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    Acute Appendicitis Together with Chylous Ascites: Is It a Coincidence?
    (Hindawi Ltd, 2010) Akbulut, Sami; Yilmaz, Davut; Bakir, Sule; Cucuk, Erdal; Tas, Mahmut
    Acute chylous ascites is a rarely seen clinical picture, therefore, examination findings are often confused with acute appendicitis. To the best of our knowledge, there is no publication to date showing the occurrence of them together. This study presents the treatment plan for a 25-year-old male patient with both acute chylous ascites and appendicitis. Surgical findings were retrocaecal appendicitis, evident lymphangiectasia in the proximal segment of jejunum, and approximately 3 lt of chylous fluid. An appendectomy was performed and drainage was applied. Low-fat total parenteral nutrition (TPN) and octreotide treatment were administered for 7 days postoperatively. We also present a general review of some studies on chylous ascites, which have been published in the English language medical literature since 1910.
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    Atypical Presentation in Lymphoma; Cyanosis in Left Hand: Case Report
    (Aves, 2011) Ozhasenekler, Ayhan; Atilgan, Zuhal Ariturk; Bakir, Sule; Gokhan, Servan; Yilmaz, Fevzi
    A 17 year old female patient was admitted to the emergency service with complaints of cough, asthma, and cyanosis in the left hand. Expanding in the mediastinum, a rightward deviation of the trachea was specified in the posterior-anterior lung x-ray. In her thoracic computerised tomography, soft tissue density, rightward deviation of trachea, narrowing inwards from outside with the left major bronchus was observed and there were common lymph nodules on the upper section of the left trachea. These lymph nodes applied pressure on major vascular structures leading to the left arm. Primarily lymphoma was considered because she was a young patient. Diagnosis-based left axial and left nodule excision was carried out. Histopathologically, a non-Hodgkin lymphoma (NHL) was diagnosed. The patient was given chemotherapy. The cyanosis in the hand was healed after the mass decreased, thus decreasing pressure on vascular structures. Lymphoma, which is one of the mediastinal masses, is also considered with congenital cardiac illnesses such as pulmonary hypertension, improved Patent Ductus Arteriosis Eisenmenger Syndrome in young patients admitted to the emergency service with atypical complaints such as cyanosis in the left hand.
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    Clinical Presentation of Primary Thyroid Tuberculosis
    (Mary Ann Liebert Inc, 2010) Akbulut, Sami; Gomceli, Ismail; Cakabay, Bahri; Arikok, Ata Turker; Sezgin, Arsenal; Bakir, Sule
    [Abstract Not Available]
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    Primary Retroperitoneal Hydatid Cyst: Report of 2 Cases and Review of 41 Published Cases
    (Int College Of Surgeons, 2010) Akbulut, Sami; Senol, Ayhan; Ekin, Abdulselam; Bakir, Sule; Bayan, Kadim; Dursun, Mehmet
    This paper gives an overview of the literature between 2000 and 2010 on primary retroperitoneal hydatid cyst. We reported 2 cases of primary retroperitoneal hydatid cyst, and studies published in English literature on hydatid cyst developing in the retroperitoneal space were accessed via Pubmed and Google Scholar databases. Forty-one published primary retroperitoneal hydatid cyst cases were evaluated, and 2 patients (1 man, 78 years old; 1 woman, 75 years old) who presented with abdominal mass caused by retroperitoneal hydatid cyst were reported. Twenty-five of the patients were men (including our patient), and 18 were women; patients ranged in age from 3 to 80 years, and the median standard deviation age was 41.37 +/- 20.4 years. On presentation, 72% of the patients complained of back or abdominal pain; 13.9% had urinary tract symptoms, and 65.1% were determined as having a palpable mass. Ultrasonography was performed on 93% of the patients, computed tomography was performed on 81.4%, magnetic resonance imaging was performed on 18.6%, and intravenous pyelography test was performed on 13.9%. The results of these tests showed a cystoid mass located on the left in 32.5% of the patients, on the right in 37.2%, and in the retrovesical area in 16.2%. Serologic tests determined 67.8% of the patients were indirect hemagglutination positive, and 71.4% were positive on enzyme-linked immunosorbent assay. As a surgical approach, total exision was performed on 55.8% of patients, partial cystectomy was performed on 39.5%, and 4.6% of patients underwent unroofing. If a cystic lesion is determined in the retroperitoneal area in a patient living in an area of endemic hydatid disease, a differential diagnosis of hydatid cyst should be considered. Clinical, radiologic, serologic, and histopathologic evaluations should be made for a differential diagnosis.
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    Thyroid Tuberculosis in Southeastern Turkey: Is This the Resurgence of a Stubborn Disease?
    (Springer, 2011) Akbulut, Sami; Sogutcu, Nilgun; Arikanoglu, Zulfu; Bakir, Sule; Ulku, Abdullah; Yagmur, Yusuf
    Background While tuberculosis (TB) has been found in many parts of the body, involvement of the thyroid gland is rare. In this study we describe the clinicopathological characteristics of seven patients with primary thyroid tuberculosis (TTB). Methods This report is a retrospective case study of seven patients with thyroid tuberculosis who were treated surgically in our clinic between 2004 and 2010. Data collected from the cases included age, sex, clinical presentation, concurrent medical illness, initial diagnosis, and history of pulmonary tuberculosis. Testing used to establish the diagnosis of TTB included thyroid function tests, histopathological examination, a tuberculin skin test, and FNAC (fine needle aspiration cytology). Surgical procedures, antitubercular therapy, and follow-up data were also analyzed. Results All seven cases were females between the age of 30 and 60 years (mean = 44.1 +/- 9.5 years). Four cases had neck swelling and three had additional complaints of dysphagia and dyspnea. While total thyroidectomy was performed in six patients with multinodular goiter, a lobectomy was performed in one patient in whom a solitary thyroid nodule was detected. Histopathologic changes consistent with thyroid tuberculosis were detected in all patients. Thoracic X-ray, erythrocyte sedimentation rate (ESR) test, and tuberculin skin test (PPD) were performed and all patients were screened for other possible foci of infection. In conclusion, all seven cases were diagnosed with primary tuberculosis. While the lobectomy patient was administered a 6-month antitubercular treatment, the total-thyroidectomy patients did not receive any medical treatment postoperatively. During the postoperative followup period, which lasted between 6 and 53 months (mean = 37.3 +/- 18.6 months), none of the patients had a recurrence of disease. Conclusion Tuberculosis should be considered in the list of differential diagnoses for thyroid abscesses and nodular lesions in people living in geographic regions with a high tuberculosis prevalence.