A case of hydatid cyst mimicking metastatic lung cancer

Akciğer kist hidatiği, akciğer kanseri gibi malign hastalıkların yanısıra tüberkülöz gibi enfeksiyoz ya da benign patolojiler gibi görünebilmektedir. Radyolojik olarak, akciğer kist hida- tiğinin başta maligniteler olmak üzere birçok akciğer pato- lojisini taklit edebileceği akıldan çıkartılmamalıdır. Ameliyat öncesi dönemde ayırıcı tanısına yönelik gerekli incelemeler yapılmalıdır. Biz de bu nedenle 31 yaşındaki metastatik akciğer kanseri düşündüğümüz akciğer kist hidatik olgusunu sunmayı amaçladık.Hydatid cysts of the lung can mimic malignant diseases such as lung cancer, infectious diseases such as tubecrculosis, or be- nign pathologies. It should be kept in mind that hydatid cysts of the lung can radiologically mimic many lung pathologies, pri- marily malignancies. Necessary investigations should be per- formed for the differential diagnosis in the preoperative period. We, therefore, believed that it is worthwhile to share a 31year- old patient with a hydatid cyst of the lung who was thought to have metastatic lung cancer

Tracheal bronchus : two case reports

Trakeal bronş nadir görülen doğumsal bir anomalidir. Genel- likle semptomsuzdur. Tanıda bilgisayarlı tomografi ile sanal bronkoskopi trakeobronşial ağacın görüntülemesinde son yıllarda kullanılan yeni bir yöntemdir. Bizde trakeal bronkus- lu iki olgumuzu nadir görülmesi nedeniyle litaratür eşliğinde sunmayı amaçladık.Tracheal bronchus is a rare congenital anomaly. In general, it is asymptomatic. Virtual bronchoscopy via computed tomog- raphy is a recently developed diagnostic method used for im- aging the tracheobronchial tree. Because tracheal bronchus is rare, we would like to present two cases with the accompany- ing literature

Organik fosfor zehirlenmesi olan hastalarda yüksek postentübasyon trakeal stenoz riski

Amaç: Bu çalışmada entübasyon sonrası trakea stenozu gelişen hastalar, entübasyonun birincil nedeni ve tedavisine göre tekrar değerlendirildi. Çalışma planı: Ocak 2001 - Aralık 206 tarihleri arasında yoğun bakım ünitesinde çeşitli nedenler ile endotrakeal entübasyon uygulanan 230 hasta arasından entübasyon sonrası trakeal stenoz gelişen 14 hasta retrospektif olarak incelendi. Hastaların tümü boyun ve göğüs bilgisayarlı tomografi taraması ile değerlendirildi ve trakeal anastomoz yapıldı. Rezeke edilen stenotik trakeal halkalar, histopatolojik olarak değerlendirildi. Bulgular: Hastaların toplam 201’ine genel travma (GT), 29’una ise organik fosfor zehirlenmesi (OFZ) nedeni ile endotrakeal entübasyon uygulandı. On dört olguda trakeal stenoz gelişti, bu olguların dokuzu OFZ, beşi GT hastası idi. Organik fosfor zehirlenmesi olan hastalarda yüksek doz atropin veya pralidoksim tedavisi dışında, medikal tedavi ve bakım her iki grupta genel olarak benzer idi. Rezeke edilen stenotik trakeal halkalarda, yaygın kronik aktif inflamasyon, fibrozis ve epitel kaybı OFZ grubunda, GT grubundan daha fazla idi. Sonuç: Entübasyonun birincil nedeni ve medikal tedavinin, entübasyon sonrası trakeal stenoz gelişimine etkisi olabilir.Background: This study aims to reevaluate patients who developed postintubation tracheal stenosis with regard to the primary reason for intubation and therapy. Methods: Between January 2001 and December 2006, 14 of 230 patients who underwent endotracheal intubation for various reasons in the intensive care unit (ICU) and then developed postintubation tracheal stenosis were analyzed retrospectively. All patients were examined with a neck and chest computed tomography (CT) scan, and tracheal anastomosis was performed. The resected stenotic tracheal rings were evaluated histopathologically. Results: A total of 201 patients underwent endotracheal intubation due to general trauma (GT), and 29 of these were due to organophosphate poisoning (OPP). Fourteen of these patients developed tracheal stenosis, including nine with OPP and five with GT. The medical therapy and care were generally similar in both groups, except that high doses of atropine and/or pralidoxime were administered to the OPP patients. Diffused chronic active inflammation, fibrosis, and epithelial loss in the resected stenotic tracheal rings were more common in the OPP group than in the GT group. Conclusion: The primary cause of intubation and the medical therapy employed may have an effect on postintubation tracheal stenosis

