Unusual cause of gastric outlet obstruction: giant gastric trichobezoar: a case report

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Rare cause of intestinal obstruction, Ascaris lumbricoides infestation: two case reports

Ascaris lumbricoides is common resident of intestine especially low socioeconomic areas in the world. Complication of Ascaris lumbricoides has been reported include obstruction of the small intestine, intestinal volvulus and intussusception. We report two children with severe sequelae of intestinal obstruction

Delayed diagnosis of traumatic diaphragmatic hernia may cause colonic perforation: a case report

Early diagnosis of diaphragmatic rupture after traumas may be difficult, and delayed diagnosis may result in increased morbidity and mortality. This paper describes the case of a 32-year-old man who experienced a traffic accident and had diagnosis of traumatic diaphragmatic hernia nearly four months later. The patient was referred to our emergency room suffering from ileus symptoms. Physical examination demonstrated an apparent abdominal distention, tenderness at the upper abdominal quadrants, rebound, and defense. Thoraco-abdominal X-rays and computerized tomography imaging demonstrated intestinal segments with air-fluid levels in thorax. Laparotomy was performed after a preoperative diagnosis of a strangulated-diaphragmatic hernia. At abdominal exploration, it was found that transverse colon and omentum entered into thorax through diaphragmatic defect located at the left diaphragm. Herniating colon segment was complicated with ischemic necrosis and perforation. In conclusion, colon necrosis and perforation may develop when early diagnosis of diaphragmatic ruptures are missed

İncisional endometrioma mimicking a malignant mass: report of two cases

Endometriozis dogurganlık çagındaki kadınlarda sık görülen klinik bir problemdir. Insizyon yerlesimli endometriomaya ise nadir rastlanır. Hastalarda genellikle sezaryen veya histerektomi gibi ameliyat öyküsü vardır. Endometriomayı olusturan dokudan malignite gelisebildigi bildirilmistir. Jinekolojik bir patoloji olmasına ragmen insizyonel herni ya da karın duvarı tümörleri gibi bulgu verebilmekte ve bu nedenle hastalar genellikle genel cerrahi polikliniklerine basvurmaktadırlar. Biz bu çalısmada dogurganlık çagında olan ve daha önce sezaryen ameliyatı öyküsü bulunan, klinik ve laboratuar olarak malignite süphesi tasıyan iki olguyu sunduk. Tedavide sezaryen skarındaki kitlelere genis eksizyon yapıldı ve olusan fasya defekti primer onarıldı. Patolojik inceleme sonucu kitlelerin endometrium dokusuna sahip endometrioma oldugu saptandı.Endometriosis is a common clinical problem of the child-bearing women. Incisional endometrioma is very rare. Patients frequently presented with a history of previous gynecological surgery such as cesarean section or hysterectomy. Although being a gynecological disorder, it may seem like an incisional hernia or abdominal wall tumor. Therefore, it is frequently referred to general surgery outpatient clinics. Here, we report two cases with previous histories of cesarean sections and questinable clinical and laboratory findings of malignancy. The masses located on the previous incision scars were excised widely, and pathological examination of surgical specimens revealed the diagnosis of endometrioma in both cases

Transomental hernia as a rare cause of small intestinal obstruction: a case report

İnternal herniler ince bağırsak obstrüksiyonunun nadir görülen bir nedeni olup insidansı %1’den daha az olarak bildirilmiştir. Transomental herni ise, internal hernilerin nadir rastlanan şekillerinden birisidir. Bu hernilerde içeriğin boğulma ve nekroza kadar giden dolaşım bozukluğu riski nedeniyle zamanında tanı konulması önemlidir. Bu olguda ileus belirtileri nedeniyle ameliyat ettiğimiz transomental herni sunuldu. Kolik tarzında ağrı ile acil servise başvuran 27 yaşındaki bayan hasta, yaklaşık on yıldır tekrarlayan karın ağrısı atakları geçiriyordu. Barsak tıkanıklığı ön tanısı ile yapılan ameliyatta ince bağırsağın omentum majustaki defekten fıtıklaştığı gözlendi. Fıtıklaşan ince barsaklar rezeksiyon yapılmadan redükte edildi. Ameliyat sonrası komplikasyon gelişmeden hasta taburcu edildi. Transomental herniler her nekadar nadir görülse de, genç ve daha önce ameliyat geçirmemiş, ve barsak tıkanıklığı görülen hastaların ayırıcı tanısında akılda tutulmalıdır. Bu hastalarda gecikmeden ameliyat kararı verilmesi önemlidir.Intestinal obstructions that account for less than 1% of all. Of these, transomental hernia is one of the rarest forms with an unknown etiology. Because of the risk of strangulation of hernia contents, immediate diagnosis is essential. We report a case of transomental hernia that was operated for signs of ileus. The patient was a 27-year old woman admitted with a colicky abdominal pain. She told that her pain lasted for ten years with repetitive attacks. During process of laparotomy, small intestine had herniated through windows in the greater omentum with a distended proximal segment. Herniated part was retrieved without resection. Then, she was discharged without any complication. Although relatively uncommon, transomental hernias should be included in the differential diagnosis of small bowel obstruction in young patients with repetitive abdominal painful attacks without any history of previous abdominal surgery

