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This case series aims to provide a comprehensive description of the utilization of doppler ultrasonography (USG) and computerized tomography angiography (CTA) in evaluating patients with earthquake-induced crush injuries in the emergency department (ED).
Methods:
This retrospective case series was conducted on 11 patients who presented with crush injuries following a seismic event. These patients underwent initial assessment using doppler USG, with CTA performed when deemed necessary. Clinical outcomes and diagnostic findings were systematically reviewed.
Results:
A cohort of 11 earthquake-related crush injury patients (six females, five males; age 3-59 years), predominantly with lower extremity injuries, with entrapped durations that ranged from 12 to 128 hours. Transport centers received patients from both affected regions and nearby provinces. Initial X-rays identified fractures in two cases. Doppler USG and subsequent CTA were employed for vascular evaluation, with CTA confirming doppler USG findings. Of the 11 patients, five exhibited abnormal doppler USG findings. Four patients required dialysis and four underwent amputation surgery. Fasciotomy and debridement procedures were performed in five and seven patients, respectively. Three patients received hyperbaric oxygen therapy (HBOT).
Conclusion:
Doppler USG emerged as a dependable tool for assessing vascular injuries in earthquake-related crush injuries, offering an effective alternative to CTA without the associated contrast agent risks. These findings underscore the need for further research to establish definitive imaging guidelines in these challenging clinical scenarios.
A 34-year-old gravida 3, para 3 is undergoing an interval bilateral salpingectomy for permanent sterilization. She is currently using combined oral contraceptive pills (containing ethinyl estradiol/norethindrone) for contraception. Because of side effects associated with the pill, she has opted for permanent sterilization. She understands sterilization is a permanent procedure and is certain she has completed her family. Her pre-procedure pregnancy test was negative. All her deliveries were spontaneous vaginal deliveries. She has no history of easy bleeding or bruising. She has no past medical or surgical history. She is not taking any other medications and she has no known drug allergies.