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Öğe Akut biliyer pankreatitli hastalarda erken laparoskopik kolesistektomi sonuçları(2010) Kapan, Murat; Yağmur, Yusuf; Önder, Akın; Beyazıt, Ünal; Gümüş, MetehanAmaç: Akut biliyer pankreatit (ABP) tedavisinde erken dönemde yapışıklıklar ve diseksiyon güçlüğü nedeniyle laparoskopik kolesistektomi (LK) uygulaması tartışmalıdır. Bu çalışmanın amacı, ABP tanısı ile kliniğimizde yatırılan ve taburcu edilmeden önce LK yapılan 43 hastanın sonuçlarını değerlendirmektir. Yöntemler: Eylül 2006 – Mart 2009 tarihleri arasında ABP tanısıyla tedavi edilen, klinik ve laboratuar bulguları düzeldikten sonra LK uygulanan 43 hasta geriye dönük olarak incelendi. Hastaların yaş, cinsiyet, laboratuar bulguları, ultrasonografi (USG), manyetik rezonans kolanjiyopankreotografi (MRKP) ve endoskopik retrograd-kolanjiyopankreotografi (ERKP) sonuçları, yapılan ameliyat, ameliyat süreleri, açık ameliyata geçme oranları, gelişen komplikasyonlar, mortalite ve hastanede yatış süreleri kaydedilerek istatistiksel analiz uygulandı. Bulgular: Hastaların ortanca yaşı 51.8 (20-83) yıl olup; 29'u (%67.4) kadın, 14'ü (%32.6) erkekti. Hastaların tamamında akut pankreatit nedeni safra taşlarıydı. Ek olarak bir hastada hiperparatiroidi, diğer birinde hiperlipidemi mevcuttu. Hastaların tamamında USG’de safra kesesinde taş saptanmıştı. İntrahepatik safra yolları ve koledokta genişleme saptanan 7 hastaya yapılan MRKP’de koledokta taş tespit edildi. Bu hastalardan 3’ünde klinik ve laboratuar bulgularında düzelme sağlanamaması nedeniyle ERKP ile sfinkterotomi ve taş ekstraksiyonu yapıldı. Hastalarımıza ortalama 11.4’üncü günde (3.–23. günlerde) operasyon uygulandı. Toplam olarak 39 (%90.6) hastaya LK uygulanırken, 4 (%9.4) hastada enfeksiyona sekonder intraabdominal yapışıklıklar ve diseksiyon güçlüğü nedeniyle açık ameliyata geçildi. Ortalama ameliyat süresi 70 (25-160) dakika olarak bulundu. Postoperatif ortalama yatış süresi 3 (1-6) gündü. LK uygulanan ve operasyon öncesi ERKP yapılan bir hastada (%2.3) komplikasyon gelişti. Bu hastada, postoperatif 3. gün nekrotizan pankreatit gelişmesi üzerine ikinci operasyona alınarak drenaj uygulandı. Erişkin tip solunum sıkıntısı sendromu gelişen bu hasta postoperatif 7. günde kaybedildi.Sonuç: Klinik ve laboratuar olarak iyileşen ABP'li hastalarda, ilk yatışta uygulanan geç LK güvenli bir cerrahi tedavi seçeneği olabilir.Öğe Akut biliyer pankreatitli olgularda erken ve geç laparoskopik kolesistektominin yeri(2011) Kapan, Murat; Önder, Akın; Arıkanoğlu, Zülfü; Taşkesen, Fatih; Böyük, Abdullah; Beyazıt, Ünal; Keleş, CelalettinAmaç: Akut biliyer pankreatitli hastalarda erken ve geç laparoskopik kolesistektomi sonuçlarını karşılaştırarak, mortalite ve morbidite üzerine olan etkisini araştırmayı amaçladık. Hastalar ve Yöntem: Anabilim Dalı'nda Ocak 2005 – Eylül 2010 tarihleri arasında şiddetli olmayan Akut biliyer pankreatit tanısı alan ve tedavisi için laparoskopik kolesistektomi uygulanan toplam 108 hasta çalışmaya alındı. Hastaların demografik özellikleri, yapılan ameliyat türü, ameliyat süreleri, açık ameliyata geçme oranları, komplikasyonlar, mortalite ve hastanede yatış süreleri kaydedildi. Bulgular: Toplam 108 hastanın 46'sı Grup A'da, 62'si Grup B'de idi. Grupların kadın erkek oranları Grup A'da % 76.1/ % 23.9 iken, Grup B'de % 71.0/ % 29.0 idi. Grup A'daki 43 (%93.5) hastaya başarılı şekilde laparoskopik kolesistektomi gerçekleştirilirken, 3 (%6.5) hastada açık ameliyata geçildi. Grup B'de 58 (%93.6) hastaya başarılı şekilde laparoskopik kolesistektomi uygulanırken, 4 (%6.4) hastada açık ameliyata geçildi. Ameliyat süreleri Grup A'da ortalama 