Early diagnosis saves lives in esophageal perforations

Aim: Esophageal perforations are rare but highly fatal pathologies. This study aims to discuss the treatment methods for esophageal perforations. Materials and methods: Twenty-two patients who were diagnosed with esophageal perforation in the Ondokuz Mayıs University Faculty of Medicine’s thoracic surgery clinics between 2000 and 2011 were retrospectively evaluated. Results: The cause of perforation was foreign body in 17 patients, dilatation with bougie in 2, balloon dilatation in 2, and spontaneous rupture in 1. Eight patients had cervical, 12 had thoracal, and 2 had thoracoabdominal esophagus perforations. The period between perforation occurrence and treatment was longer than 24 h in 10 patients and shorter than 24 h in 12 patients. Eight patients were treated with primary repair and debridement, 5 with chest tube drainage and conservative treatment, and 1 with self-opening stent, and 1 patient underwent resection. On the other hand, 7 patients were followed with conservative therapy after the removal of the foreign body with esophagoscopy. There was 1 mortality in the surgically treated group, while there were 4 in the conservatively treated group. Conclusion: Surgery is the “gold standard” for the treatment of esophageal perforations. Conservative therapy should be applied only in selected patients under careful monitoring. The most important factor for morbidity and mortality is early diagnosis and determination of the treatment method that best suits the patient.Aim: Esophageal perforations are rare but highly fatal pathologies. This study aims to discuss the treatment methods for esophageal perforations. Materials and methods: Twenty-two patients who were diagnosed with esophageal perforation in the Ondokuz Mayıs University Faculty of Medicine’s thoracic surgery clinics between 2000 and 2011 were retrospectively evaluated. Results: The cause of perforation was foreign body in 17 patients, dilatation with bougie in 2, balloon dilatation in 2, and spontaneous rupture in 1. Eight patients had cervical, 12 had thoracal, and 2 had thoracoabdominal esophagus perforations. The period between perforation occurrence and treatment was longer than 24 h in 10 patients and shorter than 24 h in 12 patients. Eight patients were treated with primary repair and debridement, 5 with chest tube drainage and conservative treatment, and 1 with self-opening stent, and 1 patient underwent resection. On the other hand, 7 patients were followed with conservative therapy after the removal of the foreign body with esophagoscopy. There was 1 mortality in the surgically treated group, while there were 4 in the conservatively treated group. Conclusion: Surgery is the “gold standard” for the treatment of esophageal perforations. Conservative therapy should be applied only in selected patients under careful monitoring. The most important factor for morbidity and mortality is early diagnosis and determination of the treatment method that best suits the patient

Cervical vertebral osteophyte as a rare cause of dysphagia : A report of three cases

Difüz idiopatik iskelet hiperostozu (ankilozan hiperostozis, Forestier hastalığı, spondylitis ossificans ligamentosa) paravertebral ligaman ve kasların enkondral ossifikasyonu sonucu gelişen, yaygın spinal osteofit oluşumları ile karakterize, kronik bir durumdur. Disfaji yakınması olan difüz idiopatik iskelet hiperostozu hastalarında, öncelikle beslenme değişikliği ve antiinflamatuvar tedavisi uygulanabilir. Klinik durumu ağır olan hastalarda cerrahi düşünülmelidir. Bu yazıda yutma güçlüğü ile başvuran üç hastanın tanı ve tedavisi literatür eşliğinde tartışıldı.Diffuse idiopathic skeletal hyperostosis (ankylosing hyperostosis, Forestier’s disease, spondylitis ossificans ligamentosa) is a chronic disease characterized by the widespread spinal osteofit formation due to enchondral ossification of paravertebral ligament and muscles. Treatment is primarily based on dietary changes and anti-inflammatory therapy in diffuse idiopathic skeletal hyperostosis patients suffering from dysphagia. Surgery should be considered in patients with a severe clinical status. In this article, we report three patients and discuss the diagnosis and treatment in the light of literature

