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Öğe Appendix Duplication: A Rare Presentation(Modestum Ltd, 2013) Gul, Mesut; Aliosmanoglu, Ibrahim; Timucin, Huseyin; Vurupalmaz, Ozgul; Arikanoglu, Zulfu; Taskesen, FatihAppendiceal duplications are among the rare congenital anomalies of the gastrointestinal tract. Laparotomy was applied to a nineteen-year-old male patient due to an injury caused by a piercing-cutting tool, during operation exploration, omental adhesions were present on the appendix and appendectomy was performed to the patient. The histopathological examination of the specimen showed that there was luminal duplication all over the appendiceal wall at the distal 4 cm. portion of the appendix. Appendiceal duplication should definitely be kept in mind in patients with a history of appendectomy and clinical complaints compatible of appendicitis.Öğe ARE ABDOMINAL PAIN AND DISTENTION SYMPTOMS OF BREAST CANCER?(Aves, 2012) Girgin, Sadullah; Onder, Akin; Kapan, Murat; Firat, Ugur; Arikanoglu, Zulfu; Kucukoner, MehmetBreast cancer usually metastasizes to bone, lungs, liver and central nervous system. Rarely, atypical metastases may occur. Isolated peritoneal metastasis of breast cancer is very uncommon. On systemic examination of a 50-yearold woman who presented to our outpatients' clinic with the complaints of abdominal pain and distention, abdominal ascites and a breast mass were found. Biopsy from the breast mass revealed invasive ductal carcinoma and laparoscopic peritoneal biopsy showed peritoneal metastasis of the breast cancer. Palliative chemotherapy was planned. The patient rejected the treatment and has been under follow-up for 6 months does not have any other metastasis now.Öğe Associated organ injuries in pancreatic injuries, morbidity, and mortality(Tubitak Scientific & Technological Research Council Turkey, 2012) Onder, Akin; Gumus, Metehan; Kapan, Murat; Boyuk, Abdullah; Arikanoglu, Zulfu; Girgin, SadullahAim: Pancreatic injuries are rarely seen due to the retroperitoneal location of the organ. Associated organ and vascular structures usually accompany injury. In this study, the effect of ductal injury and associated organ injuries on morbidity and mortality was investigated. Materials and methods: Between January 2004 and October 2010, 26 patients with abdominal trauma who developed pancreatic injury and underwent surgery at the Dicle University General Surgery Department were evaluated retrospectively. Results: Of the 26 patients, 20 were males (76.9%) and 6 (23.1%) were females. The mean age of the patients was 24.96 +/- 9.4 (14-56) years. Of the injuries, 21 (80.8%) were related to penetrating trauma and 5 (19.2%) were related to blunt trauma. Of the patients, 6(23.1%) were stage I, 12(46.2%) were stage II, 5 (19.2%) were stage III, and 3 (11.5%) were stage IV The most commonly injured associated organs were the stomach (50%) and vascular structures. Eighteen patients underwent primary suturing, 5 underwent distal pancreatectomy, 3 underwent Roux-en-Y pancreaticojejunostomy., Common postoperative complications included intraabdominal abscess and pancreatic fistula. Mortality occurred in 3 (11.5%) patients, 2 of them due to hemorrhagic shock resulting from vascular injury and 1 of them as a result of fistula-induced sepsis and multi-organ failure. Conclusion: A good exploration should be done in all abdominal traumas, remembering that pancreatic injury could occur. Mortality may increase during the early period in patients who have vascular injuries. Morbidity and late mortality may increase in patients with ductal injuries.