behlül Baydar - Academia.edu (original) (raw)

Papers by behlül Baydar

Research paper thumbnail of 71 Years Old Patient with Ovarian Cyst Torsion, Presenting with Ovarian Teratoma

Istanbul University - DergiPark, Dec 1, 2005

Dermoid kistler genellikle kadınlarda menapoz öncesi dönemde rastlanır ve büyük çoğunluğu bu döne... more Dermoid kistler genellikle kadınlarda menapoz öncesi dönemde rastlanır ve büyük çoğunluğu bu dönemde çeşitli semptomlarla tespit edilerek opere edilir. Yaşlı ve büyük tümöre sahip hastaların malignite riski daha fazla olduğundan laparoskopiden çok, laparotomi ile ameliyatı tercih edilmelidir. Over teratomlarının ileri yaştaki hastalarda nadir rastlanması nedeniyle bu olguyu sunmaya değer bulduk.

Research paper thumbnail of Long-term results of endoscopic treatment in inoperable Klatskin tumor patients

Girifl ve Amac: Klatskin tumoru ana hepatik kanal ya da sa¤-sol intrahepatik kanaldan koken alan ... more Girifl ve Amac: Klatskin tumoru ana hepatik kanal ya da sa¤-sol intrahepatik kanaldan koken alan ve sistik kanal›n ac›l›m yerinin proksimalinde gorulen epitelyal safra yolu tumorudur. Hastal›¤›n tan›s› gec konur ve yaflam beklen- tisi dufluktur. Cerrahi icin uygun olmayan hastalarda safran›n drenaj›n›n sa¤- lanmas› amac›yla endoskopik ya da perkutan drenaj gibi palyatif tedavi sece- nekleri kullan›lmaktad›r. Bu cal›flmada, endoskopik stent ve/veya perkutan drenaj tedavisi ile palyatif tedavi edilen inoperabl Klatskin tumorlu hastalar›n yaflam surelerini ve ifllemlerinin etkinliini deerlendirmeyi amaclad›k. Gerec ve Yontem: Cal›flma, ‹zmir Ataturk Eitim ve Araflt›rma Hastanesi Gastroen- teroloji Klinii'nde Ocak 2008- Eylul 2009 tarihlerinde retrospektif olarak ya- p›ld›. Cal›flmaya inoperabl hiler kolanjiokarsinomal› 34 hasta dahil edildi. Bismuth s›n›flamas› goz onune al›narak hastal›¤›n tipi belirlendi. Bulgular: Cal›flmaya 19 kad›n, 15 erkek hasta dahil edildi, ortalama yafl 7...

Research paper thumbnail of The utility of radial endosonographic features in the diagnosis of cholangio-carcinoma arising from the distal common bile duct

Minerva gastroenterologica e dietologica, 2011

Research paper thumbnail of Pankreas psödökisti pankreas kanseri tanısında gecikmeye neden olur mu? Olgu sunumu

Cystic neoplasms of the pancreas are rare and may be mistaken for pseudocysts by imaging studies.... more Cystic neoplasms of the pancreas are rare and may be mistaken for pseudocysts by imaging studies. The preoperative diagnosis is difficult due to similarity to other cystic lesions of pancreas. However, endoscopic ultrasonography is a usefull complimentary imaging method for differentiation of a pancreatic cystic lesion. Occasionally, despite a complete evaluation of a cystic mass, the differential diagnose of a pancreatic cyst may not be determinated. In order to make a correct diagnosis before proceeding with the operation and to provide proper treatment, we also need to think of pancreatic neoplasms. Such pancreatic pseudocysts may cause a delay in the diagnose and treatment of a pancreatic neoplasm. We report a new case of cystadenocarcinoma of pancreas diagnosed in the operation, misinterpreted as pancreatic pseudocyst preoperatively.

Research paper thumbnail of Varise bağlı olmayan üst gastrointestinal sistem kanamasında endoskopik bulgular ve kanamayla ilişkileri

Background and Aims: Non-variceal upper gastrointestinal system bleeding is among the common reas... more Background and Aims: Non-variceal upper gastrointestinal system bleeding is among the common reasons for urgent hospitalization worldwide and still causes high rates of mortality. In the present study, the lesions causing upper gastrointestinal bleeding were evaluated according to Forrest classification and the relationship between these lesions and rebleeding was elucidated. Materials and methods: The present study is a retrospective study conducted in a tertiary training and research hospital. Patients who were admitted between November 2005 and May 2009 with upper gastrointestinal bleeding developed within the previous 24 hours were included in the study. The data of 1647 patients were analyzed, and of those, the data of 1342 were evaluated and the results are reported herein. Results: Distribution of the lesions was as follows: 96 (7.15%) esophagus, 552 (41.13%) stomach, 523 (38.97%) duodenum, and 171 (12.74%) in multiple areas. It was also demonstrated that 34 (2.53%) of the le...

Research paper thumbnail of Endosonografinin etkin kullanımının gastroenteroloji günlük tıbbi pratiğine etkileri

Background and Aims: Our aim was to evaluate the efficient use of endosonography in the daily pra... more Background and Aims: Our aim was to evaluate the efficient use of endosonography in the daily practice of gastroenterology. Material and Methods: Our study was done retrospectively in a tertiary hospital. Data including patient demographics, diagnosis, duration of hospital stay, endoscopic retrograde cholangiopancreatography procedure, and radiologic diagnostic tests were evaluated between June 2008 and June 2009 (Period 1) and between June 2009 and June 2010 (Period 2). Therapeutic endoscopic retrograde cholangiopancreatography rates, biliary tract evaluation rates with magnetic resonance cholangiopancreatography, cytologic sampling rates from pancreatic masses, diagnostic rates of chronic pancreatitis, and duration of hospital stay of acute biliary pancreatitis patients were compared between the two periods. Results: Endoscopic ultrasound was performed in 187 and 2027 patients in Periods 1 and 2, respectively. The ratios of therapeutic endoscopic retrograde cholangiopancreatograph...

