Περιεχομενα


Τόμος 20, Τεύχος 1
Ιανουάριος-Μάρτιος 2015


Ερευνητικές εργασίες
1Our Surgical Experience on Familial Adenomatous Polyposis
T. Acar , Y. Kumkumoglu , C. Tavusbay , A. Er , E. Tarcan , M. Peskersoy , O. Ozsay , M. Hacıyanlı , N. Acar , S. Kara?sl?
Πλήρες Κείμενο | Περίληψη
Familial Adenomatous Polyposis(FAP) is an autosomal dominant inheritanced syndrom which can appear in any part of gastrointestinal system but characterized with many adenomatous polyps especially in colon and rectum. FAP gene, is known as APC gene, is located in longer branch of 5th chromosome. In this study patients who were operated because of familial polyposis coli in our clinic were analyzed. Patients' age, sex, operations they had and pathology results after operation were analysed. We had 15 of women and 6 of men 21 FAP patients totally in our clinic between January 1999-January 2013. Average age of patients is 35,9(22-63). Total proctocolectomy + end ileostomy was applied for 11 of patients, ileal pouch-anal anastomosis (IPAA) for 5 patients and ileal pouch-anal anastomosis (IPAA) + protective ileostomy for 5 patients. Colorectal cancer(CRC) in 11 patients, severe dysplasia in 8 patients and polyposis coli in 2 patients were reported according to post-operative pathologic research. Average hospitalization is 20 days(8-68 days). In conclusion, FAP is a disease whose rate of becoming cancerous is %100 without treatment. People with positive family anamnesis should be scrutinized, examined by rectosigmoidoscopy periodically and applied for optimal surgery before transformation into cancer.
5Evaluation of Alvarado score in the diagnosis of acute appendicitis and its correlation to histopathology
A.Kadimella , V. Rao , Thirunavukkarasu
Πλήρες Κείμενο | Περίληψη
Background: Acute appendicitis is the most common surgical case seen in emergency department. Despite more than 100 years of experience, accurate diagnosis still evades the surgeon. The rate of negative appendicectomy has been reported to be between 20 and 30%. Surgeons have been resorting to various scoring systems to aid in the diagnosis and operative decision making. Aims and objectives: The aim of this study is to review the usefulness of modified Alvarado scoring system and to evaluate its feasi-bility and value as an aid to surgical diagnosis by comparing it with the histopathology report and in reducing the number of negative laparotomies Methodology: A study of 100 patients presenting with pain abdomen and diagnosed provisionally as acute appendicitis was under-taken. Depending on individual presentation, a score was calculated for each case, from 9 values (based on modified Alvarado sys-tem). Operative and conservative intervention was undertaken in patients with scores between 5-9 and <5 respectively. When sur-gery was done, the appendix specimen was sent for HPE. An attempt was made to correlate the clinical presentation with pathologi-cal findings. The results of operative, conservative measures and HPE were reviewed. Results and observation: In our study males were predominant in number, in the ratio of 1.6:1. Out of 94 who were operated 78 had appendicitis and 16 had normal appendix with other disease. The overall sensitivity of the Modified Alvarado score was 78%. Males had a sensitivity of 87.5% and females of 74.28%. After application of the scoring system the overall negative appendectomy rate was 16%. Conclusion: Modified Alvarado scoring system significantly reduced the rate of negative appendectomy. It can be applied in routine practice, even in district general hospitals with minimum laboratory facilities. It has greater sensitivity in adult males than in females
9Can Hyperbilirubinemia be a Predictive Factor in the Diagnosis of Acute Appendicitis? : A Multi-Institutional Study
E. Ilhan , M. Emiroglu , A. Senlikci , O. Cetindag , M. A. Ustuner , O. Ureyen , M. Tahsin Tekeli , H. Gungor , C.Aydin
Πλήρες Κείμενο | Περίληψη
Background/Aim of the Study: In the present study, the researchers investigated whether hyperbilirubinemia could be a predictive factor in the diagnosis of non-perforated acute appendicitis and perforated acute appendicitis. Patients and Methods: A total of 372 cases were included inA total of 372 cases were included inA total of 372 cases were included inA total of 372 cases were included inA total of 372 cases were included inA total of 372 cases were included in A total of 372 cases were included inA total of 372 cases were included inA total of 372 cases were included inA total of 372 cases were included inA total of 372 cases were included inA total of 372 cases were included in A total of 372 cases were included inA total of 372 cases were included inA total of 372 cases were included inA total of 372 cases were included inA total of 372 cases were included inA total of 372 cases were included inA total of 372 cases were included inA total of 372 cases were included inA total of 372 cases were included in A total of 372 cases were included inA total of 372 