Post-Transplant Immune Tolerance in Rats Following Lymphocyte Injection Into the Anterior Chamber of the Eye

Objective. We aimed to compare the clinical and histopathological results of skin graft transplants between rats that had been injected with lymphocytes into the anterior chamber of the eye with those that had not

A Rare Cause of Acute Abdomen: Small Intestine Perforation Due to Metastasis of Lung Cancer

Approximately 50% of lung cancer patients have distant metastases at diagnosis. Intestinal metastasis of lung cancer is quite rare and mostly asymptomatic as well. A 65-year-old male patient had been referred to a peripheral hospital with the complaint of abdominal pain. A mass lesion located on the apex of the right lung had been detected; as well as brain and abdominal metastases had been documented and oncotherapy had been planned accordingly. Several days later, he was referred to emergency surgery department due to the symptoms of acute abdomen. Tests showed hollow organ perforation, and the patient underwent operation later on. Perforation secondary to metastatic small intestine implant was observed per-operatively and so, small bowel resection was performed accordingly. The pathology revealed metastatic adenocarcinoma of lung cancer. The prognosis of lung cancer patients having bowel metastasis is poor with a low rate of survival. In this study, we aimed to present a case of metastatic lung cancer patient who had Acute Abdomen syndrome due to perforation secondary to small bowel metastasis

Is Cholecystectomy Alone Enough To Prevent Acute Biliary Pancreatitis Attack?

Introduction The main objective of this study is to find out whether laparoscopic cholecystectomy alone is enough to prevent acute biliary pancreatitis attacks. Material and Method We performed a retrospective study with acute biliary pancreatitis patients who previously undergone cholecystectomy at the Istanbul Faculty of Medicine, Department of General Surgery, between January 2012 and December 2015. Acute biliary pancreatitis was diagnosed with elevated serum and urinary amylase levels with biliary pain. All the diagnoses were made with a combination of cholecystectomy history, physical examination, laboratory tests and imaging techniques [ultrasonography, magnetic resonance cholangiopancreaticography, computed tomography]. Ranson and Balthazar scores are assessed for each case. According to revised Atlanta grading system, the cases are classified as mild, moderate and severe pancreatitis. After a careful evaluation non-biliary pancreatitis patients are excluded from the study. Patients' demographic datas, comorbidities, history of cholecystectomy and pancreatitis, laboratory tests, invasive procedures, rates of morbidity and mortality and period of hospital stay were analyzed. Results The mean age was 51.5 (21-73) years. Thirty-one patients were enrolled in the study, 23 of them (74.1%) were female and eight (25.9%) were male. The average Ranson score was calculated as According to revised Atlanta scoring system; 28 cases were assessed as mild, one case was moderate and two cases were in the severe category. Necrosis was seen in both severe cases, and there was no necrosis in the moderate category. Balthazar score for the mild cases were counted as 0, moderate cases were 1, and the severe cases as 7. There was no correlation between C-reactive protein level and necrosis with clinical severity. In 19 (61%) of the cases, biliary stone was spotted in the common bile duct on the radiology. Then, endoscopic retrograde pancreaticography was applied for these 19 patients. Two of the cases had infected-necrotizing pancreatitis. Disease lasted fatal in these two cases due to sepsis and multiple organ failure. Percutaneous drainage was applied under USG by the radiologist for one patient whom had an image of collection in the gall bladder bed. Three patients were excluded from the study as non-biliary pancreatitis. The average length of hospital stay was measured as 4-5 days. Conclusion Early cholecystectomy after first pancreatitis attack together with endoscopic retrograde pancreaticography procedure (for the cases that have indication) decreases rates of complication and recurrence greatly. Laparoscopic cholecystectomy alone does not always prevent acute biliary pancreatitis attacks, in patients with prior endoscopic retrograde pancreaticography traumas and patients with high cholestasis enzymes during pancreatitis. Prospective randomized large studies are needed to reach certain etiologic reasons

Non-operative Management of Patients with Right Side Thoracoabdominal Penetrating Injuries: a Single-Center Retrospective Study

We aimed to put forward the feasibility and clinically safety of non-operative management (NOM) of right side thoracoabdominal (RST) penetrating injuries for appropriate patient groups. Medical records of 55 patients with RST penetrating injuries who were admitted to Istanbul School of Medicine, Trauma and Emergency Surgery Department between March 2011 and August 2016 were examined. We have done the follow-up of RST penetrating injured patients who were hemodynamically stable by NOM. Most of the patients had liver and lung injuries confirmed by CT scans. The evaluations were done accordingly by taking patients' past medical history, plain radiograph, and computed tomography (CT). Exclusion criteria were bilateral thoracoabdominal injuries, hemodynamic instability, and signs of peritonitis. Fifty-four of the patients were male and one patient was female (female/male = 1/54). Since 12 of the patients had undergone operations due to various causes, they were excluded from the study. A total of 43 patients were included into the study. The average age of the patients was calculated as 26.6 years (range 13-53 years). Average length of hospital stay was 6 days. Median follow-up time of the patients who were managed non-operatively was 2.6 years (range 5-72 months). Thirteen of the patients were gunshot injured, though they were followed up by conservative approach also. The liver is present on the right side of upper abdomen and therefore, its presence acts as an anatomical barrier for trauma towards the right hemi-diaphragm. It also helps the right-sided diaphragm injuries to heal spontaneously over time mostly without secondary hernia. Because of that, NOM of RST penetrating injuries is safe and feasible for selected patient groups. Also, it can reduce morbidity and mortality rates by preventing unnecessary interventions

SURGICAL MANAGEMENT OF APPENDIX TUMORS : A SINGLE-CENTER REVIEW OF 15 YEARS

Objective: Primary neoplasms of the appendix are rare and most clinicians are unfamiliar with them. The selected approach may differ, ranging from appendectomy to cytoreductive sur-gery. We aimed to present our clinical experience with the surgi-cal management of appendix tumors

The Risk Factors for Complications After Crohn's Disease Surgery

Background: Crohn's disease needs a multidisciplinary approach, and surgery will ultimately be necessary for most patients. Complications usually occur after surgery