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    Acute Abdominal Pain with an Unusual Etiology: Splenic Infarction in a Diabetes Patient
    (Aves, 2016) Yalaza, Metin; Kafadar, Mehmet Tolga; Degirmencioglu, Gurkan; Turkan, Ahmet; Sen, Meral
    Splenic infarction is a rare clinical event caused by reduced blood flow to the spleen. Its presentation can mimic other causes of acute abdominal pain. The most frequent causes of splenic infarction include thromboembolic events, malignant hematologic neoplasms, and vasculitides. A few reports of single or multiple cases of diabetes-induced splenic infarction have been published in medical journals. Herein, we report a 67-year-old patient with diabetes-associated splenic infarction who presented to an emergency department with acute abdominal pain.
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    Acute Appendicitis in Pregnant Women: Our Clinical Experience
    (Canadian Soc Clinical Investigation, 2016) Turkan, Ahmet; Yalaza, Metin; Kafadar, Mehmet Tolga; Degirmencioglu, Gurkan
    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 Ozal 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.
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    An Unusual Presentation of Lung Cancer Metastasis: Perianal Abscess
    (Derman Medical Publ, 2014) Kilic, Murat Ozgur; Sen, Meral; Turkan, Ahmet; Yildirim, Umran; Koktener, Asli
    Lung cancer is one of the most commonly diagnosed cancers in both men and women. Although the most frequent sites of distant metastasis of lung cancers are the pleura, liver, adrenal glands, skeletal system and brain, perianal region has been rarely reported as a metastasis site. A male patient was admitted to our emergency room with a long standing perianal abscess. During abscess drainage, a mass was noticed at the base of the abscess pouch, and thus a biopsy was taken. Pathologically, it was reported as a metastasis of squamous cell carcinoma, therefore some radiological investigations and endoscopic procedures were performed to determine the primary focus of cancer. A pulmonary mass was revealed in PET/CT, and was considered as primary tumor. Both primary and metastatic perianal tumors can be rarely presented as an abscess formation. In this situation, a biopsy should be performed from the lesion to avoid misdiagnosis.
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    Laparoscopic Nissen fundoplication with mesh-hiatoplasty: Single center experience and early-term results
    (Canadian Soc Clinical Investigation, 2016) Kafadar, Mehmet Tolga; Yalaza, Metin; Turkan, Ahmet; Surgit, Onder; Degirmencioglu, Gurkan; Nadir, Isilay
    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.
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    Non-Operative Management of Isolated Pneumoperitoneum Due to Severe Blunt Abdominal Trauma
    (Derman Medical Publ, 2015) Kilic, Murat Ozgur; Bozer, Mikdat; Turkan, Ahmet; Kilic, Yeliz
    Nonperative management of blunt abdominal trauma is the treatment of choice for hemodynamically stable patients. The results of nonoperative management are more successful in isolated solid organ injuries such as the liver and spleen than hollow viscus injury. In this approach, both the clinical course of the patient and the computed tomography findings play an important role. Isolated pneumoperitoneum in blunt abdominal trauma may be a surgical challenge for clinicians because it is usually a significant radiological sign for hallow viscus perforations. Here, we report a case of isolated pneumoperitoneum detected on computed tomography and managed non-surgically, in a young man suffered from a severe blunt abdominal trauma. Our aim is to attract the attention of surgeons to the management problems of the presence of pneumoperitoneum in the absence of other radiological findings in blunt abdominal trauma.