cases were included in A total of 372 cases were included in A total of 372 cases were included inA total of 372 cases were included inA total of 372 cases were included inA total of 372 cases were included in the study. the study. the study. the study. the study. the study. the study. the study. The cases were classified as normalThe cases were classified as normalThe cases were classified as normalThe cases were classified as normalThe cases were classified as normalThe cases were classified as normalThe cases were classified as normalThe cases were classified as normalThe cases were classified as normalThe cases were classified as normalThe cases were classified as normalThe cases were classified as normalThe cases were classified as normal The cases were classified as normalThe cases were classified as normal The cases were classified as normalThe cases were classified as normalThe cases were classified as normal The cases were classified as normalThe cases were classified as normalThe cases were classified as normalThe cases were classified as normalThe cases were classified as normalThe cases were classified as normalThe cases were classified as normalThe cases were classified as normalThe cases were classified as normalThe cases were classified as normal The cases were classified as normal (Group I), (Group I),(Group I),(Group I),(Group I),(Group I),(Group I), non-perforated acute (Group II), and perforated appendicitis III) according to the histopathological diagnoses. acute (Group II), and perforated appendicitis III) according to the histopathological diagnoses.acute (Group II), and perforated appendicitis III) according to the histopathological diagnoses.acute (Group II), and perforated appendicitis III) according to the histopathological diagnoses. acute (Group II), and perforated appendicitis III) according to the histopathological diagnoses.acute (Group II), and perforated appendicitis III) according to the histopathological diagnoses.acute (Group II), and perforated appendicitis III) according to the histopathological diagnoses.acute (Group II), and perforated appendicitis III) according to the histopathological diagnoses.acute (Group II), and perforated appendicitis III) according to the histopathological diagnoses.acute (Group II), and perforated appendicitis III) according to the histopathological diagnoses. acute (Group II), and perforated appendicitis III) according to the histopathological diagnoses. acute (Group II), and perforated appendicitis III) according to the histopathological diagnoses. acute (Group II), and perforated appendicitis III) according to the histopathological diagnoses.acute (Group II), and perforated appendicitis III) according to the histopathological diagnoses. acute (Group II), and perforated appendicitis III) according to the histopathological diagnoses.acute (Group II), and perforated appendicitis III) according to the histopathological diagnoses. acute (Group II), and perforated appendicitis III) according to the histopathological diagnoses.acute (Group II), and perforated appendicitis III) according to the histopathological diagnoses.acute (Group II), and perforated appendicitis III) according to the histopathological diagnoses.acute (Group II), and perforated appendicitis III) according to the histopathological diagnoses.acute (Group II), and perforated appendicitis III) according to the histopathological diagnoses.acute (Group II), and perforated appendicitis III) according to the histopathological diagnoses.acute (Group II), and perforated appendicitis III) according to the histopathological diagnoses. acute (Group II), and perforated appendicitis III) according to the histopathological diagnoses. acute (Group II), and perforated appendicitis III) according to the histopathological diagnoses.acute (Group II), and perforated appendicitis III) according to the histopathological diagnoses.acute (Group II), and perforated appendicitis III) according to the histopathological diagnoses. acute (Group II), and perforated appendicitis III) according to the histopathological diagnoses.acute (Group II), and perforated appendicitis III) according to the histopathological diagnoses.acute (Group II), and perforated appendicitis III) according to the histopathological diagnoses.acute (Group II), and perforated appendicitis III) according to the histopathological diagnoses.acute (Group II), and perforated appendicitis III) according to the histopathological diagnoses.acute (Group II), and perforated appendicitis III) according to the histopathological diagnoses. acute (Group II), and perforated appendicitis III) according to the histopathological diagnoses. acute (Group II), and perforated appendicitis III) according to the histopathological diagnoses. acute (Group II), and perforated appendicitis III) according to the histopathological diagnoses.acute (Group II), and perforated appendicitis III) according to the histopathological diagnoses.acute (Group II), and perforated appendicitis III) according to