Abdullah Oguz - Academia.edu (original) (raw)

Papers by Abdullah Oguz

Acta Chirurgica Belgica, 2016

Background Superior mesenteric artery syndrome (SMAS) results from the compression of the third p... more Background Superior mesenteric artery syndrome (SMAS) results from the compression of the third part of the duodenum between the aorta and the proximal part of the superior mesenteric artery (SMA). Clinical presentation of SMAS is characterized by the dilatation of the proximal part of the third part of the duodenum. SMAS is a rare cause of the upper gastrointestinal system (UGS) obstruction. In this study, we aimed to present our clinical experience in the treatment of five patients with SMAS, which is a rare clinical condition requiring surgery. Patients and methods The retrospective study included five patients who were treated due to SMAS at our clinic between January 2010 and January 2014. Results All the patients were underweight, with a mean BMI of 15.73 (14-16). The clinical symptoms included epigastric pain after food intake, large volume bilious emesis, early satiety, failure to gain weight, indigestion, esophageal reflux, sense of fullness, and persistent weight loss. SMAS was diagnosed using barium meal studies, upper gastrointestinal endoscopy, abdominal ultrasonography, and CT angiography. Four patients underwent duodenojejunostomy and one patient was managed with gastrojejunostomy. No complication was observed during the postoperative period, and all the patients achieved significant improvement in symptoms. Conclusion SMAS is a rare cause of UGS obstruction, and the diagnosis of SMAS is often delayed. SMAS should be suspected in the differential diagnosis of the patients with unsubstantiated symptoms of persistent nausea, emesis, and significant weight loss.

Medical ultrasonography, 2015

Minimally invasive parathyroidectomy (MIP) has become the first line of treatment for primary hyp... more Minimally invasive parathyroidectomy (MIP) has become the first line of treatment for primary hyperparathyroidism caused by solitary parathyroid adenoma. In order to increase the sensitivity of high-resolution ultrasonography (hUS), surgeon performed ultrasonography (SUS) has been increasingly used preoperatively. However, a radiologist and surgeon performing ultrasonography (RSUS) has not been a usual practice. In this study, we aimed to evaluate the clinical contribution of RSUS on MIP. From 2012 to 2014, a total of 30 consecutive patients (4 male, 26 female, mean age 48.87+/-14.52 years) with solitary parathyroid adenoma, were included in the study. All patients underwent preoperative hUS and Technetium-99m sestamibi scintigraphy. In patients, demographic characteristics, diagnostic tools used, levels of biochemical parameters, duration of operation, and length of hospital stay were recorded. Adenomas were successfully localized by US in all patients and the surgical approach was...

European Journal of Trauma and Emergency Surgery, 2015

ABSTRACT Difficulties in the detection of pancreatic damage result in morbidity and mortality in ... more ABSTRACT Difficulties in the detection of pancreatic damage result in morbidity and mortality in cases of pancreatic trauma. This study was performed to determine factors affecting morbidity and mortality in pancreatic trauma. The records of 33 patients who underwent surgery for pancreatic trauma between January 2004 and December 2013 were analyzed retrospectively. The types of injury were penetrating injury and blunt abdominal trauma in 75.8 and 24.2 % of all cases, respectively. Injuries were classified as stage 1 in 6 cases (18.2 %), stage 2 in 18 cases (54.5 %), stage 3 in 5 cases (15.2 %), and stage 4 in 4 cases (12.1 %). The average injury severity scale (ISS) value was 25.70 ± 9:33. Six patients (18.2 %) had isolated pancreatic injury, 27 (81.2 %) had additional intraabdominal organ injuries and 10 patients (30.3 %) had extraabdominal organ injuries. The mean length of hospital stay was 13.24 ± 9 days. Various complications were observed in eight patients (24.2 %) and mortality occurred in three (9.1 %). Complications were more frequent in patients with high pancreatic damage scores (p = 0.024), additional organ injuries (p = 0.05), and blunt trauma (p = 0.026). Pancreatic injury score was associated with morbidity, while the presence of major vascular injury was associated with mortality. Complications were significantly more common in injuries with higher pancreatic damage scores, additional organ injuries, and blunt abdominal trauma. Pancreatic injury score was associated with morbidity, while the presence of major vascular injury was associated with mortality.