Research paper thumbnail of Perkütan endoskopik gastroenterostomi uygulama deneyimlerimiz: Endikasyon ve komplikasyonlar

Background and Aims: We aimed to evaluate the indications and complications of percutaneous endos... more Background and Aims: We aimed to evaluate the indications and complications of percutaneous endoscopic gastrostomy applications. Materials and Methods: We retrospectively analyzed the clinical data of 112 patients who received PEG from 2006 to 2009 in the Izmir Training and Research Hospital, Clinics of Gastroenterology endoscopy laboratory. All patients were followed and treated during hospitalization. Results: Totally 112 patients needed enteral feedings (15 (13.4%) for upper esophageal narrowness after laryngectomy, 97 (86.6%) for primary or secondary permanent neurologic problems). Sixty (53.5%) patients were male and 52 (46.5%) were female. Tubes were successfully placed in 112 patients (100%) in an average time of 13.2±2.5 min. No procedure-related major complications were observed. No post-procedure major complications were found and minor complications occurred in 5 patients (4.4%). These infections recovered with oral antibiotherapy in 7 days. Conclusions: PEGs are easy to ...

Research paper thumbnail of Endosonografi ile submukozal lezyonların ayırıcı tanısı

Background and Aims: We aimed to determine the etiological factors of submucosal lesions seen dur... more Background and Aims: We aimed to determine the etiological factors of submucosal lesions seen during upper gastrointestinal system endoscopy utilizing endosonography. Materials and Methods: Our study was done prospectively between December 2008 and May 2010 in the Gastroenterology Department of Izmir Ataturk Training and Research Hospital. Eighty-seven cases with submucosal lesions determined during endoscopy were included in the study. Cases were examined with radial endosonography. Biopsy was performed with linear endosonography when required. Lesions were classified as intramural, extramural, benign, and malignant. Results: Thirty-nine (44.8%) intramural and 28 (32.1%) extramural lesions were observed in the patients. No lesion was observed in 20 cases (22.9%) on endosonography. While 14 intramural and 7 extramural lesions were malignant, 25 intramural and 21 extramural lesions were benign in nature. Thirteen cases were diagnosed with fine needle aspiration cytology (FNAC) with e...

Research paper thumbnail of Yetmişbir yaşında over kist torsiyonu olan over teratomu

Yaygin olarak dermoid kistler denen matur kistik teratomlar, menapoz oncesi kadinlarda overde en ... more Yaygin olarak dermoid kistler denen matur kistik teratomlar, menapoz oncesi kadinlarda overde en yaygin olarak bulunan benign germ hucre tumorleridir. Bunlarin buyuk cogunlugu 17-32 yas arasindadir. Tani ameliyat oncesinde nadiren konur ve prognoz genellikle kotudur. Siklikla torsiyone olan tumorler 6-15 cm buyuklugundedir ve teratomalarda en sik gorulen komplikasyon da budur. Over kistik teratomunun tanisinda batin ultrasonografisi ve tomografisi en iyi metodlardir. Overin kistik teratomlari nin tedavisinde laparoskopik cerrahi tercih edilen metod olmali dir. Bu bildiride 71 yasinda over kistik teratomu torsiyone olan bir hastayi sunduk.

Research paper thumbnail of Situs inversus totalis with adenocarcinoma of the stomach: Case report

Situs inversus totalis is a rare congenital anomaly. A 40-year-old man was admitted to our hospit... more Situs inversus totalis is a rare congenital anomaly. A 40-year-old man was admitted to our hospital with nausea, vomiting and abdominal pain. The diagnosis of situs inversus totalis was made endoscopically and with chest X-rays. Herein we report a case of situs inversus totalis with adenocarcinoma of the stomach, which was treated by subtotal gastrectomy and D2 lymph node dissection. We report this case as particularly noteworthy because of its rarity and due to the difficult nature of operation with a mirror-image abdomen anatomy.

Research paper thumbnail of Safra taşi ileusu: Olgu sunumu Gallstone ileus: Case report

Safra tas› ileusu, safra tas›n›n nadir ve al›s›lmad›k bir komplikasyonudur. Yetmis yas›nda erkek ... more Safra tas› ileusu, safra tas›n›n nadir ve al›s›lmad›k bir komplikasyonudur. Yetmis yas›nda erkek hasta klinigimize kar›n agr›s›, siskinlik ve kusma sikayetleriyle basvurdu. Anemnez ve tetkiklerinde safra tas› ileusu tespit edilen hastaya enterolitotomi yap›ld›. Bu sunumda, girisimimiz ile literaturdeki uygun cerrahi islemler ile ilgili bilgi verildi. Anahtar sozcukler: Kolesistoenterik fistul, safra tas› ileusu, kolelitiyazis, barsak obstruksiyonu Gallstone ileus is a rare and peculiar complication of biliary stone. A 70-year-old male patient admitted to our clinic with abdominal pain, distension and vomiting. Gallstone ileus was diagnosed based on the history and laboratory analysis, and enterolithotomy was applied. In this report, our approach and appropriate surgical procedures in the literature are discussed.

Research paper thumbnail of Uveal malign melanomanın karaciğer metastazı-Bir olgu sunumu

Melanoma is a neoplastic disorder produced by malignant transformation of normal melanocytes, the... more Melanoma is a neoplastic disorder produced by malignant transformation of normal melanocytes, the cells that produce the pigment melanin. During the first trimester of fetal life, precursor melanocytes arise in the neural crest. As the fetus develops, these cells migrate to areas including the skin, meninges, mucous membranes, upper esophagus, and eyes. In each of these locations, melanocytes have demonstrated a potential for malignant transformation. The eye, central nervous system, gastrointestinal tract, and even the gallbladder have been reported as primary sites of the disease. Melanoma represents 4% to 5% of all skin malignancies. Over 90% are found on the skin; however, 4% of melanomas are discovered as metastases without an identifiable primary site. Although malignant melanoma is only the eighth most common cancer diagnosis in the United States, the large majority (80%) of melanoma patients present in the productive years from age 25 to 65. The mean age for diagnosis of mel...