the histopathological diagnoses.acute (Group II), and perforated appendicitis III) according to the histopathological diagnoses.acute (Group II), and perforated appendicitis III) according to the histopathological diagnoses. acute (Group II), and perforated appendicitis III) according to the histopathological diagnoses. acute (Group II), and perforated appendicitis III) according to the histopathological diagnoses. acute (Group II), and perforated appendicitis III) according to the histopathological diagnoses.acute (Group II), and perforated appendicitis III) according to the histopathological diagnoses.acute (Group II), and perforated appendicitis III) according to the histopathological diagnoses.acute (Group II), and perforated appendicitis III) according to the histopathological diagnoses. acute (Group II), and perforated appendicitis III) according to the histopathological diagnoses. acute (Group II), and perforated appendicitis III) according to the histopathological diagnoses.acute (Group II), and perforated appendicitis III) according to the histopathological diagnoses. acute (Group II), and perforated appendicitis III) according to the histopathological diagnoses.acute (Group II), and perforated appendicitis III) according to the histopathological diagnoses.acute (Group II), and perforated appendicitis III) according to the histopathological diagnoses. acute (Group II), and perforated appendicitis III) according to the histopathological diagnoses. acute (Group II), and perforated appendicitis III) according to the histopathological diagnoses.acute (Group II), and perforated appendicitis III) according to the histopathological diagnoses.acute (Group II), and perforated appendicitis III) according to the histopathological diagnoses.acute (Group II), and perforated appendicitis III) according to the histopathological diagnoses.acute (Group II), and perforated appendicitis III) according to the histopathological diagnoses. acute (Group II), and perforated appendicitis III) according to the histopathological diagnoses.acute (Group II), and perforated appendicitis III) according to the histopathological diagnoses. acute (Group II), and perforated appendicitis III) according to the histopathological diagnoses. acute (Group II), and perforated appendicitis III) according to the histopathological diagnoses.acute (Group II), and perforated appendicitis III) according to the histopathological diagnoses. acute (Group II), and perforated appendicitis III) according to the histopathological diagnoses.acute (Group II), and perforated appendicitis III) according to the histopathological diagnoses.acute (Group II), and perforated appendicitis III) according to the histopathological diagnoses.acute (Group II), and perforated appendicitis III) according to the histopathological diagnoses.acute (Group II), and perforated appendicitis III) according to the histopathological diagnoses. Results:esults: esults:esults:esults: There was a statistically significant difference between the groups in terms of duration hospital stayThere was a statistically significant difference between the groups in terms of duration hospital stayThere was a statistically significant difference between the groups in terms of duration hospital stayThere was a statistically significant difference between the groups in terms of duration hospital stayThere was a statistically significant difference between the groups in terms of duration hospital stayThere was a statistically significant difference between the groups in terms of duration hospital stayThere was a statistically significant difference between the groups in terms of duration hospital stayThere was a statistically significant difference between the groups in terms of duration hospital stayThere was a statistically significant difference between the groups in terms of duration hospital stayThere was a statistically significant difference between the groups in terms of duration hospital stayThere was a statistically significant difference between the groups in terms of duration hospital stay There was a statistically significant difference between the groups in terms of duration hospital stayThere was a statistically significant difference between the groups in terms of duration hospital stayThere was a statistically significant difference between the groups in terms of duration hospital stayThere was a statistically significant difference between the groups in terms of duration hospital stay There was a statistically significant difference between the groups in terms of duration hospital stayThere was a statistically significant difference between the groups in terms of duration hospital stay There was a statistically significant difference between the groups in terms of duration hospital stayThere was a statistically significant difference between the groups in terms of duration hospital stay There was a statistically significant difference between the groups in terms of duration hospital stayThere was a statistically