Zeynep Özkan

Ingested bone fragment in the bowel: Two cases and a review of the literature

Generally, ingested foreign bodies are excreted from the digestive tract without any complications or morbidity. In adults, ingestion of foreign bodies frequently occurs in alcoholics and elderly individuals with dentures. The most commonly ingested foreign bodies are food stuffs or their parts, such as fish bones or fragments of bone and phytobezoars. Sharp foreign bodies like fish and chicken bones can lead to intestinal perforation and peritonitis. We report herein two cases, one of bowel perforation and another of anal impaction, both caused by ingested bone fragments. Complications due to ingested bone fragments are not common and preoperative diagnosis remains a challenge and therefore it must be considered in susceptible cases.

An obstruction not to forget: Pseudo-obstruction (Ogilvie syndrome): Single center experience.

Purpose: Colonic pseudo obstruction disease commonly seen in the elderly, immobile patient group can cause serious mortality and morbidity. Our objective in this retrospective study is to share our clinical experience by evaluating patients with Ogilvie syndrome who were followed and treated in our clinic. Methods: Eleven cases with the diagnosis of Ogilvie syndrome followed up and treated between September 2010 and April 2013 were evaluated retrospectively. All the patients that had no symptoms of acute abdominal pain were initiated conservative treatment. Colonoscopic decompression was attempted for patients whose clinical pictures were not recovered. Patients underwent operation if they developed peritoneal irritation symptoms during these procedures and of their number of white blood cells seriously increased during the follow-up period. Results: A total of 11 patients were treated for Ogilvie syndrome. 6 of the patients underwent surgical treatment, and 5 were treated medically. Mortality developed in two patients. The main cause of mortality was a delay in diagnosis and additional severe underlying diseases. Seven patients were given Neostigmine. Of these, 2 patients required surgery and 3 patients responded to Neostigmine. Conclusion: Ogilvie syndrome is a rare cause of ileus of the colon. It is more common particularly in old patients with additional problems. If the disease is suspected and diagnosed early, unnecessary surgical interventions can be prevented with medical treatment choices.

An Unusual Mesenteric Tumor ‘Paraganglioma’: A Case Report

Introduction: Paragangliomas are mostly localized in the adrenal medulla and they are usually pheochromocytomas, derived from the neural crest, but otherwise mesenteric paragangliomas are extremely rare tumors. Case Presentation: In this article we represent a 59-year-old female with an abdominal mass and pain due to mesenteric paraganglioma. Conclusions: Paragangliomas can occur as mesenteric tumors; usually, preoperative accurate diagnosis is not possible with imaging methods and precise diagnosis is possible after histological evaluation.

Diagnostic challenge in papillary thyroid carcinoma with cervical lymphadenopathy, metastasis, or tuberculous lymphadenitis.

Papillary thyroid carcinoma (PTC) is the most frequent histological subtype of thyroid cancer. Total thyroidectomy with neck dissection is recommended for treatment. Tuberculous adenitis is a common cause of lymphadenopathy in endemic areas. Therefore, tuberculous lymphadenitis should be considered in the etiology of enlarged lymph nodes when PTC patients with risk factors such as tuberculosis present with cervical lymph node enlargement. Detailed evaluation of the neck metastasis of patients with PTC is necessary to avoid postoperative complications due to neck dissection. We present a 55-year-old female patient with tuberculous lymphadenitis mimicking metastatic lymph nodes from PTC.

Elektif kolorektal cerrahi öncesinde mekanik bağırsak temizliği gerekli midir? Prospektif, randomize ve kontrollü bir çalışma

GIRIŞ Kolorektal cerrahi uygulanacak hastalara, ameliyat oncesinde mekanik bagirsak temizligi (MBT) siklikla uygulanmaktadir. MBT’nin asil amaci postoperatif enfeksiyoz komplikasyonlarin ve ozellikle de anastomoz kacaginin onlenmesidir (1). Goligher ve arkadaslarinin 1971 yilinda yayinladiklari bir makalede, hastalara 3-5 gun sureyle sivi diyet rejimi uygulanmakta, sonrasinda katartikler ve enemalar verilmekteydi (2). En az duzeyde absorbe olan ve kolonu etkin bir sekilde yikayabilen polietilen glikol preparatlarinin tanimlanmasi ile MBT uygulamalari degisime ugramis, hazirlik suresi 1 gune kadar inmistir (3). Son yillarda ise osmotik etkileriyle temizlik saglayan sodyum-fosfat solusyonlari tercih edilmektedir. Hastalarin bir kisminda elektrolit dengesizligi, hipovolemi, akut bobrek yetmezligi, kolon mukozasinda aftoz ulserler gibi yan etkiler bildirilmektedir (4). Bagirsak hazirligi icin en sik kullanilan polietilen glikol ve sodyum fosfat solusyonlari ile yapilan karsilastirmali calismalarin meta-analizinde yetersiz bagirsak hazirligi oranlarinin sirasiyla %28 ve %18 oldugu saptanmistir (5). Kolorektal cerrahi uygulanan hastalarda, bagirsak iceriginin peritoneal kaviteye dokulmesi postoperatif komplikasyon oranlarini artirmaktadir. Bununla birlikte yetersiz bagirsak temizliginin sonucu olarak sivi bagirsak icerigi olusmasi, bagirsak iceriginin peritoneal kaviteye dokulme oranlarinda artisa neden olmaktadir (6). Kolorektal cerrahide artik bir aliskanlik halinde yapilan MBT’nin anastomoz kacagi ve enfeksiyoz komplikasyon oranlarini azaltmadigi, aksine bazi calisARAŞTIRMA YAZISI