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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 Complications of Meckel's diverticulum in adults(Ortadogu Ad Pres & Publ Co, 2007) Korkmaz, Oezguer; Yilmaz, H. Guelsen; Keles, CelalettinObjective: Meckel's diverticulum is the most common congenital anomaly of the small intestine, with an estimated incidence of approximately 1-3% in the general population. We present Our experience over the past 20 years with this condition, unusual in the adult population. Material and Methods: From 1986 to 2006 at the Dicle University, Medical Faculty, General Surgery Department, Meckel's diverticulum were removed from 30 patients older than 16 years of age. We reviewed the age, sex, indication for removal, diagnosis techniques, pathological findings, postoperative complications, and hospitalization periods in those cases. Results: Fourteen of the patients were male and 16 were women. The mean age was 29.7 +/- 12.2 years. The complications of the Meckel's diveiticulitis were diverticulitis in 16 patients (53.3%), intestinal obstruction in 13 patients (43.3%), and lower gastrointestinal bleeding in I case (3.3%). The mean diverticle length was 2.98 +/- 0.7 cm. In 19 cases Wedge resection-primary Suturing was performed. Eleven cases underwent intestinal resection; anastomosis was performed in 10 of them, whereas in a case colostomy was created. One case presented with ectopic gastric mucosa. General morbidity rate was 16.7% and the mortality rate was 3.3%. Conclusion: The complication rates for Meckel's diverticulum were comparable for both genders in this study, although data from other reports suggest the reverse. Furthermore, the rate of lower gastrointestinal tract bleeding was also lower than in the literature. Since prompt diagnosis before the operation is difficult and decision for surgery is delayed serious problems may be encountered. Although Meckel's diverticulum is a rare condition, it should be considered in the diagnosis of patients presenting with ileus, acute abdomen or lower gastrointestinal tract bleeding. Thus, early diagnosis and treatment may prevent the development of postoperative complications.Öğe The evaluation of 250 patients with thoracoabdominal injuries(Turkish Assoc Trauma Emergency Surgery, 2008) Ciftci, Fatih; Girgin, Sadullah; Gedik, Ercan; Onat, Serdar; Tacyildiz, Ibrahim Halil; Keles, CelalettinBACKGROUND Prognostic factors affecting mortality and morbidity in thoracoabdominal injuries were evaluated. METHODS Two hundred and fifty patients (227 males, 23 females; mean age 30.1 +/- 5.11; range 15 to 71 years) who had been exposed to thoracoabdominal injuries and underwent laparotomy between June 1996 and November 2005 were investigated retrospectively. Patients were assessed according to age, sex, trauma-operation interval, shock, hospitalization period, number of injured organs, blood transfusion, timing of closed thorax drainage, thoracotomy, Abdominal Trauma Index, Injury Severity Score, Abbreviated Injury Score, Revised Trauma Score, and complications. RESULTS Mortality and morbidity ratios were 15.6% and 53.5%, respectively. The factors effective on mortality were trauma-operation interval >= 3 hours (p=0.03), presence of shock (p=0.03), increase in the rate of blood transfusion (p=0.001), injured organ number >= 3 (p=0.001), and not performing early-term closed thorax drainage (p=0.005). Trauma-operation interval <3 (p=0.02), increase in the rate of blood transfusion (p=0.02), injured organ number >= 3 (p=0.001), and not performing early-term closed thorax drainage (p=0.005) were the factors effective on morbidity. CONCLUSION It was determined that trauma-operation period >= 3 hours, number of injured organs >= 3, and increased number of blood transfusions increased both mortality and morbidity. However, presence of shock increased only mortality. On the other hand, application of closed thorax drainage within a reasonable time period was determined to decrease mortality and morbidity.Öğe Non-traumatic splenic rupture: Report of seven cases and review of the literature(Baishideng Publishing Group Inc, 2008) Gedik, Ercan; Girgin, Sadullah; Aldemir, Mustafa; Keles, Celalettin; Tuncer, Mehmet Cudi; Aktas, AyferAIM: To evaluate seven patients with non-traumatic splenic rupture (NSR). NSR is an uncommon dramatic abdominal emergency that requires immediate diagnosis and prompt surgical treatment to ensure the patient's survival. METHODS: Within 11 years, seven cases were evaluated for patient characteristics, anamnesis and symptoms, method of diagnosis, findings of laparotomy, and etiology of NSR. RESULTS: There were six (86%) male and one female (14%) patient, whose mean age was 36 +/- 12.8 (17-56) years. We report here four cases of Plasmodium vivax malaria (cases I -IV), one case of hemodialysis (case V), one case of spontaneous splenic rupture (case VI), and one case of hairy cell leukemia (case VU). Splenectomy was performed in all patients. All of them made an uneventful recovery and were discharged in stable condition. CONCLUSION: NSR is a rare entity that needs a high index of suspicion for diagnosis. Using ultrasonography or computer tomography, and peritoneal aspiration of fresh blood may assist in the diagnosis of NSR. Increased awareness of NSR can enhance early diagnosis and effective treatment. (C) 2008 The WJG Press. All rights reserved.