Research paper thumbnail of Varise bal› olmayan üst gastrointestinal sistem kanamas›nda endoskopik bulgular ve kanamayla iliflkileri

Amac: Non variseal ust gastrointestinal sistem kanamas› dunyada acil hasta- neye yat›fl nedenleri... more Amac: Non variseal ust gastrointestinal sistem kanamas› dunyada acil hasta- neye yat›fl nedenleri aras›nda yayg›nd›r ve hala yuksek mortalite oranlar›na neden olur. Bu cal›flmada, ust gastrointestinal sistem kanamas›na neden olan lezyonlar Forrest s›n›flamas›na gore deerlendirildi ve bu lezyonlarla tekrar kanama aras› iliflki ac›kland›. Yontem ve Gerec: Bu cal›flma, tersiyer eitim ve araflt›rma hastanesinde retrospektif olarak yap›lm›flt›r. Kas›m 2005 ile Ma- y›s 2009 aras›nda, son 24 saatte ust gastrointestinal sistem kanamas› geliflen ve hastaneye baflvuran hastalar cal›flmaya al›nd›. Binalt›yuzk›rkyedi hastan›n verileri analiz edildi ve 1342 hastan›n verileri deerlendirildi. Bulgular: Lez- yonlar›n da¤›l›m›: 96's› (%7.15) ozofagusta, 552'si (%41.13) midede, 523'u (%38.97) duodenumda ve 171'i (%12.74) birden cok bolgede yerleflmifltir. Ayr›ca 34 (%2.53) lezyon Forrest Ia, 192'si (%14.31) Forrest Ib, 85'i (%6.33) Forrest IIa, 121'i (%9.02) Forrest IIb, 2...

Research paper thumbnail of İnoperabl Klatskin tümörlü hastaların endoskopik tedavi ile uzun dönem sonuçları

Endoskopi Gastrointestinal, 2015

Girifl ve Amaç: Klatskin tümörü ana hepatik kanal ya da sa¤-sol intrahepatik kanaldan köken alan ... more Girifl ve Amaç: Klatskin tümörü ana hepatik kanal ya da sa¤-sol intrahepatik kanaldan köken alan ve sistik kanal›n aç›l›m yerinin proksimalinde görülen epitelyal safra yolu tümörüdür. Hastal›¤›n tan›s› geç konur ve yaflam beklentisi düflüktür. Cerrahi için uygun olmayan hastalarda safran›n drenaj›n›n sa¤-lanmas› amac›yla endoskopik ya da perkütan drenaj gibi palyatif tedavi seçenekleri kullan›lmaktad›r. Bu çal›flmada, endoskopik stent ve/veya perkütan drenaj tedavisi ile palyatif tedavi edilen inoperabl Klatskin tümörlü hastalar›n yaflam sürelerini ve ifllemlerinin etkinli¤ini de¤erlendirmeyi amaçlad›k. Gereç ve Yöntem: Çal›flma, ‹zmir Atatürk E¤itim ve Araflt›rma Hastanesi Gastroenteroloji Klini¤i'nde Ocak 2008-Eylül 2009 tarihlerinde retrospektif olarak ya-p›ld›. Çal›flmaya inoperabl hiler kolanjiokarsinomal› 34 hasta dahil edildi. Bismuth s›n›flamas› göz önüne al›narak hastal›¤›n tipi belirlendi. Bulgular: Çal›flmaya 19 kad›n, 15 erkek hasta dahil edildi, ortalama yafl 71.8±8.9 olarak bulundu. Yedi hastada (%21) yeterli drenaj olmad›. Drenaj sa¤lanamayan hastalardan 2'sine (%6) perkütan drenaj kateteri yerlefltirildi. Perkütan transhepatik kolanjiografi yap›lan hastalarda yeterli bilirubin düflüflü izlenmedi. Endoskopik stent sonras› drenaj›n yeterli oldu¤u hastalarda ortalama yaflam süresi 145±138 gündü. Stentleme sonras› yeterli drenaj olmayan ve perkütan transhepatik kolanjiografiyi kabul etmeyen 5 hastada ortalama yaflam süresi 13.2±7 gündü. Stentleme sonras› yeterli drenaj olmamas› sebebiyle perkütan transhepatik kolanjiografi ile dren yerlefltirilen 2 hastada ortalama yaflam süresi 22±11.3 gündü. Bismuth I hastalarda ortalama yaflam süresi 164.2±19.3, Bismuth II hastalarda 86±125.6, Bismuth III hastalarda 134.7±130.8, Bismuth IV hastalarda 89.3±132.5 gün saptand›. Bismuth'a göre gruplar ara-s›nda yaflam süreleri aç›s›ndan anlaml› fark saptanmad› (p=0.317). Sonuç: Bu çal›flmada, palyatif endoskopik tedavi baflar› oran›n›n yüksek oldu¤unu ve tümörün yerleflim yerinin ortalama yaflam süresi üzerinde etkili olmad›¤›n› sap-tad›k. Ancak stentlemenin, palyatif anlamda ortalama yaflam süresine katk›da bulunabilece¤ini ve en az 2 endoskopik retrograd kolanjiografi seans›n›n has-talar›n palyatif drenaj›n› sa¤lamak için denenmesi gerekti¤ini düflünmekteyiz.

Research paper thumbnail of The efficacy of endoscopic ultrasonography in local staging of rectal tumors

The Turkish Journal of Gastroenterology, 2012

Background/aims: The purpose of this study was to research the efficacy and reliability of endosc... more Background/aims: The purpose of this study was to research the efficacy and reliability of endoscopic rectal ultrasonography in local staging (T and N stages) of rectal tumors. Materials and Methods: This retrospective study was carried out by the Department of Gastroenterology, ‹zmir Atatürk Training and Research Hospital, which is tertiary level. Thirty-one patients with adenocarcinoma were included in the study. The patients found operable according to computed tomography underwent preoperative local staging by endoscopic ultrasonography. Radial endoscopic ultrasonography and T and N stages were evaluated. Results: It was observed that endoscopic rectal ultrasonography had 80.6% accuracy, 93.4% sensitivity, and 96.5% specificity in T stage; 70% accuracy, 70% sensitivity, and 86% specificity in the detection of presence of lymph node; and 76% accuracy, 100% sensitivity, and 22% specificity in the detection of the nature of lymph node. Conclusions: In this study, it was observed that endoscopic rectal ultrasonography is an efficient and reliable method in the detection of local lymph node and the depth of invasion of rectal tumors (T staging), although it is not reliable enough to determine the characteristics of lymph nodes.