significant difference between the groups in terms of duration hospital stayThere was a statistically significant difference between the groups in terms of duration hospital stay There was a statistically significant difference between the groups in terms of duration hospital stayThere was a statistically significant difference between the groups in terms of duration hospital stay There was a statistically significant difference between the groups in terms of duration hospital stay There was a statistically significant difference between the groups in terms of duration hospital stayThere was a statistically significant difference between the groups in terms of duration hospital stay There was a statistically significant difference between the groups in terms of duration hospital stayThere was a statistically significant difference between the groups in terms of duration hospital stayThere was a statistically significant difference between the groups in terms of duration hospital stay There was a statistically significant difference between the groups in terms of duration hospital stayThere was a statistically significant difference between the groups in terms of duration hospital stay There was a statistically significant difference between the groups in terms of duration hospital stayThere was a statistically significant difference between the groups in terms of duration hospital stayThere was a statistically significant difference between the groups in terms of duration hospital stayThere was a statistically significant difference between the groups in terms of duration hospital stay There was a statistically significant difference between the groups in terms of duration hospital stayThere was a statistically significant difference between the groups in terms of duration hospital stayThere was a statistically significant difference between the groups in terms of duration hospital stayThere was a statistically significant difference between the groups in terms of duration hospital stay There was a statistically significant difference between the groups in terms of duration hospital stayThere was a statistically significant difference between the groups in terms of duration hospital stayThere was a statistically significant difference between the groups in terms of duration hospital stay There was a statistically significant difference between the groups in terms of duration hospital stayThere was a statistically significant difference between the groups in terms of duration hospital stayThere was a statistically significant difference between the groups in terms of duration hospital stayThere was a statistically significant difference between the groups in terms of duration hospital stayThere was a statistically significant difference between the groups in terms of duration hospital stayThere was a statistically significant difference between the groups in terms of duration hospital stay There was a statistically significant difference between the groups in terms of duration hospital stayThere was a statistically significant difference between the groups in terms of duration hospital stayThere was a statistically significant difference between the groups in terms of duration hospital stayThere was a statistically significant difference between the groups in terms of duration hospital stay There was a statistically significant difference between the groups in terms of duration hospital stayThere was a statistically significant difference between the groups in terms of duration hospital stayThere was a statistically significant difference between the groups in terms of duration hospital stayThere was a statistically significant difference between the groups in terms of duration hospital stayThere was a statistically significant difference between the groups in terms of duration hospital stayThere was a statistically significant difference between the groups in terms of duration hospital stayThere was a statistically significant difference between the groups in terms of duration hospital stayThere was a statistically significant difference between the groups in terms of duration hospital stayThere was a statistically significant difference between the groups in terms of duration hospital stayThere was a statistically significant difference between the groups in terms of duration hospital stay There was a statistically significant difference between the groups in terms of duration hospital stayThere was a statistically significant difference between the groups in terms of duration hospital stayThere was a statistically significant difference between the groups in terms of duration hospital stayThere was a statistically significant difference between the groups in terms of duration hospital stayThere was a statistically significant difference between the groups in terms of duration hospital stayThere was a statistically significant difference between the groups in terms of duration hospital stayThere was a statistically significant difference between