Treatment choices in spontaneous pneumothorax

Amaç: Bu çalışmada, 2000-2011 yılları arasında Ondokuz Mayıs Üniversitesi Tıp Fakültesi Göğüs Cerrahisi Kliniği’nde tedavi edilmiş spontan pnömotorakslı hastaları geriye dö- nük olarak değerlendirmek amaçlandı. Gereç ve Yöntem: Spontan pnömotoraks tanısı ile takip ve tedavi edilmiş 160 hasta yaş, cinsiyet, sigara kullanımı, eti- yoloji, tanı yöntemleri, tedavi şekillerine göre geriye dönük olarak değerlendirildi. Bulgular: Hastaların 144’ü erkek, 16’sı kadındı. 86 hastada primer spontan pnömotoraks (PSP), 74 hastada sekonder spontan pnömotoraks (SSP) tespit edildi. SSP’li hastalarda en sık etiyolojik nedenler kronik obstrüktif akciğer hastalı- ğı (KOAH) ve tüberkülozdu. Hastaların 149’una kapalı su altı drenajı, 53’üne cerrahi tedavi, 20’sine plörodezis, 18’ine na- zal oksijen tedavisi uygulandı. Cerrahi tedavi ve plörodezis uygulanan hastalarda nüks izlenmezken, nazal oksijen teda- visi alan hastaların beşinde, tüp torakostomi uygulanan has- taların 21’inde nüks tespit edildi. Ortlama hastanede kalış 10 gün, mortalite oranı %1.8 idi. Sonuç: Spontan pnömotorakslı hastalarda tüp torakos- tominin yetersiz kaldığı durumlarda video yardımlı toraks cerrahisi ya da torakotomi ile cerrahi tedavi altın standart- tır. Cerrahi tedavi seçeneklerinin kullanılamadığı hastalar- da, nüksü önlemek için plörodezis akılda bulundurulmalı- dır.Background: In this study we retrospectively evaluated pa- tients with spontaneous pneumothorax diagnosis in Ondokuz Mayıs University, Faculty of Medicine, Department of Thoracic Surgery between 2000-2011. Methods: We retrospectively evaluated 160 patients diag- nosed with spontaneous pneumothorax on the basis of age, gender, smoking habits, etiology, methods of diagnosis, and treatment. Results: Patients included 144 males and 16 females. There were 86 primary SP and 74 secondary SP patients. COPD and tuberculosis were the most common cause in secondary SP pa- tients. In 149 patients, lung expansion was provided with tube thoracostomy. Fifty-three patients were operated on. In 20 pa- tients, chemical pleurodesis was performed. Eighteen patients were treated with nasal oxygen therapy. No recurrence was de- termined in the groups of surgical treatment and pleurodesis. The 5 patients who received nasal oxygen therapy and 21 pa- tients treated with tube thoracostomy had symptoms reoccur. Mean hospital stay was 10 days and mortality rate was 1.8%. Conclusion: In patients with spontaneous pneumothorax, video-assisted thoracoscopic surgery or surgical treatment with thoracotomy is the gold standard when tube thoracos- tomy has failed. To prevent recurrence, pleurodesis should be considered for patients in whom no surgical treatment choices can be used

The effectiveness of single port thoracoscopic approach in pleural effusions

Objective: Currently, thoracoscopic procedures have been used frequently in diagnosis and treatment of pleural effusions. It was reported, high diagnosis and treatment success with thoracoscopy in pleural effusion, which was not, diagnosed using cytology and blinding pleural biopsy procedures. In this study, it was aimed to evaluate of the patient was performed video-assisted thoracic surgery (VATS) due to pleural effusion. Methods: Between 2011 and 2014 years, it was evaluated 52 patients was performed VATS because of pleural effusion. The procedure was performed under general anesthesia and single lung ventilation in 50 patients, and local anesthesia in 2 patients. Results: Histopathological results were reported as carcinoma infiltration in 29 patients, benign disease in 23 patients. Cytological examination of liquid was executed before thoracoscopy in all of the patients with malignity positive. In addition, in eight patients pleura biopsy, on which blinding was executed, evaluated as malignity negative. The diagnostic value of our procedure has 100% in malign group and 98% in benign group. In patients with malignant disease, pleurodesis was performed peroperatively. Mean hospital stay was 5 days (3-15). Mean duration of terminating chest tube was 3 days (3-15). There were no morbidity and mortality due to procedure. Conclusion: Single port VATS is an effective and safe procedure in diagnosis and palliative treatment of patient with pleural effusion, and it has high success rate and reduces hospital stay