ABSTRACT Gallstone ileus is a rare but serious complication of cholelithiasis. It is a rare cause... more ABSTRACT Gallstone ileus is a rare but serious complication of cholelithiasis. It is a rare cause of small bowel obstruction but it accounts up to 25% of non-strangulated small bowel obstructions in elderly. Obstruction usually occurs in the terminal ileum. Although the most frequent mechanism of gallstone ileus is migration of the gallstone through a gallbladder-duodenal fistula, there have been cases of bowel obstruction caused by gallstones without any findings of bilio-enteric fistula during the operation. The diagnosis is usually delayed due to nonspecific clinical signs and symptoms. Abdominal computerized tomography (CT) scan is the optimal way to diagnose the gallstone ileus. It can identify the site and nature of the obstruction. The optimal surgical approach is a matter of debate. Enterolithotomy is the most performed operation. One stage operation should be performed in selected low risk patients. In this study, we report a 55 years old male patient who underwent surgical...

International Surgery, 2015

Our objective for this study was to discuss the usability of mean platelet volume, which is assoc... more Our objective for this study was to discuss the usability of mean platelet volume, which is associated with numerous vascular pathologies, in the early diagnosis of acute mesenteric ischemia. Acute mesenteric ischemia is an uncommon, life-threatening clinical condition mostly seen in the elderly. Early diagnosis of acute mesenteric ischemia and correction of blood circulation before necrosis occurs are important factors affecting prognosis. A total of 95 patients who underwent emergency surgery for acute mesenteric ischemia and 90 healthy volunteers as control group were included in this study. Age, gender, hemoglobin values, white blood cell counts, mean platelet volume, and platelet counts are recorded for evaluation. The mean platelet volume values were significantly higher in patients with acute mesenteric ischemia than in the controls (9.4 ± 1.1 fL and 7.4 ± 1.4 fL, respectively; P < 0.001). Receiver-operating characteristic analysis demonstrated a cutoff value of mean platelet volume as 8.1 fL (area under the curve, 0.862), a sensitivity of 83.2%, and a specificity of 80%. As a result, in the patients who are admitted to the hospital with acute nonspecific abdominal pain and suspected of having acute mesenteric ischemia, high mean platelet volume values in routine hemograms support the diagnosis of acute mesenteric ischemia.

Dicle Medical Journal / Dicle Tip Dergisi, 2015

ABSTRACT ABSTRACT Wandering spleen (WS) is a rare clinical condition resulting from an abnormally... more ABSTRACT ABSTRACT Wandering spleen (WS) is a rare clinical condition resulting from an abnormally long splenic pedicle and the absence or weakening of the supporting splenic ligaments that help to hold the spleen stationary. WS is more commonly seen in females aged between 20 and 40 years. Congenital and acquired factors are reported as the predisposing factors for WS. Patients with WS may be asymptomatic, or may be evident with a painful abdominal mass or an acute abdomen due to gastrointestinal symptoms and torsion of the WS. The diagnosis of WS can be established incidentally or during the Ultrasonography (USG) or Computed Tomography (CT) explorations performed for other pathologies. A high index of suspicion aids in the diagnosis of WS. WS is mostly treated by surgery and splenopexy remains the method of choice. In the cases with persistent ischemia following detorsion, splenectomy should be performed either via laparoscopy or laparotomy. In the present report, we present a 37-year-old woman who presented with a wandering spleen causing ileus. The patient underwent laparoscopic splenectomy. Wandering spleen is a rare condition which should be suspected as a potential cause of ileus and acute abdomen.

Dicle Medical Journal / Dicle Tip Dergisi, 2015

ABSTRACT An inguinal hernia containing appendix is termed an Amyand’s hernia. It is a rare condit... more ABSTRACT An inguinal hernia containing appendix is termed an Amyand’s hernia. It is a rare condition estimated to be found in approximately 1 % of all inguinal hernia repairs. Depending on the presence of inflammation in the hernia sac and obstruction of hernia, clinical presentation can vary. We report a case of left sided inguinal hernia in which appendix vermiformis was detected in a 74 year-old male. Appendix was not inflammated, so it was reduced and then mesh hernioplasty was performed. The postoperative course was uneventful. Performing appendectomy is controversial in Amyand hernias in which appendix is not inflammated. Appendectomy is recommended in left sided Amyand hernias, due to the risc of misdiagnosis if appendicitis develops in future. We didn’t perform appendectomy because our patient was elderly and had a low risk for developing acute appendicitis. Amyand hernias are usually diagnosed peroperatively. Decision for appendectomy relies on the inflammation of appendix, the side of the hernia, the age and the comorbidities of the patient.

