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Öğe Acute biliary pancreatitis in cholecystectomised patients(Aves, 2012) Gul, Mesut; Aliosmanoglu, Ibrahim; Turkoglu, Ahmet; Ucmak, Feyzullah; Ulger, Burak Vel; Oguz, Abdullah; Uslukaya, OmerPurpose: This study aimed to investigate the treatments of patients with acute biliary pancreatitis after cholecystectomy. Materials and Methods: Twenty-two patients who were diagnosed with acute biliary pancreatitis and underwent cholecystectomy were analysed retrospectively. The patients' demographic characteristics, severity of disease, elapsed time since cholecystectomy, whether endoscopic retrograde cholangiopancreatography and endoscopic sphincterotomy were performed, surgical intervention, duration of hospital stay, and mortality were recorded. Results: The average age of the 22 patients was 60.14 +/- 16.4 (2186), and the female to male ratio was 14:8. The average elapsed time since cholecystectomy was 81.7 (6-240) months. In 18 patients, stones and mud were detected in the choledoch duct with endoscopic retrograde cholangiopancreatography, with no factors identified in 4 patients. While 14 of these 18 patients were treated successfully with stone extraction and endoscopic sphincterotomy, endoscopic retrograde cholangiopancreatography did not succeed in 4 patients. In 3 of 4 patients, in whom stones were detected but failed to be extracted, choledoch duct exploration was carried out with open surgery. Mortality developed in one patient. Average hospital stay, with the exception of the deceased patient, was 8.5 +/- 3.5 days. Conclusion: Some choledoch duct stones can remain asymptomatic for an extended period after cholecystectomy. However, some cause acute pancreatitis ending in mortality after several months or even years. Endoscopic retrograde cholangiopancreatography and endoscopic sphincterotomy are the standard methods of treatment. Patients in whom endoscopic retrograde cholangiopancreatography and endoscopic sphincterotomy have failed, can be treated with choledoch duct exploration with open surgery and laparoscopic surgery.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 Can Mean Platelet Volume be a New Risk Factor in Portal Venous Thrombosis?(Sage Publications Inc, 2013) Aliosmanoglu, Ibrahim; Gul, Mesut; Oguz, Abdullah; Basol, Omer; Uslukaya, Omer; Keles, CelalettinBackground: The aim of this study was to discuss the possibility of mean platelet volume (MPV) being a new risk factor in the etiology of portal venous thrombosis (PVT). Methods: Study participants were categorized into 2 different groups: group I, control group (n = 35) and group II, PVT group (n = 34). Demographic data and MPV values were recorded retrospectively. Results: No differences were determined between the 2 groups regarding hypertension, diabetes mellitus, and smoking (P > .05). The average hemoglobin levels were 10.8 +/- 2.1 in group II and 14.0 +/- 1.7 in group I (P < .001). Although the MPV levels of group II patients were 8.2 +/- 0.52, the average level in group I was determined as 7.8 +/- 0.62 (P = .012). In the performed receiver-operating characteristic (ROC) analysis, the cutoff value for patients with PVT for MPV was determined as 7.9 (area under curve: 0.674), sensitivity as 70.6%, and specificity as 65.7% (P = .013). Conclusion: The current study shows that MPV is significantly higher in patients with PVT than in the control group.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 Comparison of anti-reflux mechanism between Double-J-Stent and standart Double-J-Stent use for risk of BK nephropathy and urinary tract Infection in kidney transplantation(E-Century Publishing Corp, 2015) Ay, Nurettin; Bahadir, Mehmet Veysi; Anil, Melih; Alp, Vahhac; Kaya, Safak; Sevuk, Utkan; Gul, MesutObjectives: There are studies that show that double J stenting (DJS) increase BK nephropathy (BKN) 4 fold. DJS may cause vesicoureteral reflux (VUR) with normal bladder contraction. The aim of this study is to comparison risk of BKN, urinary tract infections (UTI) and postoperative urologic complications with the use DJS with anti-reflux device (ARD-DJS) and standart double J stent (St-DJS). Matherial and methods: Ninety patients (male/female: 50/40) that had undergone kidney transplantations in Diyarbakir Training and Research Hospital and Dicle University, Faculty of Medicine Hospital between