Squamous cell carcinoma arising in Etiology of chronic pilonidal sinus disease : A case report

Pilonidal sinüs hastalığı genellikle sakrokoksigeal bölgede yerleşen, skuamöz epitelle döşeli, kıl içeren sinüslerin oluşturduğu edinsel inflamatuar bir hastalıktır. Etiyolojisi kesin bilinmemekle birlikte, patogenezinde dökülen kılların subkutanöz kistlere penetre olarak yabancı cisim reaksiyonu ve enfeksiyona sebep olduğu kabul edilir. Pilonidal sinus hastalığının sık görülen komplikasyonları sellülit, apse ve fistül oluşumudur. Kronik inflamasyonun bazı malignitelerin etiyolojisinde rol oynadığı bilinmektedir. Malign dejenerasyon, kronik pilonidal hastalıkta çok nadir bir komplikasyondur. Burada uzun yıllar tedavisiz kalmış pilonidal sinüs hastalığı zemininde gelişmiş skuamöz hücreli karsinom tanısı ile cerrahi olarak tedavi ettiğimiz bir olgumuzu sunuyoruz.Pilonidal sinus disease is usually placed in sakrokoksigeal area. The etiology is unknown exactly. The pathogenesis is assumed to deciduous hair penetration into the subcutaneous tissues and a foreign body-type reaction may then lead to formation of an abscess. Cellulitis, abscesses, fistulas are common complications in pilonidal sinus disease. Chronic inflammation may be factors in the development of some malignancies. Malignant degeneration is very rare complication in chronic pilonidal disease. We reported in this case, a squamous cell carcinoma in caused by untreated chronic pilonidal sinus

20. yüzyılda Darüşşafaka Cemiyeti

Ankara : İhsan Doğramacı Bilkent Üniversitesi İktisadi, İdari ve Sosyal Bilimler Fakültesi, Tarih Bölümü, 2017.This work is a student project of the The Department of History, Faculty of Economics, Administrative and Social Sciences, İhsan Doğramacı Bilkent University.by Ünsal, Mehmet Süha

Warfarin overdose induced intramural small-bowel hematoma (case report)

Antikoagülanların kontrolsüz kullanımı kanamalara neden olabilmektedir. Warfarine bağlı spontan ince barsak duvarı hematomu nadiren görülen bir komplikasyondur. Warfarin kullanan karın ağrısı olan hastalarda intestinal intramural hematom ayırıcı tanıda düşünülmeli ve bu hastalarda medikal tedavi ön planda uygulanırken seçilmiş olgularda cerrahi tedaviye gereksinim olacağı da akılda tutulmalıdır. Burada spontan intestinal intramural hematom nedeni ile cerrahi olarak tedavi edilen bir olguyu sunarak nadir görülen bu durumu hatırlatmayı amaçladık.Uncontrolled use of anticoagulants may cause bleeding. Warfarin- dependent spontaneous intramural hematoma of the small intestine is a rare complication. Although warfarin using patients with abdominal pain were usually treated medically, surgical interventions should be considered in selected cases with intestinal intramural hematoma. Here we present a patient who was treated surgically to bring to mind this rare condition

Assessment of a protic ionic liquid with respect to fractionation and changes in the structural features of hardwood and softwood

