Askeri cerrah, standart bir klinik alanda çalýþan ancak ayný zamanda becerilerini olaðan dýþý durumlara adapte etmeyi öðrenmek zorunda olan ve askeri týbbi strateji planlamasýný etkileyen baþlýca faktörlere ve kriz bölgelerinde mevzisine baðlý güçlüklerle baþ etmek zorunda bulunan bir doktordur. Tek kesin olan þey, bu özel koþullarýn temelde anavatanýn askeri hastanelerindeki rutin koþullardan farklýlýk göstermesidir. Personel, ekipman ve teknik kaynaklardaki kýsýtlýlýklar, mevzi bölgesindeki yalýtým, yerel bir saðlýk sisteminin olmamasý, hastalarýn özel durumlarý ile yaralanma ve hastalýklarýn doðasý, baþlýca benzersiz zorluklardýr.

A military surgeon is a physician who works in a standard clinical field, but who also has to learn to adapt his skills to exceptional circumstances and must cope with special challenges due to his deployment in crisis regions, a fact that is one of the major factors influencing military medical strategy planning. The only certainty is that these special circumstances differ fundamentally from the routine circumstances at the military hospitals of the mother country. The limitations in personnel, equipment and technical resources, the isolation within the deployment region, the lack of a local healthcare system, the specialized aspects of the patients, and the nature of the injuries and diseases represent the main unique challenges.

AMAÇ
Bu çalýþmada, sepsis tedavisinde antioksidan bir ajan olan N-asetilsistein’in (NAC) serbest oksijen radikalleri düzeylerine olan etkileri araþtýrýldý.
GEREÇ VE YÖNTEM
Çalýþmada aðýrlýklarý 180-200 gr arasýnda deðiþen 30 adet Sprague-Dawley cinsi diþi sýçan kullanýldý. Sýçanlar rastgele 10’arlý 3 gruba (Grup I: Sham, Grup II: Sepsis ve Grup III: Sepsis + NAC) ayrýldý. Grup I’e yalnýzca laparotomi yapýldý. Grup II ve Grup III’de çekal ligasyon perforasyon (ÇLP) yöntemiyle sepsis modeli oluþturuldu. Grup III’e oral yoldan 0., 8. ve 16. saatte 20 mg/kg/gün NAC verildi. 24. saatte eritrosit glutatyon (GSH), serum TNF-α deðerlerinin tayini için kan örnekleri ile histopatolojik inceleme ve doku malondialdehid (MDA) tayini için akciðer, karaciðer ve böbrek doku örnekleri alýndý.
BULGULAR
Grup III’de TNF-α, eritrosit GSH ve böbrek doku MDA deðerleri diðer gruplarla karþýlaþtýrýldýðýnda istatistiksel açýdan farklýlýk saptandý (p<0,05). Karaciðer doku MDA deðerleri ve akciðer, karaciðer ve böbrek dokularýnýn histopatolojik inceleme sonuçlarý açýsýndan ise gruplar arasýnda farklýlýk bulunmadý (p>0,05).
SONUÇ
Sepsis oluþturulan sýçanlara verilen NAC tedavisinin eritrosit GSH, serum TNF-α düzeylerine, akciðer fonksiyonlarýna, böbrek doku MDA seviyelerine olumlu etkileri saptandý. Buna karþýlýk bu olumlu etkinin histopatolojik düzelmeye yansýmadýðý görüldü. NAC’nin sepsis tedavisinde olasý yararlý etkilerini ortaya koymak için yeni çalýþmalara ihtiyaç vardýr.

BACKGROUND
The aim of this study was to investigate the effects of N-acetyl cysteine (NAC) on the levels of reactive oxygen species in sepsis.
METHODS
In this study, 30 Sprague-Dawley female rats weighing 180-200 g were used. Rats were randomized into three groups, each containing 10 rats, as follows: Group I: Sham, Group II: Sepsis and Group III: Sepsis+NAC. Group I underwent only laparotomy. In Groups II and III, sepsis was induced by cecal ligation and perforation (CLP) technique. NAC (20 mg/kg/day) was administered orally to Group III at 0, 8 and 16 hours. At the 24th hour, tissue and blood samples were taken for erythrocyte glutathione (GSH) and serum tumor necrosis factor (TNF)-α levels, histopathological determination, and lung, liver and kidney tissue malondialdehyde (MDA) analyses.
RESULTS
Group III was significantly different from the other groups with respect to erythrocyte glutathione, serum TNF-α and kidney MDA levels (p<0.05). There was no significant difference between the groups regarding liver MDA levels and histopathological parameters for lung, liver and kidney (p>0.05).
CONCLUSION
NAC treatment had beneficial effects on erythrocyte GSH, serum TNF-α, lung function, and kidney MDA levels in sepsis-induced rats. However, this beneficial effect was not confirmed as histopathological improvement. Further research is needed to prove the effect of NAC in sepsis treatment.

AMAÇ
Bu çalýþmada, deneysel travmatik beyin hasarý sonrasý beyin dokusundaki zaman baðýmlý leptin konsantrasyonlarýndaki deðiþiklik ve sitokinlerle olan iliþki deðerlendirildi.
GEREÇ VE YÖNTEM
Sirküler kranyektomi sonrasý 33 adet erkek Wistar-Albino sýçan stereotaksik çembere yerleþtirildi ve kortikal kontüzyon hasarý oluþturuldu. Denekler deformasyon derinliðine göre 3 gruba ayrýldý: 0 mm (Kontrol, n=3), 1,5 mm (Orta hasar, n=15), 2,7 mm (Ciddi hasar, n=15). Hayvanlar hasar sonrasý birinci, üçüncü ve beþinci günlerde öldürüldü.
BULGULAR
Orta hasar sonrasý ilk gün interlökin 1 beta (IL-1β), interlökin 6 (IL-6), tümör nekroz faktör alfa (TNF-α) ve leptin seviyelerinin beyin dokusunda belirgin olarak yükseldiði saptandý. Üçüncü ve beþinci günlerde bu seviyelerin kontrol seviyelerine gerilediði görüldü. Ciddi hasar sonrasý birinci gün IL-1β, IL-6, TNF-α seviyeleri korele olarak yükseldi ve sonrasýnda kontrol seviyelerine döndü. Buna raðmen leptin seviyeleri birinci ve üçüncü gün azaldý, beþinci günde ise kontrol seviyelerine ulaþtý.
SONUÇ
Ciddi beyin hasarý sonrasý erken dönemde leptin salýnýmýnýn azalmasý, leptin replasmanýnýn bu olgularýn tedavisinde önemli rol oynayabileceðini düþündürmektedir.