Research paper thumbnail of Does presence of common bile duct stones in patients with acute biliary pancreatitis affect the severity of illness or laboratory findings?

The Turkish Journal of Gastroenterology, 2011

Akut biliyer pankreatitin fliddeti ile ilgili olarak ana safra kanal›ndaki tafllar›n etkisini tan... more Akut biliyer pankreatitin fliddeti ile ilgili olarak ana safra kanal›ndaki tafllar›n etkisini tan›mlamak. Yöntem: Bu tersiyer bir hastanede 103 hastal›k, prospektif ve cross sectional olarak yap›lm›fl bir çal›flmad›r. Baflvurunun ilk 12 ve 72. saatlerindeki serum biyokimyasal ve beyaz küre say›mlar› de¤erlendirildi. Hastalar, endoskopik ultrasonografi ve endoskopik retrograd kolanjiopankreatografide tan›mlanan ana safra kanal› tafllar›n›n varl›¤›na göre grupland›r›ld›. Bunun yan›nda hastalar bilgisayarl› tomografi ve kan örneklerinden derlenen verilerle (Baltazar skorlamas›na göre) hafif ve ciddi akut pankreatit olarak s›n›fland›. Bulgular: Akut biliyer pankreatitli 103 hasta aras›nda, 41 (%39,8) hastada endoskopik ultrasonografi ve endoskopik retrograd kolanjiopankreatografi ile ana safra kanal› veya ampullada tafl ve/veya çamur saptand›. Altm›fliki (%60,2) hastada ana safra ka-nal›nda tafl yoktu. Endoskopik ultrasonografi ve endoskopik retrograd kolanjiopankreatografide tafl saptanan 41 hastan›n 9'unda (%22), saptanmayan 62 hastan›n 13'ünde (%21) fliddetli pankreatit geliflti. Ana safra kanal›nda tafl olan ve olmayan hastalar ara-s›nda fliddetli akut biliyer pankreatite gidifl insidans›nda fark saptanmad› (p=0.45). Sonuç: Ana safra kanal› tafllar› varl›¤› akut biliyer pankreatit fliddeti ile iliflkili de¤ildir.

Research paper thumbnail of Combined use of endosonography and endoscopic retrograde cholangiopancreatography in the same session

The Turkish Journal of Gastroenterology, 2011

The diagnostic value of endoscopic ultrasound in common bile duct stones is high. In this investi... more The diagnostic value of endoscopic ultrasound in common bile duct stones is high. In this investigation, we evaluated the feasibility of endoscopic ultrasound preceding endoscopic retrograde cholangiography in the same session and the potential benefits in increasing the therapeutic endoscopic retrograde cholangiography ratio in the treatment of choledocholithiasis. One hundred and sixty-five consecutive patients who presented with elevated ALP and bilirubin levels and were referred for endoscopic retrograde cholangiography of biliary stones diagnosed with magnetic resonance cholangiopancreatography were evaluated. During the evaluation period (mean: 2 weeks), 50 patients with reductions in ALP and bilirubin by at least half relative to baseline values were enrolled into the study. Endoscopic ultrasound was performed prior to endoscopic retrograde cholangiography. Time spent to perform endoscopic ultrasound was noted. For the presence of common bile duct stone, we used retrograde cholangiography findings as the standard of reference. Median endoscopic ultrasound time was 10.66 minutes (SD±1.52). Bile duct stones were revealed with retrograde cholangiography in 34 patients (68%). Sensitivity, specificity (with 95% confidence intervals [CIs]), positive predictive value and negative predictive value of endoscopic ultrasound were calculated. In identifying common bile duct stones on endoscopic ultrasound, sensitivity, specificity, positive predictive value, and negative predictive value were statistically determined as 91.2% (95% CI), 88.3% (95% CI), 91%, and 81.3%, respectively. Our results indicate that in the presence of local experience and availability of endoscopic ultrasound, it is feasible to perform endoscopic ultrasound prior to endoscopic retrograde cholangiography. The sensitivity, specificity, positive predictive value, and negative predictive value for detecting choledocholithiasis in suspected cases are high. Endoscopic ultrasound preceding endoscopic retrograde cholangiography in the same session has the potential to decrease diagnostic endoscopic retrograde cholangiography and increase therapeutic endoscopic retrograde cholangiography. Need to perform magnetic resonance cholangiopancreatography in the presence of easily accessible endoscopic ultrasound should be questioned.

Research paper thumbnail of Intrahepatic localization of pancreatic pseudocyst: A case report

The Turkish Journal of Gastroenterology, 2013

Pseudocyst as a complication of acute pancreatitis can occur at any site in the abdomen and even ... more Pseudocyst as a complication of acute pancreatitis can occur at any site in the abdomen and even in the mediastinum, but the intrahepatic location of pancreatic pseudocyst is a very uncommon event (1-4). About 30 cases have been reported in the literature. We report here a case of right and left intrahepatic pseudocyst following acute biliary pancreatitis. The mechanism was rupture of the pancreatic pseudocyst in the retroperitoneal cavity and erosion reaching the right hepatic parench-Manuscript

Research paper thumbnail of Gastrointestinal stromal tumor perforation in a case with neurofibromatosis presenting with abdominal pain

The Turkish Journal of Gastroenterology, 2012

Research paper thumbnail of A rare cause of cholangitis: Fasciola hepatica

The Turkish Journal of Gastroenterology, 2010

... LETTERS TO THE EDITOR A rare cause of cholangitis: Fasciola hepatica. Fatih ASLAN, Emrah ALPE... more ... LETTERS TO THE EDITOR A rare cause of cholangitis: Fasciola hepatica. Fatih ASLAN, Emrah ALPER, Zehra AKPINAR, Behlül BAYDAR, Mehmet Kadir AKSÖZ, Zafer BUYRAÇ, Cem ÇEKİÇ, Belkis ÜNSAL. ... Infez Med 2006; 14: 208-12. 4. Sezgin O, Altintas E, Disibeyaz S, et al. ...

