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Öğe Adrenal bez kalınlığının multi-dedektörlü bilgisayarlı tomografi ile değerlendirilmesi(Modestum Publishing Ltd., 2012) Hamidi, Cihad; Göya, Cemil; Hattapoğlu, Salih; Çetinçakmak, Mehmet Güli; Teke, Memik; Dusak, Abdurrahim; Kuday, SuzanAmaç: Bu çalışmanın amacı anatomik detayın daha iyi değerlendirildiği multi-dedektörlü bilgisayarlı tomografi ile adrenal bez boyutlarını ve her iki taraftaki adrenal bezler arasında kalınlık farkının olup olmadığını araştırmaktır. Gereç ve yöntem: Adrenal bez patolojisi bulunmayan, adrenal bez dışı kitlesi olmayan 100 hasta bilateral adrenal bez kalınlıkları açısından 16 ve 64 dedektörlü bilgisayarlı tomografi ile retrospektif olarak incelendi. Bulgular: Ölçümler sonucunda her iki adrenal bez ortalama medial ve lateral bacak kalınlıkları arasında istatistiksel olarak anlamlı farklılık saptandı (p< 0.001, p=0.035). Her iki adrenal bez gövdeleri arasında ise istatistiksel olarak anlamlı farklılık saptanmadı (p=0.611). Sonuç: Sol adrenal bez sağa nazaran varyatif olarak kalın izlenmiş olup, adrenal bez kalınlıkları standardizasyonu açısından daha geniş çalışmalara ihtiyaç duyulmaktadır.Öğe Clinical impacts of juxtapapillary duodenal diverticulum detected on computed tomography(Bentham Science Publ Ltd., 2022) Dündar, İlyas; Göya, Cemil; Hattapoğlu, Salih; Özkaçmaz, Sercan; Özgökçe, Mesut; Türkoğlu, Saim; Türko, EnsarBackground: Diverticula are commonly observed in the duodenum. Duodenal Diverticulum (DD) usually does not give symptoms throughout life and is diagnosed by coincidence. However, it may present with different symptoms in patients. Objective: This study aims to evaluate the prevalence of DD and Juxtapapillary Duodenal Diverticilium (JDD) and its association with other possible pathologies and to determine its clinical impact by using Computed Tomography (CT). Methods: This retrospective observational study, which was taken consecutively between the years of 2013-2020, was evaluated in the Radiology Department. The total number of cases was 4850 (male-2440; female-2410). CT images were evaluated by two experienced radiologists at the workstation. DD and JDD prevalence and clinical findings in the hospital registry system were examined. Results: The age of the patients included in the study ranged from 17 to 92 years (mean age 46.94 +/- 16.42). In patients with DD (female-130; male-101), mean age was 62.24 +/- 12.69 (21-92). The prevalence of DD was 4.76% (n=231). The prevalence of JDD was 4.02% (n=195) and increased with age (p<0.01). The average diameter of the JDD was measured as 23.29 +/- 8.22 (9.5-55.3) mm. A significant positive correlation was found between age and DD diameter (p=0.039). DDs were found most commonly 84.42% (n=195) in the second segment of the duodenum as JDD. In patients with JDD, the mean diameter of choledochus and wirsung canal were 6.7 +/- 2.4 (3-15.3) mm and 0.31 +/- 0.1 (0.1-6.5) mm respectively. The choledochal diameter was correlated with the JDD size (p - 0.004). Cholelithiasis (n 56), choledocholithiasis (n 20), cholecystitis (n=52), diverticulitis (n=15), duodenitis (n=37), pancreatitis (n=5) and hiatal hernia (n=60) with JDD were observed. Periampullary carcinoma was detected in one patient. Conclusion: Our study shows that cholelithiasis, choledocholithiasis, cholecystitis, diverticulitis, duodenitis, pancreatitis may be associated with JDD. Therefore, in contrast-enhanced abdominal CT scans taken for various reasons, investigation of the presence and characteristics of JDD and detection of pathologies that may be associated with JDD are important for patients to benefit from early diagnosis and treatment opportunities and to take precautions against possible complications.