70.5 dakika, Grup B'de ise ortalama 68.6 dakika idi. Ameliyat sonrası hastanede yatış süreleri Grup A'da ortalama 2.8 gün, Grup B'de ortalama 3.0 gündü. Sonuç: Verilerimize göre hafif ve orta şiddetteki pankreatitte erken laparoskopik kolesistektomi, açık ameliyata geçme oranlarını ve safra yolu komplikasyonlarını artırmamaktadır. Buna karşılık geç laparoskopik kolesistektomi'de tekrarlayan pankretit atakları gecikme süresiyle korele olarak artmaktadır. Bu yüzden hafif ve orta şiddetli biliyer pankreatitte tekrarlayan pankreatit ataklarınının morbidite ve mortalitesinden hastaları korumak için erken laparoskopik kolesistektomi önermekteyiz.Öğe Anterior chest wall musculoskeletal tuberculosis(2010) Kapan, Murat; Önder, Akın; Keleş, Ayşe Nur; Tekin, Alicem; Arıkanoğlu, ZülfüKas-iskelet tüberkülozları, tüm tüberküloz vakalarının %1-3’ünü oluştururlar ve bunlardan yalnızca %1-5’i toraks ön duvarında yerleşir. Toraks ön duvarında en sık tutulan yapılar ise sternum kenarı ve kosta gövdesidir. Bilgisayarlı tomografi lezyonların tanımlanmasında ve genişliğinin belirlenmesinde etkilidir. Eğer yüksek klinik şüphe varsa uygun histopatolojik ve mikrobiyolojik örnekler alındıktan sonra, derhal cerrahi eksizyon yapılmalı ve antitüberküloz ilaç tedavisi başlanmalıdır. Bu yazımızda, toraks ön duvarında tüberküloz tanısı alan 49 yaşında kadın hastanın güncel literatür eşliğinde irdelenmesi amaçlanmıştır. Klin Den Ar Derg 2010; 1(2): 122-124Öğe Apendektomi sonrası akut güdük apandisit(2010) Kapan, Murat; Gümüş, Metehan; Tekbaş, Güven; Böyük, Abdullah; Önder, AkınGüdük apandisit, apendektomi sonrası geride kalan apandiks dokusunun enflamasyonu ile karakterize nadir görülen bir durumdur. Apendektomi hikayesinin olması tanıda şüphelenmeyi azaltır ve morbiditeyi artırır. Önceden apendektomi geçirmiş sağ alt kadran ağrısı ve peritonit bulguları ile başvuran hastalarda güdük apandisit olabileceği akılda tutulmalıdır. Bu yazıda kliniğimize akut karın ile başvuran güdük apandisitli iki olgu sunuldu.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 Are abdominal pain and distention symptoms of breast cancer?(2012) Kapan, Murat; Önder, Akın; Arıkanoğlu, Zülfü; Girgin, Sadullah; Fırat, Uğur; Küçüköner, MehmetMeme kanseri genellikle kemik, akciğer, karaciğer ve santral sinir sistemine metastaz yapar. İzole peritoneal meme kanseri metastazı oldukça nadir görülür. Kliniğimize karınağrısı şikayeti ile baş vuran hastanın sistemik muayenesinde, abdominal distanssiyon, asit ve memede kitle tespit edildi. Memeden alınan bşyopsi invazif duktal karsinom ve laparoskopik peritoneal biyopsi sonucu ise meme kanseri metastazı olarak değerlendirildi. palyatif kemoteripi plannanan hasta tedaviyi kabul etmedi. Altı ay takip edilen hastada başka bir metastaz gelişmedi.Öğe Are Breast Masses in Teenagers Always Benign? Undifferentiated Mesenchymal Sarcoma in a 14-Year-Old Girl(Karger, 2012) Tekbas, Guven; Ince, Tulay; Kapan, Murat; Ekici, Faysal; Onder, Akin; Kucukonen, Mehmet; Bilici, AslanBackground: This article is concerned with the evaluation of an adolescent breast mass using imaging methods. Case Report: A 14-year-old girl presented with progressive asymmetric enlargement of the left breast. She had felt a breast lump about 4 months earlier, and over the last 2 months it had been growing progressively. Tumor markers, including AFP, CEA, CA15-3, and CA125, were all normal. Ultrasonography showed a hypoechoic-hyperechoic, solid mass. Magnetic resonance imaging of the breast revealed a well marginated mass with hypointensity on T1-weighted images and mild hyperintensity on T2-weighted images, which showed mild contrast uptake. Biopsy