Laparoscopic treatment of morgagni hernia: Two case reports

Morgagni hernias account for only 2–3% of all diaphragmatic hernias, and most of them (91%) are rightsided. Most Morgagni hernias are diagnosed in childhood, but rarely diagnosis may be late because they can be asymptomatic or present nonspecific-nonrespiratory symptoms. Thus, Morgagni hernia diagnosis is incidental in the majority of adulthood cases. The defect arises from a fusion failure of the diaphragm with the central arches. Surgery is the main treatment modality of the Morgagni hernia due to defect enlargement and strangulation- incarceration risks. In this paper, we present two Morgagni hernia cases treated with laparoscopic surgery. Minimal invasive techniques can be used in Morgagni hernia with all advantages

Anemiye Neden Olan Dev İnflamatuar Fibroid Polip: Olgu Sunumu

Giriş ve amaç: İnflamatuar fibroid polip gastrointestinal sistemin nadir görülen, en sık mide antrumundan köken almakla birlikte gastrointestinal sistemin her yerinde görülebilen lezyonudur. Genellikle 1-3 cm boyutlarında olan lezyonun tanısı obtrüksiyona bağlı yakınmalarla veya rastlantısal olarak konulmaktadır. Yazımızda anemiye neden olan dev ileal inflamatuar fibroid polip olgusu sunulmuştur. Olgu: 53 yaşında erkek hasta son haftalarda gelişen güçsüzlük ve renk solgunluğu yakınması ile başvurdu. Fizik muayene ve laboratuar incelemeleri ile demir eksikliği anemisi tanısı konuldu. Anemi etiyolojisi araştırılırken yapılan kolonoskopide terminal ileumda valv’den yaklaşık 20 cm proksimalde 7-8 cm boyutunda pedinküle polipoid lezyon mevcuttu. Hastaya laparoskopik segmenter ince barsak rezeksiyonu yapıldı. Lezyonun patolojik incelemesinde iltihabi fibroid polip saptandı. Sonuç :İnflamatuar fibroid polip demir eksikliği anemisine yol açabilen polipoid nitelikteki oluşumların ayırıcı tanısında göz önünde bulundurulmalıdır

Stapled Mucosectomy: An Alternative Technique for the Removal of Retained Rectal Mucosa after Ileal Pouch-Anal Anastomosis

Restorative proctocolectomy (RPC), when performed with a stapled ileal pouch-anal anastomosis (IPAA), allows the retention of the rectal mucosa above the dentate line and can result in disease persistence or recurrence, as well as neoplastic lesions in patients with ulcerative colitis (UC). We report the case of a patient with chronic UC who underwent staple mucosectomy, which is an alternative technique that evolved from stapled hemorrhoidopexy, rather than more traditional procedures. The patient had undergone laparoscopic RPC with a stapled IPAA 2 cm above the dentate line and a temporary loop ileostomy. Because the histopathology showed low-grade dysplasia in the proximal rectum, stapled mucosectomy with a 33-mm circular stapler kit at the time of ileostomy closure was scheduled. Following the application of a purse-string suture 1 cm above the dentate line, the stapler was inserted with its anvil beyond the purse-string and was fired. The excised rectal tissue was checked to ensure that it was a complete cylindrical doughnut. Histopathology of the excised tissue showed chronic inflammation. There were no complications during a follow-up period of 5 months. Because it preserves the normal rectal mucosal architecture and avoids a complex mucosectomy surgery, stapled mucosectomy seems to be a technically feasible and clinically acceptable alternative to the removal of rectal mucosa retained after RPC

The prevalence of pediculus humanus capitis and tinea capitis among elementary school students in Edirne

