Cecal diverticulitis mimicking acute Appendicitis: a report of 4 cases

Diverticulum of the cecum is a rare, benign, generally asymptomatic lesion that manifests itself only following inflammatory or hemorrhagic complications. Most patients with inflammation of a solitary diverticulum of the cecum present with abdominal pain that is indistinguishable from acute appendicitis. The optimal management of this condition is still controversial, ranging from conservative antibiotic treatment to aggressive resection. We describe four cases that presented with symptoms suggestive of appendicitis, but were found at operation to have an inflamed solitary diverticulum

Do we need mesh fixation at the laparoscopic hernia repair?

Objective: With the development of laparoscopic treatment, widespread use of laparoscopy has become inevitable for the treatment of inguinal hernias, which is one of the most common ailments in surgical practice. Fixing or not fixing the mesh during laparoscopic repair remains a debate. In our study, we aimed to compare patients with and without mesh fixation in terms of postoperative pain, recurrence, complications, hospitalization and return to social life. Method: The surgical technique to be performed was randomly determined, 81 patients whose data were kept prospectively and evaluated retrospectively were included in the study. Total extraperitoneal repair (TEP) was performed in all patients. While the mesh was not fixed in 50 patients, it was fixed with 2 tackers in 31 patients. Results: When the two groups of patients were compared, the group without mesh fixation was found to be superior in terms of postoperative pain, length of hospital stay and return to social life. There was no difference between the 2 groups in terms of complications and recurrence. Conclusions: In the light of these findings, it is seen that TEP hernia repair can be performed safely without mesh fixation, although prospective randomized studies are needed

A retrospective comparative study of hemorrhoidal artery ligation versus ligasure hemorrhoidectomy for the third degree hemorrhoidal disease

Background: Hemorrhoidal disease (HD) is the most common disease of the anorectal region. Excision of pathological hemorrhoidal structures by providing bipolar energy transfer with Ligasure, which is basically an electrosurgical device, is one of the treatment methods Ligasure hemorrhoidectomy (LH). In another method applied for the first time by Morinaga, the vascular plexus is provided by Doppler-guided ligation of the hemorrhoidal arteries (ADHL). In our study, we aimed to compare and evaluate the results of these two minimally invasive treatment methods. Materials and methods: Patients treated with ADHL and LH for HD in our Surgery Clinic were included in the study. Demographic data, complaints, number of hemorrhoidal structures, location, complications, operation time, bleeding during and after the operation, length of hospital stay, postoperative pain scoring, and postoperative results were evaluated from the patient files. Results: The number of patients included in the study was 91. While 54 patients were treated with ADHL (group 1), 37 patients (group 2) were treated with LH. Although the gender distribution between the groups was similar, there was male predominance in both groups. The mean operative time was shorter in group 1. The number of packages was 2.7 in group 1 and 2.4 in group 2. The mean hospital stay was 1.5 days in the ADHL-treated group, compared to.3.05 days in the LH group. In the postoperative period, bleeding was not observed after an average of 1.4 days in group 1, while this period was 4.9 days in group 2. While recurrence occurred in 4 patients in the ADHL group, recurrence developed in 3 patients who underwent LH. Conclusion: ADHL and LH techniques have advantages and disadvantages over each other. Although the ADHL technique seems to be superior to LH in terms of post-defecation pain and shorter hospital stay, prospective randomized controlled studies are needed to determine which method should be chosen in which patient

Parasitic infestation as cause of acute appendicitis

Scopo dello studio è di verificare il ruolo, tuttora controverso, delle infestazioni parassitarie come possibile causa di appendicite acuta. Pazienti e metodi. Nello studio retrospettivo sono stati inclusi 5.100 pazienti operati per appendicite acuta tra il 1998 e il 2005. I pazienti sono stati divisi in due gruppi, a seconda della presenza (gruppo I, n = 24) o meno (gruppo II, n = 5.076) di parassiti nel lume appendicolare. Risultati. In 24 pazienti (0,5%) l’esame istologico ha dimostrato la presenza di infestazione parassitaria: in 12 casi (50%) da Enterobius vermicularis, in 6 (25%9 da schistostomi, in 4 (17%) da Ascaris lumbricoides, in 2 (8%) da Taenia saginata. Le percentuali di pazienti con appendicite flemmonosa, gangrenosa o perforata sono risultate sovrapponibili nei due gruppi, mentre la percentuale di esami istologici del pezzo operatorio negativi è risultata significativamente maggiore nel gruppo I (25% vs 4,8%, p 0.001). Conclusioni. Pur potendo l’infestazione parassitaria dare sintomi simili a quelli dell’appendicite acuta, raramente ne è causa

The effect of progesterone in the prevention of the chemically induced experimental colitis in rats Efeito da progesterona na prevenção de colite experimental induzida quimicamente em ratos

PURPOSE: To study the effects of progesterone on an experimental colitis model. METHODS: Wistar albino rats were treated subcutaneously with 2mg/kg once a day during seven days Colitis was induced by intrarectal administration of 5mg trinitrobenzene sulfonic acid (TNBS). Disease activities, macroscopic and microscopic scores were evaluated. To determine the response provoked by progesterone we measured Colonic malondialdehyde (MDA), TNF alfa, IL-6 and Nitric oxide (NO) levels in addition to the MPO (Myeloperoxidase) and caspase-3 activities. RESULTS: Progesterone ameliorated significantly the macroscopic and microscopic scores. TNBS-induced colitis significantly increased the colonic MDA levels and caspase-3 activities in group 2 in comparison to the control group. The results of the study revealed a decline in MDA, NO, IL6 and TNF-&#945; levels in the colon tissue and in blood due to progesterone therapy in group 3 when compared to the group 2, a significant improvement. Progesterone treatment was associated with decreased MDA, MPO, TNF alfa and caspase-3 activity. CONCLUSION: Progesterone therapy decreased oxidative damage in the colonic mucosa.<br>OBJETIVO: Investigar os efeitos da progesterona em um modelo de colite experimental. MÉTODOS: Ratos albinos Wistar foram tratados subcutaneamente com 2mg/kg por dia durante sete dias. A colite foi induzida por administração intrarretal de 5mg ácido sulfônico trinitrobenzeno (TNBS). Foram avaliadas as atividades da doença, escores macroscópicos e microscópicos Para determinar a resposta provocada pela progesterona foi medida no cólon os níveis de malondialdeído (MDA), TNF alfa, IL-6 e óxido nítrico (NO), além da atividade da MPO (Myeloperoxidase) e caspase-3. RESULTADOS: A progesterone melhorou significantemente os escores macroscópicos e microscópicos. A colite induzida pelo TNBS significantemente aumentou os níveis colônicos de MDA e a atividade da caspase-3 no grupo 2 em comparação com o grupo controle. Os resultados do estudo revelaram um declínio nos níveis de MDA, NO, IL6 e TNF-&#945; no tecido colônico e no sangue devido à terapia com a progesterona no grupo 3 quando comparado ao grupo 2. O tratamento com a progesterona foi associado com decréscimo do MDA, MPO, TNF alfa e atividade da caspase-3. CONCLUSÃO: A terapia com progesterona decresce o dano oxidativo na mucosa do cólon

Effects of glutamine and curcumin on bacterial translocation in jaundiced rats

AIM: To investigate the effect of curcumin on bacterial translocation and oxidative damage in an obstructive jaundice model and compare the results to glutamine, an agent known to be effective and clinically used