BACKGROUND
The present study aimed to investigate time-dependent changes in leptin concentrations in brain tissue following experimental traumatic brain injury and to examine the relationship with cytokines.
METHODS
After circular craniectomy, 33 male Wistar-albino rats were positioned on a stereotaxic frame and subjected to cortical contusion injury and then divided into 3 groups based on the depth of deformation as: 0 mm (sham controls, n=3), 1.5 mm (moderate injury, n=15) and 2.7 mm (severe injury, n=15). Animals were sacrificed on the 1st, 3rd and 5th days post-injury.
RESULTS
One day after moderate injury, interleukin-1 beta (IL-1β), IL-6, tumor necrosis factor-alpha (TNF-α), and leptin levels were found to be markedly increased in the brain tissue. On the 3rd and 5th days, the levels returned to the sham-control levels. Following severe injury, IL-1β, IL-6 and TNF-α levels increased in correlation after the 1st day and reached the sham-control levels on the same days. However, leptin tissue levels decreased on the 1st and 3rd days and normalized to the sham-control levels on the 5th day.
CONCLUSION
Our results showed that the release of leptin is decreased in the early stage of severe injury. Thus, leptin replacement may play an important role in therapy in cases with severe traumatic brain injury.

AMAÇ
Beta glukan, güçlü makrofaj stimülatörü olup ayný zamanda antioksidatif etkinliðe de sahiptir. Bu çalýþma ile týkanma sarýlýðýnda ortaya çýkan karaciðerin oksidatif hasarýna beta glukanýn etkisinin araþtýrýlmasý amaçlandý.
GEREÇ VE YÖNTEM
Yediþer Wistar Albino sýçandan oluþan üç grup oluþturuldu: Sham grubunun dýþýnda koledok ligasyonu yapýlan kontrol grubu ve ligasyon sonrasý gavaj ile beta glukan verilen tedavi grubu. Tüm sýçanlar 11. gün öldürüldü. Karaciðer fonksiyon testlerinden baþka serumda süperoksit dismutaz (SDO), miyeloperoksidaz (MPO); karaciðer dokusunda malondialdehit (MDA), lipidperoksit (LPO), glutatyon (GSH) deðerlerine bakýldý. Ayrýca karaciðerin histopatolojik incelemesi yapýldý.
BULGULAR
Serumda AST, ALT, GGT, LDH, total ve direkt bilirubin, MPO, LPO deðerleri ve karaciðer dokusunda MDA deðerleri tedavi grubunda kontrol grubuna göre anlamlý olarak düþük idi. Ayrýca serumda SOD ve karaciðer dokusunda GSH deðerlerinin tedavi grubunda belirgin yüksek olduðu tespit edildi. Karaciðerin histopatolojik incelemesinde tedavi grubundaki doku hasarýnýn kontrol grubundakinden belirgin daha az þiddette olduðu bulundu.
SONUÇ
Beta glukanýn týkanma sarýlýðý olan sýçanlarda karaciðer hasarýný ve oksidatif stresi azalttýðý, bunun yanýnda fagositer ve antioksidatif etkiyi artýrdýðý gösterilmiþtir. Beta glukanýn týkanma sarýlýðýnda klinik kullanýmý ile ilgili ileri çalýþmalar gereklidir.

BACKGROUND
Beta-glucans are known as macrophage stimulators and antioxidants. This study aimed to investigate the effects of beta-glucans on oxidative damage to the liver during obstructive jaundice.
METHODS
Sham, control and treatment groups (7 Wistar Albino rats in each) were designed. In the treatment group, beta-glucan was given through gavages for 10 days after bile duct ligation. All groups were sacrificed on the 11th day. Liver function tests, superoxide dismutase (SOD), myeloperoxidase (MPO), malondialdehyde (MDA), lipid peroxide (LPO), glutathione (GSH), and histopathological examination of the liver were investigated.
RESULTS
In the treatment group, the levels of alanine and aspartate aminotransferases (AST, ALT), gamma glutamyl transpeptidase (GGT), lactate dehydrogenase (LDH), total and direct bilirubin, MPO in the serum, and the levels of MDA and LPO in the liver tissue were significantly lower when compared with the control group. Moreover, SOD and GSH levels were relevantly high in the treatment group. Histopathological examination of the liver revealed less damage in the treatment group.
CONCLUSION
These results show that beta-glucan induced the phagocytic and anti-oxidative effects and also reduced the liver damage and oxidative stress in obstructive jaundice. Advanced studies are required for the clinical use of beta-glucan in obstructive jaundice.

AMAÇ
Ankaferd Blood Stopper® (ABS) son yýllarda kullanýma giren, organik kökenli topikal bir hemostatik ajandýr. Bu çalýþmanýn amacý, sýçanlarda karaciðer laserasyon modelinde halen yaygýn klinik kullanýmda olan fibrin yapýþtýrýcý (FY) ile ABS’nin etkinliði karþýlaþtýrmaktýr.
GEREÇ VE YÖNTEM
Wistar Albino cinsi 32 adet sýçan eþit olarak rastgele dört gruba ayrýldý. Sham grubunda (Grup 1) karaciðer sadece eksplore edildi. Çalýþma gruplarýnda (Grup 2, 3, 4) karaciðer sol lob ön yüzünde 1 cm uzunluðunda 2 mm derinliðinde 3 adet laserasyon oluþturuldu. Grup 2 ve 3’de sýrasýyla ABS ve FY topikal hemostatik olarak kullanýldý ve kanama kontrol altýna alýndý. Kontrol grubunda (Grup 4) hiçbir materyal kullanýlmadý. Kanama zamaný, hematokrit düzeylerindeki deðiþiklikler, karýn içi yapýþýklýk düzeyi ve histopatolojik etkileri deðerlendirildi.
BULGULAR
ABS ve FY gruplarýnda topikal hemostaz zamaný arasýnda anlamlý fark bulunmazken, kontrol grubunda bu süre belirgin olarak daha uzundu, sýrasýyla 17 (15-20) sn, 18 (16-20) sn, 70 (64-74) sn (p<0,05). Karýn içi yapýþýklýk deðerlendirmesinde çalýþma gruplarý arasýnda belirgin farklýlýk görülmedi, Grup 1: 1 (0-1), Grup 2: 2 (1-3), Grup 3: 2 (1-3), Grup 4: 2 (1-3) (p>0,05). Mikroskobik incelemede ABS ve FY’nin karaciðer ve çevre dokulardaki histopatolojik etkilerinin benzer olduðu görüldü (p>0,05).
SONUÇ
ABS sýçanlarda karaciðer laserasyon modelinde FY ile eþit topikal hemostatik etkinliðe sahiptir. Karýn içi kullanýmda yapýþýklýk ve histopatolojik etkileri açýsýndan her iki materyal arasýnda anlamlý fark yoktur.