revealed an undifferentiated malignant mesenchymal sarcoma. The patient underwent mastectomy with axillary lymph node sampling. After the operation, she received 3 cycles of chemotherapy and radiotherapy. Conclusion: Due to the rarity of breast sarcoma and inadequate imaging methods to establish an exact diagnosis, radiologists and clinicians may misdiagnose and merely follow these tumors. As in our case, the histology of the patient may be the leading factor in the management of these tumors. Even in very young patients, progressively growing breast masses should alert the clinician to check for malignancy verified by biopsy.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 Atypical Trajectory of a Thoracoabdominal Gunshot Injury without Penetration(Romanian Legal Med Soc, 2010) Gumus, Metehan; BoyuK, Abdullah; Gumus, Hatice; Kapan, Murat; Onder, AkinAtypical trajectories of gunshot injuries are a major problem in forensic pathology. Thoracoabdominal gunshot injuries represent some of the most challenging injuries. A 25 years-old man applied to emergency department in consequence of multiple gunshot wounds. Thoracoabdominal helical computed tomography (CT) no injury at the intrabdominal and intrathoracic tissues. There was only a subcutenous tissue laceration of 50 cm in length, through from thoracic to abdominal walls. The patient medically managed and no surgical intervention was performed due to thoracoabdominal injury. In conclusion a trajectory of gunshot may not always be straight as is in our case. Helical CT is a useful tool in determining the real trajectory and therefore reduces the ratio of unnecessary surgical interventions.Öğe Bacterial translocation and inflammatory alterations in an experimental intestinal obstruction model in splenectomized rats(Aves, 2012) Sirca, Tarik; Onder, Akin; Kapan, Murat; Tekin, Recep; Firat, Ugur; Evliyaoglu, Osman; Taskesen, FatihPurpose: Intestinal obstruction leads to an increase in the secretion of pro-inflammatory and inflammatory cytokines, oxidative injury, mucosal barrier dysfunction and bacterial translocation with the deterioration of normal ecological balance. Mitogenic activity resulting from splenectomy is reported to influence the development of bacterial translocation as a result of an increase in the proliferation of T cells and a decrease in the levels of serum tufsin. In this study, we aimed to investigate the effect of splenectomy on bacterial translocation and inflammatory response alterations resulting from the intestinal obstruction in rats. Materials and Methods: Twenty-four rats were divided into 3 groups as follows: Group 1 (Sham), only the ileocecal junction dissection; Group 2 (intestinal obstruction), complete ileal ligation; Group 3 (Splenectomy + intestinal obstruction), splenectomy following complete ileal ligation. 24 hours after the initial laparotomy, rats were sacrificed with the reception of intra-cardiac blood. Peritoneal swap, mesenteric lymph node, liver and ileal specimens, taken in sterile conditions, were examined microbiologically, biochemically and histopathologically. Results: Intestinal obstruction resulted in a significant increase in bacterial translocation, oxidative stress, inflammation, and ileal mucosal injury (p<0.05). No significant difference occurred between the splenectomized and non-splenectomized rats. Similar asimetric dimethylarginine levels were observed in all groups (p>0.05). Conclusions: It was proven that splenectomy has no significant effect on the bacterial translocation and inflammation in experimental intestinal obstruction models in rats.