the groups in terms of duration hospital stayThere was a statistically significant difference between the groups in terms of duration hospital stayThere was a statistically significant difference between the groups in terms of duration hospital stayThere was a statistically significant difference between the groups in terms of duration hospital stay There was a statistically significant difference between the groups in terms of duration hospital stay There was a statistically significant difference between the groups in terms of duration hospital stayThere was a statistically significant difference between the groups in terms of duration hospital stayThere was a statistically significant difference between the groups in terms of duration hospital stayThere was a statistically significant difference between the groups in terms of duration hospital stay (p<0.001) and WBC (p <0.001). There was no statistically significant difference in terms of age (p=0.066), total bilirubin(p=0.207),and ALT(p=0.698). There was a statistically significant difference in WBC(p=0.001) and gender(p=0.006) when Group I and Groups II+III were compared. There was no statistically significant difference in age(p=0.061), total bilirubin(p=0.238), AST(p=0.912),and ALT(p=0.285). In the r In the rIn the r In the rIn the rIn the re- ceiver operating characteristic (ROC) curve analysis, there was no statistically significant differe ceiver operating characteristic (ROC) curve analysis, there was no statistically significant differeceiver operating characteristic (ROC) curve analysis, there was no statistically significant differeceiver operating characteristic (ROC) curve analysis, there was no statistically significant differeceiver operating characteristic (ROC) curve analysis, there was no statistically significant differe ceiver operating characteristic (ROC) curve analysis, there was no statistically significant differeceiver operating characteristic (ROC) curve analysis, there was no statistically significant differeceiver operating characteristic (ROC) curve analysis, there was no statistically significant differeceiver operating characteristic (ROC) curve analysis, there was no statistically significant differeceiver operating characteristic (ROC) curve analysis, there was no statistically significant differeceiver operating characteristic (ROC) curve analysis, there was no statistically significant differe ceiver operating characteristic (ROC) curve analysis, there was no statistically significant differe ceiver operating characteristic (ROC) curve analysis, there was no statistically significant differe ceiver operating characteristic (ROC) curve analysis, there was no statistically significant differe ceiver operating characteristic (ROC) curve analysis, there was no statistically significant differe ceiver operating characteristic (ROC) curve analysis, there was no statistically significant differeceiver operating characteristic (ROC) curve analysis, there was no statistically significant differe ceiver operating characteristic (ROC) curve analysis, there was no statistically significant differeceiver operating characteristic (ROC) curve analysis, there was no statistically significant differe ceiver operating characteristic (ROC) curve analysis, there was no statistically significant differe ceiver operating characteristic (ROC) curve analysis, there was no statistically significant differe ceiver operating characteristic (ROC) curve analysis, there was no statistically significant differeceiver operating characteristic (ROC) curve analysis, there was no statistically significant differe ceiver operating characteristic (ROC) curve analysis, there was no statistically significant differeceiver operating characteristic (ROC) curve analysis, there was no statistically significant differe ceiver operating characteristic (ROC) curve analysis, there was no statistically significant differeceiver operating characteristic (ROC) curve analysis, there was no statistically significant differeceiver operating characteristic (ROC) curve analysis, there was no statistically significant differeceiver operating characteristic (ROC) curve analysis, there was no statistically significant differeceiver operating characteristic (ROC) curve analysis, there was no statistically significant differe ceiver operating characteristic (ROC) curve analysis, there was no statistically significant differe ceiver operating characteristic (ROC) curve analysis, there was no statistically significant differeceiver operating characteristic (ROC) curve analysis, there was no statistically significant differe ceiver operating characteristic (ROC) curve analysis, there was no statistically significant differeceiver operating characteristic (ROC) curve analysis, there was no statistically significant differeceiver operating characteristic (ROC) curve analysis, there was no statistically significant differe ceiver operating characteristic (ROC) curve analysis, there was no statistically significant