January 2012 and April 2015 were enrolled in the study. Demographic data, immunosuppression protocols, presence of rejection, graft loss, postoperative urologic complications, UTI, plasma BK levels of the patients were evaluated retrospectively. Results: Median and IQR follow up time for ARD-DJS and St-DJS patients were 14 (12-18) months and 25 (16-30) months respectively. Five cases (5.5%) had BK viremia (P=0.025). All 5 cases with BK viremia were St-DJS users. Conclusion: As a result for postoperative UTI and postoperative urinary complication risk there were no statistically significant difference between ARD-DJS use and St-DJS use during ureteral anastomosis. BKN univariate analysis were significantly less than those st-DJS used. Risc factors were evaluated. But results were not statistically significant in the logistic regression analysis. We think that to demonstrate this benefit, we need randomized controlled studies with more patients and longer follow up.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 Effect of erythropoietin on liver regeneration in an experimental model of partial hepatectomy(Elsevier Science Bv, 2013) Gul, Mesut; Comert, Mustafa; Cakmak, Guldeniz Karadeniz; Kertis, Gurkan; Ugurbas, Ebru; Oner, Muzaffer OnderBackground and aim: The liver shows remarkable regeneration ability after damage or resection. The main stimulant for hepatic regeneration is resection. Erythropoietin (EPO), which was initially used for anemia therapy, is today known as a general tissue protector owing to its anti-inflammatory, antioxidant, anti-apoptotic, and angiogenic properties. This study aims to investigate the effect of systemically administered EPO on liver regeneration after partial hepatectomy. Methods: Forty-eight male Wistar albino rats were randomly split in two groups A and B consisting of 24 rats each. Standard 70% hepatectomy was performed on the rats in group A. The same surgical procedure was performed on the rats in group B, and they were additionally administered 3000 U/kg/subcutaneous EPO. The rats were sacrificed 24, 48, and 72 h after resection. The groups were compared in terms of biochemical, morphological, and histopathological parameters. Results: The biochemical results showed that the administration of EPO decreased aspartate aminotransferase levels significantly (p < 0.05) at 24 h after hepatectomy. A comparison of the groups in terms of relative liver weight showed that EPO-treated groups exhibited a statistically significant increase (p < 0.05) for all three time periods. Histopathology results showed that in the EPO-treated groups, the mitosis index at 48 and 72 h, double nuclei cell number at 72 h, and proliferating cell nuclear antigen ratio at 48 h showed a significant increase (p < 0.05). Conclusion: Our study showed that systemically administering high-dose EPO increases regeneration by affecting the biochemical, morphological, and histopathological parameters after liver resection. (C) 2012 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.Öğe Effect of Intraperitoneal Curcumin Instillation on Postoperative Peritoneal Adhesions(Karger, 2015) Turkoglu, Ahmet; Gul, Mesut; Yuksel, Hatice Kurt; Alabalik, Ulas; Ulger, Burak Veli; Uslukaya, Omer; Avci, YahyaObjective: The aim of this study was to determine the effect of curcumin on adhesion formation in a rat cecum abrasion model. Materials and Methods: Thirty Wistar rats were randomized into three groups; the control group received saline, the curcumin group received 10 mg/kg of curcumin after cecal abrasion, and in the sham group the abdominal wall was closed without any abrasion to the cecum. On day 15, adhesions were assessed blindly using a standardized scale, and histopathological samples were taken and examined. Results: There were no incisional hernias or wound dehiscences in any animals of the three groups. A comparison of adhesion scores showed a significant difference between the curcumin (median = 1) and the control group (median = 2; p < 0.05). The grade of inflammation of the curcumin (median = 1) and the sham (median = 0) group was significantly lower than that of the control group (median = 3; p < 0.01 and p < 0.001, respectively). Hydroxyproline levels were significantly lower in the sham (48.3 +/- 11.8 mu g/mg) and the curcumin (63.8 +/- 13.9 mu g/mg) group compared to the control group (85.7 +/- 22.1 mu g/mg; p < 0.05). Conclusion: These data suggest that curcumin, administered intraperitoneally, was effective in the prevention of peritoneal adhesion formation. (C) 2014 S. Karger AG, BaselÖğe The Effective Factors on Morbidity Due to Penetrating Small Intestine Injuries(Aves, 2012) Onder, Akin; Kapan, Murat; Basol, Omer; Boyuk, Abdullah; Gumus, Metehan; Gul, Mesut; Girgin, SadullahObjective: In this study, we aimed to investigate the effective factors on morbidity due to small intestine penetrating injuries. Material and Methods: Between January 2006 and December 2010, 114 patients who underwent surgery due to penetrating small intestine injuries were retrospectively reviewed. Results: The mean age was 32.8 +/- 12.3years (15-77), and there were 96 patients, (84.2%) male and 18 (15.8%) female patients. The most common etiologic cause was gun-shot injuries (66.7%).Fifty-one (44.7%) patients had isolated small intestine injuries and 63 (55.3%) had small intestine and additional organ injuries. Colon was the most common additional organ injured (66.7%) Most commonly, 68 (59.7%) patients underwent primary suture. T Postoperative morbidity occurred in 30 patients (25%) and the most common complication was wound infection. The morbidity was significantly higher in the patients with small intestine and additional organ injuries (p=0.006). The morbidity was higher in patients who exhibited signs of peritonitis (p=0.048) and had colonic injuries (p=0.002). The number of blood transfusions was effective in mortality (p<0.001). The mean length of hospital stay was 6.9 +/- 2.9 (1-21) days, significantly longer in the patients who developed morbidity (p=0.002). Seven (6.1%) patients died due to hemorrhage in 6 patients and anastomotic leakage in 1 patient. Conclusion: Small intestine injuries significantly increase the postoperative morbidiy when accompanied by additional intraabdominal organ injuries, especially the colon.Öğe THE EFFECTS OF ERYTHROPOIETIN ON BACTERIAL TRANSLOCATION AND INFLAMMATORY RESPONSE IN AN EXPERIMENTAL INTESTINAL OBSTRUCTION MODEL IN RATS(Soc Medical Biochemists Serbia, 2013) Kapan, Murat; Onder, Akin; Yuksel, Hatice; Evliyaoglu, Osman; Firat, Ugur; Tekin, Recep; Gul, MesutBackground: Intestinal obstruction results in distortion of balance of antiinflammatory cytokines and release of oxidants, and also leads to bacterial translocation, sepsis and multiple organ failure. Asymmetric dimethylarginine is related to multiple organ failure as a new prognostic marker. Erythropoietin reduces the inflammatory response by decreasing the levels of proinflammatory cytokines and cytokine-induced apoptosis. In this study, we aimed to investigate the effectiveness of erythropoietin in reducing the severity of bacterial translocation and inflammatory response after intestinal obstruction and the relation between asymmetric dimethylarginine and inflammatory markers. Methods: Forty Wistar albino rats (200-250 g) were divided into 4 groups as follows: Group 1 (Sham), only ileocaecal junction dissection; Group 2 (Erythropoietin), ileocaecal junction dissection and 3000 IU/kg erythropoietin subcutaneously; Group 3 (Intestinal Obstruction), complete ileal ligation; Group 4 (Intestinal Obstruction + Erythropoietin), complete ileal ligation and 3000 IU/kg erythropoietin subcutaneously. After 24 hours, 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, prevented the formation of inflammatory changes in the intestine, liver, spleen and mesenteric lymph nodes, and also significantly prevented the formation of intestinal damage after intestinal obstruction (p<0.05). Conclusions: Asymmetric dimethylarginine levels did not differ between the groups. Erythropoietin may be useful to preserve from intestinal injury and related sepsis in patients with intestinal obstruction. Asymmetric dimethylarginine is not a suitable prognostic marker.