Table 1. Diagnostic criteria of ROME III.Backround: Chronic constipation is a common, chronic and frequent problem of the general population. The aim of this study is to assess the efficacy of defecography in diagnosing the etiology of constipation and the relation between constipation and rectocele. Material-method: We have investigated 250 patients who have been admitted to our general surgery outpatient clinic with complaint of constipation using Rome III criteria and diagnostic defecography. Results: Out of 250 patients who were evaluated with defecography only 24 had normal findings. 136 patients were found to have rectocele. Conclusion: We propose that rectocele is an important etiology of constipation, and defecography should be considered early in the diagnosis of rectocele.

Objective: Chronic constipation is an entity with a high prevalence in the community. In our study, we analyzed the importance of defecography in the assessment of the etiology of chronic constipation. Material and Methods:Patients who were admitted to our hospital outpatient general surgery clinic with complaints of constipation between July 2010 and January 2014, and who had their demographic data and defecography results recorded were included in the study. The demographic data of patients who underwent defecography and their results were recorded along with patient gender and age. Results:The defecography was abnormal in 573 patients (90.9%) while it was normal in 57 patients (9.1%). Conclusion:Defecography is the current standard method of examination in etiological investigations for constipation, and it should be performed in each patient with a diagnosis of chronic constipation.Key Words: Chronic constipation, defecography, rectocele INTRODUCTIONChronic constipation is a frequent condition (1, 2). Colonic transit time measurement, defecography and anal manometry can all be used to determine the etiology of chronic constipation (3). Although it is assumed that the measurement of the colonic transit time distinguishes between slow passage constipation and outlet obstruction, the test may not be helpful in differentiation of these causes depending on the patient's diet (4).Defecography may enable the identification of pathologies that cause outlet obstruction (5). There are studies supporting the usefulness of defecography in demonstrating the etiology in patients with normal colonic transit time and those with outlet obstruction (6).In our study, we investigated the requirement for defecography, independent of other etiological examination tests, for patients diagnosed with chronic constipation according to the Rome III criteria. MATERIAL AND METHODSPatients who presented to the general surgery outpatient clinic of our hospital between July 2010 and January 2014 were included in the study. The diagnosis of constipation was made according to the Rome III criteria. The patients with a Rome III assessment score of 2 and above underwent defecography in order to investigate the etiology of constipation.As part of the etiological examination for chronic constipation, the patients initially received a test demonstrating the colonic transit time. Patients who were diagnosed with obstructive defecation or with a normal colonic transit time underwent defecography in the second stage.Defecography was conducted in the endoscopy unit of our hospital by general surgeons. For the procedure, the contrast material was mixed with starch flour to provide a consistency similar to stool, and was administered via 50 cc cone tip injectors. Then, a series of images were captured while the patients were being asked to repeat the straining-retaining processes for three times.Defecography results were recorded as well as gender and age. RESULTSBetween July, 2010 and January, 2014, 715 patients presented to the general surgery outpat...

Purpose: We aimed to investigate the effect of COVID-19 pandemic on general surgical emergencies. On the other hand, we analyzed the effectiveness of the measures we have taken and the incidence of COVID-19 of patients and healthcare professionals.Method: In the pandemic period between March 14 and May 15, 2020, and in the same period of the previous year, the files of patients who underwent emergency surgery and followed up nonoperatively were reviewed retrospectively. The incidence of COVID-19 was questioned in patients operated on in the pandemic period and in health professionals working in the general surgery department.Results: Demographic data were similar between the two groups. The number of patients operated on in the pandemic group (n = 103) was lower than during the control group (n = 252) (p = 0.001). In the pandemic group, there was a significant decrease in the number of surgeries of uncomplicated appendicitis, acute cholecystitis and incarcerated hernia (p=0.001, p=0.005, p=0.001, respectively). Others surgeries were similar in both groups. In the pandemic group, nonoperatively follow-up rates were significantly lower in acute mechanical intestinal obstruction and acute cholecystitis (p=0.001, p=0.011, respectively). The findings of COVID-19 were positive in 6(6/103, %5.82) patients undergoing emergency surgery. None of our doctors had COVID-19 infection (0/20). The findings were positive only in 2 nurses from the general surgery department(2/24, %8,33).Conclusion: In these and similar pandemics, we think that a new algorithm is needed to approach emergencies and the results of this study can help for that.

Background. Outlet obstruction syndrome refers to all pelvic floor dysfunctions that are responsible for incomplete evacuation of fecal contents from the rectum. Defecography is the first step for diagnosis of outlet obstruction syndrome. The free selection of imaging planes, good temporal resolution, and excellent soft tissue contrast has helped to transform this method into the preferred imaging modality for evaluation of patients with pelvic floor dysfunction. The purpose of our study was to compare conventional and magnetic resonance (MR) defecography in patients who were admitted for outlet obstruction syndrome. Materials and methods. Twenty-eight patients who presented with constipation between January 2015 and January 2020 were included in this study. MR defecography was performed 1 to 2 weeks after conventional defecography. The methods were compared with regard to their ability to diagnose anterior rectocele, internal mucosal intussusception with or without rectocele, and puborectal spasm. Additional abnormalities were also noted. Results. Comparison of conventional and MR defecography for their ability to diagnose anterior rectocele, internal mucosal intussusception, and puborectal spasm showed no significant differences between the 2 methods. The continuity correction ratio of the 2 methods for diagnosis of anterior rectocele, internal mucosal intussusception, and puborectal spasm was 0.146, 0.007, and 1.000, respectively. Conclusions. Although conventional defecography is the gold standard for diagnosis of rectocele, intussusception, and puborectal spasm, MR defecography has garnered considerable attention due to the lower radiation, increased safety, and higher incidence for diagnosis of another pathology, such as uterine diversion.