Öğe Breast Tuberculosis in Southeast Turkey: Report of 27 Cases(Karger, 2010) Tanrikulu, Abdullah C.; Abakay, Abdurrahman; Abakay, Ozlem; Kapan, MuratBackground: Breast tuberculosis (TB) is a very rare form of TB. Case series on breast TB are scarce. Patients and Methods: The patients with breast TB treated between 2004 and 2008 at our hospital were retrospectively investigated. Results: All patients were female (mean age 31.5 +/- 8.4 years). All but 1 patient were new cases. Patients presented with swelling of the breast (48.1%), mass and fluctuation (each, 40.7%), and breast pain (18.5%). The mean treatment duration was significantly shorter in 14 patients who received directly observed therapy (DOT) compared with those (n = 12) who did not (6.7 +/- 1.7 months vs. 8.5 +/- 1.6 months, respectively; p = 0.01). Seven patients underwent segmental mastektomy as complementary surgery. The highest rate of breast TB was seen in 2007 (37.1% compared with 14.8% between 2004 and 2006). Conclusions: Breast TB should be considered in patients with breast neoplasia, swelling, and discharge, and can be successfully treated by DOT with shorter treatment duration.Öğe Cerrahi tedavi uygulanan varis-dışı ve malignite-dışı üst gastrointestinal sistem kanamalarında mortaliteyi etkileyen faktörler(Turkish Surgical Society, 2011) Önder, Akın; Kapan, Murat; Taşkesen, Fatih; Aliosmanoğlu, İbrahim; Arıkanoğlu, Zülfü; Gül, Mesut; Başol, Ömer; Aldemir, MustafaÖz:Giriş: Tedavi yöntemlerindeki ilerlemelere rağmen, üst gastrointestinal kanamaları hala ciddi bir sorundur. Bu çalışmada, endoskopik olarak durdurulamayan varis ve malignite dışı üst gastrointestinal sistem kanaması nedeniyle cerrahi uygulanan hastalarda mortaliteyi etkileyen risk faktörlerini araştırmayı amaçladık. Hastalar ve Yöntem: 1997–2010 yılları arasında endoskopik olarak durdurulamayan üst gastrointestinal sistem kanaması nedeniyle cerrahi uygulanan 74 hasta retrospektif olarak incelendi. Varis ve maligniteye bağlı kanamalar dışlandı. Bulgular: Hastaların 61'i (%82.4) erkek, 13'ü (%17.6) kadın olup, yaş ortalaması 51.8 yıldı. Başvuruda en sık şikayet melenaydı (%50). Hastaların 19'unda (%27.4) görülen kardiyovasküler hastalıklar en sık gözlenen yandaş hastalıktı. Şok bulguları 48 (%64.9) hastada görüldü. Endoskopik olarak 34 (%51.5) hastada saptanan en sık kanama şekli Forrest 1a idi. 56 (%75.7) hastada duodenal ülser saptandı. En sık uygulanan cerrahi prosedür bilateral trunkal vagotomi ve piloroplasti ile birlikte gastroduodenali arter ligasyonuydu (%70.3). Morbidite oranı %24.3 olup, akciğer komplikasyonu en sık görüleniydi. On beş (%20.3) hastada mortalite görüldü. Rockall skoru <5 olan hastalarda mortalite gözlenmezken, diğerlerinde mortalite oranı %25.4 idi. İleri yaş, erkek cinsiyet, yandaş hastalık, şok, hemoglobin değerinin düşük olması, kan transfüzyonu, Rockall skorunun yüksek olması mortalite üzerine etkili risk faktörler iydi. Sonuç: Gastroenterolog ile cerrah arasında yakın işbirliği ve erken cerrahinin varis ve malignite dışı yüksek riskli üst gastrointestinal sistem kanamalarının tedavisinde faydalı olacağını düşünmekteyiz.Öğe Çocuk vericiden erişkine en bloc böbrek nakli: Olgu sunumu(2012) Kapan, Murat; Aliosmanoğlu, Çiğdem; Aliosmanoğlu, İbrahim; Hakseven, Musluh; Tekeş, Fırat; Gül, MesutBöbrek nakli son dönem böbrek yetmezliğinde en önemli tedavi seçeneklerinden biridir. Bekleme listelerinde- ki hasta sayısının artması nakil merkezlerinin marjinal donörleri kullanmasına itmiştir. En bloc böbrek nakli 1970’ten beri uygulanmasına rağmen, teknik komplikasyonlar, greft trombozu, hiperfiltrasyon hasarı kaygısı nedeniyle özellikle ülkemizde sınırlı kalmıştır. Bu çalışmadaki amacımız, özellikle ülkemizde çocuk vericiden erişkin alıcıya nadir olarak yapılan en bloc böbrek naklinin güncel tutulmasını sağlamaya çalışmaktır.