Posttraumatic True Aneurysm of the Axillary Artery Following Blunt Trauma

The majority of the axillary artery aneurysm cases arise as pseudoaneurysms secondary to blunt or iatrogenic trauma. Isolated traumatic true axillary artery aneurysm is a relatively unusual disorder and generally occurs with repetitive blunt trauma. A 22-year-old female patient with distal axillary artery true aneurysm due to simple blunt axillothoracic trauma is presented. The aneurysm was excised with subpectoral-axillary approach and saphenous vein graft interposition was applied. Long-term follow-up with the patient was uneventful

Changing Trends and Experience with Esophageal Cancer Surgery in a Single University Hospital: Are The Results Similar or Not?

Objective: The main treatment modality for esophageal cancer remains to be surgery. Over the last decades, surgical strategies have evolved remarkably. When neoadjuvant chemoradiotherapy became standard, discussions about the role, type, and timing of surgery began. In this study, we share results we obtained after operating our patients using various surgical techniques.Material and Methods:Reliable data from 51 esophageal cancer patients were evaluated retrospectively. Of the 51 cases, 31 were operable. These operable cases were further classified according to surgical method and neoadjuvant therapy status. Median survival time in months, complications, hospital mortality, length of hospital stay, and pathology results (total lymph nodes harvested and pathologic tumor node metastasis stage [p_TNM]) were documented for the different surgical approaches.Results: Open surgical methods were performed in 21 cases, while in 10 cases the Minimally Invasive Surgery (MIS) method was used. The MIS group received neoadjuvant therapy more frequently than the open surgical methods group (p=0.013). Although more complications were observed in the MIS group, the difference to the open esophagectomy methods group was not significant. Patients in the MIS group also had longer hospital stays, but again the difference was not significant. Although a pathologic complete response was seen in 8 of the 11 (72.7%) patients in our study who received chemoradiotherapy as neoadjuvant treatment, the surgical results of patients who received chemoradiotherapy were worse, although not to a statistically significant extent.Conclusion: Despite changing trends and treatment options in esophageal cancer surgery, we have yet to see the expected improved results

Hepatic artery pseudoaneurysm : delayed presentation after a blunt trauma

BACKGROUND: Ruptured hepatic artery pseudoaneurysm is a rare condition that is life-threatening if not diagnosed and treated rapidly. We present a case of a spontaneously ruptured hepatic artery pseudoaneurysm that occurred after a blunt trauma, and provide a review of the current literature on this topic. This case study demonstrates a spontaneously ruptured hepatic artery pseudoaneurysm which emerged following a blunt trauma and it also presents current literature studies on the topic. CASE REPORT: A man at the age of 34 years with blunt trauma dating back to 1.5 month was admitted to the emergency department of a hospital with hematemesis and epigastric tenderness. He also had a duodenal ulcer, blood in the gastric lumen and a large pseudoaneurysm that developed from the left hepatic artery. Soon after the diagnosis, the patient worsened and underwent distal gastrectomy and cholecystectomy that included removing the bleeding aneurysm. CONCLUSIONS: Ruptured hepatic artery pseudoaneurysm stands as a deadly condition which has to be diagnosed and managed as soon as possible. Physicians need to take aneurysms of abdominal arteries into consideration after routine diagnostic practises as long as the cause of gastrointestinal haemorrhage is unidentified

The efficiency of apparent diffusion coefficient quantification in diagnosis of acute cholecystitis and in differentiation of cholecystitis from extrinsic benign gallbladder wall thickening

Yavuz, Alpaslan/0000-0002-8796-988XWOS: 000342176400004PubMed: 24972840The aim of the current study was to assess the efficiency of the apparent diffusion coefficient (ADC) measurement in diagnosis of acute cholecystitis and in differentiation of cholecystitis from extrinsic benign gallbladder wall thickening. Forty patients who were diagnosed to have acute cholecystitis by ultrasonographic examination were included in this study. the control group consisted of 18 patients without symptoms of gallstones and cholecystitis whose gallbladder walls were thickened due to cirrhotic ascites. Both groups were examined using diffusion weighted imaging, and the mean ADC values were compared using Student's t-test. the diagnoses of the 40 patients were proven by histopathological examination. the mean ADC values of patients diagnosed with cholecystitis (1.68 +/- A 0.36 x 10(-3) mm(2)/s) were significantly lower than the mean ADC values of the control group (2.35 +/- A 0.24 x 10(-3) mm(2)/s) (p < 0.05). Receiver operating characteristics curve analysis based on ADC revealed a cut-off value of 2.04 x 10(-3) mm(2)/s for the diagnosis of cholecystitis, with a sensitivity of 94 % and a specificity of 89.7 %. ADC value quantification may be an efficient method for making a diagnosis of cholecystitis and in differential diagnosis of cholecystitis from the extrinsic benign gallbladder wall thickening that can be seen during the course of cirrhotic ascites

Early and mid-term results of application unipolar radiofrequency ablation Unipolar radyofrekans ablasyon uygulamasinin erken ve orta dönem sonuçlari

Objective: The aim of this study is to investigate the effectiveness of unipolar radiofrequency ablation in patients in whom valve replacement was performed for persistent atrial fibrillation. Material and Methods: In our study 22 patients were included which had concomitant mitral valve replacement and left atrial ablation between January 2010-January 2012. Mid-term control and postoperative electrocardiography records of the patients were evaluated retrospectively. In addition, the effects of cardiac function on postoperative AF were investigated. Results: After cardiopulmonary bypass, 14 (63.6%) patients maintained normal sinus rhythm, including one patient with the support of a temporary pace among 8 (36.3%) patients observed in the intensive care unit after replacement. In the early period, one patient died due to low flow, and prolonged intubation. At the end of the first month, 15 (71.4%) patients were in sinus rhythm, 6 patients (28.6%) had persistent atrial fibrillation. By the tenth postoperative month permanent pace maker was implanted to a patient with persistent atrial fibrillation. At the end of 6 th month he had no atrial fibrillation. Conclusion: The success achieved with the unipolar radiofrequency left atrial ablation was found to be consistent with the findings of the literature. In our study, patient age and pulmonary hypertension was evaluated as predictive of ongoing postoperative AF