A rare cause of recurrent gastrointestinal bleeding: mesenteric hemangioma

Lower gastrointestinal hemorrhage accounts for approximately 20% of gastrointestinal hemorrhage. The most common causes of lower gastrointestinal hemorrhage in adults are diverticular disease, inflammatory bowel disease, benign anorectal diseases, intestinal neoplasias, coagulopathies and arterio-venous malformations. Hemangiomas of gastrointestinal tract are rare. Mesenteric hemangiomas are also extremely rare

Postmastectomy irradiation in breast in breast cancer patients with T1-2 and 1-3 positive axillary lymph nodes: Is there a role for radiation therapy?

<p>Abstract</p> <p>Background</p> <p>We aimed to evaluate retrospectively the correlation of loco-regional relapse (LRR) rate, distant metastasis (DM) rate, disease free survival (DFS) and overall survival (OS) in a group of breast cancer (BC) patients who are at intermediate risk for LRR (T1-2 tumor and 1-3 positive axillary nodes) treated with or without postmastectomy radiotherapy (PMRT) following modified radical mastectomy (MRM).</p> <p>Methods</p> <p>Ninety patients, with T1-T2 tumor, and 1-3 positive nodes who had undergone MRM received adjuvant systemic therapy with (n = 66) or without (n = 24) PMRT. Patient-related characteristics (age, menopausal status, pathological stage/tumor size, tumor location, histology, estrogen/progesterone receptor status, histological grade, nuclear grade, extracapsular extension, lymphatic, vascular and perineural invasion and ratio of involved nodes/dissected nodes) and treatment-related factors (PMRT, chemotherapy and hormonal therapy) were evaluated in terms of LRR and DM rate. The 5-year Kaplan-Meier DFS and OS rates were analysed.</p> <p>Results</p> <p>Differences between RT and no-RT groups were statistically significant for all comparisons in favor of RT group except OS: LRR rate (3%vs 17%, p = 0.038), DM rate (12% vs 42%, p = 0.004), 5 year DFS (82.4% vs 52.4%, p = 0.034), 5 year OS (90,2% vs 61,9%, p = 0.087). In multivariate analysis DM and lymphatic invasion were independent poor prognostic factors for OS.</p> <p>Conclusion</p> <p>PMRT for T1-2, N1-3 positive BC patients has to be reconsidered according to the prognostic factors and the decision has to be made individually with the consideration of long-term morbidity and with the patient approval.</p

The Value of Intra-abdominal Pressure Measurement in Patients with Acute Abdomen

To find out the potential benefit of bladder pressure (BP) measurement as a diagnostic tool for acute abdomen. Background: Acute abdomen is one of the most important clinical entities among general surgical clinics. The diagnosis can be achieved by considering the patient's history, physical examination, laboratory analysis or by different imaging modalities. Abdominal compartment syndrome (ACS) occurs due to elevated intra-abdominal pressure (IAP), and can be diagnosed by measurement of BP. We observed in our clinical routine elevated IAP levels in patients with acute abdomen. Methods: Two groups were established: one containing 65 consecutive patients diagnosed as having acute abdomen in the emergency room, and the control group of 10 consecutive patients with no acute abdominal complaints elected for laparoscopic operation. IAP measurements were performed before the operations. BP was measured in the supine position with 50 mL of sterile saline instilled into the bladder after the bladder had been emptied. The catheter was connected to a water manometer with the reference point being the symphisis pubis. BP levels greater than 7 cmH2O were accepted as abnormal and interpreted as a diagnostic criteria for acute abdomen. Results: Sensitivity, specificity, positive predictive value, negative predictive value and the accuracy are calculated 95.4%, 80%, 96.9%, 72.7%, 93.3%, respectively. Conclusion: We found elevated IAP may support the physician's diagnosis of acute abdomen with approximately 27.3% false negative rate

Primary Hydatid Disease of Retroperitoneum: Case Report

Hydatid disease is still seen as an endemic disease in several regions of the world and holds importance for both our country and region as a common health problem. We present an isolated primary retroperitoneal hydatid cyst, without any other confirmed cyst localization. Hydatid cyst should be considered for differential diagnosis of retroperitoneal masses, as a rare location

Primary Hydatid Disease of Pancreas Mimicldng Cystic Neoplasm

Primary hydatid disease of the pancreas is very rare. We report a 33-year-old female who was admitted to the hospital with abdominal discomfort due to the pancreatic mass. A diagnosis of a pancreatic cystic mass was established through abdominal ultrasonography and computed tomography scan. Hydatid disease as well as a cystic neoplasm of the pancreas were both thought in the differential diagnosis. Distal pancreatectomy with splenectomy was performed. The histopathologic evaluation of the specimen revealed a hydatid cyst affecting the tail of the pancreas. Hydatid disease Should be considered in the differential diagnosis of all cystic masses of the pancreas, especially in endemic regions

Pancreas is an Unusual Initial Metastatic Site of Intracranial Hemangiopericytoma

Intracranial hemangiopericytoma (HPC) is rare and aggressive tumor with local recurrences as well as distant metastases. The majority of metastases are encountered in bone, lung, and liver. Pancreatic metastasis is extremely rare. Described in the present report is the case of a 41-year-old woman who had undergone surgical resection of intracranial HPC 16 years earlier. The tumor recurred 3 years after the operation and was successfully managed with surgery followed by adjuvant radiotherapy. Thirteen years later, an isolated pancreatic metastasis developed. Patient underwent Whipple procedure for pancreatic head lesion and received adjuvant radiotherapy. Patient died of extensive disease in lungs, bones, mediastinum, cranium and peritoneal carcinomatosis in abdomen 17 months after pancreatic surgery

Protective effect of Urtica dioica on liver damage induced by biliary obstruction in rats

The aim of this study was to evaluate the possible protective effects of Urtica dioica (UD) against liver damage in the common bile duct-ligated rats. A total of 24 male Sprague Dawley rats were divided into three groups, namely, control, bile duct ligation (BDL) and BDL+received UD groups, containing eight animals in each group. The rats in UD-treated groups were given UD oils (2ml/kg) once a day intraperitoneally for 2weeks starting 3days prior to BDL operation. The change demonstrating the bile duct proliferation and fibrosis in expanded portal tracts includes the extension of proliferated bile ducts into the lobules; inflammatory cell infiltration into the widened portal areas were observed in BDL group. Treatment of BDL with UD attenuated alterations in liver histology. The -smooth muscle actin, cytokeratin-positive ductular proliferation and the activity of terminal deoxynucleotidyl transferase dUTP nick end labeling in the BDL were observed to be reduced with the UD treatment. The data indicate that UD attenuates BDL-induced cholestatic liver injury, bile duct proliferation and fibrosis

Financial Aspects of Bile Duct Injuries

Background: Major bile duct injury is the most worrisome complication of cholecystectomy. There is no detailed data about the incidence or treatment-related costs of bile duct injuries in Turkey. We aimed to determine prevalence and therapeutic costs of patients with major biliary duct injuries managed in our department, and further estimate a projection of these parameters at the national level

Comparison between Karydakis flap repair and primary closure for surgical treatment of sacrococcygeal pilonidal sinus

Objectives: In this prospective study, we compared primary closure and Karydakis flap repair which has recently proved a popular technique for surgical treatment of pilonidal sinus