Öğe Benign fibrous histiocytoma arising from the intercostal space(Springer Japan Kk, 2011) Arikanoglu, Zulfu; Akbulut, Sami; Basbug, Murat; Meteroglu, Fatih; Senol, Ayhan; Mizrak, BulentBenign fibrous histiocytoma is a tumor of unknown etiology that is believed to be of mixed fibroblastic and histiocytic origin. Deep benign fibrous histiocytomas are most commonly found in the lower limbs or the head and neck region; it is relatively rare that they are seen in the intercostal space. Only six case reports of this entity are described in the literature. We report a 20-year-old woman who suffered from a painless swelling in the left chest wall, with a computed tomographic correlation. The lesion was totally excised, and histopathology revealed a benign fibrous histiocytoma. This is the first case of a benign fibrous histiocytoma that arose from the intercostal space reported in the English-language literature. The six cases reported in the medical literature are also discussed.Öğe Coexistence of Behcet's disease and colonic diverticulitis: Is it causal or just a coincidence?(Aves, 2013) Arikanoglu, Zulfu; Taskesen, Fatih; Onder, Akin; Kapan, Murat; Boyuk, Abdullah; Gul, Mesut; Girgin, Sadullah[Abstract Not Available]Öğe Cold abscess of tuberculosis on Thoracic wall: three case report(Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2014) Meteroglu, Fatih; Arikanoglu, Zulfu; Eren, SevvalNearly 15 to 20% of tuberculosis cases are extrapulmonary and can be rarely seen as isolated in the thoracic wall. Three consecutive patients who were admitted to our clinic with complaint of painful swelling on chest were examined with a preliminary diagnosis of a mass on the thoracic wall. The common complaint of the patients, including two women and one man of 60, 35 and 30 years of age, respectively, was a palpable mass. A soft mass in the right eight rib on physical examination was palpable in our second case. In the other two cases, the masses which were fluctuating and presented with soft characteristics in their natures (on manibrium sterni in the first case and in the third left rib in the third case) were evaluated with a preliminary diagnosis of a tumor by using computed tomography. The lesions were completely removed by excisional biopsy in all cases. Histopathological examination was reported as the tissue showing caseose necrosis. Acid resistant bacteria studies were negative. Anti-tuberculosis therapy with four-drug combination was started for the cases. An isolated tuberculosis-related cold abscess in three cases, which is a rarely seen in the thoracic wall, was discussed in regard to clinical characteristics, diagnostic and treatment methods.Öğe Continuing Diagnostic and Therapeutic Challenges in Gallbladder Polyps(Southeastern Surgical Congress, 2013) Arikanoglu, Zulfu; Taskesen, Fatih; Aliosmanoglu, Ibrahim; Gul, Mesut; Gumus, Hatice; Celik, Yusuf; Tas, Ilhan[Abstract Not Available]Öğe Discussion of Breast Atrophy in One Case(Aves, 2013) Egeli, Tufan; Taskesen, Fatih; Okudan, Murat; Arikanoglu, ZulfuBreast atrophy can occur due to various reasons and it may be a cosmetic problem for women. The main etiological factors are hormonal insufficiency, hormonal axis suppression, virilizing tumors, and the use of anabolic hormones. In all of these conditions both two breasts are affected and atrophy is bilateral. Atrophy, hypoplasia, agenesis or other developmental disorders in only one of the breasts are more rare. However, several examples can be found in the literature. Occurence of atrophy in one of the breasts after bilateral normal development is quite rare. In this paper we present a young female patient whom we examined owing to shrinking in her right breast.Öğe Diverticulitis of Cecum Mimicking Plastron Appendicitis: A Diagnostic and Therapeutic Dilemma(Modestum Ltd, 2013) Arikanoglu, Zulfu; Taskesen, Fatih; Kapan, Murat; Gumus, Hatice; Tacyildiz, Ibrahim HalilCecal diverticulitis is an unusual condition that presents clinically similar to appendicitis. Although it is usually asymptomatic, it may cause inflammation, bleeding, or perforation. The diagnosis is not always easy and in the majority of cases, the diagnosis is usually made at laparotomy. There have been various controversies in the literature regarding the optimal management of cecal diverticulitis. The aim of this study is a detailed description of this rare cause of acute abdomen. A 40-year-old female patient presenting with acute onset pain in the right lower abdominal quadrant, nausea and fever had mild leukocytosis. Abdominal ultrasonography and computed tomography revealed findings suggestive of plastron appendicitis. The diagnosis of cecal diverticulitis was established during the surgery. The patient underwent diverticulectomy and appendectomy operations. Cecal diverticulitis is rare clinical entity that should be considered in the differential diagnosis of emergency patients admitted with the complaint of pain in the right lower abdominal quadrant.