differeceiver operating characteristic (ROC) curve analysis, there was no statistically significant differeceiver operating characteristic (ROC) curve analysis, there was no statistically significant differeceiver operating characteristic (ROC) curve analysis, there was no statistically significant differeceiver operating characteristic (ROC) curve analysis, there was no statistically significant differeceiver operating characteristic (ROC) curve analysis, there was no statistically significant differeceiver operating characteristic (ROC) curve analysis, there was no statistically significant differeceiver operating characteristic (ROC) curve analysis, there was no statistically significant differeceiver operating characteristic (ROC) curve analysis, there was no statistically significant differeceiver operating characteristic (ROC) curve analysis, there was no statistically significant differeceiver operating characteristic (ROC) curve analysis, there was no statistically significant differeceiver operating characteristic (ROC) curve analysis, there was no statistically significant differeceiver operating characteristic (ROC) curve analysis, there was no statistically significant differeceiver operating characteristic (ROC) curve analysis, there was no statistically significant differeceiver operating characteristic (ROC) curve analysis, there was no statistically significant differe ceiver operating characteristic (ROC) curve analysis, there was no statistically significant differe ceiver operating characteristic (ROC) curve analysis, there was no statistically significant differeceiver operating characteristic (ROC) curve analysis, there was no statistically significant differe ceiver operating characteristic (ROC) curve analysis, there was no statistically significant differeceiver operating characteristic (ROC) curve analysis, there was no statistically significant differeceiver operating characteristic (ROC) curve analysis, there was no statistically significant differe ceiver operating characteristic (ROC) curve analysis, there was no statistically significant differeceiver operating characteristic (ROC) curve analysis, there was no statistically significant differe ceiver operating characteristic (ROC) curve analysis, there was no statistically significant differe ceiver operating characteristic (ROC) curve analysis, there was no statistically significant differe ceiver operating characteristic (ROC) curve analysis, there was no statistically significant differeceiver operating characteristic (ROC) curve analysis, there was no statistically significant differe ceiver operating characteristic (ROC) curve analysis, there was no statistically significant differeceiver operating characteristic (ROC) curve analysis, there was no statistically significant differeceiver operating characteristic (ROC) curve analysis, there was no statistically significant differeceiver operating characteristic (ROC) curve analysis, there was no statistically significant difference in terms of nce in terms of nce in terms of nce in terms of nce in terms of nce in terms of nce in terms of nce in terms of nce in terms of nce in terms of nce in terms of nce in terms of nce in terms of nce in terms of total bilirubin, and AST/ALT in the patient and control groups. When Group II and Group III were compared to each other, only age was statistically sig-nificant(p <0.001). Total bilirubin was not statistically significant(p=0.057). Conclusions:The researchers concluded that hyperbilirubinemia has no diagnostic value in the diagnosis of non-perforated acute appendicitis and perforated acute appendicitis.
14Pregnancy, Parturition, Parity and Position in the family. Any influence on the development of paediatric inguinal hernia/hydrocele?
D.O. Irabor , O.O. Ogundoyin , D.I. Ogunlana
Πλήρες Κείμενο | Περίληψη
Aim: To see if pre-partum factors have a relationship to the development of inguinal hernia in children. Method: A prospective study on children with hernia. On first contact, the affected child was examined and data like the age, sex, weight, blood group, the diagnosis, side of the lesion and other co-morbid conditions was recorded. The mother filled a questionnaire about her age, parity, illness during pregnancy, her mode of delivery and the patient?s position in the family. Results: There were 104 patients from 103 mothers, their ages ranged from 13days to 14 years with the highest incidence in the 1-4 age group. The sex ratio was overwhelmingly male (M: F ratio was 38: 1). Right sided hernias were predominant. Only 7% had a family history. The peak age group of the mothers was 26-32 years and about 33% of the mothers had some illness during pregnancy. The birth positions of the patients showed that majority of them were either 1st or 2nd born children. Conclusion: Women of ages 26-32 likely to have children with inguinal hernia. Malarial illness during pregnancy may have a role to play. 1st and 2nd born male children have a higher chance of having inguinal hernia.