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 Coexistence of Behcet’s disease and colonic diverticulitis: Is it causal or just a coincidence?(2013) Girgin, Sadullah; Kapan, Murat; Önder, Akın; Arıkanoğlu, Zülfü; Böyük, Abdullah; Taşkesen, Fatih; Gül, Mesut[Abstract Not Available]Öğe Comparing the effects of nebivolol and dexpanthenol on wound healing: an experimental study(Wiley, 2016) Ulger, Burak V.; Kapan, Murat; Uslukaya, Omer; Bozdag, Zubeyir; Turkoglu, Ahmet; Alabalik, Ulas; Onder, AkinWound healing is a dynamic, interactive process that is initiated in response to injury. A number of investigations and clinical studies have been performed to determine new approaches for the improvement ofwound healing. The aim of this studywas to compare the effects of dexpanthenol, a molecule that is widely used for improvingwound healing, and nebivolol, a molecule that increases nitric oxide release, on wound healing. A total of 30 rats were divided into three equal groups (n = 10). A linear 2 cm incision was made in the rats' skin. No treatment was administered in the first (control) group. Dexpanthenol cream was administered to the rats in the second group and 5% nebivolol cream was administered to the rats in the third group. The wound areas of all of the rats were measured on certain days. On the 21st day, all wounds were excised and histologically evaluated. The wound healing rates of the dexpanthenol and nebivolol groups were higher than those of the control group (P < 0.05). However, the wound healing rates of the dexpanthenol and nebivolol groups were not significantly different. Nebivolol and dexpanthenol have comparable effects on wound healing.Öğe Comparison of the early complications of total and subtotal thyroidectomy in the multinodular goitre(Aves, 2011) Durgun, Cemalettin; Boyuk, Abdullah; Girgin, Sadullah; Kapan, Murat; Onder, Akin; Gumus, Metehan; Tacyildiz, Ibrahim HalilPurpose: In the recent years, total thyroidectomy is increasingly being accepted in the surgical treatment of benign multinodular goitre due to the high rate of recurrence after bilateral subtotal thyroidectomy. The aim of this study is to compare early postoperative complications of total and bilateral subtotal thyroidectomy in benign multinodular goitre. Materials and Methods: In our study, the findings of 419 patients operated due to multinodular goitre between January 2005 - December 2009 in Dicle University Medical School Department of General Surgery were retrospectively evaluated. Patients were divided into two groups as total thyroidectomy and bilateral subtotal thyroidectomy. Results: The mean age of patients was 41.72 +/- 12.55. 329 (78.5%) patients were women and 90 (21.5%) were men. A total of 263 (62.8%) patients underwent total and 156 (37.2%) patients bilateral subtotal thyroidectomy. Six (2.3%) of total thyroidectomy patients and 3 (1.9%) of bilateral subtotal thyroidectomy patients had recurrent laryngeal nerve injury. Bilateral subtotal thyroidectomy group revealed no permanent damage whereas in total thyroidectomy group one (0.4%) patient did. Hypocalcemia was observed in 40 (15.2%) patients in the total thyroidectomy group and in 27 (17.3%) patients in the bilateral subtotal thyroidectomy group. One (0.4%) patient in total thyroidectomy group suffered from permanent hypocalcemia whereas it wasn't observed in bilateral subtotal thyroidectomy group. Haematoma occurred in 3 (1.9%) patients treated with bilateral subtotal thyroidectomy and in 3 (1.1%) treated with total thyroidectomy, wound infection occured in one (0.6%) patient subjected to bilateral subtotal thyroidectomy and 3 (1.1%) patients treated with total thyroidectomy. Conclusion: In conclusion, our study supports total thyroidectomy for multinodular goitre involving both lobes as a safe technique with low complication rate.