Öğe An easily overlooked cause of mortality in trauma: rupture of diaphragm(Edizioni Luigi Pozzi, 2016) Taskesen, Fatih; Arikanoglu, Zulfu; Boyuk, Abdullah; Gumus, Metehan; Yasti, Ahmet Cinar; Onder, Akin; Kapan, MuratBACKGROUND: The purpose of our study was to share our experience in patients with traumatic diaphragmatic rupture. METHODS: Patients underwent surgery for traumatic diaphragm rupture between 2005 and 2010 were reviewed. RESULTS: There were sixty-two patients with traumatic diaphragm rupture. The mean age of the study group was 28.7 years (range 15-62 years). Diaphragmatic rupture was left sided in 43 patients (69%), right sided in 17 (28%) and bilateral in 2 (3%). Thoracotomy applied in 8 patients, laparotomy in 50, thoracoabdominal approach in 4. Mortality seen at 4 (64%) patients and hemorrhagic shock was the reason in two and pneumonia and sepsis in two. CONCLUSIONS: Diaphragm ruptures are inftegent injuries, however, are easily overlooked due to mask effect of accompaning visceral injuries, and it should be kept in mind at lower thoracic or upper abdominal traumas to prompt and proper management to lower the risk of mortality.Öğe Ectopic Bone Formation and Extramedullary Hematopoiesis in the Thyroid Gland: Report of a Case and Literature Review(Int College Of Surgeons, 2011) Akbulut, Sami; Yavuz, Ridvan; Akansu, Bulent; Sogutcu, Nilgun; Arikanoglu, Zulfu; Basbug, MuratThis purpose of this article is to document ectopic bone formation (EBF) and extramedullary hematopoiesis (EMH) in thyroidectomy specimens. We present a case of multinodular goiter with EMH and EBF, as well as a literature review of studies published in the English language on EMH and/or bone formation in the thyroid gland, accessed through PubMed and Google Scholar databases. Thirteen published cases of EMH and/or EBF in the thyroid gland were evaluated, and a case of multinodular goiter with histopathologically proven EMH and EBF in a 54-year-old woman is herein presented. In the reviewed literature, 12 patients were women, and 1 was a man (age range, 28-82 years; median, 56.46 +/- 18 years). EMH was histopathologically detected in 8 patients, EMH and EBF were detected in 4 patients, and only bone formation was detected in 1 patient Although a solitary nodule was detected in 7 patients, multinodular goiter was detected in 6 patients. Fine needle aspiration cytology was used in the preoperative period to arrive at a diagnosis in 6 of the 13 patients, but it was not possible to obtain proper biopsy material in the remaining patients. Although no previously known hematologic disease was detected in 11 patients, 2 were known to have myelofibrosis in the preoperative period. When EMH is pathologically detected in the thyroid, the question of whether there is an underlying hematologic disease in the patient must be investigated. In addition, it must be kept in mind during fine needle aspiration cytology and frozen section examinations that EMH may be among the differential diagnoses for anaplastic thyroid cancers.