Research paper thumbnail of 71 Years Old Patient with Ovarian Cyst Torsion, Presenting with Ovarian Teratoma

Istanbul University - DergiPark, Dec 1, 2005

Dermoid kistler genellikle kadınlarda menapoz öncesi dönemde rastlanır ve büyük çoğunluğu bu döne... more Dermoid kistler genellikle kadınlarda menapoz öncesi dönemde rastlanır ve büyük çoğunluğu bu dönemde çeşitli semptomlarla tespit edilerek opere edilir. Yaşlı ve büyük tümöre sahip hastaların malignite riski daha fazla olduğundan laparoskopiden çok, laparotomi ile ameliyatı tercih edilmelidir. Over teratomlarının ileri yaştaki hastalarda nadir rastlanması nedeniyle bu olguyu sunmaya değer bulduk.

Research paper thumbnail of Long-term results of endoscopic treatment in inoperable Klatskin tumor patients

Girifl ve Amac: Klatskin tumoru ana hepatik kanal ya da sa¤-sol intrahepatik kanaldan koken alan ... more Girifl ve Amac: Klatskin tumoru ana hepatik kanal ya da sa¤-sol intrahepatik kanaldan koken alan ve sistik kanal›n ac›l›m yerinin proksimalinde gorulen epitelyal safra yolu tumorudur. Hastal›¤›n tan›s› gec konur ve yaflam beklen- tisi dufluktur. Cerrahi icin uygun olmayan hastalarda safran›n drenaj›n›n sa¤- lanmas› amac›yla endoskopik ya da perkutan drenaj gibi palyatif tedavi sece- nekleri kullan›lmaktad›r. Bu cal›flmada, endoskopik stent ve/veya perkutan drenaj tedavisi ile palyatif tedavi edilen inoperabl Klatskin tumorlu hastalar›n yaflam surelerini ve ifllemlerinin etkinliini deerlendirmeyi amaclad›k. Gerec ve Yontem: Cal›flma, ‹zmir Ataturk Eitim ve Araflt›rma Hastanesi Gastroen- teroloji Klinii'nde Ocak 2008- Eylul 2009 tarihlerinde retrospektif olarak ya- p›ld›. Cal›flmaya inoperabl hiler kolanjiokarsinomal› 34 hasta dahil edildi. Bismuth s›n›flamas› goz onune al›narak hastal›¤›n tipi belirlendi. Bulgular: Cal›flmaya 19 kad›n, 15 erkek hasta dahil edildi, ortalama yafl 7...

Research paper thumbnail of The utility of radial endosonographic features in the diagnosis of cholangio-carcinoma arising from the distal common bile duct

Minerva gastroenterologica e dietologica, 2011

Research paper thumbnail of Pankreas psödökisti pankreas kanseri tanısında gecikmeye neden olur mu? Olgu sunumu

Cystic neoplasms of the pancreas are rare and may be mistaken for pseudocysts by imaging studies.... more Cystic neoplasms of the pancreas are rare and may be mistaken for pseudocysts by imaging studies. The preoperative diagnosis is difficult due to similarity to other cystic lesions of pancreas. However, endoscopic ultrasonography is a usefull complimentary imaging method for differentiation of a pancreatic cystic lesion. Occasionally, despite a complete evaluation of a cystic mass, the differential diagnose of a pancreatic cyst may not be determinated. In order to make a correct diagnosis before proceeding with the operation and to provide proper treatment, we also need to think of pancreatic neoplasms. Such pancreatic pseudocysts may cause a delay in the diagnose and treatment of a pancreatic neoplasm. We report a new case of cystadenocarcinoma of pancreas diagnosed in the operation, misinterpreted as pancreatic pseudocyst preoperatively.

Research paper thumbnail of Varise bağlı olmayan üst gastrointestinal sistem kanamasında endoskopik bulgular ve kanamayla ilişkileri

Background and Aims: Non-variceal upper gastrointestinal system bleeding is among the common reas... more Background and Aims: Non-variceal upper gastrointestinal system bleeding is among the common reasons for urgent hospitalization worldwide and still causes high rates of mortality. In the present study, the lesions causing upper gastrointestinal bleeding were evaluated according to Forrest classification and the relationship between these lesions and rebleeding was elucidated. Materials and methods: The present study is a retrospective study conducted in a tertiary training and research hospital. Patients who were admitted between November 2005 and May 2009 with upper gastrointestinal bleeding developed within the previous 24 hours were included in the study. The data of 1647 patients were analyzed, and of those, the data of 1342 were evaluated and the results are reported herein. Results: Distribution of the lesions was as follows: 96 (7.15%) esophagus, 552 (41.13%) stomach, 523 (38.97%) duodenum, and 171 (12.74%) in multiple areas. It was also demonstrated that 34 (2.53%) of the le...

Research paper thumbnail of Endosonografinin etkin kullanımının gastroenteroloji günlük tıbbi pratiğine etkileri

Background and Aims: Our aim was to evaluate the efficient use of endosonography in the daily pra... more Background and Aims: Our aim was to evaluate the efficient use of endosonography in the daily practice of gastroenterology. Material and Methods: Our study was done retrospectively in a tertiary hospital. Data including patient demographics, diagnosis, duration of hospital stay, endoscopic retrograde cholangiopancreatography procedure, and radiologic diagnostic tests were evaluated between June 2008 and June 2009 (Period 1) and between June 2009 and June 2010 (Period 2). Therapeutic endoscopic retrograde cholangiopancreatography rates, biliary tract evaluation rates with magnetic resonance cholangiopancreatography, cytologic sampling rates from pancreatic masses, diagnostic rates of chronic pancreatitis, and duration of hospital stay of acute biliary pancreatitis patients were compared between the two periods. Results: Endoscopic ultrasound was performed in 187 and 2027 patients in Periods 1 and 2, respectively. The ratios of therapeutic endoscopic retrograde cholangiopancreatograph...

