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Öğe Asymptomatic thyroid tuberculosis in a multinodular goitre patient(Taylor & Francis Ltd, 2007) Girgin, S.; Gedik, E.; Bueyuekbayram, H.Thyroid tuberculosis is a very rare disease of the thyroid gland. In recent years, the incidence of extra-pulmonary tuberculosis has been showing a progressive increase. We present the case of a 41 -year old female patient, operated for an asymptomatic multinodular goiter, and who had a histopathological diagnosis of thyroid tuberculosis. Thyroid tuberculosis should be kept in mind in the differential diagnosis of thyroid nodules, even in patients with no history and no symptom of tuberculosis disease.Öğe Blunt trauma - related isolated pancreatic injury(Comenius Univ, 2013) Onder, A.; Kapan, M.; Tekbas, G.; Arikanoglu, Z.; Aliosmanoglu, I; Taskesen, F.; Girgin, S.Background: Pancreatic injuries arising from blunt trauma are rarely seen. Diagnosis and treatment are difficult because of retroperitoneal localization of the organ. We present four pancreatic cases with isolated pancreatic injury due to blunt abdominal trauma. Methods: This retrospective study included four pancreatic patients who were operated on due to isolated injury caused by blunt abdominal trauma at our department between January 2004 and October 2010. Results: The patients consisted of three males and one female. One of them was in stage IV and the rest were in stage III. All underwent pancreaticojejunostomy, distal pancreatectomy, distal pancreatectomy + splenectomy and drainage, respectively. Fistula developed in two of them, and abscess developed in one, while the other one died. Conclusion: Diagnosis may be delayed since the clinical condition is initially stable. Tomography remains one of the most important diagnostic tools. Common risk factors for morbidity and mortality are the presence of ductal injury and delayed laparotomy (Tab. 1, Fig. 4, Ref. 22). Full Text in PDF www.elis.sk.Öğe Bochdalek hernia with concomitant partial situs inversus in an adult(Via Medica, 2010) Gedik, E.; Girgin, S.; Tuncer, M. C.; Onat, S.; Avci, A.; Karabulut, Oe.We report the case of 44-year-old woman with a left-sided Bochdalek hernia (BH) with concomitant partial situs inversus. The patient was presented from the outpatient clinic with lower chest discomfort. She had suffered from abdominal pain for one year, with no history of trauma, previous surgery, or extreme physical exertion. Chest radiograph revealed a large left-sided BH. The patient underwent thoracotomy. Intestinal organs, containing bowel, small intestine, caecum, and appendix were seen in the left hemithorax. Because of the failure to reduce the intestinal organs into the peritoneal cavity, laparotomy was performed. The right side of the abdominal cavity was empty. In conclusion, partial situs inversus was diagnosed. The diaphragmatic defect was repaired with non-absorbable sutures via laparotomy, and with a prolene mesh via thoracotomy. Bochdalek hernia with partial situs inversus is a rare clinical entity with none reported in medical literature. (Folia Morphol 2010; 69, 2: 119-122)Öğe Evaluation of primary and recurrent colorectal cancer patients with Tc99m IMMU-4(Fab' fragment) radioimmunoscintigraphy(Springer, 2008) Ar, S.; Kaya, H.; Girgin, S.; Altunci, G. Kaya; Gedik, E.[Abstract Not Available]Öğe Factors affecting morbidity and mortality in gangrenous cholecystitis(Acta Medical Belgica, 2006) Girgin, S.; Gedik, E.; Tacyildiz, I. H.; Akguen, Y.; Bac, B.; Uysal, E.Introduction : Gangrenous cholecystitis is a serious complication of acute cholecystitis. Male gender, older age, leukocytosis, cardio-vascular diseases and diabetes were reported as factors that increase the risk of gangrenous cholecystitis. The aim our study was to determine variables affecting morbidity and mortality as well as to define the independent risk factors in Gangrenous Cholecystitis. Methods : Fifty three patients who had been treated for Gangrenous Cholecystitis were reviewed. The variables are defined as follows : age, gender, systemic