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 ANTIOXIDANT AND RENOPROTECTIVE EFFECTS OF ELLAGIC ACID ON ISCHEMIA/REPERFUSION INDUCED NEPHROPATHY IN RATS(Oxford Univ Press, 2014) Yildirim, Yas Ar; Aba, Ozlem; Yilmaz, Zulfukar; Kadiroglu, Ali Kemal; Yilmaz, Mehmet Emin; Gul, Mesut; Ketani, Aydin[Abstract Not Available]Öğe EVALUATION OF THE ANTIOXIDANT AND RENOPROTECTIVE EFFECTS OF ELLAGIC ACID ON ISCHEMIA/REPERFUSION INDUCED NEPHROPATHY IN RATS(Carbone Editore, 2014) Yildirimi, Yasar; Adiyaman, Ozlem Aba; Yilmaz, Zulfukar; Kadiroglu, Al Kemal; Yilmaz, Mehmet Emin; Gul, Mesut; Ketani, AydinAims: Renal ischemia-reperfusion (I/R) injury is one of the important cause of acute kidney injury (AKI). Reactive oxygen species and inflammatory cytokines play major role in the pathogenesis of IR injury. Ellagic acid (EA), a phenolic compound, have shown to exert antioxidants, anti-inflammatory, anticarcinogenic, antihyperlipidemic effects. We aim to evaluate, the effect of EA on renal I/R induced nephropathy in rats. Materials and methods: Twenty-eight male Sprague-Dawley rats were divided into four groups; control, control + EA, I/R, and EA+I/R. EA (85 mg/kg, perorally) was administered 30 min prior to the ischemia. Rats were unilaterally nephrectomized and subjected to 45 min of renal pedicle occlusion followed by 60 min of reperfusion. Both groups were subsequently studied by renal function tests, oxidant and antioxidant parameters, and kidney histology. Results: Serum/kidney TAC, NO and paraoxonase levels were significantly higher, while serum urea and creatinine, serum/kidney MDA and TOS were significantly lower in EA+I/R group compared to I/R group (p<0.05). Histopathologic examination revealed that the severity of damage was significantly lower in the EA+I/R group compared to the I/R alone group. Conclusion: Administration of EA appears to have beneficial effects on I/R induced renal injury by reducing oxidative stress, thus preventing histological injuries and bringing about an improvement in renal function.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 effecting mortality in abdominal major vascular injuries(Drunpp-Sarajevo, 2012) Gul, Mesut; Aliosmanoglu, Ibrahim; Oguz, Abdullah; Ulger, Burak Veli; Turkoglu, AhmetBackground and Aim: Despite recent advancements of medical facilities and improvements in surgical techniques, traumatic abdominal major vascular injuries still has high morbidity and mortality rates. Our objective in this study is to investigate the factors effecting mortality in patients who had surgery due to abdominal major vascular injury. Methods: Seventeen patients who had emergent surgery for abdominal major vascular injury were analyzed retrospectively. Age, gender, cause of injury, existence of additional organ injuries, vascular repair technique, blood replacement, mortality and duration of hospital stay are evaluated. Results: The study group consisted of 16 male and 1 female patients. Average age was 28.4 +/- 8.3. Cause of injury was firearms for 15 patients (88.2 %), cutter for 1 patient (5.9 %) and traffic accident in vehicle for 1 patient (5.9 %). Iliac veins, iliac arteries and vena cava inferior were the most injured vessels. Elapsed time between injury and operation was 140.0 +/- 18.2 minutes for patients who have died, 97.3 +/- 16.1 minutes for the other patients (p=0.003). For patients who had additional organ injury accompanying vessel injury, mortality rate was higher (p=0.028). Four patients have died (23,5 %). Conclusion: Successful surgical results in abdominal vascular injuries depend on well knowledge of abdominal vascular anatomy, experience in vascular repair techniques, less additional organ injury and surgical intervention without delay.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.Öğe Is Ostomy Still Mandatory in Rectal Injuries?(Int College Of Surgeons, 2013) Ulger, Burak Veli; Turkoglu, Ahmet; Oguz, Abdullah; Uslukaya, Omer; Aliosmanoglu, Ibrahim; Gul, MesutThe aim of this study was to compare the outcomes of the treatment methods of ostomy and primary repair in rectal injuries. A total of 63 patients with rectal injury who had been treated at Dicle University Hospital between 2000 and 2011 were retrospectively reviewed. To determine the outcomes of the treatment methods, the patients were divided into 2 groups (ostomy group: patients who underwent ostomy plus primary repair; repair group: patients who only underwent primary repair) and compared. The patients included 51 men and 12 women. A total of 44 patients underwent ostomy, whereas 19 patients underwent primary repair. No morbidity was detected in either group with grade II intraperitoneal rectal injury. The outcomes of the patients with grade II intraperitoneal and extraperitoneal rectal injury were similar. In the treatment of patients with low-grade rectal injuries, primary repair can be preferred to ostomy.