International Journal of Surgery, 2015

The purpose of this study was to investigate the effect of Sulforaphane on ischemia/ reperfusion ... more The purpose of this study was to investigate the effect of Sulforaphane on ischemia/ reperfusion (IR) injury of the liver and distant organs resulting from liver blood flow arrest. Fourty Wistar rats were assigned into four groups, each included 10 rats were used. Group I as only laparatomy, Group II laparatomy and Sulforaphane application, Group III hepatic IR; and Group IV as hepatic IR and Sulforaphane application group. Animals were subjected to liver ischemia for 30 min and then reperfusion is started. 5 mg/kg Sulforaphane was applied via oral lavage 15 minutes before initiating the experimental study. Blood samples were taken from the animals for biochemical analysis at 60th minutes of the experiment in the first and second groups; 30 minutes after beginning reperfusion in the third and forth groups. Simultaneously, liver, lung and kidney tissues were sampled for biochemical and histopathological examinations. The administration of sulforaphane significantly reduced the serum TOA and liver TOA levels, increased the serum TAC and liver TAC levels and also decreased The OSI and liver OSI levels. In the histopathologic examination, the injury was reduced by the administration of sulforaphane. Administration of sulforaphane did not lead to any significant changes in any parameter including histopathological parameters in both the kidney and the lung. Sulforaphane reduced the liver oxidative stress from I/R injury. A histological injury in liver was reduced by sulforaphane administration. However, there were no significant effects of sulforaphane on the remote organ injuries induced by IR.

International surgery, Jan 10, 2015

We aimed to present our clinical experience with FG treatment. Fornier's Gangrene (FG) is a r... more We aimed to present our clinical experience with FG treatment. Fornier's Gangrene (FG) is a rare but serious disease characterized by progressive necrosis in the genitourinary and perineal region. The retrospective study included 43 patients. The patients were divided into two groups as survivors and non-survivors. Included in the analysis were data pertaining to demographics, predisposing factors, comorbidities, results of bacteriologic analyses, number of debridements, duration of treatment, the FG Severity Index (FGSI) score, fecal diversion methods (Trephine ostomy or Flexi-Seal Fecal Management System-FMS), and dressing methods (wet or negative aspiration system). In the non-survivor group, urea, WBC, and age were significantly higher, whereas albumin, hematocrit, platelet count, and length of hospital stay (LOHS) were significantly lower compared to the survivor group. Mean FGSI was lower in survivors in comparison with non-survivals (5.00±1.86 and 10.00±1.27, respectively...

La Clinica terapeutica, 2014

Rectovaginal fistula is an epithelial connection between the anterior wall of the rectum and post... more Rectovaginal fistula is an epithelial connection between the anterior wall of the rectum and posterior wall of the vagina. The etiology of the rectovaginal fistula can be trauma orginated from violent acts or foreign bodies as well as trauma during obstetric, gynecologic, or colorectal surgeries. The purpose of this study was to share our clinic experience and surgical management for rectovaginal fistulas. This study was conducted at the Department of General Surgery, University of Dicle. All patients who were treated for rectovaginal fistulas between January 2005 and December 2011 were included to this study. There were fifteen patients in a mean age of 32 ± 9.6. The most common complains of patients were arrival of gas and stool from the vagina. The etilogy of rectovaginal fistula was most commonly obstetric trauma in our patients and three of them had anal incontinance. The mean time of hospital stay was 5 days ± 1.7. Postoperative wound infection was seen in two patients and rec...

Minerva chirurgica, 2012

The aim of this study was to emphasize the efficacy of the laparoscopic surgical method performed... more The aim of this study was to emphasize the efficacy of the laparoscopic surgical method performed for elimination of catheter-induced mechanical complications developing in CAPD patients. Medical records of 31 patients who had undergone CAPD catheter implantation at the Dicle University Medical Faculty Hemodialysis Unit between January 2001 and June 2012 were examined retrospectively. Double-felted spiral Tenckhoff catheters were used in all patients for peritoneal access. We performed a retrospective review of 31 patients who, over an 11-year period, underwent revision of a peritoneal dialysis catheter using laparoscopy. Chronic renal failure requiring dialysis occurred in 31 patients (12 males and 19 female). Ages ranged from 13 to 77 years (mean age 35.8 years). As a conclusion, CAPD is currently a choice to be frequently used in patients with ESRD. In the treatment of CAPD-associated mechanical catheter complications laparoscopic method may be preferred because of patient comfor...