Öğe Diagnosis of Bride Ileus By Multidetector CT andSurgical Correlation(2014) Oğuz, Abdullah; Hamidi, Cihad; Yavuz, Alparslan; Çetinçakmak, Mehmet Güli; Teke, Memik; Göya, Cemil; Hattapoğlu, SalihAmaç: Amacımız brid ileus ön tanılı hastaların cerrahi bilgileri ve patoloji sonuçları ışığında çok kesitli bilgisayarlı tomografi bulgularını retrospektif olarak değerlendirmektir. Yöntem: Çalışmamıza Ocak 2010 ve Ocak 2014 dönemleri arasında genel cerrahi servisine başvurmuş ve operasyon sonrasında brid ileus kesin tanısı alan yaşları 13-87 arasında değişen 35'i kadın, 30'u erkek toplam 65 olgu dâhil edildi. Hastalarımızın tüm abdomen BT çekimleri 64 kesitli çok kesitli BT cihazıyla; ksifoid proçesten başlayarak simfizis pubise kadar inguinal kanal orifislerini de içine alacak şekilde nefes tutturularak yapıldı. Radyolojik bulgular cerrahi ve patoloji verileriyle beraber istatistiksel olarak karşılaştırıldı. Bulgular: Brid ileusu tesbit etmede çok kesitli bilgisayarlı tomografi'nin sensitivitesi %91, spesifitesi 44 olarak saptandı. Vakalarımızın %72'sinde ince barsak tipi, %28'inde ise kalın barsak tipi obstrüksiyon saptandı. İleuslu olgularımıza eşlik eden mezenterik kirlenme, batında serbest mayi, "inci dizisi" bulgusu ve geçiş zonu ile barsak obstrüksiyonu arasında istatistiksel olarak anlamlı ilişki saptandı (p<0.05). Sonuç: Çok kesitli bilgisayarlı tomografi brid ileuslu hastalarda obstrüksiyonun varlığı, seviyesi ve ikincil olarak oluşan bulguların değerlendirilmesinde etkili görüntüleme yöntemidir.Öğe The diagnostic efficacy of low-dose cervical and thoracic CT in multiple trauma patients(Dicle Üniversitesi Tıp Fakültesi, 2013) Göya, Cemil; Yavuz, Alpaslan; Hamidi, Cihad; Andiç, Çağatay; Çetinçakmak, Mehmet Guli; Teke, Memik; Özkaynak, CanObjective: The aim of this study was to evaluate the initial diagnostic efficacy of low-dose computed tomography (CT) in multi-trauma patients. Methods: 74 patients (44 male, 30 female; average age: 36.9 years) accepted to the emergency unit with the reason of multiple trauma which is included in this study. Cervical and thoracic injury sites were initially evaluated with portable X-Ray and low-dose CT. The Patients’ progress, surgical findings and additional radiologic examination results were recorded until the patients were discharged. Results: The sensitivity and specificity of X-Ray graphies were 50% and 95% for thoracic traumatic pathologies; 0-40% and 95-100% for cervical injuries respectively. CT examination sensitivity and specificity values were 95-100% and 80-100% for thoracic injuries; 95-100% and 96-100% for cervical injuries respectively. Conclusion: Low-dose CT examination is more sensitive than X-Ray graphs for the evaluation of cervicothoracic traumatic injuries. We recommend to prefer low-dose CT as an initial radiologic examination for managing cervicothoracic trauma cases because of its higher diagnostic capability than X-Ray graphy.Öğe Does contrast-enhanced computed tomography raise awareness in the diagnosis of the invisible side of celiac disease in adults?(Springer, 2022) Göya, Cemil; Dündar, İlyas; Özgökçe, Mesut; Türko, Ensar; Özkaçmaz, Sercan; Durmaz, Fatma; Alabalık, Ulaş; Hattapoğlu, SalihPurpose This study aimed to evaluate the diagnosis and determine major and minor criteria of celiac disease (CD) with the malabsorption patterns (MABP) in the small intestine and colon on computed tomography (CT) and additional CT findings. Methods This retrospective study was conducted with 116 patients diagnosed with CD, 14 CD patients recovering with treatment, and 35 control patients with non-CD. All patients had CT examinations and histopathological diagnoses. The sensitivity, specificity, PPV, NPV, and accuracy values of each CT finding defined in the literature were statistically evaluated. According to the patient and control groups, the numerical values of the findings and the sensitivity and specificity values were measured according to this cut-off value. The distribution of CT findings according to pathological Marsh data was evaluated in CD