diseases, Mannheim Peritonitis index, aspartate aminotransferase, alanine aminotransferase, white blood cell count and type of surgery. In order to determine the independent risk factors that might affect morbidity and mortality in Gangrenous Cholecystitis, we made use of multivariate logistic regression analysis. Results : The independent risk factors affecting on morbidity were age (P = 0.037), existing systemic disease (P 0.047) and >= 29 Mannheim Peritonitis index (P = 0.008), and the independent risk factors affecting on mortality were age (P = 0.046), white blood cell count (P = 0.035). Pre-operative and post-operative third day aspartate aminotransferase and alanine aminotransferase average values were compared, there was a significant difference (P < 0.0001, P < 0.0001 respectively). Conclusions : We found that older age, >= 29 Mannheim Peritonitis index and existence of systemic diseases were independent risk factors affecting morbidity. Older age and lower of white blood cell count were independent risk factors affecting mortality. We believe that further comprehensive studies, involving prospective, multi-center and a large number of patients, are needed.Öğe Gunshot injuries of the ureter: One center 15-years experience(Elsevier Science Bv, 2007) Akay, A. F.; Girgin, S.; Akay, H.; Sahin, H.; Bircan, K.[Abstract Not Available]Öğe Gunshot injuries of the ureter: One centre's 15-year experience(Acta Medical Belgica, 2006) Akay, A. F.; Girgin, S.; Akay, H.; Sahin, H.; Bircan, M. K.Purpose : Ureteral injury is a rare condition. It is difficult to identify the best diagnostic methods and treatment. We report our experience with penetrating ureteral injuries secondary to gunshot wounds. The methods of diagnosis and treatment options of these cases are described and discussed. Materials and Methods : A retrospective review of ureteral injuries due to penetrating trauma between January 1990 and December 2005, in the Urology and General Surgery departments of our hospital. Ureteral injures were graded according to the AAST-OIS. We evaluated mechanism of injury, initial urinalysis, radiologic and operative procedure, associated injuries, and postoperative complications. Results : A total of twenty-one (sixteen male, five female) cases of gunshot ureteral injuries were evaluated retrospectively. The median patient age was 27.85 years (16-48 years). All patients had signs and symptoms of an acute abdomen and only nine patients were evaluated radiologically. Haematuria was absent in 71.4% of patients (15 of 21). All patients had associated injuries and were evaluated from grade I to V. Grade I had none, grade II had 1 (4.76%), grade III had 3 (14.29%), grade IV had 14 (66.6%), grade V had 3 (14.29%). Ureteral stent or nephrostomy tubes were used in all primarily repaired patients. Two patients developed urinary leakage, which resolved spontaneously. Conclusions : Ureteral injury should always be borne in mind and, when suspected, the surgeon should dissect and visualize the ureter during exploration. Adequate debridment, and ureteral stenting or nephrostomy drainage are good techniques for successful treatment.Öğe The Independent Risk Factors of Mortality and Morbidity from upper Gastrointestinal System Haemorrhages after Surgery(Acta Medical Belgica, 2009) Kafadar, T.; Gedik, E.; Girgin, S.; Tacyildiz, I. H.; Bac, B.Background : The aim this study was to determine the variables influencing the morbidity and mortality of operated patients with upper gastrointestinal haemorrhage (UGIH) and to define the independent risk factors. Patients and methods : The medical records of 62 patients with upper gastrointestinal haemorrhage who underwent operation were reviewed for variables including age, gender, shock, association with co-morbidity, pulse rate, haemoglobin levels, white blood cell count. serum urea, creatinine, sodium and potassium level. time of operation, blood transfusion unit, Rock all risk score and the length of hospital stay. In order to determine the independent risk factors related to mortality and morbidity, we