International Surgery, 2015

As a serious complication of cholelithiasis, gangrenous cholecystitis presents greater mortality ... more As a serious complication of cholelithiasis, gangrenous cholecystitis presents greater mortality than noncomplicated cholecystitis. The aim of this study was to specify the risk factors on mortality. 107 consecutive patients who underwent surgery due to gangrenous cholecystitis between January 1997 and October 2011 were investigated retrospectively. The study included 60 (56.1%) females and 47 (43.9%) males, with a mean age of 60.7 ± 16.4 (21-88) years. Cardiovascular diseases were the most frequently accompanying medical issues (24.3%). Thirty-six complications (33.6%) developed in 29 patients, and surgical site infection was proven as the most common. Longer delay time prior to hospital admission, low white blood cell count, presence of diabetes mellitus, higher blood levels of aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase and total bilirubin, pericholecystic fluid in abdominal ultrasonography, and conversion from laparoscopic surgery to open surgery were identified as risk factors affecting mortality (P < 0.001, P = 0.001, P = 0.044, P = 0.005, P = 0.049, P = 0.009, P = 0.022, P = 0.011, and P = 0.004, respectively). Longer delay time prior to hospital admission and low white blood cell count were determined as independent risk factors affecting mortality.

International Surgery, 2015

The aim of this study was to analyze the presence of malignancy in patients with Hashimoto&am... more The aim of this study was to analyze the presence of malignancy in patients with Hashimoto's thyroiditis and to investigate the reliability of preoperative fine-needle aspiration biopsy (FNAB). The retrospective study included 44 patients who were operated on for nodular goiter between December 2010 and October 2011. The patients underwent thyroidectomy following a cytologic analysis plus FNAB. Hashimoto's thyroiditis was confirmed on histopathology in all patients. FNAB results were defined as benign in 14 (31.8%), suspicion for malignancy in 17 (38.6%), malignant in 9 (20.5%), and inadequate in 4 (9.1%). Following the thyroidectomy, presence of papillary thyroid carcinoma and follicular variant of papillary thyroid carcinoma were detected in 10 patients (22.7%) and 1 (2.3%) patient, respectively. The FNAB results were interpreted in terms of malignancy, which revealed the sensitivity as 80%; specificity, 40%; false positives, 69.2%; false negatives, 14.3%; positive predictive value, 31.8%; negative predictive value, 85.7%; and diagnostic accuracy, 50%. The coexistence of Hashimoto's thyroiditis with papillary thyroid carcinoma is quite common. The FNAB results for such cases are hard to evaluate, and they are likely to increase the number of false positives.

Turkish Journal of Surgery, 2013

Gastroenterology Review, 2012

The Journal of Infection in Developing Countries, 2014

We aimed to analyze the approaches to the diagnosis and treatment of patients with fascioliasis i... more We aimed to analyze the approaches to the diagnosis and treatment of patients with fascioliasis in light of current literature. Thirty-nine patients with fascioliasis admitted to the Surgery Clinic of Dicle Medical Faculty (Turkey) were included in this study. The demographic, clinical, diagnostic, treatment and outcome data were analyzed retrospectively. Abdominal pain (n = 37; 95%) and eosinophilia (n = 31; 79%) were the most common findings. Twenty-seven patients were diagnosed by clinical and radiological findings. Patients were treated with triclabendazole. Thirty-six (92.4%) of the patients improved after medical treatment. The presence of typical clinical, laboratory and radiological findings is sufficient for diagnosis. Triclabendazole administration is often an effective treatment, with improvements occurring over the course of a few months.

Journal of Obstetrics and Gynaecology Research, 2014

The purpose of this study was to evaluate the diagnostic methods, predisposing risk factors and s... more The purpose of this study was to evaluate the diagnostic methods, predisposing risk factors and surgical treatment options in patients with translocation of intrauterine devices (IUD). Diagnosis, predisposing factors and treatment of 34 patients with translocation of IUD was evaluated in this retrospective study. Complaints of pain during insertion and history of cesarean section were present in 70.5% and 58.8% of patients, respectively. IUD-related complications were detected in 52.8% of patients. Transvaginal ultrasonography was used to detect translocation of IUD in 55.8% of cases. Laparoscopy was performed in 55.8% of patients. There were high rates of history of cesarean section, insertion in the puerperal period and insertion by midwives in patients with translocated IUD. These may be predisposing factors for IUD translocation. The clinician who inserts the IUD should be experienced in this area and obtain sufficient information from the pelvic examination prior to insertion of the device. Gynecological examination should be conducted for a proper diagnosis of translocation of IUD. In the event that the IUD string is not visible in the gynecological examination, transvaginal ultrasonography should be performed. If the IUD is still not visible, then abdominal radiography should be performed. As soon as diagnosis of translocation of IUD has been established, surgical treatment should be planned. First treatment of choice should be laparoscopy.