Research paper thumbnail of Perkütan endoskopik gastroenterostomi uygulama deneyimlerimiz: Endikasyon ve komplikasyonlar

Background and Aims: We aimed to evaluate the indications and complications of percutaneous endos... more Background and Aims: We aimed to evaluate the indications and complications of percutaneous endoscopic gastrostomy applications. Materials and Methods: We retrospectively analyzed the clinical data of 112 patients who received PEG from 2006 to 2009 in the Izmir Training and Research Hospital, Clinics of Gastroenterology endoscopy laboratory. All patients were followed and treated during hospitalization. Results: Totally 112 patients needed enteral feedings (15 (13.4%) for upper esophageal narrowness after laryngectomy, 97 (86.6%) for primary or secondary permanent neurologic problems). Sixty (53.5%) patients were male and 52 (46.5%) were female. Tubes were successfully placed in 112 patients (100%) in an average time of 13.2±2.5 min. No procedure-related major complications were observed. No post-procedure major complications were found and minor complications occurred in 5 patients (4.4%). These infections recovered with oral antibiotherapy in 7 days. Conclusions: PEGs are easy to ...

Research paper thumbnail of Endosonografi ile submukozal lezyonların ayırıcı tanısı

Background and Aims: We aimed to determine the etiological factors of submucosal lesions seen dur... more Background and Aims: We aimed to determine the etiological factors of submucosal lesions seen during upper gastrointestinal system endoscopy utilizing endosonography. Materials and Methods: Our study was done prospectively between December 2008 and May 2010 in the Gastroenterology Department of Izmir Ataturk Training and Research Hospital. Eighty-seven cases with submucosal lesions determined during endoscopy were included in the study. Cases were examined with radial endosonography. Biopsy was performed with linear endosonography when required. Lesions were classified as intramural, extramural, benign, and malignant. Results: Thirty-nine (44.8%) intramural and 28 (32.1%) extramural lesions were observed in the patients. No lesion was observed in 20 cases (22.9%) on endosonography. While 14 intramural and 7 extramural lesions were malignant, 25 intramural and 21 extramural lesions were benign in nature. Thirteen cases were diagnosed with fine needle aspiration cytology (FNAC) with e...

Research paper thumbnail of Yetmişbir yaşında over kist torsiyonu olan over teratomu

Yaygin olarak dermoid kistler denen matur kistik teratomlar, menapoz oncesi kadinlarda overde en ... more Yaygin olarak dermoid kistler denen matur kistik teratomlar, menapoz oncesi kadinlarda overde en yaygin olarak bulunan benign germ hucre tumorleridir. Bunlarin buyuk cogunlugu 17-32 yas arasindadir. Tani ameliyat oncesinde nadiren konur ve prognoz genellikle kotudur. Siklikla torsiyone olan tumorler 6-15 cm buyuklugundedir ve teratomalarda en sik gorulen komplikasyon da budur. Over kistik teratomunun tanisinda batin ultrasonografisi ve tomografisi en iyi metodlardir. Overin kistik teratomlari nin tedavisinde laparoskopik cerrahi tercih edilen metod olmali dir. Bu bildiride 71 yasinda over kistik teratomu torsiyone olan bir hastayi sunduk.

Research paper thumbnail of Situs inversus totalis with adenocarcinoma of the stomach: Case report

Situs inversus totalis is a rare congenital anomaly. A 40-year-old man was admitted to our hospit... more Situs inversus totalis is a rare congenital anomaly. A 40-year-old man was admitted to our hospital with nausea, vomiting and abdominal pain. The diagnosis of situs inversus totalis was made endoscopically and with chest X-rays. Herein we report a case of situs inversus totalis with adenocarcinoma of the stomach, which was treated by subtotal gastrectomy and D2 lymph node dissection. We report this case as particularly noteworthy because of its rarity and due to the difficult nature of operation with a mirror-image abdomen anatomy.

Research paper thumbnail of Safra taşi ileusu: Olgu sunumu Gallstone ileus: Case report

Safra tas› ileusu, safra tas›n›n nadir ve al›s›lmad›k bir komplikasyonudur. Yetmis yas›nda erkek ... more Safra tas› ileusu, safra tas›n›n nadir ve al›s›lmad›k bir komplikasyonudur. Yetmis yas›nda erkek hasta klinigimize kar›n agr›s›, siskinlik ve kusma sikayetleriyle basvurdu. Anemnez ve tetkiklerinde safra tas› ileusu tespit edilen hastaya enterolitotomi yap›ld›. Bu sunumda, girisimimiz ile literaturdeki uygun cerrahi islemler ile ilgili bilgi verildi. Anahtar sozcukler: Kolesistoenterik fistul, safra tas› ileusu, kolelitiyazis, barsak obstruksiyonu Gallstone ileus is a rare and peculiar complication of biliary stone. A 70-year-old male patient admitted to our clinic with abdominal pain, distension and vomiting. Gallstone ileus was diagnosed based on the history and laboratory analysis, and enterolithotomy was applied. In this report, our approach and appropriate surgical procedures in the literature are discussed.

Research paper thumbnail of Uveal malign melanomanın karaciğer metastazı-Bir olgu sunumu

Melanoma is a neoplastic disorder produced by malignant transformation of normal melanocytes, the... more Melanoma is a neoplastic disorder produced by malignant transformation of normal melanocytes, the cells that produce the pigment melanin. During the first trimester of fetal life, precursor melanocytes arise in the neural crest. As the fetus develops, these cells migrate to areas including the skin, meninges, mucous membranes, upper esophagus, and eyes. In each of these locations, melanocytes have demonstrated a potential for malignant transformation. The eye, central nervous system, gastrointestinal tract, and even the gallbladder have been reported as primary sites of the disease. Melanoma represents 4% to 5% of all skin malignancies. Over 90% are found on the skin; however, 4% of melanomas are discovered as metastases without an identifiable primary site. Although malignant melanoma is only the eighth most common cancer diagnosis in the United States, the large majority (80%) of melanoma patients present in the productive years from age 25 to 65. The mean age for diagnosis of mel...