carried out logistic regression analysis. Results : Morbidity and mortality rates were 35.4% (22 patients) and 29 1% (18 patients), respectively. The independent risk factors affecting morbidity were. serum albumin level and Rockall score >= 5. and the independent risk factors affecting mortality were advanced age. and high Rockall score. Conclusion : To decrease the postoperative morbidity and mortality rates in patients with UGIH requiring surgery, their pre-operative risk factors should be demonstrated. We believe that the establishment of interventional indication on time and the evaluation of the intra-operative surgical region and technique in combination with the patient- and disease-related factors would help reduce morbidity and mortality rates.Öğe N-Acetylcysteine Prevents Deleterious Effects of Ischemia/Reperfusion Injury on Healing of Colonic Anastomosis in Rats(Karger, 2009) Kabali, B.; Girgin, S.; Gedik, E.; Ozturk, H.; Kale, E.; Buyukbayram, H.This study was designed to determine the effects of intraperitoneally or orally administered N-acetylcysteine (NAC) on wound healing following resection and anastomosis of a colon segment with ischemia/reperfusion injury. Forty female Spraque-Dawley rats were randomly allocated to one of four groups containing 10 rats each: (1) normal resection plus anastomosis; (2) ischemia/reperfusion plus resection plus anastomosis; (3) ischemia/reperfusion plus resection plus anastomosis plus intraperitoneal NAC; (4) ischemia/reperfusion plus resection plus anastomosis plus oral NAC. Group comparison showed that the anastomosis bursting pressure was significantly higher in group 3 than in the other groups. The mean tissue hydroxyproline concentration in the anastomotic tissue was significantly lower in group 2 than in the other groups. The collagen deposition was significantly increased on day 7 in groups 3 and 4 compared to the other groups. In conclusion, this study demonstrates that NAC significantly prevents the effects of reperfusion injury on colonic anastomoses in a rat model. Copyright (C) 2009 S. Karger AG, BaselÖğe Our Clinical Outcome: Patients With Benign Hematological Disease(Emergency Medicine Physicians Assoc Turkey, 2008) Girgin, S.; Gedik, E.; Bac, B.; Tacyildiz, H. I.Background: Surgical diseases of the spleen are most hematological diseases especially in patients with a severe refractory medical treatment. In this tstudy, we assessed our clinical experience patients with benign hematological disease clinical outcome of the disease processes requiring splenectomy. Materials-Methods: A retrospective review of the 115 patients who had undergone splenectomy for hematological diseases was reveiwed. Age, gender, type of hematolojik disease, presence of accessory spleens and location, duration operation, Number of unit blood transfusion, length of hospital stay, long-term outcomes, morbidity and mortality were evaluated. Results: The mean age was 41.08 +/- 17.90 and, there were 67.8% female patients and 32.2% male patients. The most benign hematological disease which requiring splenectomy was idiopatic thrombocytopenic purpura (56.6%). The accessory spleens were encountered 26% patients during opration, and in six patients, who operated for anemia, were underwent cholesystectomy. Complicatoin was occured 9.56% and the most complication was atelectasia. A patient was dieded from postsplenectomic sepsis. Conclusion: Investigation of accessory spleens would not be missed to prevent the recurrences and in these patients anticoagulan profilaxy never be forgotten besides vaccination, and antibiotic profilaxyÖğe Retroperitoneal schwannoma(Oxford Univ Press, 2011) Kapan, M.; Onder, A.; Gumu, M.; Gumu, H.; Girgin, S.Retroperitoneal schwannomas are rare tumors and a correct pre-operative diagnosis is often not possible. They are usually identified incidentally via cross-sectional imaging. Diagnosis is based on histopathologic examination and immunohistochemistry. A 57-year-old man with a retroperitoneal schwannoma, as an unusual localisation, is presented.