Acta Chirurgica Belgica, 2016

Background Superior mesenteric artery syndrome (SMAS) results from the compression of the third p... more Background Superior mesenteric artery syndrome (SMAS) results from the compression of the third part of the duodenum between the aorta and the proximal part of the superior mesenteric artery (SMA). Clinical presentation of SMAS is characterized by the dilatation of the proximal part of the third part of the duodenum. SMAS is a rare cause of the upper gastrointestinal system (UGS) obstruction. In this study, we aimed to present our clinical experience in the treatment of five patients with SMAS, which is a rare clinical condition requiring surgery. Patients and methods The retrospective study included five patients who were treated due to SMAS at our clinic between January 2010 and January 2014. Results All the patients were underweight, with a mean BMI of 15.73 (14-16). The clinical symptoms included epigastric pain after food intake, large volume bilious emesis, early satiety, failure to gain weight, indigestion, esophageal reflux, sense of fullness, and persistent weight loss. SMAS was diagnosed using barium meal studies, upper gastrointestinal endoscopy, abdominal ultrasonography, and CT angiography. Four patients underwent duodenojejunostomy and one patient was managed with gastrojejunostomy. No complication was observed during the postoperative period, and all the patients achieved significant improvement in symptoms. Conclusion SMAS is a rare cause of UGS obstruction, and the diagnosis of SMAS is often delayed. SMAS should be suspected in the differential diagnosis of the patients with unsubstantiated symptoms of persistent nausea, emesis, and significant weight loss.

Medical ultrasonography, 2015

Minimally invasive parathyroidectomy (MIP) has become the first line of treatment for primary hyp... more Minimally invasive parathyroidectomy (MIP) has become the first line of treatment for primary hyperparathyroidism caused by solitary parathyroid adenoma. In order to increase the sensitivity of high-resolution ultrasonography (hUS), surgeon performed ultrasonography (SUS) has been increasingly used preoperatively. However, a radiologist and surgeon performing ultrasonography (RSUS) has not been a usual practice. In this study, we aimed to evaluate the clinical contribution of RSUS on MIP. From 2012 to 2014, a total of 30 consecutive patients (4 male, 26 female, mean age 48.87+/-14.52 years) with solitary parathyroid adenoma, were included in the study. All patients underwent preoperative hUS and Technetium-99m sestamibi scintigraphy. In patients, demographic characteristics, diagnostic tools used, levels of biochemical parameters, duration of operation, and length of hospital stay were recorded. Adenomas were successfully localized by US in all patients and the surgical approach was...

European Journal of Trauma and Emergency Surgery, 2015

ABSTRACT Difficulties in the detection of pancreatic damage result in morbidity and mortality in ... more ABSTRACT Difficulties in the detection of pancreatic damage result in morbidity and mortality in cases of pancreatic trauma. This study was performed to determine factors affecting morbidity and mortality in pancreatic trauma. The records of 33 patients who underwent surgery for pancreatic trauma between January 2004 and December 2013 were analyzed retrospectively. The types of injury were penetrating injury and blunt abdominal trauma in 75.8 and 24.2 % of all cases, respectively. Injuries were classified as stage 1 in 6 cases (18.2 %), stage 2 in 18 cases (54.5 %), stage 3 in 5 cases (15.2 %), and stage 4 in 4 cases (12.1 %). The average injury severity scale (ISS) value was 25.70 ± 9:33. Six patients (18.2 %) had isolated pancreatic injury, 27 (81.2 %) had additional intraabdominal organ injuries and 10 patients (30.3 %) had extraabdominal organ injuries. The mean length of hospital stay was 13.24 ± 9 days. Various complications were observed in eight patients (24.2 %) and mortality occurred in three (9.1 %). Complications were more frequent in patients with high pancreatic damage scores (p = 0.024), additional organ injuries (p = 0.05), and blunt trauma (p = 0.026). Pancreatic injury score was associated with morbidity, while the presence of major vascular injury was associated with mortality. Complications were significantly more common in injuries with higher pancreatic damage scores, additional organ injuries, and blunt abdominal trauma. Pancreatic injury score was associated with morbidity, while the presence of major vascular injury was associated with mortality.