BACKGROUND
Ankaferd Blood Stopper® (ABS) is an organic topical hemostatic agent that has become available in recent years. The aim of this study was to compare the effectiveness of ABS in a liver laceration model in rats with that of fibrin glue (FG), which is currently being used widely in clinics.
METHODS
Thirty-two Wistar Albino type rats were randomly divided into four groups. In the Sham group (Group 1), only the liver was explored. In the other study groups (Groups 2, 3 and 4), three incisions were performed, each 1 cm long and 2 mm deep, on the front of the left lobe of the livers. In Groups 2 and 3, ABS and FG were used as hemostatic agents, respectively. No materials were used for the injuries in the Control Group (Group 4). Bleeding periods, changes in the hematocrit levels, intraabdominal adhesion levels, and histopathological effects were taken into consideration.
RESULTS
There was no significant difference between the period of hemostasis in Groups 2 and 3, whereas the same period was evidently longer in Group 4 (17 (15-20) sec, 18 (16-20) sec, 70 (64-74) seconds, respectively; p<0.05). No significant difference was detected between the groups regarding intraabdominal adhesion levels (Group 1: 1 (0-1), Group 2: 2 (1-3), Group 3: 2 (1-3), Group 4: 2 (1-3); p>0.05). Microscopic evaluations revealed similar histopathological effects of ABS and FG on the liver and surrounding tissues (p>0.05).
CONCLUSION
The topical hemostatic effectiveness of ABS was shown to be comparable to FG in a liver laceration model in rats. There was no significant difference between these materials regarding adhesion formation in intraabdominal use or histopathological effects.

AMAÇ
Altý yýllýk bir dönemde A Milli Erkek Futbol Takýmý’nda meydana gelen yaralanmalarýn anatomik bölge, sýklýk ve oluþ mekanizmasý deðerlendirildi.
GEREÇ VE YÖNTEM
Saðlýk ekibi tarafýndan Ocak 2000 ile Aralýk 2005 tarihleri arasýný kapsayan dönemde yapýlan tüm resmi ve özel karþýlaþmalar, antrenmanlar ve kamplar sýrasýnda kayýt tutuldu. Yaralanmalarýn anatomik bölgeleri, tipleri, uygulanan tedavilere dair bilgiler içeren bu kayýtlarýn deðerlendirilmesi deskriptif istatistik, frekans analizi, çapraz tablolar ve ki-kare testi ile yapýldý.
BULGULAR
Çalýþma süresince toplam 208 antrenman, 52 resmi ve hazýrlýk karþýlaþmasý yapýldý. Bu sürede 108 sakatlýk kaydedildi. Bu sakatlýklarýn maç ve antrenman baþýna oraný sýrasýyla 1,0 ve 0,27 idi. Yaralanmalarýn %80,6’sý alt ekstremitelerde meydana geldi. En sýk yaralanan anatomik bölge uyluk (%25), en sýk sakatlýk tipi kontüzyon (%32) ve en sýk uygulanan tedavi yöntemi fizik tedavi ve rehabilitasyon (%89,8) idi.
SONUÇ
Çalýþmamýz futbolda gerçekleþen yaralanmalarýn görülme sýklýðý, etkilenen anatomik bölge yaralanmanýn tipi ve ciddiyeti hakkýnda deðerli sonuçlar vermektedir. Çalýþmanýn sonuçlarý bu alanda daha sonra yapýlacak çalýþmalar için ve futbol yaralanmalarýndan korunmak açýsýndan önemlidir.

BACKGROUND
The aim of our study was to evaluate the incidence, mechanisms and anatomic sites of injuries of the Turkish National Men’s Football Team over six years.
METHODS
The affected anatomic site, incidence rate, type of injury, and applied treatment procedures were recorded by the medical staff. Official and friendly games and training sessions over the period January 2000 - December 2005 were documented daily. Cross- tabulation, frequency analysis, descriptive statistics, and chi-square test methods were used in statistical evaluations.
RESULTS
In total, 52 official and friendly games were played and 208 training sessions were conducted. The total number of injuries recorded in this period was 108, and the averages per match and training were 1.0 and 0.27, respectively. The most commonly affected anatomic site was the thigh (25%), the most common injury type was contusion (32%) and the most common applied treatment procedure was physical therapy and rehabilitation (89.8%).
CONCLUSION
Our results provide valuable information about the incidence, affected anatomical site, and type and severity of injuries in football. This study can serve as reference data for future scientific studies in the field, and also provides information regarding the prevention of injuries.

AMAÇ
Bu çalýþma, Türkiye’deki trafik kazasý istatistiklerinde 0-17 yaþ ölüm ve yaralanmalarýnýn boyutunu incelemeyi amaçlamaktadýr.
GEREÇ VE YÖNTEM
Çalýþma trafik kaza istatistik yýllýklarýndan 2003-2007 yýllarýna iliþkin beþ yýllýk dönemi kapsayan kayýt tabanlý bir incelemedir.
BULGULAR
Çalýþma kapsamýnda incelenen beþ yýlýk periyotta meydana gelen ölümlerin %10,88’ini ve yaralanmalarýn %20,05’ini 0-17 yaþ grubu oluþturmaktadýr. Bu ölümlerin %53,54’ü, yaralanmalarýn %70,65’i yerleþim yerlerinde meydana gelmiþtir. Yerleþim yerleri ölümlerinde yaya, yerleþim yeri dýþý ölümlerde ise yolcu ölümleri dikkat çekmektedir. Yaralanmalarda da benzerlik vardýr.
SONUÇ
Ýncelenen beþ yýllýk istatistiklere göre Türkiye’de 0-17 yaþ grubuna iliþkin trafik kazalarýndan kaynaklanan ölüm ve yaralanmalar, koruyucu politika ve programlar geliþtirilmesini gerektiren bir halk saðlýðý sorunudur.

