Bezoarlar gastointestinal sistemde bulunan yabancı cisimlerin oluşturduğu sert kitlelerdir. Midede bulunan bezoarlar medikal olarak tedavi edilebilir. Bezoara bağlı gelişen akut barsak tıkanmasının tek tedavisi cerrahidir. Bu çalışmada akut barsak tıkanmasına neden olan bezoarların medikal tedavileri irdelenmektedir. Son 5 yıl içinde hastanemize bezoarlara bağlı akut barsak tıkanması ile 22 hasta yatırıldı. Onsekiz hasta ameliyat edildi. Medikal tedaviyi tolere edebilecek olan 4 hastaya ananas suyu tedavisi uygulandı. Medikal tedavi uyguladığımız 4 hastada ortalama 3 gün boyunca devam eden bulantı, kusma ve distansiyon şikayetleri mevcuttu. Ayakta direk batın grafilerinde hava-sıvı seviyeleri saptandı. Tüm hastalarda bilgisayarlı tomografide ince barsakta kısmi tıkanmaya yol aç-mış bezoar ile uyumlu kitle saptandı. Tüm hastalar medikal tedaviye cevap verdi. Akut barsak tıkanmasına sebep olan ve genel durumu medikal tedaviyi tolere edebilecek olan hastalarda ananas suyu ile medikal tedaviler denenebilir.J. Exp. Clin. Med., 2011; 28:55-58 ABSTRACTBezoars are concretions or hard masses of foreign matter that are found in the gastrointestinal tract. Gastric bezoars can be treated medically. Surgery is the only treatment option for acute intestinal obstruction secondary to bezoars. In this report, we share our experience of medical treatment with pine apple juice for acute intestinal obstruction secondary to bezoars. We hospitalized 22 patients for acute intestinal obstruction secondary to bezoars. Eighteen of them underwent surgical treatment. Four patients who were able to tolerate medical treatment, were treated medically with pine apple juice. All patients were admitted with complaints of nausea, vomiting and distention for a period of 3 days. Plain abdominal graphy showed air-fluid levels and CT scan showed intestinal obstruction secondary to bezoars. All patients responded to medical treatment. Patients with intestinal obstruction secondary to bezoars can be treated medically with pine apple juice if they are able to tolerate medical treatment.
How and when does a hydatid cyst die in humans? There is an ongoing debate in medicine about this subject. Calcification of the hydatid cyst wall is believed to indicate the death of the contents of the cyst . However, rarely, the cyst may be alive even though the wall is calcified. With this report, we presented a patient with a hydatid cyst with calcified wall. Our patient presented here was followed up for 8 years after the diagnosis and sufficient and effective treatment was not given thinking that the hydatid cyst was dead because of the calcified cyst wal, but intrabiliary rupture occurred after the follow-up. Criteria for the viability of hydatid cyst are discussed and the literature is reviewed.
Recently, stapler anastomosis is the method of choice in low or ultra low resection for rectal carcinoma. In this study, risk of rectal stricture formation after double stapling colorectal anastomosis was evaluated. We here with presented an invitro investigation and a retrospective analysis of 91 cases of rectal carcinoma treated by low or ultra low anterior resection with hand-sewn or double-stapled colorectal anastomosis between the years 2002-2006 regarding the late complication of postoperative stenosis. In in vitro investigation external and internal diameters of staplers were measured. Also diameters of anastomotic lines were investigated on stapled sheep intestine and low anterior resection specimen of human, in vitro. External and internal diameters of 29 and 33 mm staplers were found 19.5-24 mm respectively. Also diameters of anastomosis with 29 mm stapler at sheep intestine and 33 mm stapler at low anterior specimen were found 15 mm, 20 mm respectively.Rectal stricture was not seen in any of the patients with hand-sewn anastomoses. We found postoperative stricture of the rectal anastomosis in 11 (17.2 %) of the patients treated by double-stapled group (p=0.022). The risk factors that we have investigated were age and gender of the patient, location and stage of the tumour, diameter of EEA staplers, and presence of neoadjuvant or adjuvant chemoradiotherapy. Although double-stapling anastomosis in rectal cancers has clear technical advantages over hand-sewn technique, the late complication of stenosis occurred at a significantly higher rate after this technique
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