Ενδιαφέρουσες περιπτώσεις
17Kikuchi-Fujimoto disease- a rare cause of cervical lymphadenopathy
N. Kamargiannis , D. Papadopoulou
Πλήρες Κείμενο | Περίληψη
Kikuchi-Fujimoto disease is a rare benign self-limited disorder that is characterized of tender cervical lymphadenopathy accom-panied with fever. It occurs more frequently in people of Asian descent but is described worldwide. Herein, we describe a case of a 22 year-old female who was referred to our hospital with tender right cervical lymphadenopathy with fever that was investi-gated thoroughly. The definitive diagnosis of Kikuchi-Fujimoto disease was set only after histological examination of the biopsied lymph node. Thereafter, the patient was managed conservatively. Kikuchi-Fujimoto disease although an uncommon disease should be included in the differential diagnosis of a cervical mass as it may mimic lymphoma and systemic lupus erythematosus and misdiagnosis can lead to unnecessary treatment with subsequent side effects.
19Colonic tuberculosis presenting as duodenocolic fistula
Chandrakant K Munjewar , Hemant Khowal , Ishaq Nabi , Poras Chaudhary , Shailesh Gupta , Gyan Ranjan , Mohinder P Arora , Vinod K Ramteke
Πλήρες Κείμενο | Περίληψη
We report a rare case of duodenocolic fistula secondary to colonic tuberculosis, who presented to surgical emergency in shock with symptoms and signs of acute intestinal obstruction. After initial resuscitation, patient underwent emergency exploratory laparoto-my, fistulous communication between third part of duodenum and mid transverse colon was separated, duodenal defect was re-paired with jejunal serosal patch and approximately 10 cm of transverse colon was resected, proximal part was brought out as colos-tomy and distal part was closed. Final histopathogical examination revealed colonic tuberculosis. A large number of studies have been published on abdominal tuberculosis describing ileocaecal tuberculosis, but colonic tuberculosis is a rare occurrence. To the best of our knowledge, this is seventh case of colonic tuberculosis presenting as duodenocolic fistula. The management options of such cases, if they present in emergency, have been discussed and literature has also been reviewed
22Enterolithiasis secondary to tubercular stricture: A report of two cases
Shahbaz Habib Faridi , Mohammad Aslam , Bushra Siddiqui , Wasif M Ali
Πλήρες Κείμενο | Περίληψη
Abdominal tuberculosis is a common disease in the developing countries. It presents mainly in the form of intestinal obstruction or perforation. Enterolithiasis, the formation of gastrointestinal tract calculi has rarely been reported in such patients. We report two cases of enterolithiasis secondary to tubercular ileal strictures. Diagnosis of the patient was made on radiography and further con-firmed on exploratory laparotomy. Owing to the rare presentation of this common disease, these cases are being reported here.
26Intramural hemorrhage as a cause of small bowel obstruction: A case report
A. Khalifa , M. Ramadan , M. Moussa
Πλήρες Κείμενο | Περίληψη
Spontaneous intramural hematoma is a rare complication of anticoagulant therapy. We reported a cases of intramural and submu-cosal small bowel hematoma resulting from warfarin administration. The case attended at the General Surgery Division in Ahmadi Hospital, Kuwait. The patient presented with abdominal pain and vomiting and revealed to have intramural hematoma at the jeju-num. Typical findings on abdominal computerized tomography yielded the diagnosis. The patient markedly improved after conserva-tive treatment. The history of anticoagulant use with prolonged INR value in a patient presented with abdominal pain should alert physicians to search for this entity. It is of value to recognize this syndrome in order to avoid an unnecessary surgery since the out-come is usually satisfactory after conservative treatment.