BACKGROUND
This study aimed to examine the extent of death and injuries among the 0-17 years of age group recorded in the official road traffic injury statistics.
METHODS
This is a record-based study covering a 5-year-period (2003-2007) using the annual records of national road traffic injury statistics in Turkey.
RESULTS
The 0-17 age group accounted for 10.9% of deaths and 20.1% of injuries over the 5-year-period that served as the scope of the study. It was found out that 53.5% of deaths and 70.7% of injuries occurred in residential areas. The occurrence of death among pedestrians in residential areas is notable. Injuries showed a similar tendency.
CONCLUSION
According to the 5-year period statistics examined in this study, road traffic-related deaths and injuries are a public health problem, and necessitate the development of programs and policies aimed at their prevention.

AMAÇ
Ýki ayrý yanýk tedavi merkezinde tandýra düþme sonucu yanýk oluþan hastalarýn demografik özellikleri, enfeksiyon oranlarý ve mobidite oranlarý tedavi yöntemleri ile birlikte incelendi.
GEREÇ VE YÖNTEM
Bu çalýþmada yanýklý hastalarýn yaþ, cinsiyet, sosyoekonomik durum, toplam vücut yüzey yanýk oranlarý, yanýk bölgeleri, yanýk yaralarýndan izole edilen mikroorganizmalar, tedavi yöntemleri, hastanede kalma süreleri, hastalara uygulanan debridman ve greft operasyonlarý, ekstremite amputasyonlarý ile yanýk hastalarýnýn mortaliteleri araþtýrýldý.
BULGULAR
Bu iki merkezde tedavi edilen tandýr yanýklý hastalarýn ortalama hastanede kalma süresi 27,6±9,5 gün idi. Buna karþýn tandýr dýþý yanýklý hastalarýn ortalama hastanede kalma süresi ise 16,5±12,5 gün idi. Bu iki grup arasýnda hastanede kalma süreleri arasýnda anlamlý derecede farklýlýk saptandý (p<0,001). Benzer þekilde tandýr yanýklý hastalarýn toplam yanýk yüzey alan ortalamasý %17,4±12,3 iken tandýr dýþý yanýklý hastalarýn toplam yanýk yüzey alan ortalamasý %10,6±9,9 idi ve gruplar arasýndaki fark anlamlý idi (p<0,001).
SONUÇ
Bu çalýþma sýrasýnda tandýr yanýklarýnýn diðer yanýklardan daha derin yanýk oluþturduðunu ve hastanede kalma süresinin de diðer yanýk türlerinden daha uzun olduðu sonucuna ulaþtýk. Yine cerrahi giriþimlerin tandýr yanýklý hastalarda diðer yanýklý hastalara göre daha fazla yapýldýðýný tespit ettik.

BACKGROUND
We examine herein the demographic characteristics, implemented treatment methods, infection rates, and morbidities of patients with tandir burns from two burn centers.
METHODS
In this study, gender, age, socioeconomic status, total body burn ratio, burn area, burn level, microorganisms isolated in burn wounds, implemented treatments, length of hospital stay, debridement and grafting operations, extremity amputations, and mortality among burn patients were investigated.
RESULTS
Tandir burn patients were treated in the hospital for an average of 27.6 ± 9.5 days, while non-tandir burn patients were treated for a period of 16.5 ± 12.5 days. A significant difference was found between the hospitalization periods of the two groups (p<0.001). Similarly, while the total burn surface area average of the tandir burn patients was 17.4% ± 12.3%, the total burn surface area average of the non-tandir burn patients was 10.6% ± 9.9%, and a significant difference was found between the two (p<0.001).
CONCLUSION
In our study, it was determined that tandir burns were deeper than other burns, and that hospitalization durations were longer than for other burn causes. Surgical intervention was also more prevalent among patients with tandir burn than among those with other burn causes.

AMAÇ
Bu çalýþmanýn amacý, toraks yaralanmasý olan hastalarýn epidemiyolojik özelliklerini belirlemek, fizyolojik ve anatomik risk faktörlerinin mortaliteyle iliþkisini saptamak ve þiddetli travmanýn erken tanýnmasýna olanak saðlamaktýr.
GEREÇ VE YÖNTEM
Çalýþmada toraks travmalý 371 olgu geriye dönük olarak incelendi. Olgularýn acil servise ilk baþvuru durumlarý analiz edildi ve mortalite geliþimi açýsýndan deðerlendirildi. Ölen ve yaþayan olgular; yaþ, cinsiyet, travma mekanizmasý, baþvuru anýndaki sistolik kan basýncý ve solunum karakteri, eþlik eden yaralanmalar, toraks patolojisi, travma skorlarý, tedavi yaklaþýmlarý açýsýndan karþýlaþtýrýldý. Travma ve Yaralanma Þiddeti Ölçeði (TRISS) yöntemiyle olgularýn yaþama olasýlýklarý ve beklenmeyen ölüm oranlarý saptandý.
BULGULAR
Yaþ, hipotansiyon, patolojik solunum, künt ve yandaþ yaralanma, karýn travmasý varlýðý, yüksek Yaralanma Þiddeti Ölçeði (ISS), düþük Glasgow Koma Skalasý (GKS), Revize Travma Skoru (RTS) ve TRISS mortaliteye etkili faktörler olarak bulundu. Künt yaralanma, TRISS <85, ISS >22 ve GKS <13 olmasý baðýmsýz prognostik faktörler olarak bulundu. Mortaliteyi göstermede en güçlü faktör TRISS olarak bulundu. TRISS analizinde yaþam olasýlýðý %50’nin üstünde olan 307 olgudan 34’ü hayatýný kaybetti.
SONUÇ
Mortaliteye etkili bulunan faktörlerin varlýðýnda toraks travmalý hastalar yüksek risk grubu olarak deðerlendirilip, taný ve tedavide agresif olunmalýdýr. TRISS yöntemine dayalý olarak yapýlacak olgu analizleri hasta bakýmýnda yapýlacak yanlýþlarý daha iyi ortaya koyacak, bunlarýn düzeltilmesine olanak saðlayacaktýr.

