Small Bowel Obstruction due to Mesodiverticular Band of Meckel's Diverticulum: A Case Report

Meckel's diverticulum is the most common congenital anomaly of the small intestine. Common complications related to a Meckel's diverticulum include haemorrhage, intestinal obstruction, and inflammation. Small bowel obstruction due to mesodiverticular band of Meckel's diverticulum is a rare complication. Herein, we report the diagnosis and management of a small bowel obstruction occurring due to mesodiverticular band of a Meckel's diverticulum

Matrix Metalloproteinases in Pathogenesis of Hemorrhoidal Disease

The aim of this study is to investigate the accuracy of serum matrix metalloproteinase (MMP) levels in an effort to find a reliable factor that may play an important role in pathogenesis of hemorrhoidal disease. Twenty control subjects and 21 Grade I, 19 Grade II, 20 Grade III, and 21 Grade IV patients with internal hemorrhoid were included in this prospective study. The mean ages of control subjects were 47.65 +/- 6.71 standard deviation (SD) years (range, 37 to 60 years). The mean age of internal Grade I, Grade II, Grade III, and Grade IV patients with internal hemorrhoid were 48.85 +/- 6.44, 47.20 +/- 6.75, 44.90 +/- 6.13, and 42.95 +/- 3.49 SD years (ranges, 38 to 58, 38 to 60, 34 to 55, and 38 to 50 years), respectively. Ten milliliters of blood was taken from all subjects. Enzymelinked immunosorbent assay (ELISA) for MMP-1, -2, -7, and -9 levels were performed using an ELISA kit (R&D Systems) following the manufacturer's instructions. There was an important difference between Grade I and Grade II groups in the serum levels of MMP-9 (P <0.01). Patients with Grade III hemorrhoidal disease had significantly higher serum levels of all MMP than patients with Grade I and Grade II hemorrhoidal disease (P < 0.001). Also, patients with Grade 4 hemorrhoidal disease had higher serum levels of MMP-7 and -9 according to Grade I, II, and III groups (P < 0.01, 0.001). High serum levels of MMP are present in patients with hemorrhoids, suggesting the possible mechanism in the pathogenesis of hemorrhoids

The role of ERCP and sonagraphyin thediagnosis of choledocholithiazis

Endoskopik retrograd kolanjiopankreatikografi safra yollan ve periampuller bölge hastalıklarının tanı ve tedavisinde kullanılan bir yöntemdir. Laparoskopik kolesistektominin kullanılmaya başlamasından sonra daha popüler bir yöntem olmuştur. Bu klinik çalışmada amacımız Endoskopik retrograd kolanjiopankreatografi ile Ultrasonografi’nin koledokolitiazis tanısında yerini belirlemektir. Yüzüncü Yıl Üniversitesi Tıp Fakültesi Genel Cerrahi Anabilim Dalı’nda 118 hastaya uygulanan Endoskopik retrograd kolanjiopankreatografi ve ultrasonografi sonuçları karşılaştırıldı. Bu çalışmada Endoskopik retrograd kolanjiopankreatografi tanı standartı olarak kabul edildi ve ultrasonografi sonuçlan endoskopik retrograd kolanjiopankreatografi sonuçlarına göre değerlendirildi. Ultrasonografi’nin %83.3 sensitiviteye ve %60 spesifiteye,%90.9 pozitif prediktif değere ve %42.8 negatif prediktif değere sahip olduğu görüldü. Sonuç olarak ultrasonografi, obstrüktif ikter tanısında endoskopik retrograd kolanjiopankreatografi ile birlikte kullanıldığında daha başarılı sonuçlar elde edilebilecektir.Endoscopic retrograde cholangiopancreatography is a method which is being used in the diagnosis and treatment of the disease of bile ducts and periampullary area. It was being a more popular method after laparoscopic cholesistectomies were begun to use. Our purpose was being determined Endoscopic retrograde cholangiopancreatography’s and Ultrasonography’s place in the diagnosis of choledocolithiazis in this clinical study. Endoscopic retrograde cholangiopancreatography and Ultrasonography results of 118 patients who were applied Endoscopic retrograde cholangiopancreatography and Ultrasonography were compared at the department of general surgery, medical school of Yuzuncu Yil University, Van. Endoscopic retrograde cholangiopancreatography was accepted as a diagnostic standart in this study and Ultrasonography results were evaluated according to Endoscopic retrograde cholangiopancreatography’s results. Ultrasonography has 83.3% sensitivity, 60% specificity, 90.9% positive predictive value and 42.8% negative predictive value. In conclusion, when ultrasonography use with ERCP in the diagnosis of obstructive jaundice, more successful results would be obtained

Biliary tract reconstruction with autologous rectus sheath graft - An experimental study

WOS: 000230154300009PubMed: 16001620Background/Aims: Common bile duct injuries which cause significant morbidity and mortality are one of the most serious complications of cholecystectomies. They can be repaired by various approaches. Methodology: We used an autologous graft obtained from the posterior sheath of the rectus muscle in biliary tract reconstruction for common bile duct defect. This experimental study was carried out on six dogs. A tissue fragment was excised from the posterior sheath of the rectus muscle together with the fascia transversalis and peritoneum. A channel from the fascial graft was formed around a T-tube. The autologous rectus sheath graft was sutured to the common bile duct as a segmental conduit graft. Afterwards, blood biochemistry values and liver histopathology were investigated. Dogs were studied by T-tube cholangiography 4 months postoperatively just prior to removing the T-tube and again 2 months later at relaparotomy. The hepatic parenchyma, intra- and extrahepatic bile ducts were detected by ultrasonography during the last 2 months, one time in fifteen days. Results: There was no anastomotic insufficiency. The fascial graft gained an appearance similar to bile duct in dogs. Postoperatively, no change in blood biochemical parameters was observed, and in the preoperative and postoperative periods no histopathological change in the liver was Conclusions: These findings indicate that the use of an autologous fascial graft to repair common bile duct injuries as a conduit graft for segmental bile duct loss may be a feasible and alternative method of treatment