patients. Results Sensitivity and specificity were found to be higher in small bowel MABP findings, mesenteric hypervascularity, and increased SMV/aorta diameter. There was a numerically significant difference in MDCT findings between the control and pathological Marsh groups. In the ROC analysis performed in terms of the total numerical values of each MDCT finding observed between the groups, it was found that there were more than 7 MDCT findings, 100% sensitivity, and 92% specificity. The presence of four major and three minor criteria or three major and four minor criteria were considered significant. Conclusions Being aware of CT findings below the iceberg that may suggest CD in abdominal CT examinations performed in patients with atypical clinical and malabsorption findings or other nonspecific findings may prevent diagnostic delay and unnecessary procedures.Öğe Dyke-Davidoff-Masson sendromu iki olgu sunumu(Dicle Üniversitesi Tıp Fakültesi, 2014) Bulut, Mehmet Deniz; Gülşen, İsmail; Bora, Aydın; Yavuz, Alpaslan; Göya, Cemil; Batur, AbdussametDyke-Davidoff Masson sendromu nadir bir konjenital malformasyon olarak ilk kez 1933 yılında Dyke tarafından bildirilmiştir. Ana klinik bulguları; tek taraflı serebral atrofi, fasiyal asimetri, kontralateral hemiparezi ve epilepsidir. Klinik bulgular beyin hasarının büyüklüğüne bağlı olarak değişiklikler gösterebilir. Etyolojisinde prenatal enfeksiyonlar, konjenital patolojiler, doğum travması, beyin tümörleri, febril nöbetler ve beyin damar hastalıkları sorumlu tutulmuştur. Radyolojik olarak serebral atrofi ve aynı taraf lateral ventrikülde genişleme, kalvariumda kalınlaşma, mastoid hava hücreleri ve paranazal sinüslerde havalanma artışı ve bombeleşmiş temporal kemik en önemli bulgulardır. Etyolojisi ve serebral parankim hasarının büyüklüğünü saptamada başlıca magnetik rezonans görüntüleme ve bilgisayarlı tomografi yöntemleri kullanmanın yanında diffüzyon magnetik rezonans görüntülemede tanıya katkı sunabilir. Bu makalede Dyke-Davidoff Masson sendromlu iki olgu klinik bulgular ve radyolojik görüntüler eşliğinde sunulmuştur.Öğe Evaluation of celiac disease with uniphasic and multiphasic dynamic MDCT imaging(Springer, 2021) Göya, Cemil; Dündar, İlyas; Özgökçe, Mesut; Türkoğlu, Saim; Türko, Ensar; Özkaçmaz, Sercan; Aydoğdu, Gülay; Almalı, NecatPurpose An analysis of dynamic contrast MRI has been shown to provide valuable information about disease activity in Crohn's disease and Celiac disease (CD). However, there are no reports of dynamic multi-detector computer tomography use in patients with CD. The aim of this study is to determine and compare the perfusion dynamics of the patients treated with control subjects and the perfusion dynamics in patients with untreated CD, using dynamic contrast in MDCT and compare studying contrast dynamics in Marsh types as well. Methods In this retrospective study, uniphasic and multiphasic MDCT, untreated, treated, incompatible CD patients and healthy control group duodenum wall thickness and HU values were compared in terms of patient groups and modified Marsh types. Result In dynamic CT, the highest contrast curve was observed in the untreated group and Marsh type 1. While the contrast curve of the untreated and non-compliant patients increased rapidly and showed wash out, the type 4 contrast curve was observed, whereas the treated and control group slowly increased type 5 contrast curve. In the contrast-enhanced CT in the venous phase, in the ROC analysis between Marsh 1-2 and Marsh 3a-c, the sensitivity was 97% and the specificity was 87% when the cut off was taken as 4.45 mm for wall thickness (p: 0.005). Conclusion Contrast-enhanced single-phase and dynamic MDCT imaging in CD patients may be useful in evaluating the inflammatory and pathological process in the small intestine.Öğe Evaluation of the relationship between splenic iron overload and liver, heart and muscle features evident on T2?