BACKGROUND
The purpose of this study was to define the epidemiologic properties and correlation of physiological and anatomical risk factors with the mortality rate among patients with thorax trauma and to ensure early prediction of severe trauma.
METHODS
Files of 371 cases were retrospectively examined. Their initial state in the emergency department was analyzed in terms of mortality development. Age, gender, trauma mechanism, systolic blood pressure and respiration type on admission, accompanying injuries, thorax pathology, trauma scores, and treatment approaches in exitus and surviving cases were compared. Survival probabilities and unexpected mortality rates were computed using the Trauma Revised Score-Injury Severity Score (TRISS).
RESULTS
Age, hypotension, pathologic respiration, blunt injury, accompanying injury, abdominal trauma, high Injury Severity Score (ISS), and low Glasgow Coma Scale (GCS), Revised Trauma Score (RTS), and TRISS were the factors affecting mortality, and presence of blunt injuries, TRISS <85, ISS >22 and GCS <13 were found to be independent prognostic factors. The strongest factor indicating mortality was TRISS. Thirty-four of 307 cases with survival probability of over 50% died.
CONCLUSION
In the presence of factors affecting mortality, patients with thorax trauma should be evaluated as being in a high-risk group and treatment strategies must be aggressive. Case analysis based on the TRISS model would further reveal the mistakes and may improve patient care.

AMAÇ
Türkiye’nin kuzeybatý bölgesinde, açýk göz yaralanmalarý nedeni ile tedavi edilen hastalarýn epidemiyolojisi ve görme sonuçlarý deðerlendirildi.
GEREÇ VE YÖNTEM
2004 ve 2008 yýllarý arasýnda Kocaeli Üniversitesi Týp Fakültesi Göz Hastalýklarý Anabilim Dalýn’da açýk göz yaralanmasý nedeni ile tedavi edilen tüm hastalar retrospektif olarak deðerlendirildi.
BULGULAR
Yaþlarý 3 ile 79 arasýnda deðiþen, 95 hastanýn 95 gözüne ait yaralanmalar deðerlendirildi. Açýk göz yaralanmasý tipi, 76 gözde (%80), laserasyon, 19 gözde (%20) ise yýrtýk idi. Sýçrayýcý cisimlerin neden olduðu göz yaralanmalarý, tüm yaþ gruplarýnda en sýk görülen nedendi. Keskin cisimler 18 yaþ ve üzerindeki hastalarda açýk göz yaralanmalarýnýn en az görülen nedeni iken (%11), 18 yaþtan genç hastalarda, en sýk görülen nedendi (%38,1) (p=0,01). On sekiz yaþýndan genç hastalarda yaralanmalarýn %68,3’ü evde gerçekleþirken, 18 yaþ ve üzerindeki hastalarda yaralanamalarýn %59,2’sinin iþyerinde gerçekleþtiði belirlendi (p=0,000). Görme keskinliðindeki düzelmenin, izole zon 1 yaralanmalarýnda, diðer zon yaralanmalarýna göre daha iyi olduðu görüldü (p=0,043).
SONUÇ
Türkiye’nin kuzeybatýsýnda açýk göz yaralanmalarý, yaþ ve cinsiyete göre deðiþmektedir. Eðitim ve güvenlik önlemleri, açýk göz yaralanmalarýnýn önlenmesinde önemlidir.

BACKGROUND
We aimed to review the epidemiology and visual outcome of patients with open globe injuries in the northwest part of Turkey.
METHODS
All patients admitted to the Department of Ophthalmology, Kocaeli University Faculty of Medicine with open globe injuries between 2004-2008 were reviewed retrospectively.
RESULTS
Ninety-five eyes of 95 patients, aged between 3 and 79 years, were reviewed. The type of open eye injury was laceration in 76 eyes (80%) and rupture in 19 eyes (20%). In all age groups, projectile objects were the most common cause of injury. In patients 18 years and older, sharp objects (11.1%) were the least prevalent cause of open globe injuries; however, traumas with sharp objects were common in patients younger than 18 years (38.1%) (p=0.01). In patients younger than 18 years, most injuries occurred at home (68.3%), while in patients 18 years and older, the majority of ocular traumas occurred at work (59.2%) (p=0.000). Isolated Zone I lesions showed more improvement in visual acuity than other zones (p=0.043).
CONCLUSION
Open globe injury in northwest Turkey varied with age and gender. Education and safety precautions are essential to prevent open eye injuries.

AMAÇ
Bu çalýþmada, bozulmuþ cesetlerdeki travmatik lezyonlarýn irdelenmesi amaçlandý.
GEREÇ VE YÖNTEM
2004-2008 yýllarý arasýnda Adnan Menderes Üniversitesi Týp Fakültesi Adli Týp Anabilim Dalý çalýþanlarý tarafýndan yapýlan toplam 1390 otopsinin kayýtlarýndan, 62 adet bozulmuþ cesede ait rapor incelendi, bunlardan 19 tanesinde travmatik lezyonlar saptandý. Raporlarda bulunan cinsiyet, yaþam þekli, olay yeri, medeni durum, kimlik tanýðý, mevsim, postmortem interval, ölüm nedeni ve orijin, travmatik lezyonlarýn varlýðý gibi özellikler araþtýrýldý.
BULGULAR
Toplam 1390 adli otopsinin %4,5’i bozulmuþ ceset idi. Bunlarýn da %91,9’u erkek, %8,1’i kadýn ve E/K oraný 11.4/1 idi. Olgularýn %38,7’si yalnýz yaþamakta olup, olay yeri %59,7’inde evdi, %30,6’sýnýn vücudunda travmatik lezyon saptandý. Ýlk sýrayý doðal ölümlerde kalp hastalýklarý, intihar orijinli ölümlerde asý, cinayet orijinli ölümlerde kesici delici alet, kaza sonucunda meydana gelen ölümlerde karbonmonoksit zehirlenmesi almaktaydý. Bekar olanlarýn ev içinde cesetlerinin bulunmasý ve cesetleri ev dýþýnda bulunanlarda travmatik bulgularýn olmasý istatistiksel olarak anlamlý idi.
SONUÇ
Bozulmuþ cesetlerde travmatik lezyonlarýn ayrýmýnýn özenli bir þekilde yapýlmasý gerektiðinden tam inceleme ve otopsi yapýlmasý uygun olacaktýr.