Amaç: Bu çalışmada Edirne Merkez İlköğretim Okulları öğrencilerinde pedikulus humanus kapitis ve tinea kapitisin görülme sıklığı ve tinea kapitis yapan etkenlerin saptanması amaçlandı. Olgular ve Yöntemler: 2003 yılı Nisan ve Mayıs aylarında Edirne merkezindeki 34 ilköğretim okulunda 12.868 öğrenci tarandı. Saç ve saçlı deride lezyon görülenlerin lezyonlu bölgelerinden, saç teli ve saçlı derilerinden kazıntı örneği alındı. Alınan örneklerden KOH ile direkt mikroskobik inceleme ve sikloheksimidli Sabouraud dekstroz agarda mantar kültürü yapıldı. Bulgular: Toplam 698 (%5.4) öğrencinin başında pedikulusun sirke, nimf veya olgun şekli saptandı. Kız öğrencilerdeki pozitiflik (%10.3) erkek öğrencilerdekinden (%0.9) daha yüksekti (p<0.001). Enfestasyon oranı en az yedi yaş altında (%3.4) bulundu (p<0.001). Sosyo-ekonomik düzeyi düşük ailelerin bulunduğu bölgelerde bitlenme oranı daha yüksekti (p<0.001). Hiçbir öğrencide tinea kapitise rastlanmadı. Sonuç: Pedikulus humanus kapitisin Edirne’de bir halk sağlığı sorunu olmaya devam ettiği görüldü. Eradikasyon için aileler, öğretmenler ve sağlık çalışanları tarafından öğrencilerin periyodik kontrollerinin yapılması, hasta kişilerin tedavi edilmesi, alt yapı hizmetlerinin iyileştirilmesi, etkenden nasıl korunulması gerektiği üzerine sürekli eğitim verilmesinin yerinde olacağı sonucuna varıldı.Objectives: In this study, we aimed to determine the prevalences of pediculus humanis capitis and tinea capitis and the causative agents of tinea capitis in elementary school children in Edirne. Materials and Methods: A total of 12,868 students from 34 elementary schools were scanned in April and May 2003. Samples of skin scrapings and hair roots were collected from students with hair and scalp lesions. Specimens were evaluated microscopically by KOH, and were inoculated into agar slants of Sabouraud dextrose agar with cycloheximide. Results: Eggs, nits or adult forms of head lice were detected in 698 (5.4%) students. The prevalence of head lice was significantly higher in girls (10.3%) than in boys (0.9%) (p&lt;0.001). The infestation rate was the lowest below seven years of age (3.4%, p&lt;0.001). Infestation rate was also high in families with low socioeconomic conditions (p&lt;0.001). Tinea capitis was not detected in any of the students. Conclusion: Pediculus humanis capitis was found to continue to be a public health problem in Edirne. The following conclusions were drawn for its eradication: periodic scanning of the students by families, teachers, and health professionals should be implemented; affected children should be properly treated; health facilities should be improved; and continuous education should be given to prevent its spread

Gallbladder Duplication: A Rare Case Treated Laparoscopically

Gallbladder duplication is a rare congenital malformation. Predicting and identifying the presence of this anomaly and other anatomical variations is important to avoid unwelcome surprises. Preoperative diagnosis is critical for planned surgery and prevention of possible complications. When bile duct anomalies are suspected, cholangiography during the operation has a critical importance in terms of prevention of complications. Laparoscopic removal of both gallbladders with intraoperative cholangiography seems to be the appropriate treatment of gallbladder duplication

Histopathological Response and Adhesion Formation After Omentectomy with Ultrasonic Energy, Bipolar Sealing, and Suture Ligation

This study was designed to evaluate the histopathological response and intra-abdominal adhesion formation after an omentectomy in rats using the bipolar vessel-sealing device, ultrasonic coagulator, and suture ligation techniques. Forty Wistar albino rats were used, divided into four random groups. The rats underwent a midline laparotomy, and a partial omentectomy was performed using a 3-0 silk suture with suture ligation in group 1, bipolar device in group 2, and ultrasonic coagulator in group 3; only a laparotomy was performed on the control group. Lateral thermal damage was examined the same day, and a piece of the omentum was left in the animals to be examined on postoperative day 15. A relaparotomy was performed to assess adhesion formation and histopathological response. In pairwise comparisons, there was no statistically significant difference among the ultrasonic device, bipolar device, and suture ligation groups in terms of microscopic adhesion scoring; however, the scores of the bipolar device and suture ligation groups were significantly higher compared with those of the control group (p < 0.01). Furthermore, the macroscopic adhesion scores were significantly lower for the ultrasonic device group when compared with those of the bipolar device and suture ligation groups (p < 0.05 and p < 0.01). The ultrasonic device seems to be superior to the bipolar device and suture ligation in terms of macroscopic adhesion formation, but no significant difference was found in terms of the histopathological response in rats following an omentectomy. Further research may be required