ABSTRACT Gallstone ileus is a rare but serious complication of cholelithiasis. It is a rare cause... more ABSTRACT Gallstone ileus is a rare but serious complication of cholelithiasis. It is a rare cause of small bowel obstruction but it accounts up to 25% of non-strangulated small bowel obstructions in elderly. Obstruction usually occurs in the terminal ileum. Although the most frequent mechanism of gallstone ileus is migration of the gallstone through a gallbladder-duodenal fistula, there have been cases of bowel obstruction caused by gallstones without any findings of bilio-enteric fistula during the operation. The diagnosis is usually delayed due to nonspecific clinical signs and symptoms. Abdominal computerized tomography (CT) scan is the optimal way to diagnose the gallstone ileus. It can identify the site and nature of the obstruction. The optimal surgical approach is a matter of debate. Enterolithotomy is the most performed operation. One stage operation should be performed in selected low risk patients. In this study, we report a 55 years old male patient who underwent surgical...

International Surgery, 2015

Our objective for this study was to discuss the usability of mean platelet volume, which is assoc... more Our objective for this study was to discuss the usability of mean platelet volume, which is associated with numerous vascular pathologies, in the early diagnosis of acute mesenteric ischemia. Acute mesenteric ischemia is an uncommon, life-threatening clinical condition mostly seen in the elderly. Early diagnosis of acute mesenteric ischemia and correction of blood circulation before necrosis occurs are important factors affecting prognosis. A total of 95 patients who underwent emergency surgery for acute mesenteric ischemia and 90 healthy volunteers as control group were included in this study. Age, gender, hemoglobin values, white blood cell counts, mean platelet volume, and platelet counts are recorded for evaluation. The mean platelet volume values were significantly higher in patients with acute mesenteric ischemia than in the controls (9.4 ± 1.1 fL and 7.4 ± 1.4 fL, respectively; P < 0.001). Receiver-operating characteristic analysis demonstrated a cutoff value of mean platelet volume as 8.1 fL (area under the curve, 0.862), a sensitivity of 83.2%, and a specificity of 80%. As a result, in the patients who are admitted to the hospital with acute nonspecific abdominal pain and suspected of having acute mesenteric ischemia, high mean platelet volume values in routine hemograms support the diagnosis of acute mesenteric ischemia.

Dicle Medical Journal / Dicle Tip Dergisi, 2015

ABSTRACT ABSTRACT Wandering spleen (WS) is a rare clinical condition resulting from an abnormally... more ABSTRACT ABSTRACT Wandering spleen (WS) is a rare clinical condition resulting from an abnormally long splenic pedicle and the absence or weakening of the supporting splenic ligaments that help to hold the spleen stationary. WS is more commonly seen in females aged between 20 and 40 years. Congenital and acquired factors are reported as the predisposing factors for WS. Patients with WS may be asymptomatic, or may be evident with a painful abdominal mass or an acute abdomen due to gastrointestinal symptoms and torsion of the WS. The diagnosis of WS can be established incidentally or during the Ultrasonography (USG) or Computed Tomography (CT) explorations performed for other pathologies. A high index of suspicion aids in the diagnosis of WS. WS is mostly treated by surgery and splenopexy remains the method of choice. In the cases with persistent ischemia following detorsion, splenectomy should be performed either via laparoscopy or laparotomy. In the present report, we present a 37-year-old woman who presented with a wandering spleen causing ileus. The patient underwent laparoscopic splenectomy. Wandering spleen is a rare condition which should be suspected as a potential cause of ileus and acute abdomen.

Dicle Medical Journal / Dicle Tip Dergisi, 2015

ABSTRACT An inguinal hernia containing appendix is termed an Amyand’s hernia. It is a rare condit... more ABSTRACT An inguinal hernia containing appendix is termed an Amyand’s hernia. It is a rare condition estimated to be found in approximately 1 % of all inguinal hernia repairs. Depending on the presence of inflammation in the hernia sac and obstruction of hernia, clinical presentation can vary. We report a case of left sided inguinal hernia in which appendix vermiformis was detected in a 74 year-old male. Appendix was not inflammated, so it was reduced and then mesh hernioplasty was performed. The postoperative course was uneventful. Performing appendectomy is controversial in Amyand hernias in which appendix is not inflammated. Appendectomy is recommended in left sided Amyand hernias, due to the risc of misdiagnosis if appendicitis develops in future. We didn’t perform appendectomy because our patient was elderly and had a low risk for developing acute appendicitis. Amyand hernias are usually diagnosed peroperatively. Decision for appendectomy relies on the inflammation of appendix, the side of the hernia, the age and the comorbidities of the patient.

