Ersan Semerci

Prognostic value of preoperative CEA, CA 19-9, CA 72-4, and AFP levels in gastric cancer

IntroductionRecent research has suggested that serum tumor markers can give valuable prognostic information in gastric cancer. In this study, we examined the relationship between preoperative serum carcinoembryonic antigen (CEA), carbohydrate antigen (CA) 19-9, CA 72-4, and alfa fetoprotein (AFP) levels on clinicopathologic significance in gastric cancer patients.MethodsPreoperative plasma levels of CEA, CA 19-9, CA 72-4, and AFP were retrospectively examined in 95 patients who underwent surgical resection for gastric cancer, and the prognostic value of the tumour markers were estimated.ResultsThe percentage of CA 19-9, CA 72-4, CEA, and AFP-positive cases were 41%, 32.6%, 24.2%, and 8.4%, respectively. CEA was more frequently positive in the patients with liver metastases (P=0.02). CA 19-9 was more frequently positive in patients with lymph node (P=0.005), peritoneal (P=0.01), and serosal (P=0.03) involvement. CA 72-4 was more frequently positive in patients with lymph node (P=0.01), peritoneal (P=0.03), and liver (P=0.01) involvement. Low 3-year cumulative survival was associated significantly with elevated serum levels of CEA (P=0.001), CA 19-9 (P=0.001), CA 72-4 (P=0.001), and AFP (P=0.01). In multivariate analysis, age, tumor stage, and CA 72-4 were the only independent prognostic factors. Being positive for CA 72-4 was associated with a 3.8-fold higher risk of death (95% confidence intervals: 1.3, 10.9).ConclusionOur results suggest that high preoperative serum levels of CA 72-4 in gastric cancer patients are associated with a higher risk of death due to gastric cancer.

A right sliding indirect inguinal hernia containing paraovarian cyst, fallopian tube, and ovary: a case report

Albeit very uncommon, the hernia sac may contain unusual structures such as vermiform appendix, acute appendicitis, ovary, fallopian tube and, urinary bladder. Most of the cases of hernia containing ovary and fallopian tubes were reported to be found in children and, often accompanied with other congenital anomalies of genital tract. We present the first case of sliding inguinal hernia containing right ovary and fallopian tube and a right paraovarian cyst in 80-year-old, multiparous patient without any associated genital anomaly. The hernia was repaired with plication darn, while the paraovarian cyst was excised and adnexa were preserved. It is of utmost importance to keep in mind that the hernia sac may contain almost any abdominal organ, and surgical dissection should be carried out accordingly. Pathophysiologically, the ovary might be simply pulled along with a sliding paraovarian cyst or the paraovarian cyst might be accompanying the maldescended ovary. There seems to be a need for clinical and experimental studies to further explain the mechanisms that apply to the pathogenesis of sliding inguinal hernias.

Delayed diagnosis of traumatic diaphragmatic hernia may cause colonic perforation: a case report

Early diagnosis of diaphragmatic rupture after traumas may be difficult, and delayed diagnosis may result in increased morbidity and mortality. This paper describes the case of a 32-year-old man who experienced a traffic accident and had diagnosis of traumatic diaphragmatic hernia nearly four months later. The patient was referred to our emergency room suffering from ileus symptoms. Physical examination demonstrated an apparent abdominal distention, tenderness at the upper abdominal quadrants, rebound, and defense. Thoraco-abdominal X-rays and computerized tomography imaging demonstrated intestinal segments with air-fluid levels in thorax. Laparotomy was performed after a preoperative diagnosis of a strangulated-diaphragmatic hernia. At abdominal exploration, it was found that transverse colon and omentum entered into thorax through diaphragmatic defect located at the left diaphragm. Herniating colon segment was complicated with ischemic necrosis and perforation. In conclusion, colon necrosis and perforation may develop when early diagnosis of diaphragmatic ruptures are missed.

Unusual cause of gastric outlet obstruction: giant gastric trichobezoar: a case report

BackgroundTrichobezoars are caused by hair ingestion. The usual presentation of a trichobezoar is with early satiety and malnutrition. Obstructive symptoms and manifestations of gastric outlet obstruction may occur. The diagnosis may be suspected in young females with malnutrition, who have a history of trichophagia.Case presentationWe report a case of 12-year-old female admitted to the emergency room for abdominal pain. On physical examination, she was cachectic and an epigastric mass was palpated. An exploratory laparotomy was conducted. A giant trichobezoar was palpated in the stomach and was removed through an anterior gastrostomy.ConclusionThere were no complications postoperatively and the patient was referred to a psychiatrist.

Rare cause of intestinal obstruction, Ascaris lumbricoides infestation: two case reports

Ascaris lumbricoides is common resident of intestine especially low socioeconomic areas in the world. Complication of Ascaris lumbricoides has been reported include obstruction of the small intestine, intestinal volvulus and intussusception. We report two children with severe sequelae of intestinal obstruction.

Squamous Cell Carcinoma Arising in Etiology of Chronic Pilonidal Sinus Disease:A Case Report

DOI: 10.4328/JCAM.183 Received: 18.01.2010 Accepted: 25.01.2010 Printed: 01.01.2011 J Clin Anal Med 2011;2(1):31-3 Corresponding Author: Ibrahim Yetim, Mustafa Kemal Universitesi Tayfur Ata Sokmen Tip Fakultesi Genel Cerrahi A.B.D, Serinyol, Hatay ,Turkiye. Phone: +903262111900, +905325060009 E-mail: yetim54@gmail.com Ozet Pilonidal sinus hastaligi genellikle sakrokoksigeal bolgede yerlesen, skuamoz epitelle doseli, kil iceren sinuslerin olusturdugu edinsel inflamatuar bir hastaliktir. Etiyolojisi kesin bilinmemekle birlikte, patogenezinde dokulen killarin subkutanoz kistlere penetre olarak yabanci cisim reaksiyonu ve enfeksiyona sebep oldugu kabul edilir. Pilonidal sinus hastaliginin sik gorulen komplikasyonlari sellulit, apse ve fistul olusumudur. Kronik inflamasyonun bazi malignitelerin etiyolojisinde rol oynadigi bilinmektedir. Malign dejenerasyon, kronik pilonidal hastalikta cok nadir bir komplikasyondur. Burada uzun yillar tedavisiz kalmis pilonidal sinus hastaligi zemininde gelismis skuamoz hucreli karsinom tanisi ile cerrahi olarak tedavi ettigimiz bir olgumuzu sunuyoruz. Anahtar Kelimeler Pilonidal Sinus Hastaligi, Skuamoz Hucreli Karsinom. Abstract