Öğe Effects of ellagic acid on experimental acute pancreatitis in rats(Wiley-Blackwell, 2015) Bozdag, Zubeyir; Yilmaz, Edip Erdal; Yazgan, Umit Can; Kaplan, Ibrahim; Arikanoglu, Zulfu; Ibiloglu, Ibrahim; Atamanalp, Sabri Selcuk[Abstract Not Available]Öğe The effects of erythropoietin on bacterial translocation and inflammation in rats with obstructive jaundice(Edizioni Luigi Pozzi, 2014) Onder, Alin; Kapan, Murat; Yuksel, Hatice; Tekin, Recep; Kele, Ayserur; Evliyaoglu, Osman; Arikanoglu, ZulfuINTRODUCTION: Obstruction of the common bile duct is associated with hepatic paranchymal damage and increased susceptibility to subsequent bacterial infections. Erythropoietin has antiinflammatory and cytoprotective effects and it induces antiinflammatory cytokines and suppresses the production of proinflammatory cytokines. In this study, we aimed to investigate the effect of Erythropoietin on bacterial translocation, inflammation and tissue damage in rats with obstructive jaundice. MATERIALS AND METHODS: Thirty-two Wistar albino rats (200-250 g) were divided into 4 groups as follows: Group 1 (Sham); only hepatoduodenal ligament dissection, Group 2 (Erythropoietin); hepatoduodenal ligament dissection and given 500 IU/kg Erythropoietin subcutaneously, Group 3 (Obstructive jaundice); complete hepatoduodenal ligament ligation, Group 4 (Obstructive jaundice + Erythropoietin); complete hepatoduodenal ligament ligation and given 500 IU/kg Erythropoietin subcutaneously. After 7 days, the rats were sacrificed by taking blood from the heart for biochemical analyses. Peritoneal swab culture, liver, mesenteric lymph nodes, spleen and ileum were collected for microbiological and histopathological examinations. RESULTS: Erythropoietin reduced the secretion of inflammatory cytokines, oxidative damage and bacterial translocation, prevent the formation of inflammatory changes in intestine and liver after obstructive jaundice. Conclusion: The treatment of EPO in rats with Of reduces bacterial translocation, inflammation and tissue damage.Öğe EFFECTS OF ERYTHROPOIETIN ON THE SERUM AND LIVER TISSUE LEVELS OF COPPER AND ZINC IN RATS WITH OBSTRUCTIVE JAUNDICE(Sciendo, 2013) Aliosmanoglu, Ibrahim; Kapan, Murat; Gul, Mesut; Arikanoglu, Zulfu; Onder, Akin; Taskesen, Fatih; Basarili, Mustafa KemalBackground: Erythropoietin is an anti-apoptotic, anti-inflammatory, angiogenetic cytokine and has protective properties against oxidative stress. In this study we investigated the effects of erythropoietin on the levels (serum and liver tissue) of copper and zinc in cholestatic rats. Methods: Thirty-two Wistar albino rats used in the study were divided into four groups Group I: Sham; Group II: Erythropoietin; Group III: Obstructive Jaundice; Group IV: Obstructive Jaundice+Erythropoietin. After the first operation, rats were followed up for seven days and then operated for the second time. Rats were sacrificed by intracardiac blood taking, and the liver tissue samples were obtained immediately. Results: Erythropoietin reduces copper, and increases zinc levels in serum and liver tissues after obstructive jaundice (p<0.05). Furthermore, it has been shown that the levels of alanine aminotransferase, aspartate aminotransferase, gamma glutamyl transferase, alkaline phosphatase and total bilirubin/direct bilirubin were significantly lower in Obstructive Jaundice+ Erythropoietin group than Obstructive Jaundice group. Conclusions: Erythropoietin affects the changes in copper and zinc levels, thus decreasing the liver damage biochemically in rats with obstructive jaundice. However; further investigations are needed to discover how erythropoietin therapy might reduce target organ damage in cholestatic liver cases by affecting copper and zinc levels.Öğe Evaluation of the early and delayed cholecystectomy in patients with acute biliary pancreatitis(Turkish Surgical Assoc, 2011) Beyazit, Unal; Taskesen, Fatih; Boyuk, Abdullah; Arikanoglu, Zulfu; Onder, Akin; Kapan, Murat; Aliosmanoglu, IbrahimPurpose: We aimed to compare the results of early and late laparoscopic cholecystectomy (LC) and to investigate their effects on mortality and morbidity in patients with acute biliary pancreatitis (ABP). Patients and Methods: One hundred eight patients, who underwent LC with the diagnosis of moderate acute pancreatitis in our clinic between January 2005 and September 2010 were