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    ARE ABDOMINAL PAIN AND DISTENTION SYMPTOMS OF BREAST CANCER?
    (Aves, 2012) Girgin, Sadullah; Onder, Akin; Kapan, Murat; Firat, Ugur; Arikanoglu, Zulfu; Kucukoner, Mehmet
    Breast 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.
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    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, Aslan
    Background: 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.
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    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, Sadullah
    Aim: 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.
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    Atypical Trajectory of a Thoracoabdominal Gunshot Injury without Penetration
    (Romanian Legal Med Soc, 2010) Gumus, Metehan; BoyuK, Abdullah; Gumus, Hatice; Kapan, Murat; Onder, Akin
    Atypical 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.
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    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, Fatih
    Purpose: 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.
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    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]
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    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, Akin
    Wound 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.
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    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 Halil
    Purpose: 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.
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    An easily overlooked cause of mortality in trauma: rupture of diaphragm
    (Edizioni Luigi Pozzi, 2016) Taskesen, Fatih; Arikanoglu, Zulfu; Boyuk, Abdullah; Gumus, Metehan; Yasti, Ahmet Cinar; Onder, Akin; Kapan, Murat
    BACKGROUND: The purpose of our study was to share our experience in patients with traumatic diaphragmatic rupture. METHODS: Patients underwent surgery for traumatic diaphragm rupture between 2005 and 2010 were reviewed. RESULTS: There were sixty-two patients with traumatic diaphragm rupture. The mean age of the study group was 28.7 years (range 15-62 years). Diaphragmatic rupture was left sided in 43 patients (69%), right sided in 17 (28%) and bilateral in 2 (3%). Thoracotomy applied in 8 patients, laparotomy in 50, thoracoabdominal approach in 4. Mortality seen at 4 (64%) patients and hemorrhagic shock was the reason in two and pneumonia and sepsis in two. CONCLUSIONS: Diaphragm ruptures are inftegent injuries, however, are easily overlooked due to mask effect of accompaning visceral injuries, and it should be kept in mind at lower thoracic or upper abdominal traumas to prompt and proper management to lower the risk of mortality.
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    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, Sadullah
    Objective: 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.
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    Effects of Ellagic Acid on Copper, Zinc, and Biochemical Values in Serum and Liver of Experimental Cholestatic Rats
    (Humana Press Inc, 2011) Gumus, Metehan; Yuksel, Hatice; Evliyaoglu, Osman; Kapan, Murat; Boyuk, Abdullah; Onder, Akin; Aldemir, Mustafa
    Ellagic acid (EA) is a natural polyphenolic compound. Although, modulator effects of EA on copper (Cu) and zinc (Zn) levels in some liver diseases have been reported in experimental animals, its effects in obstructive jaundice (OJ) has not been clarified. We aimed to evaluate potential effects of EA on Cu and Zn levels in liver and serum of cholestatic rats. Forty Wistar albino rats were equally divided into four groups. First group was used as controls. Second group received EA (60 mg(-1) kg(-1) day(-1)) for 8 days. Third was OJ group, and fourth group was OJ plus EA group. After 8 days, blood and liver samples were obtained. Higher serum and liver Cu and lower serum and liver Zn levels were found in OJ group (p < 0.05) compared with other groups. However, these differences reached to significant levels for Cu in serum and for Zn in lever. Higher serum copper levels were decreased, and lower liver Zn levels were increased by EA treatment in cholestatic rats (p < 0.05). Also, higher Cu/Zn ratio in OJ group was decreased by EA treatment both in liver (p < 0.05) and in serum (p < 0.05). Significantly higher serum bilirubin, alkaline phosphatase, alanine aminotransferase, and aspartate aminotransferase values were found in OJ and OJ + EA groups compared with the control and EA groups (p < 0.05). In conclusion, result of the current study indicated that ellagic acid has modulator effects on Cu and Zn levels in liver and serum of cholestatic rats.
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    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, Mesut
    Background: 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.
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    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 Kemal
    Background: 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.
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    Ellagic acid ameliorates lung injury after intestinal ischemia-reperfusion
    (Wolters Kluwer Medknow Publications, 2011) Boyuk, Abdullah; Onder, Akin; Kapan, Murat; Gumus, Metehan; Firat, Ugur; Basarali, Mustafa Kemal; Alp, Harun
    Background: The aim of this study was to investigate the possible protective role of antioxidant treatment with ellagic acid (EA) on lung injury after intestinal ischemia-reperfusion (I/R) injury using biochemical and histopatological approaches. Materials and Methods: Forty rats were divided into four groups as control, control + EA, I/R, and I/R + EA. The control and control + EA groups were also anesthetized and subjected to laparotomy, but without clamp application. The control + EA and I/R + EA groups were given EA (85 mg/kg) orally prior to experiment. The I/R and I/R + EA groups underwent 30 minutes of intestinal ischemia and 1 hour of reperfusion. In all groups, serum total antioxidant capacity (TAC) and malondialdehyde (MDA) levels were determined. TAC, total oxidative status (TOS), and oxidative stress index (OSI) in lung tissue were measured. Lung tissue histopathology was also evaluated by light microscopy. Results: TAC levels were higher in control, EA, and I/R + EA groups while TOS, OSI, and MDA levels were lower in these groups compared with I/R group. Serum MDA levels were significantly higher in I/R + EA group than that of control group. Lung tissue TAC levels were lower in I/R + EA group while OSI values were higher in that groups compared with EA group. Histological tissue damage was milder in the EA treatment group than in the I/R group. Conclusion: These results suggest that EA treatment protected the rats lung tissue against intestinal I/R injury.