-weighted magnetic resonance imaging(Wroclaw University of Medicine, 2020) Çetinçakmak, Mehmet Güli; Hattapoǧlu, Salih; Söker, Murat; Ekici, Faysal; Yılmaz, Kamil; Göya, Cemil; Hamidi, CihadBackground. Splenic iron overload is the most common clinical condition in patients with thalassemia. However, few studies of the effects of splenectomy have been published. Objectives. To evaluate the relationship between splenic iron overload and liver, heart and muscle features visible in T2∗-weighted magnetic resonance imaging, and to investigate the effects of splenectomy on these tissues in patients with beta-thalassemia major (TM). Material and methods. We retrospectively included 131 patients (76 male and 55 female) diagnosed with TM. All radiological assessments were performed with the aid of a Philips Achieva 1.5T scanner running a multiecho gradient-echo sequence. Hepatic and splenic T2∗ values were assessed in the same gradient multiecho series. Muscle T2∗ values were assessed in the shoulder girdle muscles adjacent to the heart area. The relationships among splenic T2∗, hepatic T2∗, cardiac T2∗ and muscle T2∗ parameters, serum ferritin levels, age and other parameters were evaluated. Results. The splenic T2∗ value correlated with serum ferritin level and the hepatic T2∗ value (p < 0.001 and p < 0.001, respectively). The splenic T2∗ value did not correlate with age, cardiac or muscle T2∗ values, or with spleen size (p = 0.27, 0.21, 0.99, and 0.39, respectively). The muscle T2∗ value correlated weakly with the serum ferritin level (p = 0.022). The cardiac T2∗ value was lower and the liver size greater in patients who had undergone splenectomy compared with those who had not (p < 0.001 and 0.001, respectively). Conclusions. Splenic iron overload correlated with hepatic overload and the serum ferritin level. Splenectomy increased cardiac iron overload and triggered liver enlargement. However, the muscle iron overload was low and the muscles were therefore unaffected by splenectomy.Öğe Factors affecting early mortality and morbidity in congenital duodenal obstruction: summary of a 20-year experience(Int College of Surgeons, 2021) Aydoğdu, Bahattin; Tireli, Gülay; Demirali, Oyhan; Güvenç, Ünal; Beşik, Cemile; Kavuncuoğlu, Sultan; Göya, Cemil; Okur, Mehmet Hanifi; Sander, SerdarThe duodenum is the most frequently obstructed region of the gastrointestinal tract, an important cause of mortality and morbidity in neonatal period. The objective of the present study was to summarize the causes of early mortality and morbidity in infants with congenital duodenal obstruction (CDO). Data on a total of 94 patients with CDO diagnosed in our clinic, and treated surgically between January 1993 and December 2012, were studied retrospectively. Patients were divided into 3 groups in terms of diagnosis: annular pancreas (n = 45), duodenal atresia (n = 31), and duodenal web (n = 18). The groups were compared in terms of sex, birth weight, age at the time of operation, and morbidity and mortality rates. Of the patients, 54 were male and 40 female, and the mean birth weight was 2278 g (range, 1180-3400 g). The average age at the time of the operation was 6.96 days (range, 1-38 days). The time to full oral intake postoperatively was 10.32 days (range, 4-38 days). Additional anomalies were found in 61 cases (64.8%). Early morbidity was most commonly associated with an anastomosis problem. Early mortality occurred in 6 cases (6.4%), and the most common causes were sepsis and cardiac anomalies. Elimination of sepsis, cardiac anomalies, and anastomosis problems is critical to ensure continued reductions in infant mortality and morbidity caused by CDO.