BACKGROUND
In this study, we discuss traumatic lesions as assessed in decomposed bodies.
METHODS
From 1390 autopsies, which were performed by Adnan Menderes University, Faculty of Medicine, Department of Forensic Medicine staff during the period 2004-2008, reports of 62 decomposed bodies were searched, and traumatic lesions were found in 19 of them. Features like gender, living conditions, crime scene, identity witness, season, postmortem interval, cause and origin of deaths, and existence of traumatic lesions were investigated.
RESULTS
From the 1390 forensic autopsies, 4.5% were decomposed bodies. Male cases accounted for 91.9%, and the male/female ratio was 11.4/1. From reports, 38.7% lived alone, and the crime scene was the home in 57.9%. Traumatic lesions were found in 30.6%. The leading causes of death were cardiac diseases in natural deaths, hanging in suicide cases, stab wounds in homicide cases, and carbon monoxide poisoning in accidents. It was statistically significant that traumatic lesions were common in outdoor cases and indoor bodies were common among single cases.
CONCLUSION
As it is necessary to distinguish traumatic lesions carefully in decomposed bodies, a full examination and autopsy should be performed.

AMAÇ
Bu çalýþmanýn amacý eriþkin hastalarda oluþan intestinal inkarserasyonlu karýn duvarý fýtýklarýnda morbiditeyi etkileyen faktörleri araþtýrmaktýr.
GEREÇ VE YÖNTEM
Mart 1999-Mart 2008 tarihleri arasýnda 124 olgu (73 erkek) inkarsere intestinal fýtýk tanýsý ile acil ameliyat edildi. Olgularýn yaþ ortalamasý 61±13,87 idi. Ortanca fýtýk süresi 5 yýl (0,1-30) bulundu. Fýtýk tipi, fýtýk süresi, yandaþ hastalýklar, uygulanan cerrahi tedavi ve ameliyat sonrasý komplikasyon bilgileri geriye dönük araþtýrýldý.
BULGULAR
Yirmi beþ hastada (%20) komplikasyon geliþti. On iki hastada (%10) cerrahi alan enfeksiyonu, 10 hastada (%8) septik komplikasyonlar oluþtu. Dört hasta (%3) ameliyat sonrasý dönemde kaybedildi. Strangülasyon geliþmiþ 40 olgunun 18’ine baðýrsak rezeksiyonu yapýldý. Baðýrsak rezeksiyonu yapýlmasýyla iliþkili tek baðýmsýz deðiþkenin kasýk fýtýðý dýþýndaki fýtýklar olduðu görüldü (p=0,039). Fýtýk süresi ve inkarserasyon süresi ile komplikasyonlar arasýnda anlamlý bir iliþki saptanmadý. Yandaþ hastalýðý olanlarda komplikasyon oranlarý anlamlý derecede yüksek idi (p<0,001). Yaþ ile komplikasyon geliþimi arasýnda da anlamlý iliþki bulundu (p=0,034). Çok deðiþkenli analizde komplikasyon oluþumunda tek baðýmsýz deðiþkenin ASA skoru olduðu saptandý (p<0,001).
SONUÇ
Yandaþ hastalýðý olan ve ASA skoru yüksek hastalarda komplikasyon oraný yüksek olduðundan fýtýk boðulmasý geliþmeden önce planlý ameliyat yapýlmasý önerilir.

BACKGROUND
The aim of this study was to investigate factors that affect morbidity in adults with incarcerated intestinal hernia of the abdominal wall.
METHODS
124 patients with a mean age of 61±13.87 years (73 males) underwent emergency surgery for incarcerated intestinal hernia between March 1999 and March 2008. The median duration of the hernia was 5 years (0.1-30). Type and duration of hernia, accompanying diseases, surgical procedure, and operation-related complications were retrospectively evaluated.
RESULTS
Twenty-five patients (20%) had complications. Twelve patients (10%) had surgical site infection and 10 patients (8%) had septic complications. Four patients (3%) died in the postoperative period. Out of 40 patients developing strangulation, 18 underwent bowel resection. The only independent variable concerning bowel resection other than inguinal hernia was found to be ventral hernia (p=0.039). There was no statistical significance between duration of hernia and incarceration and complications. The rate of complications was significantly high in the patients with accompanying diseases (p<0.001). The relation between age and complications was also significant (p=0.034). Multivariate analyses showed high ASA scores as the only independent variable for development of complications (p<0.001).
CONCLUSION
Patients with comorbid diseases and high ASA scores should be informed about the elevated risk of complications, and scheduled surgery before the development of incarceration should be recommended.

GEREÇ VE YÖNTEM
Ocak 2006-Ocak 2010 tarihleri arasýnda elektrik çarpmasý nedeniyle acil servise baþvuran olgular geriye dönük olarak incelendi. Olgular yaþ, cinsiyet, elektrik kaynaðýnýn gücü (düþük-yüksek voltaj), mevsimsel daðýlým, EKG deðiþiklikleri, laboratuvar sonuçlarý, takip edildiði klinikler, komplikasyon ve ölüm oranlarý bakýmýndan deðerlendirildi.
BULGULAR
Olgularýn 84’ü (%57,1) düþük voltaj elektriðe (I. Grup), 63’ü (%42,9) yüksek voltaj elektriðe (II. Grup) maruz kalmýþtý. Yaralanan olgularýn çoðunluðunu 26-45 yaþ arasý grup oluþturmaktaydý. Kadýnlarýn %85,7’sinin düþük voltaj, erkeklerin %51,8’inin yüksek voltaj elektrikle yaralandýðý saptandý. Alanin aminotransferaz, aspartat aminotransferaz, laktat dehidrogenaz, kreatin kinaz ve kreatin kinaz-miyokardiyal band Grup II’de yüksek, kalsiyum düzeyi ise Grup II’de düþüktü (p<0,005). Komplikasyonlar (yüksekten düþmeye baðlý patolojiler, kardiyak disritmiler, kompartman sendromu) ve ölüm sýklýðý grup II’de fazlaydý (p<0,005).
SONUÇ
Yüksek voltajlý elektrik çarpmasýnda kas harabiyetinin derecesiyle birlikte, kardiyak ve yüksekten düþmeye baðlý komplikasyonlarýn ve ölüm oranýnýn daha fazla olduðu görülmektedir.