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    Evaluation of the early and delayed cholecystectomy in patients with acute biliary pancreatitis
    (Turkish Surgical Assoc, 2011) Beyazit, Unal; Taskesen, Fatih; Boyuk, Abdullah; Arikanoglu, Zulfu; Onder, Akin; Kapan, Murat; Aliosmanoglu, Ibrahim
    Purpose: We aimed to compare the results of early and late laparoscopic cholecystectomy (LC) and to investigate their effects on mortality and morbidity in patients with acute biliary pancreatitis (ABP). Patients and Methods: One hundred eight patients, who underwent LC with the diagnosis of moderate acute pancreatitis in our clinic between January 2005 and September 2010 were enrolled in this study. The demographic characteristics, type of surgery, operation time, rate of conversion to open surgery, complications, mortality and hospital stay were recorded. Results: The number of the patients was 46 in group A and 62 in group B. The distribution of women and men were 76.1% / 23.9% in group A and 71.0% / 29.0% in group B, respectively. LC was performed successfully in 43 (93.5%) patients in group A and in 58 patients in group B. We had to perform open surgery in 3 (6.5%) patients in group A and 4 (6.4%) patients in group B. The average operation times were 70.5 minutes in group A and 68.6 minutes in group B. The average postoperative hospital stays were 2.8 days in group A and 3.0 days in group B. Conclusion: Early LC did not increase the rates of conversion to open surgery and biliary tract complications. On the other hand, the rate of recurrent pancreatitis attacks was higher in group B correlating with the duration of elapsed time for LC. Therefore, we recommend early LC to protect the patients from the morbidity and mortality of the recurrent attacks in the patients with mild to moderate pancreatitis.
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    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, Feyzi
    Aim: 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.
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    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, Ibrahim
    Patients 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.
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    Factors affecting morbidity in penetrating rectal injuries: a civilian experience
    (Turkish Assoc Trauma Emergency Surgery, 2011) Gumus, Metehan; Kapan, Murat; Onder, Akin; Boyuk, Abdullah; Girgin, Sadullah; Tacyildiz, Ibrahim
    BACKGROUND The principles of the treatment of rectal injuries have been determined based on the experiences gained from military injuries. While adopting these principles in civilian life, it is essential to know the characteristics of civilian rectal injuries as well as the risk factors affecting morbidity. METHODS The characteristics of 29 inpatients who had been treated due to rectal injuries caused by gunshot wounds and penetrating devices were evaluated. In order to determine the risk factors, the patients were divided into two groups regarding the presence of morbidity (Group 1, with morbidity; Group 2, without morbidity) and compared. RESULTS Severe fecal contamination, perianal or gluteal injuries, duration of trauma- treatment interval, and isolated extraperitoneal injury were significant factors that affected the development of morbidity. The length of hospital stay was significantly longer in Group 1 as compared to Group 2. CONCLUSION Although rectal injuries are rarely encountered, they carry high morbidity and mortality. Awareness of the risk factors and planning of a patient-based treatment are essential for the success of the therapy. The rate of morbidity is substantially decreased when patients are treated in time. Thus, the awareness of both patients as well as physicians managing trauma about rectal injuries should be increased.
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    Gangrenous Cholecystitis: Mortality and Risk Factors
    (Int College Of Surgeons, 2015) Onder, Akin; Kapan, Murat; Ulger, Burak Veli; Oguz, Abdullah; Turkoglu, Ahmet; Uslukaya, Omer
    As a serious complication of cholelithiasis, gangrenous cholecystitis presents greater mortality than noncomplicated cholecystitis. The aim of this study was to specify the risk factors on mortality. 107 consecutive patients who underwent surgery due to gangrenous cholecystitis between January 1997 and October 2011 were investigated retrospectively. The study included 60 (56.1%) females and 47 (43.9%) males, with a mean age of 60.7 6 16.4 (21-88) years. Cardiovascular diseases were the most frequently accompanying medical issues (24.3%). Thirty-six complications (33.6%) developed in 29 patients, and surgical site infection was proven as the most common. Longer delay time prior to hospital admission, low white blood cell count, presence of diabetes mellitus, higher blood levels of aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase and total bilirubin, pericholecystic fluid in abdominal ultrasonography, and conversion from laparoscopic surgery to open surgery were identified as risk factors affecting mortality (P < 0.001, P = 0.001, P = 0.044, P = 0.005, P = 0.049, P = 0.009, P = 0.022, P = 0.011, and P = 0.004, respectively). Longer delay time prior to hospital admission and low white blood cell count were determined as independent risk factors affecting mortality.
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    Hydatid cyst-like intra-abdominal esophageal duplication cyst in an endemic region
    (Aves, 2011) Gumus, Metehan; Onder, Akin; Firat, Ugur; Kapan, Murat; Onder, Hakan; Girgin, Sadullah
    [Abstract Not Available]