29T1 μονοεστιακό πορογενές διηθητικό καρκίνωμα με συνοδό καταγραφή σποραδικού DCIS, με μεταστάσεις σε επιπέδου ΙΙΙ υπερκλειδίους λεμφαδέ- νες.Mια σπάνια περίπτωση
Χ. Βρέκας , Π. Σπυριδόπουλος , Β. Παντελίδου , Κ. Πασενίδου , Β. Kαλύβας , Γ. Xατζούλης
Πλήρες Κείμενο | Περίληψη
Οι Τ1 Όγκοι μαστού με DCIS με μεταστάσεις σε υπερκλειδίους λεμφαδένες είναι πολύ σπάνιοι. Γυναίκα 73 ετών προσέρχεται με ψηλαφητό μόρφωμα στην μασχάλη. Στο υπερηχογράφημα μασχάλης ανευρέθησαν διηθημένοι λεμφαδένες και στα 3 επίπεδα, καθώς και υποκλείδιοι και υπερκλείδιοι λεμφαδένες. Η μαστογραφία ανέδειξε περιοχή με επασβεστώσεις, ενώ το υπερηχο- γράφημα δύο διηθητικές βλάβες διαμέτρου 5 χιλ. εκάστη στην περιοχή. Η Core biopsy λεμφαδένα της μασχάλης απέδειξε ότι είναι μετάσταση από τον δεξιό μαστό. Έγινε μαστεκτομή και λεμφαδενικός καθαρισμός δεξιά στα επίπεδα I, II και III. Εξαιρέθη- καν 96 λεμφαδένες εκ των οποίων οι 87 ήταν διηθημένοι. Η ιστολογική εξέταση έδειξε 1 εκ.διηθητικό πορογενές καρκίνωμα (grade 3). H πολυδύναμη θεραπεία στους ανωτέρω όγκους παίζει σημαντικό ρόλο, ενώ ο λεμφαδενικός καθαρισμός στο στάδια ΙΙΙΒ-C σε όγκους με σύγχρονες μεταστάσεις δεν έχει μόνο παρηγορικό, αλλά και ουσιαστικό χαρακτήρα βελτιώνοντας την επι- βίωση.
33Pyoderma Gangrenosum After Umblical Hernia Repair
T. Dinc , S. Kayilioglu , K. Katar , O. Yildirim , M. Cete , D. Unal , F. Coskun
Πλήρες Κείμενο | Περίληψη
Pyoderma gangrenosum is an extremely rare condition, characterized with progressive necrotic skin ulcers and destructive inflammation. It can be defined as a neutrophilic dermatosis with sterile inflammation. Incidence of the disease is 3-10 per million. A surgical intervention may trigger this immunological condition. Herein we present pyoderma gangrenosum case, which occurred after umbilical hernia repair.

Εγχειρητική τεχνική
35Pancreaticogastrostomy with one continuous seromuscular circular suture
D. Kostov , G. Kobakov , D. Yankov
Πλήρες Κείμενο | Περίληψη
One of the most feared complications after pancreaticoduodenectomy (PD) remains postoperative pancreatic fistula (POPF). In recent years, various methods of pancreatico-digestive reconstruction were performed in order to reduce the rate of POPF. In the current study we demonstrate a new technique for pancreaticogastrostomy (PG), using one continuous seromuscular circu-lar suture without transpancreas sutures for PG. We conclude that the suture-less PG is possesses several advantages over con-ventional PG and pancreaticojejunostomy (PJ). This technique appears to reduce the risk of pancreatic leakage, possibly by de-creasing the risk of suture injury of the pancreas and by embedding the transected stump into the wall of the stomach. This nov-el PG technique is an effective reconstructive procedure, especially for patients with a soft, nonfibrotic pancreas.

Εικόνες στη χειρουργική
39Meckel's diverticulum in a femoral hernia (Littre's hernia)
A. Amo , D. Valdueza , E. Martin-Perez , JL. Munoz de Nova
Πλήρες Κείμενο

Επιστολές προς Εκδότη
41Giant mucinous cystadenoma of the ovary in a post-menopausal woman
K. Kofina , D. Paramythiotis , V. Papadopoulos , A. Michalopoulos , K. Papapolychroniadis , G. Basdanis
Πλήρες Κείμενο
43Heterotopic pregnancy with tubal rupture accompanied with severe anemia. Case presentation
E. Papamargaritis , C. Sofoudis , C. Kotsonis , D. Gkolias , K. Karasaridou , K. Louis , A. Gerolymatos
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