Öğe Risk factors affecting morbidity in typhoid enteric perforation(Springer, 2008) Gedik, E.; Girgin, S.; Tacyildiz, I. H.; Akgun, Y.Introduction Typhoid enteric perforation is a cause of high morbidity and mortality. This study aim is to determine the factors affecting morbidity in patients with typhoid enteric perforation. Materials and methods Ninety-six patients with typhoid enteric perforation were reviewed. The variables are defined as follows: Age, gender, complaints, perforation-operation interval, typhoid fever treatment before the perforation or not, white blood cell (WBC) count, hemoglobin level (Hgb), intraoperative peritonitis intensity, the number of perforations, and type of surgery were examined. To determine the independent risk factors that might affect morbidity in typhoid enteric perforation, we made use of multivariate logistic regression analysis. Results Nine variables were applied the univariate analysis, which were greater than 30 years (P = 0.218), male gender (P = 0.02), preoperative treatment (P = 0.147), less than or equal to 48 h perforation-operation interval (P = 0.013), greater than 4,000 K/UL WBC (P = 0.388), less than 8 g/dL Hgb (P = 0.026), greater than 29 Mannheim Peritonitis Index (P < 0.0001), multiple perforation number (P = 0.614), and primary repair (P = 0.105). Logistic regression analysis showed that Mannheim Peritonitis Index (P = 0.014) and perforation-operation interval (P = 0.047) were defined as independent risk factors affecting morbidity. Conclusions If liquid electrolyte, blood, antibiotics, and parenteral nutrition are applied in typhoid enteric perforation cases adequately, then severe peritonitis becomes an independent risk factor that affects morbidity. Early diagnosis and appropriate surgery type would decrease morbidity and mortality.Öğe Surgical management of pyogenic liver abscess(Verduci Publisher, 2011) Onder, A.; Kapan, M.; Boyuk, A.; Gumus, M.; Tekbas, G.; Girgin, S.; Tacyildiz, I. H.Background and Aim: Although Pyogenic Liver Abscess (PLA) has lower mortality rate in recent years due to the broad spectrum antibiotic usage, developed imaging techniques and improved intensive care services, it is still a potentially fatal disease. The objective of this study is to examine the treatment methods and our case load with the current literature. Materials and Methods: Of 55 patients with PLA, between January 2000 and December 2009, records of 28 who received surgical drainage treatment have retrospectively been analysed. Results: Nineteen (67.9%) of the patients were male, while 9 (32.1%) were female. Average age was 41.07 (15-76). Seven (25%) had associated disease. The most common symptoms were fever and abdominal pain. Twenty three (82.1%) patients had single and 5 (17.9%) had multiple cavitary lesion. Nineteen (67.9%) patients had abscess on the right and 7 (25%) had on the left one, while 2 (7.1%) had on both lobes. All were treated surgically, because of 11 (39.3%) inappropriate localization for percutaneous treatment, 6 (21.5%) insufficient percutaneous drainage, 6 (21.5%) intraabdominal free rupture and 5 (17.7%) multiple cavitary lesion. We observed 5 pulmonary complications, 5 wound infections and 2 perihepatic collections. The average hospital stay was 11.2 days. We observed only two deaths (7.1%). Conclusions: Surgical treatment is the sole option for the patients with PLA who; (a) can't be treated by percutaneous drainage or had an unsuccessful one, (b) have multiple abscess cavity, (c) are thought to have perforated abscess, (d) have additional abdominal pathology requiring laparatomy.Öğe An unusual bilateral mastitis in a postmenopausal woman caused by brucellosis(Acta Medical Belgica, 2007) Akay, H.; Girgin, S.; Ozmen, C. A.; Kilic, L.; Sakarya, H.Breast involvement of brucella can be frequently detected in animals, however, it is extremely rare in humans : Clinical findings and complications may cause difficulties in diagnosis. We report the case of a 52-year old woman with bilateral brucella mastitis, which is difficult to differentiate from inflammatory breast carcinoma.