Research paper thumbnail of Varise bal› olmayan üst gastrointestinal sistem kanamas›nda endoskopik bulgular ve kanamayla iliflkileri

Amac: Non variseal ust gastrointestinal sistem kanamas› dunyada acil hasta- neye yat›fl nedenleri... more Amac: Non variseal ust gastrointestinal sistem kanamas› dunyada acil hasta- neye yat›fl nedenleri aras›nda yayg›nd›r ve hala yuksek mortalite oranlar›na neden olur. Bu cal›flmada, ust gastrointestinal sistem kanamas›na neden olan lezyonlar Forrest s›n›flamas›na gore deerlendirildi ve bu lezyonlarla tekrar kanama aras› iliflki ac›kland›. Yontem ve Gerec: Bu cal›flma, tersiyer eitim ve araflt›rma hastanesinde retrospektif olarak yap›lm›flt›r. Kas›m 2005 ile Ma- y›s 2009 aras›nda, son 24 saatte ust gastrointestinal sistem kanamas› geliflen ve hastaneye baflvuran hastalar cal›flmaya al›nd›. Binalt›yuzk›rkyedi hastan›n verileri analiz edildi ve 1342 hastan›n verileri deerlendirildi. Bulgular: Lez- yonlar›n da¤›l›m›: 96's› (%7.15) ozofagusta, 552'si (%41.13) midede, 523'u (%38.97) duodenumda ve 171'i (%12.74) birden cok bolgede yerleflmifltir. Ayr›ca 34 (%2.53) lezyon Forrest Ia, 192'si (%14.31) Forrest Ib, 85'i (%6.33) Forrest IIa, 121'i (%9.02) Forrest IIb, 2...

Research paper thumbnail of İnoperabl Klatskin tümörlü hastaların endoskopik tedavi ile uzun dönem sonuçları

Endoskopi Gastrointestinal, 2015

Girifl ve Amaç: Klatskin tümörü ana hepatik kanal ya da sa¤-sol intrahepatik kanaldan köken alan ... more Girifl ve Amaç: Klatskin tümörü ana hepatik kanal ya da sa¤-sol intrahepatik kanaldan köken alan ve sistik kanal›n aç›l›m yerinin proksimalinde görülen epitelyal safra yolu tümörüdür. Hastal›¤›n tan›s› geç konur ve yaflam beklentisi düflüktür. Cerrahi için uygun olmayan hastalarda safran›n drenaj›n›n sa¤-lanmas› amac›yla endoskopik ya da perkütan drenaj gibi palyatif tedavi seçenekleri kullan›lmaktad›r. Bu çal›flmada, endoskopik stent ve/veya perkütan drenaj tedavisi ile palyatif tedavi edilen inoperabl Klatskin tümörlü hastalar›n yaflam sürelerini ve ifllemlerinin etkinli¤ini de¤erlendirmeyi amaçlad›k. Gereç ve Yöntem: Çal›flma, ‹zmir Atatürk E¤itim ve Araflt›rma Hastanesi Gastroenteroloji Klini¤i'nde Ocak 2008-Eylül 2009 tarihlerinde retrospektif olarak ya-p›ld›. Çal›flmaya inoperabl hiler kolanjiokarsinomal› 34 hasta dahil edildi. Bismuth s›n›flamas› göz önüne al›narak hastal›¤›n tipi belirlendi. Bulgular: Çal›flmaya 19 kad›n, 15 erkek hasta dahil edildi, ortalama yafl 71.8±8.9 olarak bulundu. Yedi hastada (%21) yeterli drenaj olmad›. Drenaj sa¤lanamayan hastalardan 2'sine (%6) perkütan drenaj kateteri yerlefltirildi. Perkütan transhepatik kolanjiografi yap›lan hastalarda yeterli bilirubin düflüflü izlenmedi. Endoskopik stent sonras› drenaj›n yeterli oldu¤u hastalarda ortalama yaflam süresi 145±138 gündü. Stentleme sonras› yeterli drenaj olmayan ve perkütan transhepatik kolanjiografiyi kabul etmeyen 5 hastada ortalama yaflam süresi 13.2±7 gündü. Stentleme sonras› yeterli drenaj olmamas› sebebiyle perkütan transhepatik kolanjiografi ile dren yerlefltirilen 2 hastada ortalama yaflam süresi 22±11.3 gündü. Bismuth I hastalarda ortalama yaflam süresi 164.2±19.3, Bismuth II hastalarda 86±125.6, Bismuth III hastalarda 134.7±130.8, Bismuth IV hastalarda 89.3±132.5 gün saptand›. Bismuth'a göre gruplar ara-s›nda yaflam süreleri aç›s›ndan anlaml› fark saptanmad› (p=0.317). Sonuç: Bu çal›flmada, palyatif endoskopik tedavi baflar› oran›n›n yüksek oldu¤unu ve tümörün yerleflim yerinin ortalama yaflam süresi üzerinde etkili olmad›¤›n› sap-tad›k. Ancak stentlemenin, palyatif anlamda ortalama yaflam süresine katk›da bulunabilece¤ini ve en az 2 endoskopik retrograd kolanjiografi seans›n›n has-talar›n palyatif drenaj›n› sa¤lamak için denenmesi gerekti¤ini düflünmekteyiz.

Research paper thumbnail of The efficacy of endoscopic ultrasonography in local staging of rectal tumors

The Turkish Journal of Gastroenterology, 2012

Background/aims: The purpose of this study was to research the efficacy and reliability of endosc... more Background/aims: The purpose of this study was to research the efficacy and reliability of endoscopic rectal ultrasonography in local staging (T and N stages) of rectal tumors. Materials and Methods: This retrospective study was carried out by the Department of Gastroenterology, ‹zmir Atatürk Training and Research Hospital, which is tertiary level. Thirty-one patients with adenocarcinoma were included in the study. The patients found operable according to computed tomography underwent preoperative local staging by endoscopic ultrasonography. Radial endoscopic ultrasonography and T and N stages were evaluated. Results: It was observed that endoscopic rectal ultrasonography had 80.6% accuracy, 93.4% sensitivity, and 96.5% specificity in T stage; 70% accuracy, 70% sensitivity, and 86% specificity in the detection of presence of lymph node; and 76% accuracy, 100% sensitivity, and 22% specificity in the detection of the nature of lymph node. Conclusions: In this study, it was observed that endoscopic rectal ultrasonography is an efficient and reliable method in the detection of local lymph node and the depth of invasion of rectal tumors (T staging), although it is not reliable enough to determine the characteristics of lymph nodes.

