Huge retrorectal cystic teratoma mimicking menengitis

Retrorectal primary mature cystic teratomas are extremely rare and can be challenging to diagnose and treat in adults. These lesions are frequently clinically unrecognized and misdiagnosed. We present a case of a 39-year-old male patient with mature cystic teratoma presenting with repeated episodes of meningitis. He presented to our emergency department with complaints of fever, headache and vomiting since 15 days. He was treated for initial diagnosis as tuberculosis meningitis by a specialist of infection disease with antibiotics after a CSF study which was culture negative. Since he had recurrent meningitis, radiological investigations revealed by suggested it to be a retrorectal mature cyst 20cm in diameter which may be related with the cerebrospinal fluid. He underwent a total cyst excision of the lesion and histopathology confirmed a mature cystic teratoma. We identified about 25 cases of recurrent meningitis associated with dermoid and epidermoid cysts in the Medline literature search. A high index of suspicion is an important factor in making an early diagnosis; rectal examination and radiologic evaluation are also valuable

Neuroendocrine tumor of appendix located Spiegel hernia – case report and review of the literature

Introduction. Appendix, located within the Spiegel hernia is a rare condition. Few cases have been reported to date. Although it is generally asymptomatic, patients can apply with strangulation findings. Along with the physical examination findings, imaging methods play an important role in diagnosis and definitive diagnosis is made intraoperatively. Per-operative surgical method is determined according to the condition of the structures in the hernia sac. If an appendix is detected in the hernia sac, appendectomy is often preferred regardless of symptoms. Postoperative pathology is mostly benign but malign appendix pathologies should be kept in mind. Aim. Here, we aimed to present our case undergoing emergency surgery due to incarcerated hernia as it is the first case of appendix neuroendocrine tumor in the Spiegel hernia sac according to our literature review. Description of the case. A 77-year-old female patient who was admitted to the hospital with complaints of nausea and vomiting was evaluated as an emergency. In the clinical evaluation of the patient, we detected ileus due to hernia. We operated on the patient and found the appendix and cecum in the spiegel hernia. We did appendectomy and hernia repair. Histopathological examination of the appendix revealed a well-differentiated neuroendocrine tumor. Conclusion. Detection of the appendix in a Spiegel hernia is a rare condition. This is the first case of appendiceal malignancy in a Spiegelian hernia

The factors that affect the mortality of emergency operated ASA 3 colon cancer patients

Introduction: colorectal cancers take third place among cancer-related deaths and 10-28% of these patients are admitted with the necessity of emergency surgical intervention. The main propose of this study was to investigate the factors affecting mortality in ASA 3 colorectal cancer patients who undergo emergency surgery. Methods: between 2010 and 2017 ASA 3 patients who underwent emergency colon cancer surgery were included in the study. All of the study group was evaluated within the first 30-day time-frame. The results were obtained by a statistical comparison of the data of patients with and without mortality. Results: one hundred and twenty eight patients included in the study. There was no statistical difference in the demographic data of the groups and the indications of the operation. The differences and durations of surgery also did not make any statistical difference. The complication rate was the same according to the Clavien-Dindo classification. Conclusion: despite the screening programs applied in colorectal cancers, applications to emergency services and procedures performed under emergency conditions are still at high levels. Surgical operations, which have to be performed in patients with impaired metabolic status, carry major risks for patients, but their outcomes are also satisfactory for them

Predictive Factors for Lymph Node Metastasis and the Effect on Survival in Early Gastric Cancer Patients with Radical Gastric Resection

Objectives: Selected patients with early gastric cancer (GC) are treated endoscopically. Lymph node metastasis (LNM) in the T1 stage may also be detected during surgical resection for early GC. The aim of this study was to determine factors associated with LNM and the effect on survival