enrolled in this study. The demographic characteristics, type of surgery, operation time, rate of conversion to open surgery, complications, mortality and hospital stay were recorded. Results: The number of the patients was 46 in group A and 62 in group B. The distribution of women and men were 76.1% / 23.9% in group A and 71.0% / 29.0% in group B, respectively. LC was performed successfully in 43 (93.5%) patients in group A and in 58 patients in group B. We had to perform open surgery in 3 (6.5%) patients in group A and 4 (6.4%) patients in group B. The average operation times were 70.5 minutes in group A and 68.6 minutes in group B. The average postoperative hospital stays were 2.8 days in group A and 3.0 days in group B. Conclusion: Early LC did not increase the rates of conversion to open surgery and biliary tract complications. On the other hand, the rate of recurrent pancreatitis attacks was higher in group B correlating with the duration of elapsed time for LC. Therefore, we recommend early LC to protect the patients from the morbidity and mortality of the recurrent attacks in the patients with mild to moderate pancreatitis.Öğe An extremely rare clinical condition: isolated post-traumatic diaphragmatic injuries(Termedia Publishing House Ltd, 2012) Taskesen, Fatih; Arikanoglu, Zulfu; Onder, Akin; Gul, Mesut; Aliosmanoglu, Ibrahim; Oguz, Abdullah; Celik, FeyziAim: Isolated post-traumatic diaphragmatic injuries are observed less commonly, and the preoperative diagnosis is difficult to make. Material and methods: Thirteen patients with post-traumatic isolated diaphragmatic injury were treated in our department between January 2005 and June 2011. Age, sex, the cause, the location, the size of rupture, the severity of organ injury, the surgical materials used for repair, the associated morbidity and mortality, and the duration of hospitalization were all evaluated. Results: There were 12 male patients (92.3%) and 1 female patient (7.7%) with an overall mean age of 28.76 years (range: 15-55 years). Blunt trauma was responsible for the injuries in 4 patients (30.8%), while 9 patients (69.2%) had penetrating injuries. The diagnosis was established preoperatively in all patients (100%) via a plain chest X-ray and/or a computed tomography (CT) scan. The location of rupture was on the left side of the diaphragm in 12 patients (92.3%) and on the right side in 1 (7.7%). Isolated post-traumatic diaphragmatic rupture was repaired with interrupted nonabsorbable sutures or polypropylene mesh. Postoperative complications were observed in 2 patients (15.3%). Mortality did not occur in any of our patients. Conclusions: A meticulous physical examination and obtaining a chest X-ray should be the first steps to be taken in patients with suspicious isolated post-traumatic diaphragmatic rupture. In case of uncertainty in diagnosis, advanced modalities such as CT, ultrasonography, and magnetic resonance imaging should be utilized.Öğe Factors Affecting Morbidity and Mortality in Patients Who Underwent Emergency Operation for Incarcerated Abdominal Wall Hernia(Int College Of Surgeons, 2012) Gul, Mesut; Aliosmanoglu, Ibrahim; Kapan, Murat; Onder, Akin; Taskesen, Fatih; Arikanoglu, Zulfu; Tacyildiz, IbrahimPatients with incarcerated abdominal wall hernias (AWHs) are often encountered in emergency care units. Despite advances in anesthesia, antisepsis, antibiotic therapy, and fluid therapy, the morbidity and mortality rates for these patients remain high. Between 2006 and 2011, we retrospectively analyzed the cases of 131 patients who underwent emergency surgery for incarcerated abdominal wall hernias. Of these, there were 70 women (53.4%) and 61 men (46.6%) with an average age of 63.3 +/- 17.4 years (range, 17-91 years). Morbidity was observed in 28 patients (21.4%), and the mortality rate was 2.3%. Intestinal resection, presence of concomitant disease, and general anesthesia were the independent variants that affected morbidity of patients with incarcerated abdominal wall hernias.