Öğe Hidrosefali ile birlikte seyreden bilateral konjenital perisilviyan sendrom(2012) Teke, Memik; Hamidi, Cihad; Göya, Cemil; Çetinçakmak, Mehmet Güli; Hattapoğlu, SalihKonjenital bilateral slyvian sendrom (KBPS) mental retardasyon, epilepsi, konuşma bozukluğu, psödobulbar palsi gibi bulgularla kendini gösteren, genetik ve genetik dışı nedenlerle ortaya çıkan konjenital bir hastalıktır. Klinik bulgularla birlikte, MR görüntüleme ile karakteristik bulguların (polimikrogiri gibi) ortaya konması, tanı konulmasında katkı sağlamaktadır. Yazımızda hidrosefali bulgusu bulunan KBPS tanısı konulan 18 aylık kız çocuğu olgusu-nu sunmayı amaçladık.Öğe Hydatid disease localized in mesorectum: Case report(Modestum Publishing Ltd., 2015) Oğuz, Abdullah; Gümüş, Metehan; Türkoğlu, Ahmet; Göya, Cemil; Alabalık, Ulaş; Böyük, AbdullahHydatid disease is a parasitic disease, which is caused by echinococcus and often located in the liver and lung but occasionally found in other organs. Only one previous study reported localization in the mesorectum. In this case report, we present a 27-year-old male, as a second case in the literature, with a hydatid cyst located in the mesorectum. Abdominopelvic computed tomography revealed cystic masses localized in the mesorectum with no pulmonary or hepatic involvement. Pre-operative cyst hydatid IgG (1/1000) was positive, and the preliminary diagnosis was hydatid disease. The patient underwent partial cystectomy. Macroscopic and microscopic examination of the specimens confirmed the hydatid cyst. This case report demonstrates that hydatid disease should be taken into consideration in the differential diagnosis of a cystic mass in any anatomic localization, especially in endemic areas. J Clin Exp Invest 2015; 6 (1): 75-77.Öğe Imaging of anterior cruciate ligament graft reconstruction imaging of anterior cruciate ligament graft reconstruction(Akdeniz Üniversitesi Tıp Fakültesi, 2018) Durmaz, Mehmet Serdar; Göya, Cemil; Hamidi, Cihad; Hattapoğlu, Salih; Teke, MemikAmaç: Ön çapraz bağ (ÖÇB) greft rekonstrüksiyonunun postoperatif direkt grafi , manyetik rezonans görüntüleme(MRG) normal bulgularını tanımlamak, operasyon sonrası gelişebilecek potansiyel komplikasyonlarının MRG bulgularını sunmaktır.Gereç ve Yöntemler: Çalışmaya ÖÇB rekonstrüksiyon cerrahisi geçirmiş 52 hasta alındı. Hastaların direkt grafi , manyetik rezonans görüntüleri ÖÇB greft bütünlüğü ve eşlik edebilecek komplikasyonlar açısından retrospektif olarak değerlendirildi.Bulgular: Çalışmaya alınan 52 hastanın 18'inde postoperatif patolojik bulgular saptandı. Dört hastada total greft rüptürü, bir hastada parsiyel greft rüptürü, iki hastada gevşek greft, 10 hastada anterior yerleşimli tibial tünel, sekiz hastada tepe impigement, iki hastada yan duvar impigement, dört hastada tünelde kistik genişleme, bir hastada patellar fraktür, iki hastada operasyon materyaline bağlı iliotibial band sürtünme sendromu ve dört hastada artrofi brozis saptandı.Sonuç: MRG, ÖÇB greftinin, tünellerin ve fi ksasyon materyallerinin pozisyonunu değerlendirmede, operasyon sonrası ağrı ve fonksiyon kaybının nedenini araştırmada kullanılabilen etkili bir görüntüleme yöntemidir.Öğe The importance of acoustic radiation force impulse (ARFI) elastography in the diagnosis and clinical course of acute pancreatitis(Aves Yayıncılık, 2018) Kaya, Muhsin; Değirmenci, Mehmet Serdar; Göya, Cemil; Tuncel, Elif Tuğba; Uçmak, Feyzullah; Kaplan, Mehmet AliBackground/Aims: Acute pancreatitis (AP) is characterized by acute inflammation of the pancreas and it has a highly variable clinical course. The aim of our study was to evaluate the value of acoustic radiation force impulse (ARFI) elastography in the diagnosis and clinical course of AP. Materials and Methods: Consecutive patients with a diagnosis of AP (patients group) and healthy subject (control group) were prospectively enrolled to the study. Demographic features and clinical, laboratory, and radiological data were recorded. Virtual Touch Tissue Quantification (VTQ) was used to implement ARFI elastography. The tissue elasticity is proportional to the square of the wave velocity (SWV). Results: A