Esophageal squamous papilloma

Özofagus skuamoz papillomu, genellikle alt özofagusta soliter bir lezyon olarak görülen, iyi huylu skuamoz epitelyal polipoid bir tümördür. Prevalans oranları çok düşüktür ve 1959’dan bu yana literatürde yaklaşık 250 vaka bidirilmiştir. Kronik mukozal irritasyon ve human papilloma virus enfeksiyonu suçlanan etyolojik nedenlerdir. Tipik özofagus skuamöz papillomunun hiçbir özgün semptomu yoktur. Bizim vakamız kronik dispeptik şikayetleri olan ve endoskopik olarak reflü özofajiti saptanan 51 yaşındaki erkek hasta idi. Endoskopik incelemede özofagus 25. cm’de 3-4 mm’lik polipoid oluşum izlendi. Buradan aldığımız biyopsi örneğinin patolojik inceleme sonucu özofagus skuamoz papillomu olarak geldi.Esophageal squamous papilloma is a benign squamous epithelial polypoid tumor and is usually seen as a solitary lesion of the lower esophagus. They have a low prevalence, and about 250 cases have been reported in the literature since 1959. Chronic mucosal irritation and infection with human papilloma virus are proposed etiologies. There are no pathognomonic symptoms for the typical esophageal squamous papilloma. Our patient was a 51-yearold man who had chronic dyspeptic complaints and endoscopically detected reflux esophagitis. A 3-4 mm sized polypoid formation was seen at the 25’th cm of his esophagus during the endoscopic examination. Pathologic inspection of the biopsied specimen taken from this part of his esophagus indicated esophageal squamous papilloma

A non-obstructive gastric antral web case detected after upper gastrointestinal system bleeding

This is the first study on the construction of the relation-ship between a non-obstructive gastric antral web and gastric-outlet obstruction in children and adults.Congenital or acquired gastric antral webs (GAWs) may cause gastric-outlet obstruction in children and adults. Endoscopic methods are often used in the treatment of obstructive GAWs. We report the case of a patient with a congenital non-obstructive antral gastric web. The pa-tient was a 25-year-old male with gastrointestinal hem-orrhage followed by dyspeptic complaints. There was a follow-up period for the patient after treatment. Because GAWs are encountered and rarely reported in the litera-ture, the images taken during endoscopic surgery of the patient, as a significant contribution to the literature, are also presented

Endoscopic balloon dilatation after rectal mesalazine treatment within an uncertainty of colonic anastomosis

Anastomoz darlıkları kolorektal cerrahinin bilinen bir komplikasyonu olma-sına rağmen benign hastalıklarda komplet kolonik anastomoz obstrüksiyonu nadirdir. Benign darlıklar low-anterior rezeksiyon sonrası yapılan kolorektal anastomozda nispeten sık görülen bir komplikasyondur ve kolorektal anas-tomozların %5-22’sinde gelişebilir. Günümüzde benign anastomoz darlık-larının tedavisinde ilk seçenek endoskopik girişimlerdir. Çeşitli endoskopik teknikler tarif edilmesine rağmen optimal yaklaşım için kontrollü prospek-tif çalışma verileri eksiktir. Bu çalışmada ileri derecede anastomoz darlığı gelişmiş ve endoskopik balon dilatasyon uygulanan bir hastanın sunulması amaçlandı. Hastaya bir haftalık rektal mesalazin tedavisinden sonra bir kez ayaktan balon dilatasyonu uygulandı ve darlık giderildi. Rektal mesalazin uygulamasının darlık bölgesindeki inflamutuvar sürece olumlu etkisi oldu ve balon dilatasyon sayısını azalttı. Kolorektal darlıkların tedavisinde endos-kopik balon dilatasyon 1985’ten beri kullanılmaktadır. Minimal invaziv bir yöntemdir, başarı oranı yüksektir, güvenle direkt görüş altında yapılabilir, tekrarlanabilir ve hastanede yatış gerektirmez.Although anastomotic strictures are a recognized complication of colorectal surgery, complete colonic anastomotic obstruction from benign disease is rare. A benign stricture is a relatively common complication of colorectal anastomosis after low anterior resection and may develop colonic anasto-mosis in 5%-22% of cases. Today, endoscopic interventions have become the preferred first-line treatment for postoperative large bowel strictures. A variety of endoscopic techniques have been described, but there is a lack of data from controlled prospective trials regarding the optimal approach. In this study, a case of severe anastomotic stricture of the colon, during which endoscopic balloon dilatation was performed, is presented. After a one-week course of treatment with rectal mesalazine, the ambulatory patient under-went balloon dilation only once and the stricture resolved. Rectal mesalazine administration had a positive effect on the inflammatory process at the site of stenosis and reduced the number of balloon dilatations. Endoscopic balloon dilatation has been used since 1985 for the treatment of colorectal strictures. It is a minimally invasive method, has a high success rate, can be performed safely under visual control, can be performed repeatedly, and does not re-quire hospitalization