Öğe Factors effective on morbidity and mortality in rectal injuries caused by penetrating and blunt traumas: a civilian experience(Drunpp-Sarajevo, 2012) Aliosmanoglu, Ibrahim; Gul, Mesut; Arikanoglu, Zulfu; Taskesen, Fatih; Uslukaya, Omer; Hakseven, MusluhPurpose: Our objective in this study is to establish the factors effecting morbidity and mortality in rectal injuries which occurred in civilian injuries. Methods: Fifty-two patients who had been hospitalized for rectal injuries are evaluated. Patients are arranged in two groups according to the etiology: Group I rectal injuries caused by penetrating traumas; Group II rectal injuries caused by blunt traumas. To determine the risk factors, demographic data of the patients are compared. Results: Group I consisted of 35 male and 2 female patients and average age was 27,5 +/- 7,5, while Group II consisted of 12 male and 3 female patients, and average age was 32,8 +/- 12,4 (p>0.05). Mean average of ISS was 10.1 +/- 10.1 in Group I and 19.4 +/- 12.1 in Group II (p=0.014). However, mean average of TRISS was 98.5 +/- 1.4 in Group I, and 96.4 +/- 3.5 in Group II; and the difference was statistically significant (p=0.011). Mortality numbers for the groups were 1 patient in Group I (2.7 %), 3 patients in Group II (20%), (p=0.034). Conclusions: Although rectal injuries are rarely seen in clinic, morbidity and mortality rates are high. So, being aware of the risk factors and developing a therapy plan, considering the patient is important for the success of therapy.Öğe Giant myxoid liposarcoma of descending mesocolon origin(Termedia Publishing House Ltd, 2014) Uslukaya, Omer; Taskesen, Fatih; Aliosmanoglu, Ibrahim; Arikanoglu, Zulfu; Gul, Mesut; Dusak, AbdurrahimLiposarcomas are one of the most common primary lesions of the retroperitoneal region. They rarely exhibit intra-abdominal location. Because the symptoms emerge later on, they often remain unnoticed until they grow large. Our aim in this paper is to present a case of myxoid liposarcoma of descending mesocolon origin, 40 cm wide and weighing 7000 g, seen in a 47-year-old male patient. No cases at this weight and radius, originating from descending mesocolon, belonging to the myxoid sub-type, were found in our literature scan.Öğe The impact of etiological factors on mortality in retroperitoneal hematomas(Edizioni Luigi Pozzi, 2013) Aliosmanoglu, Ibrahim; Gul, Mesut; Kapan, Murat; Arikanoglu, Zulfu; Taskesen, Fatih; Onder, Akin; Aldemir, MustafaThe impact of etiological factors on mortality in retroperitoneal hematoma AIM: Retroperitoneal hematomas (RPH) mostly occur after blunt and penetrating traumas. However, these hematomas may develop spontaneously in the elderly and the patients who use anticoagulants. Between January 2006 and December 2011, 31 patients with RPH were evaluated retropectively. The patients were allocated into three groups according to the underlying etiological factor: Group I; spontaneous RPH, group II; RPH caused by penetrating trauma, group III; RPH caused by blunt trauma. RESULTS: There were 22 (71%) male and 9 (29%) female patients with a mean age of 35.7 +/- 18.7 (range: 15-88 years). Spontaneous RPH was diagnosed in eight patients (25.8%) while RPH caused by penetrating trauma in 13 patients (41.9%) and RPH induced by blunt trauma in 10 (32.3%) patients. Retroperitoneal hematomas were located at zone I in 2 patients (65%) whereas zone II-III in I patients (61.3%) and zone III in 9 patients (29%). On the other hand, RPH was regarded to be at zone in I patient (3.2%). Additional organ injury was defined in 18 patients (58.1%). Twenty patients (65%) were treated surgically. The morbidity rates were 12.5%, 7.7% and 20% and the mortality rates were denoted as 12.5%, 15.4% and 50%, for group I, group II and group III, respectively. DISCUSSION: Additional organ injury, massive blood transfusion, the route of injury and the need for surgery are defined as the most significant factors associated with increased mortality.