In this work, the potential of protic ionic liquid, triethylammonium hydrogen sulfate (TEAHSO4) was shown regarding the pretreatment of the hardwood, hornbeam and softwood, pine at different temperatures and times. TEAHSO4 was effective for lignin extraction and enhancing the enzymatic digestibility of both the biomass. Cellulose content of hornbeam increased to 85% with 87% lignin extraction from the biomass subjected to pretreatment at 150 °C for 3 h which was then readily converted into glucose with 97% yield. On the other hand, pine as a softwood demonstrated more resilience to deconstruction; 76% glucose yield was achieved following the enzymatic hydrolysis of biomass pretreated at 150 °C for 30 min. As put forward in the present work through TEAHSO4 pretreatment, any lignocellulosic feedstock that can be effectively disassembled into cellulose and lignin should be regarded as high value for the production of liquid and gaseous fuels through thermochemical and biochemical routes. © 2019 Elsevier Ltd116M444 Türkiye Bilimsel ve Teknolojik Araştirma KurumuThe authors acknowledge the financial support from The Scientific and Technological Research Council of Turkey (TUBITAK) via project 116M444 . Appendix

Acute mesenteric ıschemia : Clinical experience

AMAÇ: Akut mezenterik iskemi (AMİ) erken tanı ve tedavi gerektiren hayatı tehdit edici bir vasküler acildir.Günümüzde hala yüksek mortalite ve morbidite ile seyretmekte olan bu hastalığın önlenmesi erken klinik şüphe ve zamanında müdahaleye bağlıdır. Bu çalışmada Mustafa Kemal Üniversitesi Tıp Fakültesi Genel Cerrahi kliniğinde Ocak 2004- Aralık 2008 tarihleri arasında mezenter iskemi tanısıyla takip edilip opere edilen olgularımızın özelliklerini analiz etmeyi amaçladık. GEREÇ-YÖNTEM: Operasyonda AMİ tanısı konulan olgular retrospektif olarak değerlendirildi. Preoperatif, operatif ve postoperatif bulgular SPSS 16.0 programına yüklenerek istatistiki olarak incelendi. BULGULAR: Değerlendirmeye 18 olgu alındı. Yaş ortalaması 69 idi. En sık Kalp hastalıkları ve Hipertansiyon olmak üzere bütün hastalarda ek morbidite mevcuttu. Lökositoz, Hiperglisemi, Hiperamilazemi, Hipoalbüminemi ve kreatinin yüksekliği saptandı. 16 hastada Superior mezenter vasküler nekroz, 1 hastada İnferior mezenter vasküler nekroz ve 1 olguda nonoklüzif mezenter iskemi saptandı. 13 olguya segmenter rezeksiyon uygulanırken, İnferior Mezenter arter embolisi saptanan hasta abdominoperineal rezeksiyon uygulandı. 2 olguya düodenotransversostomi, 2 olguya sadece eksplorasyon uygulandı. 4 olguya tekrar iskemi gelişmesi, 1 olguda insizyonel evisserasyon nedeniyle reoperasyon uygulandı. Toplam 7 olgu postop multiorgan yetmezliğinden ve 2 olgu kardiyak patoloji nedeniyle eksitus olmuştur. SONUÇ: Mezenter iskemi erken tanının çok önemli olduğu halen yüksek mortalite oranları taşıyan, özellikle kardiyak patolojisi olan karın ağrılı hastalarda ayırıcı tanıda mutlaka düşünülmesi gerekli bir hastalıktır.Backgound: Acute mesenteric ischemia (AMI) is a life threatening vasculer emergency which requires prompt diagnosis and treatment. The prevetion of this cause of high mortality and morbidity depends on early clinical suspicion end timely intervention. In the present study we aimed to analyze the acute mesenteric ischemia cases treated in Mustafa Kemal University Department of General Surgery between January 2004 – December 2008. Material/ METHODS: The clinic records of all the patients who underwent surgical treatment for AMI between January 1, 2004, and December 2008, were retrospectively reviewed. The data from operative records, postoperative complications, mortality, and hospital stay were recorded. RESULTS: The study group included 18 patients. Mean age was 69. There was a comorbidity in all patients and cardiac disease and hypertension were the most common ones. The most common laboratory abnormalities were leukocytosis, hypoalbuminemia, hyperamylasemia. There was superiory vasculary necrosis in 16 patients, inferior vasculary necrosis in one patient.One patient had nonocclusive mesenteric ischemia. Segmentery resection was performed to 13 patients. Abdominoperineal resection was performed to the patient with inferior mesenter artery occlusion. We performed duodenotransversostomy on two patients and only laparotomy on two patients. Reoperation was required in 5 patients. Causes of death was multiorgan insufficiency in 7 cases, cardiac death in 2 cases.One patient died due to short intestine syndrome. CONCLUSION: Acute mesenteric ischemia is highly mortal emergency which should always be suspected in elderly patients with cardiac disease suffering from abdominal pain