International Journal of Surgery, 2015

The purpose of this study was to investigate the effect of Sulforaphane on ischemia/ reperfusion ... more The purpose of this study was to investigate the effect of Sulforaphane on ischemia/ reperfusion (IR) injury of the liver and distant organs resulting from liver blood flow arrest. Fourty Wistar rats were assigned into four groups, each included 10 rats were used. Group I as only laparatomy, Group II laparatomy and Sulforaphane application, Group III hepatic IR; and Group IV as hepatic IR and Sulforaphane application group. Animals were subjected to liver ischemia for 30 min and then reperfusion is started. 5 mg/kg Sulforaphane was applied via oral lavage 15 minutes before initiating the experimental study. Blood samples were taken from the animals for biochemical analysis at 60th minutes of the experiment in the first and second groups; 30 minutes after beginning reperfusion in the third and forth groups. Simultaneously, liver, lung and kidney tissues were sampled for biochemical and histopathological examinations. The administration of sulforaphane significantly reduced the serum TOA and liver TOA levels, increased the serum TAC and liver TAC levels and also decreased The OSI and liver OSI levels. In the histopathologic examination, the injury was reduced by the administration of sulforaphane. Administration of sulforaphane did not lead to any significant changes in any parameter including histopathological parameters in both the kidney and the lung. Sulforaphane reduced the liver oxidative stress from I/R injury. A histological injury in liver was reduced by sulforaphane administration. However, there were no significant effects of sulforaphane on the remote organ injuries induced by IR.

International surgery, Jan 10, 2015

We aimed to present our clinical experience with FG treatment. Fornier's Gangrene (FG) is a r... more We aimed to present our clinical experience with FG treatment. Fornier's Gangrene (FG) is a rare but serious disease characterized by progressive necrosis in the genitourinary and perineal region. The retrospective study included 43 patients. The patients were divided into two groups as survivors and non-survivors. Included in the analysis were data pertaining to demographics, predisposing factors, comorbidities, results of bacteriologic analyses, number of debridements, duration of treatment, the FG Severity Index (FGSI) score, fecal diversion methods (Trephine ostomy or Flexi-Seal Fecal Management System-FMS), and dressing methods (wet or negative aspiration system). In the non-survivor group, urea, WBC, and age were significantly higher, whereas albumin, hematocrit, platelet count, and length of hospital stay (LOHS) were significantly lower compared to the survivor group. Mean FGSI was lower in survivors in comparison with non-survivals (5.00±1.86 and 10.00±1.27, respectively...

La Clinica terapeutica, 2014

Rectovaginal fistula is an epithelial connection between the anterior wall of the rectum and post... more Rectovaginal fistula is an epithelial connection between the anterior wall of the rectum and posterior wall of the vagina. The etiology of the rectovaginal fistula can be trauma orginated from violent acts or foreign bodies as well as trauma during obstetric, gynecologic, or colorectal surgeries. The purpose of this study was to share our clinic experience and surgical management for rectovaginal fistulas. This study was conducted at the Department of General Surgery, University of Dicle. All patients who were treated for rectovaginal fistulas between January 2005 and December 2011 were included to this study. There were fifteen patients in a mean age of 32 ± 9.6. The most common complains of patients were arrival of gas and stool from the vagina. The etilogy of rectovaginal fistula was most commonly obstetric trauma in our patients and three of them had anal incontinance. The mean time of hospital stay was 5 days ± 1.7. Postoperative wound infection was seen in two patients and rec...

Minerva chirurgica, 2012

The aim of this study was to emphasize the efficacy of the laparoscopic surgical method performed... more The aim of this study was to emphasize the efficacy of the laparoscopic surgical method performed for elimination of catheter-induced mechanical complications developing in CAPD patients. Medical records of 31 patients who had undergone CAPD catheter implantation at the Dicle University Medical Faculty Hemodialysis Unit between January 2001 and June 2012 were examined retrospectively. Double-felted spiral Tenckhoff catheters were used in all patients for peritoneal access. We performed a retrospective review of 31 patients who, over an 11-year period, underwent revision of a peritoneal dialysis catheter using laparoscopy. Chronic renal failure requiring dialysis occurred in 31 patients (12 males and 19 female). Ages ranged from 13 to 77 years (mean age 35.8 years). As a conclusion, CAPD is currently a choice to be frequently used in patients with ESRD. In the treatment of CAPD-associated mechanical catheter complications laparoscopic method may be preferred because of patient comfor...