Kolonun benign anastomoz darlığında rektal mesalazin tedavisi sonrası endoskopik balon dilatasyonu

Anastomoz darlıkları kolorektal cerrahinin bilinen bir komplikasyonu olma-sına rağmen benign hastalıklarda komplet kolonik anastomoz obstrüksiyonu nadirdir. Benign darlıklar low-anterior rezeksiyon sonrası yapılan kolorektal anastomozda nispeten sık görülen bir komplikasyondur ve kolorektal anas-tomozların %5-22’sinde gelişebilir. Günümüzde benign anastomoz darlık-larının tedavisinde ilk seçenek endoskopik girişimlerdir. Çeşitli endoskopik teknikler tarif edilmesine rağmen optimal yaklaşım için kontrollü prospek-tif çalışma verileri eksiktir. Bu çalışmada ileri derecede anastomoz darlığı gelişmiş ve endoskopik balon dilatasyon uygulanan bir hastanın sunulması amaçlandı. Hastaya bir haftalık rektal mesalazin tedavisinden sonra bir kez ayaktan balon dilatasyonu uygulandı ve darlık giderildi. Rektal mesalazin uygulamasının darlık bölgesindeki inflamutuvar sürece olumlu etkisi oldu ve balon dilatasyon sayısını azalttı. Kolorektal darlıkların tedavisinde endos-kopik balon dilatasyon 1985’ten beri kullanılmaktadır. Minimal invaziv bir yöntemdir, başarı oranı yüksektir, güvenle direkt görüş altında yapılabilir, tekrarlanabilir ve hastanede yatış gerektirmez.Although anastomotic strictures are a recognized complication of colorectal surgery, complete colonic anastomotic obstruction from benign disease is rare. A benign stricture is a relatively common complication of colorectal anastomosis after low anterior resection and may develop colonic anasto-mosis in 5%-22% of cases. Today, endoscopic interventions have become the preferred first-line treatment for postoperative large bowel strictures. A variety of endoscopic techniques have been described, but there is a lack of data from controlled prospective trials regarding the optimal approach. In this study, a case of severe anastomotic stricture of the colon, during which endoscopic balloon dilatation was performed, is presented. After a one-week course of treatment with rectal mesalazine, the ambulatory patient under-went balloon dilation only once and the stricture resolved. Rectal mesalazine administration had a positive effect on the inflammatory process at the site of stenosis and reduced the number of balloon dilatations. Endoscopic balloon dilatation has been used since 1985 for the treatment of colorectal strictures. It is a minimally invasive method, has a high success rate, can be performed safely under visual control, can be performed repeatedly, and does not re-quire hospitalization

Effect of HLA on Hepatitis C Virus Clearance and Persistence in Anti-HCV-positive End-stage Renal Disease Patients

Background/Aims: The efficacy of immune response against hepatitis C virus (HCV) is determined by human leukocyte antigen (HLA) molecules of the host which present HCV antigens to CD4+ and CD8+ Tlymphocytes. In this study, we aimed to investigate the possible relationship between the frequencies of certain HLA class I-II alleles and the natural history of HCV in patients with end-stage renal disease (ESRD). Settings and Design: This is a retrospective cohort study conducted in a university hospital. Patients and Methods: The present study comprised 189 ESRD patients (candidates for renal transplantation) who had positive anti-HCV antibody test. The results concerning HCV and HLA status were gathered from patients files. The viral persistence was compared between the groups that were determined by HLA sub-typing. Statistical Analysis: Statistical evaluation was performed using Mann-Whitney U-test, Chi-square test, and Fisher's exact test. Level of error was set at 0.05 for all statistical evaluations, and P values < 0.05 were considered statistically significant. Results: We found possible association between the course of HCV infection and specific HLA alleles. HLA class I Cw*6 and HLA class II DRB*10 alleles were observed more frequently in the viral clearance group (P < 0.05). The HLA class I B*38 allele group was more prone to develop chronic hepatitis C (P < 0.01). Conclusions: These findings suggest that HLA class I Cw*6 and HLA class II DRB*10 alleles may be associated with immunological elimination of HCV in Turkish patients on hemodialysis. HLA sub-typing could help predict the prognosis of HCV infection