This is an open access article distributed under the terms of the CreativeCommons Attribution-NonCommercial-NoDerivatives License 4.0 (CC BY-NC-ND 4.0) where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. AbstractAim: Honey is well known for its beneficial wound healing-related effects, including anti-edematous effects, stimulation of granulation tissue formation, chemical debridement, and immune system enhancement. In this experimental study, the effects of honey and prednisolone on stricture formation in sodium hydroxide-induced corrosive esophagitis were investigated. Methods: This study was carried out on Wistar albino rats weighing between 200-250 grams. Rats were divided into four equal groups. Corrosive esophagitis induced by 37.5% sodium hydroxide was formed in three groups. The first group received no specific treatment.The second group was treated with honey via the oral route, and the third group was treated by prednisolone intraperitoneally. The control group underwent a sham laparotomy. All subjects were sacrificed by the end of the 28 th day. A 20-mm long segment of the distal esophagus was harvested for histopathological examination. The tissue damage scores and stenosis index scores of the groups were measured and compared.Results: A total of 32 rats were included in the study, with eight subjects in each group. The mean values of stenosis index score and tissue damage score were significantly lower in the honey-treated group (P=0.001).Conclusion: Oral honey treatment seems to reduce the severity of esophageal strictures associated with corrosive esophagitis, when compared to untreated and prednisolone-treated groups. Öz Amaç: Bal antiödem etkisi, granülasyonu hızlandırıcı etkisi, enzimatik debridman ve immün sistemi güçlendirici etkisi bilinen bir doğal gıdadır. Bu deneysel çalışmanın amacı bir alkali ajan olan sodyum hidroksit ile oluşturulan koroziv özofajitte darlık gelişimi üzerine balın ve prednisolonun etkilerini araştırıldı. Yöntemler: Bu çalışma, ağırlıkları 200-250 gram arasında değişen Wistar tipi albino sıçanlar üzerinde gerçekleştirildi. Denekler, eşit sayıda dört gruba bölündü. Birinci, ikinci ve üçüncü gruplar özofajit modeli grupları olup, bu gruplardaki tüm deneklerde %37,5'luk sodyum hidroksit ile koroziv özofajit oluşturuldu. Birinci gruba herhangi bir tedavi uygulanmazken, ikici gruba oral bal tedavisi ve üçüncü gruba intraperitoneal prednisolon tedavisi uygulandı. Kontrol grubunun özofagusuna herhangi bir işlem yapılmadan şam laparotomi uygulandı. Tüm denekler 28. gün sakrifiye edildi ve deneklerin distal özofaguslarından alınan 20 mm uzunluğundaki örnekler histopatolojik incelemeye tabi tutuldu. Grupların doku hasarı skorları ve stenoz indeksi skorları ölçülerek kıyaslandı. Bulgular: Çalışmaya toplam 32 denek dahil edildi ve her bir grupta sekiz denek mevcuttu. Stenoz indeksi skoru ortalama değeri ve doku hasarı skoru ortalama değeri balla ted...

Objective: Endoscopic treatment is an effective and successful treatment for non-variceal upper gastrointestinal system (GIS) bleedings. In recent years, endoscopic combined therapies have been recommended for hemostasis. The aim of this study was to investigate primary hemostasis rates and re-bleeding rates obtained by epinephrine injection alone. Material and Methods: We analysed patients who had alone endoscopic epinephrine injection treatment for upper gastrointestinal system bleeding between January 2014 and January 2019. Gender, age, etiology of bleeding, Forrest classification, treatment efficacy and re-bleeding rates of the patients were recorded. The files of the patients were analyzed retrospectively. Results: The number of patients who met the study criteria was 107. There were 16 patients in Group 1 (Forrest 1a), 64 patients in Group 2 (Forrest 1b) and 27 patients in Group 3 (Forrest 2a). Primary hemostasis was achieved in 14 (87.5%) of 16 patients in Group 1, 62 (97%) of 64 in Group 2, and 27 (100%) of 27 Group 3. Re-bleeding rates were 4 (28%), 10 (16%), 2 (7%) in groups 1,2 and 3, respectively. Conclusion: It is thought that endoscopic combined treatment should be applied especially in patients with Forrest 1a and 1b bleeding ulcers, whereas in Forrest 2a ulcer patients, because of both the high rate of primary hemostasis and low rate of re-bleeding according to the results of the present study, the treatment of adrenalin injection alone can be used alone like other hemostasis modalities

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