Acute Appendicitis in Pregnant Women: Our Clinical Experience

Purpose: The purpose of this study was to analyse 13 patients who were treated in our clinic due to acute appendicitis during pregnancy. Methods: Records of the patients who received appendectomy with appendicitis diagnosis in our Turgut Özal University Research and Application Hospital between January 2007 and December 2015 have been analyzed retrospectively. Results: Appendectomies were performed on 13 pregnant patients with an acute appendicitis diagnosis. Average age of the patients was 27.69 years (between 22-37 years). Most frequent complaint of the patients was abdominal pain and most frequent examination finding was tenderness at right lower quadrant. Ultrasonography was used in all cases for diagnosis. Surgery was decided with clinical diagnosis for five cases (38.5%) where appendix had not been identified with ultrasonography. While laparoscopic appendectomy was applied in one case (7.7%) and open appendectomy was applied using a McBurney incision in 12 cases (92.3%). Average hospitalization duration was 1.69 days. All patients were tracked together through the Gynaecology Department for two weeks after they had been discharged from the hospital. Preterm delivery, maternal and fetal loss did not occur. Conclusion: It is considered appropriate to apply ultrasonography routinely to all pregnant patients in whom acute appendicitis is suspected. Concern for maternal or fetal complication that may occur in consequence of an unnecessary surgery should not be at a level that will delay surgical treatment needed by the patient

Endometriosis mimicking incisional hernia detected in the rectus abdominis muscle after caesarean section

Azerbaycan Tıp Üniversitesi, 3. Cerrahi Hastalıklar Kliniği, BaküNumune Eğitim ve Araştırma Hastanesi, Genel Cerrahi (Cerrahi Onkoloji) Kliniği, AnkaraYıldırım Beyazıt Üniversitesi, Tıp Fakültesi Genel Cerrahi Anabilim Dalı, AnkaraMedical Park Ankara Hastanesi, Genel Cerrahi Kliniği, AnkaraEndometriozis, fonksiyonel endometrium bez ve stromanın, uterus boşluğu dışında büyümesi olarak tanımlanır. Sezaryen, histerektomi, apendektomi ve laparoskopi sonrası trokar yerinde; epizyotomi ve amniyosentez sonrasında skar dokusunda endometriozis saptanabilmektedir. Karın duvarı endometrioması ise sezaryen başta olmak üzere yapılan jinekolojik girişimler sonrası, insizyon skar dokusunda veya komşuluğunda gelişebilen endometrium bez ve stromasından oluşan bir kitledir. Bu yazıda, rektus abdominis kası içinde insizyonel herniyi taklit eden ağrılı kitlesi olan, beş yıl önce sezaryen ile doğum öyküsü olan, 41 yaşında bir kadın hasta sunuldu. Geniş eksizyonla tedavi edilen hastanın histopatolojik incelemesi endometriozis olarak rapor edildiEndometriosis is defined as the growth of functional endometrial gland and stroma outside the uterine cavity. Endometriosis can be detected at the trocar site after caesarean section, hysterectomy, appendectomy, and laparoscopy; and within the scar tissue after episiotomy and amniocentesis. Abdominal wall endometrioma, on the other hand, is a mass composed of endometrial gland and stroma that may develop within or adjacent to incisional scar tissue after gynecological procedures, mainly caesarean section. In this article, we present a 41-year-old female patient with a history of giving birth via caesarean section five years ago, who presented with a painful mass mimicking an incisional hernia within rectus abdominis muscle. The patient was treated with a large excision and we report the histopathological examination to be endometriosis

Laparoscopic Nissen fundoplication with mesh-hiatoplasty: Single center experience and early-term results

Purpose: In this study we report early-term results of laparoscopic Nissen fundoplication with mesh hiatoplasty that we perform to treat gastroesophageal reflux disease. Methods: We retrospectively reviewed the medical records of 68 patients who underwent laparoscopic Nissen fundoplication with mesh hiatoplasty at our clinic. Thirty-six (53%) patients were male and 32 (47%) were female. The mean age of the study population was 46.1 (25-72) years. All patients underwent endoscopy, esophagus pH metry and manometry before the operation. All operations were performed under general anesthesia using five ports. In addition to Nissen fundoplication, all patients also underwent polypropylene mesh placement. Results: Preoperatively, all patients reported a burning sensation in the chest and regurgitation of the stomach contents up into the mouth. The mean time from symptom onset to operation was 28 (6-84) months. All patients were diagnosed with  esophagitis in the preoperative endoscopic examination. The mean operative time was 80 (40-125) minutes, the median duration of hospital stay was 1.2 (1-4) days and the median follow-up time was 12 (2-30) months. Functional outcome was excellent in 65% of patients, good in 24.5%, moderately good in 7% and poor in 3.5%. Conclusion: Fundoplication with mesh hiatoplasty is a surgical procedure performed for the traetment of gastroesophageal reflux disease and hiatal hernia. Surgery can be safely carried out with low morbidity and mortality rates and constitutes an alternative to long-term drug therapy. We believe that this operation is beneficial since it reduces the rate of recurrences to a significant degree