International Surgery, 2015

As a serious complication of cholelithiasis, gangrenous cholecystitis presents greater mortality ... more As a serious complication of cholelithiasis, gangrenous cholecystitis presents greater mortality than noncomplicated cholecystitis. The aim of this study was to specify the risk factors on mortality. 107 consecutive patients who underwent surgery due to gangrenous cholecystitis between January 1997 and October 2011 were investigated retrospectively. The study included 60 (56.1%) females and 47 (43.9%) males, with a mean age of 60.7 ± 16.4 (21-88) years. Cardiovascular diseases were the most frequently accompanying medical issues (24.3%). Thirty-six complications (33.6%) developed in 29 patients, and surgical site infection was proven as the most common. Longer delay time prior to hospital admission, low white blood cell count, presence of diabetes mellitus, higher blood levels of aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase and total bilirubin, pericholecystic fluid in abdominal ultrasonography, and conversion from laparoscopic surgery to open surgery were identified as risk factors affecting mortality (P < 0.001, P = 0.001, P = 0.044, P = 0.005, P = 0.049, P = 0.009, P = 0.022, P = 0.011, and P = 0.004, respectively). Longer delay time prior to hospital admission and low white blood cell count were determined as independent risk factors affecting mortality.

International Surgery, 2015

The aim of this study was to analyze the presence of malignancy in patients with Hashimoto&am... more The aim of this study was to analyze the presence of malignancy in patients with Hashimoto's thyroiditis and to investigate the reliability of preoperative fine-needle aspiration biopsy (FNAB). The retrospective study included 44 patients who were operated on for nodular goiter between December 2010 and October 2011. The patients underwent thyroidectomy following a cytologic analysis plus FNAB. Hashimoto's thyroiditis was confirmed on histopathology in all patients. FNAB results were defined as benign in 14 (31.8%), suspicion for malignancy in 17 (38.6%), malignant in 9 (20.5%), and inadequate in 4 (9.1%). Following the thyroidectomy, presence of papillary thyroid carcinoma and follicular variant of papillary thyroid carcinoma were detected in 10 patients (22.7%) and 1 (2.3%) patient, respectively. The FNAB results were interpreted in terms of malignancy, which revealed the sensitivity as 80%; specificity, 40%; false positives, 69.2%; false negatives, 14.3%; positive predictive value, 31.8%; negative predictive value, 85.7%; and diagnostic accuracy, 50%. The coexistence of Hashimoto's thyroiditis with papillary thyroid carcinoma is quite common. The FNAB results for such cases are hard to evaluate, and they are likely to increase the number of false positives.

Turkish Journal of Surgery, 2013

Gastroenterology Review, 2012

The Journal of Infection in Developing Countries, 2014

We aimed to analyze the approaches to the diagnosis and treatment of patients with fascioliasis i... more We aimed to analyze the approaches to the diagnosis and treatment of patients with fascioliasis in light of current literature. Thirty-nine patients with fascioliasis admitted to the Surgery Clinic of Dicle Medical Faculty (Turkey) were included in this study. The demographic, clinical, diagnostic, treatment and outcome data were analyzed retrospectively. Abdominal pain (n = 37; 95%) and eosinophilia (n = 31; 79%) were the most common findings. Twenty-seven patients were diagnosed by clinical and radiological findings. Patients were treated with triclabendazole. Thirty-six (92.4%) of the patients improved after medical treatment. The presence of typical clinical, laboratory and radiological findings is sufficient for diagnosis. Triclabendazole administration is often an effective treatment, with improvements occurring over the course of a few months.

Journal of Obstetrics and Gynaecology Research, 2014

The purpose of this study was to evaluate the diagnostic methods, predisposing risk factors and s... more The purpose of this study was to evaluate the diagnostic methods, predisposing risk factors and surgical treatment options in patients with translocation of intrauterine devices (IUD). Diagnosis, predisposing factors and treatment of 34 patients with translocation of IUD was evaluated in this retrospective study. Complaints of pain during insertion and history of cesarean section were present in 70.5% and 58.8% of patients, respectively. IUD-related complications were detected in 52.8% of patients. Transvaginal ultrasonography was used to detect translocation of IUD in 55.8% of cases. Laparoscopy was performed in 55.8% of patients. There were high rates of history of cesarean section, insertion in the puerperal period and insertion by midwives in patients with translocated IUD. These may be predisposing factors for IUD translocation. The clinician who inserts the IUD should be experienced in this area and obtain sufficient information from the pelvic examination prior to insertion of the device. Gynecological examination should be conducted for a proper diagnosis of translocation of IUD. In the event that the IUD string is not visible in the gynecological examination, transvaginal ultrasonography should be performed. If the IUD is still not visible, then abdominal radiography should be performed. As soon as diagnosis of translocation of IUD has been established, surgical treatment should be planned. First treatment of choice should be laparoscopy.