Zamaninda taninmaz ve tedavi edilmezse hayati tehdit edebilir. Bu calismanin amaci SHP’ li hastalarin tedavisinde kurumumuzun deneyimlerini paylasmaktir. Hastalar ve Yontemler: Temmuz 2005-Mayis 2017 yillari arasinda 610 adet spontan pnomotoraks hastasi klinigimize basvurdu. Hastalarin yasi, cinsiyeti, etkilenen taraf, drenaj miktari, klinik bulgulari ve tedavi sonuclari retrospektif olarak degerlendirildi. Bulgular: Tum hastalarin on-arka akciger (PA Akc) grafisi, bilgisayarli toraks tomografisi (BT), tam kan, biyokimya ve koagulasyon testleri degerlendirildi. Tum hastalara kapali su alti drenaji uygulandi. Altiyuz on hastadan 7 (%1,14)’sinde SHP tesbit edildi. Toraks drenaj takibi sonrasi 7 hasta operasyona alindi. Uc hastaya video yardimli torakoskopik cerrahi (VYTC), diger hastalara torakotomi yapildi. Postoperatif komplikasyon olmadi. Sonuc: Travma hikâyesi olmadan ani baslayan gogus agrisi ve nefes darligi olan hastalarda, radyografide pnomotoraksla beraber sivi seviyesi var ise SHP dusunulmelidir. Ilk tedavi yaklasimi tup torakostomi olmalidir. Sonrasinda, hasta yakin klinik ve hemodinamik kontrol altinda tutulmali ve eger kanama devam ederse oncelikli olarak VATS veya acil torakotomi uygulanmalidir. Boylece erken tani ve uygun cerrahi yaklasimla gelisebilecek olumcul komplikasyonlar onlenebilir.

Do Meteorological Changes Have an Effect on The Occurence of Spontaneous Pneumothorax

OBJECTIVES Spontaneous pneumothorax refers to the leakage of air into the space between the parietal and the visceral layers of the pleura. It occurs with or without a known lung disease. We aimed to investigate the effects of atmospheric pressure, humidity, and temperature changes on the incidence of spontaneous pneumothorax (SP). MATERIAL AND METHODS This study included 551 patients with spontaneous pneumothorax retrospectively screened between January 2009 and December 2013. The medical data of the patients were accessed via their medical records on the hospital automation system. The atmospheric pressure, temperature, humidity rate, amount of precipitation, and wind velocity on the day of spontaneous pneumothorax were obtained from the data provided by the general directorate of meteorology. The three consecutive days on which at least 2 cases of SP presented were collectively considered as a cluster. The study data were analyzed with the SPSS version 15 software package, using the Chi-square and the Students t tests. A p value less than 0.05 was considered statistically significant. RESULTS Of the 552 patients included in the study, 89.3% had primary spontaneous pneumothorax and 10.7% had secondary spontaneous pneumothorax. Ninety-two percent of the patients were male and 8% were female. The mean age was 24 years. Clustering was observed in 71.7% of the study population. No significant differences were observed between yearly and monthly SP incidences. There were, however, differences between the days with SP and the days without SP with respect to atmospheric pressure, ambient temperature, wind velocity, and humidity rate. The differences between the atmospheric pressures were not statistically significant, although the differences between the ambient temperature and the humidity rate were statistically significant (p≤ 0.05). CONCLUSION We determined that the changes in the ambient temperature and the humidity rate affected the rate of spontaneous pneumothorax by altering the meteorological conditions.

[Diaphragmatic injury: condition be noticed in the management of thoracic trauma].

BACKGROUND The aim of the present study was to emphasize diaphragmatic injuries that can be overlooked in chest traumas. METHODS Between January 2000 and June 2013, fifty-three patients with traumatic diaphragmatic laceration were evaluted among 1349 patients who had chest injuries. Patients were examined regarding age, gender, associated injuries, surgical interventions, postoperative morbidity, mortality and length of hospital stays. RESULTS Of them, fifty-three cases had diaphragmatic lacerations. There were forty-eight male and five female patients, with a mean age of 31.06 (4-60) years and 35.80 (18-50) years. Thoracotomy in 66%, laparotomy in 20.75% and laparotomy+thoracotomy in 13.20% of the cases were performed. Video-assisted thoracoscopy was carried out in 15.09% of the patients. Diaphragm was repaired on the left in thirty-one cases and in the right in twenty-two cases. Pulmonary complications like morbidity was mostly seen in 37.73% of blunt trauma. Mortality was seen in three cases of penetrating trauma. Mean hospital duration was 8.75 days (range, 4-15 days). Patients were followed for a mean duration of 28.13 months (range, 3-60 months). There was no significant statistical difference between types of injury, ages and gender of cases (p=0.05); whereas, morbidity rate was important in patients with blunt trauma. DISCUSSION Diaphragmatic lacerations should be kept in mind when penetrating and blunt injuries to the thorax are evaluated.