Öğe A conservative approach to rectus sheath haematomas(Tıp Araştırmaları Derneği, 2011) Önder, Akın; Kapan, Murat; Gümüş, Metehan; Böyük, Abdullah; Tekbaş, Güven; Girgin, Sadullah; Taçyıldız, İbrahimAim: Rectus sheath haematoma (RSH) is the result of a rupture of epigastric vessels or rectus muscle occurring mostly in infraumblical region. Etiological factor is predominantly trauma and rarely spontaneous. Generally, misdiagnosed or delays in diagnosis result in unnecessary surgical intervention. Method: Between December 2008 and September 2009, five patients diagnosed for RSH in our hospital retrospectively analyzed in terms of the demographical characteristics, clinical and radiological findings and length of stay in hospital. Result: The average age of the patients was 67 (59-76) years and all were female. At least one of the patients had a systematic disease. All the patients were using anticoagulant and none of them had trauma story. On physical examination, we determined palpable masses loca ted as follows; in left lower quadrant of three patients, in right lower quadrant of one patient and in left upper quadrant of one patient. The types of RSH in radiological imaging were Type 1 in one patient, Type 2 in three patients and Type 3 in one patient. Anticoagulant treatments were stopped and all patients were treated conservatively. The average stay in hospital time of the patients was 8 days. The computed tomography control at the end of the first month revealed that the mass disappeared in cases with Type 1 RSH while the other four cases had a marked decrease in the mass size. Conclusion: RSH should be taken into consideration in differential diagnosis when elder patients - especially females - with anemia, palpable mass, anticoagulant medication history admitted to clinics with acute abdomen. Early diagnosis of RSH provides the preventing of the unnecessary surgical interventions and determines the success of conservative treatment.Öğe Cryptogenic hepatitis simulating cyst rupture and hydatid jaundice in a patient with preexisting asymptomatic hydatid cyst(Babol Univ Medical Sciences, 2017) Aday, Ulas; Kayaalp, Cuneyt; Kapan, MuratBackground: Rupture into the biliary ducts is the most frequent complication of hydatid liver disease. In endemic areas of Echinococcus granulosus, development of jaundice in a patient with liver cyst is initially suspected to have hydatid cyst. Case Presentation: A 48 year-old woman with history of asymptomatic hydatid liver cysts was admitted to the emergency department with right upper quadrant abdominal pain, increased levels of liver enzymes, bilirubin and alkaline phosphatase and the initial clinical diagnosis was the hydatid cyst rupture into the bile ducts. Surgery was planned but radiological evaluation (MRI) revealed non-dilated intra-extra biliary ducts. High suspicion of hydatid rupture required diagnostic ERCP that was normal and surgery was cancelled then. A possible diagnosis of coexistent hepatitis was suspected. Liver function tests normalized gradually and no cyst rupture was determined during surgery. Conclusion: These findings suggest considering the possible development of cryptogenic hepatitis in patients with preexisting hydatid cyst.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.
