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    Assessment of demographic, clinical and histopathological features of patients who underwent appendectomy due to a presumed diagnosis of acute appendicitis
    (Turkish Assoc Trauma Emergency Surgery, 2021) Akbulut, Sami; Bahce, Zeynep Sener; Oztas, Tulin; Gumus, Serdar; Sogutcu, Nilgun; Sakarya, Hamdi; Gok, Ali Fuat Kaan
    BACKGROUND: To compare the clinical, biochemical, and histopathological features of patients who underwent appendectomy due to a presumed diagnosis of acute appendicitis (AAp). METHODS: The demographic, biochemical and histopathological data of 8206 patients who underwent appendectomy for AAp between January 2006 and March 2014 were retrospectively analyzed in this study. Patients were compared regarding the following characteristics: disruption by season (autumn vs. winter vs. spring vs. summer), working days (weekdays vs. weekends), histopathological findings (AAp vs. normal appendix [NAp]) and histopathological subgroup (non-perforated AAp vs. perforated AAp vs. NAp). RESULTS: Of the 8206 patients aged between 16 and 89 years, 4763 (58.0%) were male. Appendectomy distribution by season was as follows: autumn (n=1959; 23.9%), winter (n=2062; 25.1%), spring (n=2061; 25.1%) and summer (n=2124, 25.9%). NAp rates were higher in summer than those in other seasons. White blood cell (WBC) and neutrophil levels were significantly higher in autumn and winter compared with those in other seasons. In total, 6120 (74.6%) appendectomies occurred on weekdays and 2086 (25.4%) on weekends. WBC and neutrophil levels were significantly higher on weekends than those on weekdays. Appendectomy distribution by histopathological groups as follows: AAp (n=7414; 90.3%) and NAp (n=792; 9.7%). Appendectomy distribution by histopathological subgroups was as follows: non-perforated AAp (n=6966; 84.9%), perforated AAp (n=448; 5.5%), and NAp (n=792; 9.7%). WBC, neutrophil, and TBil levels in the non-perforated and perforated AAp groups were significantly higher than in the NAp group. While most of the patients with perforated AAp (62.1%) and non-perforated AAp (59.6%) were males, most of the patients with NAp (58.1%) were females. CONCLUSION: This study suggests that a relationship exists between demographic features, histopathological findings of appendectomy specimens, seasons, days of the week, and working days in patients undergoing appendectomy.
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    Giant Acrochordon Arising from the Thigh
    (Coll Physicians & Surgeons Pakistan, 2015) Bahce, Zeynep Sener; Akbulut, Sami; Sogutcu, Nilgun; Oztas, Tulin
    Acrochordons commonly develop from skin on the neck and axillar region, but may be found on any region of body. Although some predisposing factors have been implicated, the definite etiology has yet to be determined. We report the case of a 46-year female patient who presented with a large mass lesion on the inner aspect of the thigh. She stated that the swelling had emerged some 20 years ago and had progressively grown since then. Magnetic resonance imaging revealed a solid lesion with no anatomic relationship with musculoskeletal structures. Taking into account the basal width of the lesion, spinal anesthesia was administered and the lesion was excised with an intact surgical border of approximately 1 cm. The resulting defect was primarily closed. A histopathologic examination led to the diagnosis of an acrochordon with a size of 20 x 14 cm. To the best of our knowledge, this is the largest acrochordon lesion with the widest base reported in the literature.
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    Unusual Histopathological Findings in Appendectomy Specimens Obtained from 1683 Pediatric Patients with Suspected Acute Appendicitis
    (Springer India, 2019) Oztas, Tulin; Dursun, Ahmet; Sogutcu, Nilgun; Bilici, Salim
    The aim of this study is to emphasize the importance of rare histopathological findings in appendix specimens of pediatric patients who underwent surgery for the preliminary (underwent appendectomy to treat an initial diagnosis) diagnosis of acute appendicitis. In this study, the demographic and histopathologic data of 1683 patients who underwent surgery for (presumed acute appendicitis) acute appendicitis between 2011 and 2017 were retrospectively evaluated. Appendectomy specimens were classified microscopically as appendix vermiformis, lymphoid hyperplasia, acute appendicitis, phlegmonous appendicitis, gangrenous appendicitis, perforated appendicitis, and unusual histopathological findings. Age, sex, clinical features, surgical reports, and macroscopic and microscopic features of appendix vermiformis were evaluated in patients with unusual histopathological findings. Ages of these 1683 patients ranged between 6 months and 17 years; among them, 1091 were men and 592 were women. Pathology reports included acute appendicitis (n = 827), phlegmonous appendicitis (n = 300), lymphoid hyperplasia (n = 274), perforated appendicitis (n = 181), appendix vermiformis (n = 50), gangrenous appendicitis (n = 3), and abnormal findings (n = 48). Of the 48 patients who were detected to have unusual findings, 32 were women and 16 were men and their ages ranged from 6 to 17 years. The frequency of unusual histopathological findings were as follows: Enterobius vermicularis (n = 37), fibrous obliteration (n = 6), neuroendocrine tumor (n = 2), mucinous neoplasm (n = 1), pseudodivericulitis (n = 1), and foreign body in the lumen (n = 1). No tumor recurrence or distant metastasis developed during the 2-year follow-up in any of the three patients detected to have a tumor. Even if the appendectomy specimen is normal during the surgery, histopathologic evaluation is necessary for the diagnosis of diseases that require treatment and follow-up after surgery.