BACKGROUND
The purpose of this study was to investigate the demographic and clinical characteristics of electrical injuries, laboratory findings, complications, and mortality and morbidity rates of these injuries.
METHODS
Patients with electrical injuries admitted to the emergency department between January 2006-2010 were retrospectively analyzed. The cases were evaluated by age, gender, source of electrical power (low-high voltage), seasonal distribution, ECG changes, laboratory findings, clinical care units, complications, and mortality rate.
RESULTS
Eighty-four (57.1%) of the cases were exposed to low-voltage electricity (Group I), while 63 (42.9%) of the cases were exposed to high-voltage electricity (Group II). The majority of cases with electrical injuries were aged 26-45 years. Thirty of the women (85.7%) were wounded by low-voltage while 58 of the men (51.8%) were wounded by high-voltage electricity. Alanine aminotransferase, aspartate aminotransferase, lactate dehydrogenase, creatine kinase, and CK-MB levels were higher and the level of calcium was lower in Group II. Complications (pathologies due to fall from high levels, cardiac dysrhythmias, compartment syndrome) and the mortality rate were higher in Group II.
CONCLUSION
In cases with high-voltage electrical injuries, cardiac complications, complications due to fall from high levels and the mortality rate increase in conjunction with the degree of the muscle damage.

Ýnsizyonel hernilerin tamirinde yama kullanýmýnýn nüks oranýný azalttýðý, ancak cerrahi bölgesi enfeksiyonu riskini arttýrabildiði gösterilmiþtir. Bu durum, cerrahi olarak karýn duvarý tamirinde en çok korkulan ve yýkýcý olan komplikasyonlardan biridir. Bu çalýþmanýn amacý, kronik protez enfeksiyonlu iki hastada uygulanan yeni bir cerrahi tekniði tanýmlamaktýr. Ek olarak, bu iþlemin sonucu, güvenilirlik, daha sonraki cerrahi bölgesi enfeksiyonu ve nüks önlenmesi bakýmýndan analiz edilmiþtir. Burada iki olgu sunuldu. Prosedürün temelini enfekte protez ile çevre dokularýn geniþ cerrahi eksizyonu + biyolojik protezle karýn duvar tamiri oluþturmaktadýr. Her iki hasta da ameliyat sonrasý problemsiz takip edildi. Prosedürden sonra cerrahi bölgenin enfeksiyonu ortalama 36 aylýk bir takipten sonra tamamen iyileþti. Ýnsizyonel herni nüks etmedi. Bu benzersiz cerrahi teknik, yalnýzca güvenilir olduðunu kanýtlamakla birlikte, ayný zamanda radikal eksizyon yoluyla kullanýlmasý ve hiçbir ameliyat sonrasý komplikasyon veya nüks oluþmamasý ile kronik protez enfeksiyonunu da çözmüþtür. Bu teknik, biyolojik protezlerin enfeksiyon bölgelerinde implantasyon ile ilgili olarak güvenle ve etkin bir þekilde kullanýlabileceðini doðrulamýþtýr.

The use of meshes to repair incisional hernias has been shown to reduce the recurrence rate, though it may increase the risk of surgical site infection. This is one of the most feared and devastating complications of surgical abdominal wall repair. The aim of this work is to describe a new surgical technique that was used to treat two patients suffering from chronic prosthesis infection. Additionally, the outcome of this procedure will be analyzed in terms of its safety, subsequent site infection and recurrence prevention. Two case reports are presented. The procedure was based on a wide surgical excision of the infected prosthesis and the surrounding tissues, plus abdominal wall repair with biological prosthesis. Both patients experienced an uneventful postoperative course. Infection of the surgical site resolved following the procedure and, after a mean follow-up of 36 months, no recurrences of the incisional hernia had occurred. This unique surgical technique not only proved to be safe, but it also solved the chronic prosthesis infection through its use of radical excision, without any postoperative complications or recurrence. This technique confirmed that biological prostheses can be used safely and effectively for implantation in sites of infection.

Yabancý cisim aspirasyonu çocukluk döneminde yaygýn ve hayatý tehdit eden acil bir durumdur. Mental retardasyon öyküsü olan, 14 yaþýnda erkek hasta, yabancý cisim aspirasyonu tanýsýyla baþka bir merkezden hastanemize nakledildi. Öyküsünden birkaç yýldýr epilepsisi olduðu öðrenildi. Yaklaþýk 10 saat önce, evde, jeneralize tonik-klonik kasýlmalar sýrasýnda, olasý bir havayolu yaralanmasýný önlemek amacýyla ailesi aðzýna acilen tahta kaþýk yerleþtirmiþ. Ancak hasta diþleriyle kaþýðýn sapýný kýrarak, aniden büyük bir tahta parçasýný aspire etmiþti. Rijit bronkoskopla yapýlan deðerlendirme, glottisin 2 cm ilerisinde, dikey olarak yerleþmiþ, büyük bir tahta parçasýnýn varlýðýný gösterdi. Bu büyük tahta kaþýk parçasýnýn trakeadan bronkoskopla çýkarýlmasý uzun ve zor olsa da baþarýlý oldu. Ancak bu giriþimi takiben, yoðun bakým ünitesinde hastada subkutan amfizem ve pnömotoraks olduðu görüldü. Yoðun bakým ünitesinde yerleþtirilen toraks tüpü ile genel durumu düzelen hasta, rijit bronkoskopiden üç gün sonra taburcu edildi. Erken taný ve yabancý cismin acilen çýkarýlmasý mortaliteyi önemli ölçüde azaltmaktadýr. Ancak yabancý cisme veya bronkoskopiye ait komplikasyonlar geliþebilir. Sonuç olarak, yabancý cismin fiziksel özellikleri, pozisyonu ve yerleþim yeri, tecrübeli ellerde bile, sonucu etkileyebilir.

Foreign body aspiration in childhood is a common and life-threatening emergency. A 14-year-old male with history of mental retardation was transferred from another center to our hospital with diagnosis of foreign body aspiration. According to the anamnesis, he had been diagnosed with epilepsy a few years ago. Approximately 10 hours before admission, while at home, his parents had urgently placed a wooden spoon in the boy’s mouth during a generalized tonic-clonic seizure to avoid possible airway injury. Nevertheless, he had inhaled a large piece of the wood after breaking the handle of the spoon with his teeth. Rigid bronchoscopic evaluation revealed the presence of a large piece of wood sitting vertically 2 cm beyond the glottis. Although bronchoscopic removal of the wooden piece from the trachea was difficult and prolonged, it was successful. Following this process, he presented with subcutaneous emphysema and pneumothorax in the intensive care unit (ICU). After improvement with the aid of chest tube drainage in the ICU, he was discharged from the hospital on the 3rd day of rigid bronchoscopy. Early diagnosis and urgent removal of a foreign body are very important for reducing mortality. However, complications related to the foreign body itself or the bronchoscopy may occur. In conclusion, the physical characteristics, position and location of the foreign body can influence the outcome, even in skilled hands.