total of 108 patients (age, 57±1.8 y) and 79 healthy subjects (age, 53.6±1.81 y) were included in the study. There were 100 (92.5%) edematous and 8 (7.4%) necrotizing AP. The mean SWV was significantly higher in the patient group than in the control group (2.43±0.08 vs. 1.27±0.025 m/s, p<0.001). There was not significant difference between patient and control group regarding age and gender. SWV cutoff value of 1.63 m/s was associated with 100% sensitivity and 98% specificity for the diagnosis of AP. There was not significant difference between patients with and without complications and patients with edematous and necrotizing AP regarding mean SWV value. There was also not significant correlation between mean SWV value and age, mean length of hospital stay, and mean amylase level. Conclusion: ARFI elastography may be a feasible method for the diagnosis of AP, but it has no value for the prediction of clinical course of AP.Öğe Konvülsiyon ile Başvuran Fahr Sendromu: Olgu Sunumu(2014) Gözel, Nevzat; Kılınç, Faruk; Göya, Cemil; Demircan, FatihFahr sendromu; kalsiyum ve fosfor metabolizma bozukluğu sonucu gelişen, çift taraflı simetrik intrakranyal kalsifikasyon ile seyreden nörodejeneratif bozukluklarla karakterize nadir görülen bir hastalıktır. Etyolojisi kesin olarak bilinmemektedir. Klinik olarak genellikle yürümede dengesizlik, konuşma bozukluğu, istemsiz hareketler, ya da kas krampları ile başlayıp tabloya psikoz, kişilik değişiklikleri gibi nöropsikiyatrik semptomlar da eklenebilir.Yazımızda, nöroloji tarafından epilepsi tanısıyla takip edilirken, acil servise tonik klonik nöbetle getirilen, idyopatik hipoparatiroidizme sekonder gelişen hipokalsemi ve BTde bazal ganglionlarda bilateral yaygın kalsifikasyon saptanan Fahr sendromu olgusu sunulmuştur.Öğe Koroner arter kalsiyum skoru ile koroner arter hastalığı arasındaki ilişkinin çok kesitli bilgisayarlı tomografi ile değerlendirilmesi(Dicle Üniversitesi Tıp Fakültesi, 2013) Kartal, Tuba; Yavuz, Alpaslan; Çetinçakmak, Mehmet Güli; Göya, Cemil; Çubuk, MetinAmaç: Koroner arter hastalığı (KAH) gelişmiş ülkelerde en sık ölüm nedeni olup, erken tanı ve tedavisi mortalite ve morbidite oranlarını azaltmada büyük önem taşımaktadır. Biz bu çalışmada multidetektör bilgisayarlı tomografi (MDBT) tetkiki ile KAH olgularındaki klasik risk faktörleri, anjiografi bulguları ve koroner arter kalsiyum skoru arasındaki ilişkinin değerlendirilmesini amaçladık. Yöntemler: Çalışmamızda 141 koroner arter hastasına ait MDBT ile elde edilmiş koroner arter kalsiyum skorları ve anjiografi bulguları retrospektif olarak değerlendirildi. Hastalarda hiperlipidemi, hipertansiyon, diyabet, ailesel koroner arter hastalığı ve sigara kullanma öyküsü gibi klasik koroner risk faktörlerinin varlığı kaydedildi. Hastaların kalsiyum skoru Agatston sınıflamasına göre hesaplandı. Bulgular: Çalışmaya alınan 141 hastanın ortalama yaş 56±12 olup yaş aralığı 17 ile 80 arasında değişmekteydi. Otuz üç (%23) hastada MDBT ile saptanan koroner arter darlık yüzdeleri %50’nin üzerinde idi. Diyabet ve hipertansiyon; koroner kalsiyum skoru ile istatistiksel olarak anlamlı korelasyon gösteren (sırasıyla p=0,023 ve p<0,01) yegane koroner risk faktörleri idi. Kalsiyum skoru ile KAH ciddiyeti arasındaki ilişkisinin irdelenmesi için ROC analizi yapıldı ve eğri altında kalan alan 0,842 (%95 CI 0.771-0.898, p<0,001) olarak hesaplandı. Sonuç: Koroner arter kalsiyum skorunun 39’un altında olması anlamlı koroner arter darlığını ekarte etmek için kuvvetli değişken olarak bulundu. Kalsiyum skoru “0” değerinin, yumuşak plakların mevcudiyetini tamamen ekarte edememekle beraber, yüksek sensitivite ve negatif prediktif değeriyle kimi hastaların invaziv tanısal tetkik gereksinimlerini elimine edebilecek potansiyele sahip olduğu sonucuna varıldı.