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    Factors Associated with Morbidity and Mortality in Patients with Mechanical Bowel Obstruction
    (Emergency Medicine Physicians Assoc Turkey, 2012) Halis, Nurkal; Sogut, Ozgur; Guloglu, Cahfer; Ozgonul, Abdullah; Gokdemir, Mehmet Tahir; Durgun, Hasan Mansur
    Objective: The aim of this study was to investigate the factors affecting morbidity and mortality by evaluating the demographical, etiological and clinical characteristics of patients with mechanical bowel obstruction. Materials and Methods: Data for 171 mechanical bowel obstruction patients were evaluated retrospectively. The patients were assessed in mortality (n=21), morbidity (n=55) and recovery (n=95) groups. Results: Of the patients, 70% were men; and 27.4% were =55 years of age. While gender had no impact on mortality and morbidity, age did. Adhesion was observed to be the leading cause (45.6%) of mechanical bowel obstruction, followed by incarcerated hernia in 17.5%. Intestinal necrosis was associated with mortality but not with morbidity. Late presentation and multiple concomitant diseases had no impact on mortality but were associated with morbidity. The presence of a concomitant disease and leukocytosis or leukopenia had a significant impact on both mortality and morbidity. Conclusion: Older age and presence of a concomitant disease, leukocytosis or leukopenia were established to be associated with mortality and morbidity. Late presentation and multiple concomitant diseases were associated only with morbidity. The presence of intestinal necrosis was associated only with mortality. Establishing the risk factors well will be beneficial in lowering the incidences of morbidity and mortality.
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    A rare case of Chilaiditi syndrome presenting free air under diaphragm and mimicking a perforated viscus
    (Int Scientific Literature, Inc, 2009) Sogut, Ozgur; Orak, Murat; Sayhan, Mustafa Burak; Ustundag, Mehmet; Ozgonul, Abdullah
    Background: Chilaiditi syndrome (CS) is the interposition of the right colon between the liver and the right hemidiaphragm. The incidence of CS in the general population is very low and it is seen more frequently in adults than in children. Here a case is presented of Chilaiditi syndrome presenting with abdominal pain and vomiting; its initial diagnosis was perforated viscus. Case Report: A 36-year-old man was admitted to a state hospital with abdominal pain and vomiting which began three days before without any history of prior trauma. On chest x-ray, free air under the right hemidiaphragm was diagnosed as a perforated viscus. Upon physical examination in the authors' hospital, his abdomen was distended, with normal bowel sounds, but no rebound tenderness were detected on palpation. CS was subsequently confirmed by a chest x-ray and abdominal ultrasound. The patient was managed conservatively and his symptoms resolved over the next 24 hours. Conclusions: CS may be mistaken for more serious abnormalities, which may lead to unneeded exploratory abdominal surgery. This case emphasizes the importance of considering CS by emergency physicians or surgeons in the differential diagnosis of free air under the right hemidiaphragm on a chest x-ray.