Research paper thumbnail of Does presence of common bile duct stones in patients with acute biliary pancreatitis affect the severity of illness or laboratory findings?

The Turkish Journal of Gastroenterology, 2011

Akut biliyer pankreatitin fliddeti ile ilgili olarak ana safra kanal›ndaki tafllar›n etkisini tan... more Akut biliyer pankreatitin fliddeti ile ilgili olarak ana safra kanal›ndaki tafllar›n etkisini tan›mlamak. Yöntem: Bu tersiyer bir hastanede 103 hastal›k, prospektif ve cross sectional olarak yap›lm›fl bir çal›flmad›r. Baflvurunun ilk 12 ve 72. saatlerindeki serum biyokimyasal ve beyaz küre say›mlar› de¤erlendirildi. Hastalar, endoskopik ultrasonografi ve endoskopik retrograd kolanjiopankreatografide tan›mlanan ana safra kanal› tafllar›n›n varl›¤›na göre grupland›r›ld›. Bunun yan›nda hastalar bilgisayarl› tomografi ve kan örneklerinden derlenen verilerle (Baltazar skorlamas›na göre) hafif ve ciddi akut pankreatit olarak s›n›fland›. Bulgular: Akut biliyer pankreatitli 103 hasta aras›nda, 41 (%39,8) hastada endoskopik ultrasonografi ve endoskopik retrograd kolanjiopankreatografi ile ana safra kanal› veya ampullada tafl ve/veya çamur saptand›. Altm›fliki (%60,2) hastada ana safra ka-nal›nda tafl yoktu. Endoskopik ultrasonografi ve endoskopik retrograd kolanjiopankreatografide tafl saptanan 41 hastan›n 9'unda (%22), saptanmayan 62 hastan›n 13'ünde (%21) fliddetli pankreatit geliflti. Ana safra kanal›nda tafl olan ve olmayan hastalar ara-s›nda fliddetli akut biliyer pankreatite gidifl insidans›nda fark saptanmad› (p=0.45). Sonuç: Ana safra kanal› tafllar› varl›¤› akut biliyer pankreatit fliddeti ile iliflkili de¤ildir.

Research paper thumbnail of Combined use of endosonography and endoscopic retrograde cholangiopancreatography in the same session

The Turkish Journal of Gastroenterology, 2011

The diagnostic value of endoscopic ultrasound in common bile duct stones is high. In this investi... more The diagnostic value of endoscopic ultrasound in common bile duct stones is high. In this investigation, we evaluated the feasibility of endoscopic ultrasound preceding endoscopic retrograde cholangiography in the same session and the potential benefits in increasing the therapeutic endoscopic retrograde cholangiography ratio in the treatment of choledocholithiasis. One hundred and sixty-five consecutive patients who presented with elevated ALP and bilirubin levels and were referred for endoscopic retrograde cholangiography of biliary stones diagnosed with magnetic resonance cholangiopancreatography were evaluated. During the evaluation period (mean: 2 weeks), 50 patients with reductions in ALP and bilirubin by at least half relative to baseline values were enrolled into the study. Endoscopic ultrasound was performed prior to endoscopic retrograde cholangiography. Time spent to perform endoscopic ultrasound was noted. For the presence of common bile duct stone, we used retrograde cholangiography findings as the standard of reference. Median endoscopic ultrasound time was 10.66 minutes (SD±1.52). Bile duct stones were revealed with retrograde cholangiography in 34 patients (68%). Sensitivity, specificity (with 95% confidence intervals [CIs]), positive predictive value and negative predictive value of endoscopic ultrasound were calculated. In identifying common bile duct stones on endoscopic ultrasound, sensitivity, specificity, positive predictive value, and negative predictive value were statistically determined as 91.2% (95% CI), 88.3% (95% CI), 91%, and 81.3%, respectively. Our results indicate that in the presence of local experience and availability of endoscopic ultrasound, it is feasible to perform endoscopic ultrasound prior to endoscopic retrograde cholangiography. The sensitivity, specificity, positive predictive value, and negative predictive value for detecting choledocholithiasis in suspected cases are high. Endoscopic ultrasound preceding endoscopic retrograde cholangiography in the same session has the potential to decrease diagnostic endoscopic retrograde cholangiography and increase therapeutic endoscopic retrograde cholangiography. Need to perform magnetic resonance cholangiopancreatography in the presence of easily accessible endoscopic ultrasound should be questioned.

Research paper thumbnail of Intrahepatic localization of pancreatic pseudocyst: A case report

The Turkish Journal of Gastroenterology, 2013

Pseudocyst as a complication of acute pancreatitis can occur at any site in the abdomen and even ... more Pseudocyst as a complication of acute pancreatitis can occur at any site in the abdomen and even in the mediastinum, but the intrahepatic location of pancreatic pseudocyst is a very uncommon event (1-4). About 30 cases have been reported in the literature. We report here a case of right and left intrahepatic pseudocyst following acute biliary pancreatitis. The mechanism was rupture of the pancreatic pseudocyst in the retroperitoneal cavity and erosion reaching the right hepatic parench-Manuscript

Research paper thumbnail of Gastrointestinal stromal tumor perforation in a case with neurofibromatosis presenting with abdominal pain

The Turkish Journal of Gastroenterology, 2012

Research paper thumbnail of A rare cause of cholangitis: Fasciola hepatica

The Turkish Journal of Gastroenterology, 2010

... LETTERS TO THE EDITOR A rare cause of cholangitis: Fasciola hepatica. Fatih ASLAN, Emrah ALPE... more ... LETTERS TO THE EDITOR A rare cause of cholangitis: Fasciola hepatica. Fatih ASLAN, Emrah ALPER, Zehra AKPINAR, Behlül BAYDAR, Mehmet Kadir AKSÖZ, Zafer BUYRAÇ, Cem ÇEKİÇ, Belkis ÜNSAL. ... Infez Med 2006; 14: 208-12. 4. Sezgin O, Altintas E, Disibeyaz S, et al. ...