Öğe Multiplanar reformatted CT enterography in acute abdomen(Maltepe University, 2016) Dusak, Abdurrahim; Alan, Bircan; Güzel, Abdulmenap; Çakmak, Muharrem; Taşkesen, Fatih; Göya, Cemil; Bilici, AslanAim: To investigate the correlation between surgical - histopathological data and CT enterography CTE in patients with acute abdomen due to mecanical ileus. Methods: Ninety one 46 female, 45 male; 44±11 year- old consecutive acute abdomen cases admitted to emergency department and operated in general surgery department with a preoperative diagnoses of mechanical ileus were included in this study. CTE was carried-out using Multi sliced CT 64 detector CT, Philips Brilliance . Subjects were scanned from xiphoid process to symphysis pubis during a single breath-hold. Correlation analyses were done between radiological findings and surgical and histopathological findings. Result: Gastrointestinal tract GIT obstruction finding was evident in 82% of subjects with mecanical ileus and acute abdomen. Sensitivity and specificity of CTE was 85% and 55% respectively in terms of demonstration of etiopathology. 80% of cases had small bowel obstruction and remaining 20% had large bowel obstruction. Bridled ileus, mass, hernia, mesenteric ischemia, perforation, peritonitis carcinomatosa, volvulus, invagination, narrowed anastomosis, torsion, abscess, gossypiboma, gallstone ileus and malrotation were among underlying etiological factors. Statistically significant correlation found between GIT obstruction and findings such as mesenteric stranding, intra abdominal free fluid, string of pearls sign and transition-zone. In contrary, bowel wall thickening, mass lesion, faeces sign, peritoneal nodule, whirl sign, target sign, intra abdominal free air, pneumatosis intestinalis were not statistically significantly correlated with GIT obstruction. Conclusion: CT Entherography is an efficient imaging modality with high diagnostic value in demonstrating the existence and etiopathology of bowel obstruction.Öğe Multislice computed tomography imaging of gastrointestinal stromal tumors(2017) Araç, Eşref; Emin, Mehmet; Deniz, Muhammed Akif; Sezer, Nadir; Taş, Zelal Deniz; Göya, CemilGastrointestinal stromal tumors (GIST) are mesenchymal tumors that constitute 1-3% of primary gastrointestinal tumors and approximately 5% of all sarcomas of the gastrointestinal tract. Multislice Computed Tomography (MSCT) is a highly sensitive imaging technique for detecting GISTs. We retrospectively evaluated findings of 56 consecutive subjects that were examined at Dicle University, School of Medicine, between 2008-2015 and diagnosed with GIST. Lesions were divided into two clinically distinct entities as recurrent and primary lesions. Densities of lesions in comparison to liver, origins of and spreading of the lesions, dimensions of the lesions, behavior pattern, and factors such as contour properties, invasion, and calcification which could potentially indicate malign behavior were also evaluated. Age span of included subjects were between 28 and 81. The most common tumor location for hollow organs was found to be stomach (n=19, 32%). In extra-luminal, regions the most common tumor location was found to be mesentery (n=4). Hansfield Unit densities of tumoral lesions in comparison to liver density were hypodens (n=32, 71%), isodens (n=9, 20%) and hyperdens (n=4, %9) in a descending order. The tumor invasion was found to be effecting liver, peritoneum, and bladder, in a descending order. In 11(24%) subjects, distant metastasis to the liver was evident. In 4(9%) subjects peritoneum, in 3(7%) subjects adrenal gland and in 1(2%) subject bone metastasis was evident. MSCT is an important and indispensable modality for the detection, localization and identification of GISTs that can be seen in different parts of the gastrointestinal tract.