The role of ERCP and sonagraphyin thediagnosis of choledocholithiazis

Endoskopik retrograd kolanjiopankreatikografi safra yollan ve periampuller bölge hastalıklarının tanı ve tedavisinde kullanılan bir yöntemdir. Laparoskopik kolesistektominin kullanılmaya başlamasından sonra daha popüler bir yöntem olmuştur. Bu klinik çalışmada amacımız Endoskopik retrograd kolanjiopankreatografi ile Ultrasonografi’nin koledokolitiazis tanısında yerini belirlemektir. Yüzüncü Yıl Üniversitesi Tıp Fakültesi Genel Cerrahi Anabilim Dalı’nda 118 hastaya uygulanan Endoskopik retrograd kolanjiopankreatografi ve ultrasonografi sonuçları karşılaştırıldı. Bu çalışmada Endoskopik retrograd kolanjiopankreatografi tanı standartı olarak kabul edildi ve ultrasonografi sonuçlan endoskopik retrograd kolanjiopankreatografi sonuçlarına göre değerlendirildi. Ultrasonografi’nin %83.3 sensitiviteye ve %60 spesifiteye,%90.9 pozitif prediktif değere ve %42.8 negatif prediktif değere sahip olduğu görüldü. Sonuç olarak ultrasonografi, obstrüktif ikter tanısında endoskopik retrograd kolanjiopankreatografi ile birlikte kullanıldığında daha başarılı sonuçlar elde edilebilecektir.Endoscopic retrograde cholangiopancreatography is a method which is being used in the diagnosis and treatment of the disease of bile ducts and periampullary area. It was being a more popular method after laparoscopic cholesistectomies were begun to use. Our purpose was being determined Endoscopic retrograde cholangiopancreatography’s and Ultrasonography’s place in the diagnosis of choledocolithiazis in this clinical study. Endoscopic retrograde cholangiopancreatography and Ultrasonography results of 118 patients who were applied Endoscopic retrograde cholangiopancreatography and Ultrasonography were compared at the department of general surgery, medical school of Yuzuncu Yil University, Van. Endoscopic retrograde cholangiopancreatography was accepted as a diagnostic standart in this study and Ultrasonography results were evaluated according to Endoscopic retrograde cholangiopancreatography’s results. Ultrasonography has 83.3% sensitivity, 60% specificity, 90.9% positive predictive value and 42.8% negative predictive value. In conclusion, when ultrasonography use with ERCP in the diagnosis of obstructive jaundice, more successful results would be obtained

PREVENTION OF WRAP DISRUPTION AFTER ANTIREFLUX SURGERY: AN EXPERIMENTAL STUDY

WOS: 000373722800008Objective: The worst complication after a fundoplication is the disruption of the fundic wrap which is the main cause of recurrent gastro-esophageal reflux. The purpose of this experimental study is to seek for an alternative technique to prevent wrap-breakdown. Material and Method: The experiments were carried out on thirty canine subjects those were randomly allocated into 3 groups for performance of a Nissen procedure. Silk sutures were used for construction of the fundic wrap in Group I, silk sutures and fibrin glue were used in Group II and only fibrin glue was used in Group III for the same purpose. Operation durations were noted as minutes. The break-down force of the fundic wrap was measured and recorded. The results were recorded as kg and statistical examinations were performed by SPSS 13.0 statistical software program. The intergroup comparisons were performed with Kruskal-Wallis and Mann-Whitney U tests. p was significant at 0.05). Operation times were 47.9 in Group I, 53.2 in Group II and 28.38 minutes in Group III. Operation times were significantly longer in Group II than in Group I and III (p<0.05), and significantly shorter in Group III than in Groups I and II (p<0.05). Conclusion: We believe that, application of the fibrin glue together with the conventional suturing technique in construction of the fundoplication may prevent wrap-breakdown after the Nissen antireflux procedure

Hypertrophic Pyloric Stenosis Mr Findings

Infantile hypertrophic pyloric stenosis (IHPS) is a condition affecting young infants, in which the antropyloric portion of the stomach becomes abnormally thickened and manifests as obstruction to gastric emptying. The clinical diagnosis hinges on palpation of the thickened pylorus, or &apos;olive.&apos; Abdominal palpation is accurate but not always successful, in such cases, radiologic examinations including US or MRI can be performed. US is the first choice of imaging modality. Unfortunately, in case of difficulty by the sonographic diagnosis of IHPS such as overlying bowel gas, MRI could be useful for the diagnosis

Levels of matrix metalloproteinase-1 and tissue inhibitors of metalloproteinase-1 in gastric cancer

AIM: To evaluate the levels of preoperative serum matrix metalloproteinase-1 (MMP-1) and tissue inhibitor of metalloproteinase-1 (TIMP-1) in gastric cancer