Pnömobili safra kesesinde veya safra yollarýnda hava oluþmasý olarak tanýmlanýr. Pnömobilinin birçok nedeni vardýr ve bunlar arasýnda cerrahi olarak oluþturulmuþ biliyoenterik fistüller, endoskopik retrograt kolanjiopankreatografide safra yollarýna girilmesi, anfizamatöz kolesistit ve piyojenik kolanjit yer almaktadýr. Künt karýn travmasý sonrasýnda da pnömobili geliþebileceði bildirilmiþtir. Fakat bu sayý günümüze kadar beþ olguyu geçmemektedir. Bu yazýda, motorlu taþýt çarpmasý sonucu oluþan künt karýn travmasýna baðlý pnömobili geliþen ve medikal tedavi uygulanan olgu sunuldu.

Pneumobilia is described as occurrence of free air in the gallbladder or biliary tree. There are a number of causes of pneumobilia, including surgically created biliary enteric fistula, instrumentation of the bile duct on endoscopic retrograde cholangiopancreatography, emphysematous cholecystitis, and pyogenic cholangitis. Pneumobilia has also occurred following blunt abdominal trauma, but to date, no more than five cases of such injury have been reported in the literature. In this report, we present a patient struck by a motor vehicle with traumatic pneumobilia following blunt trauma to the abdomen, which was managed conservatively.

Mesane divertikülleri detrusor kasýnýn doðuþtan zayýflýðýndan kaynaklanýr. Sýklýkla divertikül içindeki üriner staz sunucu geliþen idrar yollarý enfeksiyonu ile kendini gösterir. Mesane çýkým týkanýklýðý, alt ekstremitede siyanoz, intestinal týkanýklýk, üreteral týkanýklýk gibi divertikülün doðrudan basýsý sonucu ve divertikülün kendiliðinden rüptüre sonucu geliþen peritonit gibi farklý klinik tablolara neden olabilmektedir. Bu yazýda, perfore apandisiti taklit eden ve perforasyon olmadan tekrarlayan jeneralize peritonite neden olan mesane divertikülü olan bir olgu sunuldu.

Bladder diverticula develop from congenital detrusor muscle defect and frequently present with urinary tract infection, which occurs as a result of urinary stasis in the diverticula. Different clinical presentations, such as bladder outlet obstruction, cyanosis of the lower extremities, intestinal obstruction, ureteral obstruction (which may occur due to direct diverticular compression), and peritonitis due to spontaneous rupture of the diverticula, were reported previously. Here, we report a case with the diagnosis of bladder diverticulum that caused recurrent generalized peritonitis without perforation and mimicked perforated appendicitis.

Spontan pnömomediastinum (SPM) nadir, çoðunlukla genç erkeklerde görülen, zemin hazýrlayan faktör bulunmayan, ya da altta yatan sebebi bulunmayan selim bir hastalýktýr. SPM konservatif tedaviye oldukça iyi yanýt verir ve tekrarlama riski oldukça düþüktür. Çalýþmamýzda, kliniðimizde yatýrýlarak takip edilen iki SPM olgusu literatür eþliðinde tartýþýldý.

Spontaneous pneumomediastinum (SPM) is an uncommon, benign, self-limited disorder that usually occurs in young adult males without any apparent precipitating factor or disease. SPM responds extremely well to conservative treatment, without recurrence in the great majority of cases. In this report, two patients who were admitted for SPM are discussed together with the associated literature.

Tüm dünyada genç erkekler arasýnda en sevilen sporlardan biri olan futbol, pek çok ortopedik yaralanmalara yol açabilir. Diseksiyon gibi vasküler yaralanmalar nadir görülmelerine raðmen, taný konulmadýðýnda ölüme sebebiyet verebilir. Bu yazýda, baþýna ve boynuna futbol topu çarptýktan sonra travmatik internal karotid arter diseksiyonu oluþarak geniþ orta serebral arter infarktý geliþen 31 yaþýndaki erkek hasta sunuldu. Hasta dekompresif cerrahi sonrasý hafif nörolojik hasarla düzeldi.

Soccer, one of the most popular sports worldwide among young men, can result in a wide range of orthopedic injuries. Although vascular injuries such as dissection occur rarely, they can cause significant mortality if left undiagnosed. We report herein a 31-year-old male who suffered a large middle cerebral artery infarction due to traumatic internal carotid artery dissection after a ball struck his head and neck. He recovered with mild neurologic deficit after decompressive surgery.

Kolorektal yabancý cisimlere seyrek rastlanmakla birlikte çoðunlukla artan eþcinsellik ve anal otoerotizm insidansý ile iliþkilidir. Taný, düz abdominal grafiler ve rektal inceleme ile doðrulanabilir, ancak bilgisayarlý karýn tomografisi tedavide daha belirleyicidir. Elle çýkarma, yalnýzca çok aþaðý bölgede bulunan nesneler için mümkün olabilir; yukarý bölgede yabancý cisim bulunan hastalar, çoðunlukla ameliyathanede majör bir müdahale gerektirirler. Erken bir laparotomi kararý, nesnenin yerleþimini tam olarak belirlemek, komþu damar yapýlara yönelik elde olmayan herhangi bir hasar ile birlikte anal inkontinansý engellemek üzere yalnýzca hastanýn uygun incelemelere tabi tutulmasýndan sonra yapýlmalýdýr. Bu yazýda, acil servise, sýkýþmýþ, büyük ve ihmal edilmiþ rektal yabancý cisim (boða boynuzu) nedenli baðýrsak týkanmasýyla baþvuran genç bir erkek olgu sunuldu. Yabancý cismin çýkartýlmasý için acil laparotomi yapýldý.

Colorectal foreign bodies are infrequently encountered, and are mostly associated with increased incidence of homosexuality and anal auto-erotism. The diagnosis may be confirmed by plain abdominal radiographs and rectal examination, but abdominal computerized tomography can be decisive in the further management. Manual extraction is only possible for very low-lying objects; patients with high-lying foreign bodies usually require a major intervention in the operation theater. An early decision of laparotomy should only be made after subjecting the patient to suitable investigations to determine exactly the localization of the object, in order to avoid any inadvertent damage to the adjoining vasculature as well as anal incontinence. We report the case of a young adult male who presented in the emergency department with an incarcerated, large, neglected rectal foreign body, a ‘bull horn’, causing intestinal obstruction. Emergent laparotomy was required for its removal.