Öğe Olfaktör nöroblastoma (esthesioblastoma) radyolojik bulguları(2013) Göya, Cemil; Bora, Aydın; Andiç, Çağatay; Beyazal, Mehmet; Yavuz, AlpaslanOlfaktör nöroblastoma (ONB), diğer bir isimle esthesi- oblastoma, olfaktör epitelyumdan köken olan, genelliklenazal kavite olfaktör bölgede ve ön kafa tabanında yeralan nadir malign bir neoplazidir. Bugüne kadar literatürde az sayıda vaka bildirilmiştir. ONB tanısı ve sınıflandırması için ayrıntılı radyolojik ve histopatolojik inceleme gereklidir. Özellikle lokal seyreden tümörlerde prognoz iyi seyirli olup bölgesel ve uzak metastaz kötü prognozbelirtileri olarak kabul edilmiştir. Cerrahi ve radyoterapi günümüzdeki başlıca tedavi yöntemleridir. Biz buradaONB saptanan 64 yaşındaki erkek olgunun X-ray grafi, B Mod-Doppler Ultrason (US) ve Bilgisayarlı Tomografi (BT) bulgularını sunduk.Öğe Ön Çapraz Bağ Greft Rekonstrüksiyonunda Görüntüleme Bulguları(2018) Göya, Cemil; Teke, Memik; Hamidi, Cihad; Durmaz, Mehmet Sedat; Hattapoğlu, SalihAmaç: Ön çapraz bağ (ÖÇB) greft rekonstrüksiyonunun postoperatif direkt grafi , manyetik rezonans görüntüleme(MRG) normal bulgularını tanımlamak, operasyon sonrası gelişebilecek potansiyel komplikasyonlarının MRG bulgularını sunmaktır.Gereç ve Yöntemler: Çalışmaya ÖÇB rekonstrüksiyon cerrahisi geçirmiş 52 hasta alındı. Hastaların direkt grafi , manyetik rezonans görüntüleri ÖÇB greft bütünlüğü ve eşlik edebilecek komplikasyonlar açısından retrospektif olarak değerlendirildi.Bulgular: Çalışmaya alınan 52 hastanın 18'inde postoperatif patolojik bulgular saptandı. Dört hastada total greft rüptürü, bir hastada parsiyel greft rüptürü, iki hastada gevşek greft, 10 hastada anterior yerleşimli tibial tünel, sekiz hastada tepe impigement, iki hastada yan duvar impigement, dört hastada tünelde kistik genişleme, bir hastada patellar fraktür, iki hastada operasyon materyaline bağlı iliotibial band sürtünme sendromu ve dört hastada artrofi brozis saptandı.Sonuç: MRG, ÖÇB greftinin, tünellerin ve fi ksasyon materyallerinin pozisyonunu değerlendirmede, operasyon sonrası ağrı ve fonksiyon kaybının nedenini araştırmada kullanılabilen etkili bir görüntüleme yöntemidir.Öğe Operative and non-operative management of children with abdominal gunshot injuries(Ulusal Travma ve Acil Cerrahi Derneği, 2018) Arslan, Mehmet Şerif; Zeytun, Hikmet; Arslan, Serkan; Basuguy, Erol; Okur, Mehmet Hanifi; Aydoğdu, Bahattin; Göya, Cemil; Uygun, İbrahim; Otçu, SelçukABSTRACT: BACKGROUND: Non-operative management (NOM) is a standard treatment method for solid organ injuries worldwide. There is no consensus on the management of gunshot wounds (GSW) because of the higher frequency of hollow viscus injuries (HVI) and the unpredictable depth of tissue damage produced by kinetic energy transfer during retardation of the bullet. Here we aimed to reevaluate indications for surgery and NOM based on our pediatric patients with abdominal GSW. METHODS: We performed a retrospective analysis of patients evaluated and treated for abdominal GSW at University of Dicle between January 2010 and October 2016. Patients with hemodynamic instability, signs of peritonitis on serial abdominal examination, and free air in the abdomen underwent laparotomy; these were included in group I (n=17). Patients managed non-operatively were included in group II (n=13). RESULTS: Our statistical analysis showed significantly lower Hb levels and systolic blood pressure levels (p<0.001) and higher pulse rate, higher mean injury severity score, and longer length of stay at intensive care unit in patients in group I than in those in group II (p<0.001). We further detected colon perforation (n=10) and small bowel perforation (n=7) in patients in group I; liver laceration (n=4), splenic injury (n=1), and renal injury (n=3) but no solid organ injury or HVI (n=5) were detected in patients in group II. CONCLUSION: The major drawback of NOM is the difficulty in diagnosing HVI in abdominal GSW, which may delay treatment. We suggest that patients with solid organ damage who are hemodynamically stable and exhibit no signs of peritonitis upon serial abdominal exam may be treated with NOM.
