Ilker Sengul

An elective detection of an Amyand's hernia with an adhesive caecum to the sac: Report of a rare case

Context: Existence of non-inflamed or inflamed vermiform appendix in an inguinal hernia is named Amyands hernia in honor to the surgeon Claudius Amyand who successfully performed first perforated appendicitis. Case Report: A 69-year-old Turkish male patient with a slight right groin pain and swelling was presented to our clinic, and found to have a slightly tender and reducible right inguinal hernia. He underwent surgery under general anesthesia, and a adhesive caecum and an inflamed appendix were explored within the hernia sac. Adhesions were divided by sharp dissection and appendectomy was performed. After carrying out a Lichtenstein hernioplasty, a broad-spectrum antibiotic was postoperatively admitted for 3 days. He recovered uneventfully, and neither complication nor recurrence was detected during 52 months of follow-up. Conclusions: Although occurrence of an appendicitis in an inguinal hernia is rare, a surgeon should be vigilant for facing with it even in elective cases. Treatment can be provided only surgically, but surgical treatment is not standard except from appendectomy. In our opinion, application of mesh hernia repair should depend on the degree of inflammation of appendix and the presence of incarceration of hernia sac with a suitable antibiotic admission for 3-5 days postoperatively.

Ectomesenchymal chondromyxoid tumor of the anterior tongue: a rare case.

Ectomesenchymal chondromyxoid tumor is a rare tumor seen in the anterior dorsal aspect of the tongue. Diagnosis of this lesion without a prediagnosis clinically is made only with histopathological findings including the immunohistochemical examinations. However, diverse results are being reported in the literature with keratin staining. While glial fibrillary acid protein positiveness maintain being a fixed repeating feature, we emphasized for our case of a 28‐year‐old Caucasian woman having the findings of qualities supporting the ectomesenchymal origin of the mentioned tumor.

Gangrenous meckel's diverticulum in a strangulated umbilical hernia in a 42 year-old woman: a case report

IntroductionMeckels diverticulum affects 1 - 3% of general population and is known as the most common anomaly of gastrointestinal tract. However, its estimated lifetime complication rate is approximately 4%. Intestinal obstruction is most common complication of Meckels diverticulum in adult population.Case presentationIn the present study, we reported a 42-year-old female patient with a gangrenous Meckels diverticulum in a strangulated umbilical hernia sac treated by dissection of diverticulomesenteric bands and diverticulectomy. In 36 months follow-up, there was neither any complication nor recurrence of hernia.ConclusionThis case represents a gangrenous Meckels diverticulum in a strangulated umbilical hernia sac diagnosed in case of emergency. Although it is a very rare phenomenon, we should be vigilant for this entity especially in case of emergency.

Pleomorphic adenoma of the lower lip: A rare site of location

Context: Pleomorphic adenoma is the most common neoplasm of the minor salivary glands which are uncommon among the entire salivary gland tumors. The lower lip is a very rare site of occurrence for pleomorphic adenoma. We intended to present a case of pleomorphic adenoma of the lower lip. Case Report: A 49-year-old Turkish man presented with the painless mass on his lower lip. A total excision was choiced for the mass by both we and the patient because of some cosmetic reasons. The histopathological evaluation revealed the diagnosis of pleomorphic adenoma and neither complication nor recurrence was observed during a clinical follow-up for 40 months. Conclusions: A clinician should be vigilant for the possibility of existence of a pleomorphic adenoma located on the lower lip even it is rare. Once it is diagnosed concisely, a wide excision is suggested in general if there is no cosmetic care and no risk of damage to functional structures of head and neck.

Postconditioning attenuates acute intestinal ischemia–reperfusion injury

The aim of this study was to test the hypothesis that postconditioning (POC) would reduce the detrimental effects of the acute intestinal ischemia–reperfusion (I/R) compared to those of the abrupt onset of reperfusion. POC has a protective effect on intestinal I/R injury by inhibiting events in the early minutes of reperfusion in rats. Twenty‐four Wistar–Albino rats were subjected to the occlusion of superior mesenteric artery for 30 minutes, then reperfused for 120 minutes, and randomized to the four different modalities of POC: (1) control (no intervention); (2) POC‐3 (three cycles of 10 seconds of reperfusion–reocclusion, 1 minute total intervention); (3) POC‐6 (six cycles of 10 seconds of reperfusion–reocclusion, 2 minutes total intervention); and (4) sham operation (laparotomy only). The arterial blood samples [0.3 mL total creatine kinase (CK) and 0.6 mL malondialdehyde (MDA)] and the intestinal mucosal MDA were collected from each after reperfusion. POC, especially POC‐6, was effective in attenuating postischemic pathology by decreasing the intestinal tissue MDA levels, serum total CK activity, inflammation, and total histopathological injury scores. POC exerted a protective effect on the intestinal mucosa by reducing the mesenteric oxidant generation, lipid peroxidation, and neutrophil accumulation. The six‐cycle algorithm demonstrated the best protection.

Pleomorphic adenoma of the lower lip: A review

The lower lip is a very rare emerging site for pleomorphic adenoma. The present review is to accentuate the definition, frequency, clinical and histopathological features, differential diagnosis, prognosis, and treatment choices of pleomorphic adenoma. We reviewed the English-language literature addressing pleomorphic adenoma of the lower lip. The tumors of minor salivary glands are not frequent among whole salivary glands tumors. Pleomorphic adenoma is the most common neoplasm among the minor salivary glands. A wide excision is recommended if there is no cosmetic care and no risk of damage to the functional structures of head and neck. Malignancy of the minor salivary glands are not rare. In addition, malignant transformation of pleomorphic adenoma involved in the benign tumors of minor salivary glands are possible. Thus, awareness of the possibility of existence of a pleomorphic adenoma or a malignant tumor within a mass located on the lower lip has a mentionable importance.

Meckel's diverticulum in a strangulated umbilical hernia

Sir, Meckel’s diverticulum (MD) was determined by Meckel on a small bowel diverticula in 1800.[1] It is the most common anomaly of gastrointestinal tract and reported to occur in 1-3% of general population and autopsy series.[2] The co-occurence of MD and umbilical hernia (UH) is very rare in the literature.[3] Although Meckel’s diverticulum is the most common anomaly of the gastrointestinal tract affecting 1-3% of general population, Meckel’s diverticulum in a strangulated UH is very rare. The most common complication of Meckel’s diverticulum is bleeding in children, unlike intestinal obstruction in the adult population. Although it is rare, a clinician should be vigilant for this entity especially in the case of an abdominal emergency of a non-trauma origin. The clinical features of strangulated Meckel’s diverticulum in an UH are documented.[3]