AIM:To evaluate seven patients with non-traumatic splenic rupture (NSR). NSR is an uncommon dramatic abdominal emergency that requires immediate diagnosis and prompt surgical treatment to ensure the patient's survival. METHODS: Within 11 years, seven cases were evaluated for patient characteristics, anamnesis and symptoms, method of diagnosis, findings of laparotomy, and etiology of NSR. RESULTS: There were six (86%) male and one female (14%) patient, whose mean age was 36 ± 12.8 (17-56) years. We report here four cases of Plasmodium vivax malaria (cases Ⅰ-Ⅳ), one case of hemodialysis (case Ⅴ), one case of spontaneous splenic rupture (case Ⅵ), and one case of hairy cell leukemia (case Ⅶ). Splenectomy was performed in all patients. All of them made an uneventful recovery and were discharged in stable condition. CONCLUSION: NSR is a rare entity that needs a high index of suspicion for diagnosis. Using ultrasonography or computer tomography, and peritoneal aspiration of fresh blood may assist in the diagnosis of NSR. Increased awareness of NSR can enhance early diagnosis and effective treatment.

Management of a splenic hydatid cyst is not consensual. Total splenectomy is optimal because it provides definitive treatment. However, spleen-preserving surgery is the preferred treatment in selected patients. The choice of technique depends on the localization, number, and size of hydatid cysts, and the absence or presence of other hydatic organ cysts.

Subcapsular liver hematomas and ruptures are unusual fatal complications of HELLP (hemolysis, elevated liver enzymes, and low platelets) syndrome (HS). We present two cases of a spontaneous rupture of subcapsular liver hematoma occurring in HS and review the literature on this subjects. One case demonstrated a secondary rupture of a subcapsulary liver hematoma due to HS in one patient and HS associated with preeclampsia in another. The defects were on the medial and lateral sectors of the left lobe in one patient and on the medial sector of the right lobe in the other patient. In case 1 deep mattress sutures and omentoplasty were performed, and in the other case a defective area was closed with an absorbable gelatin sponge with a hemostatic effect. In addition, the liver was compressed by abdominal towels. A high index of suspicion and immediate recognition are keys to proper diagnosis and management of affected patients. The multidisciplinary approach to the management of these patients led to a remarkable decrease in the mortality rates. Less aggressive treatment is preferable to aggressive intervention such as a hepatic resection in such patients with coagulopathy.

Malaria has long been among the most common diseases in the southeast Anatolia region of Turkey. In 1992, 18 676 cases were diagnosed in Turkey, and Diyarbakir city had the highest incidence (4168 cases), followed by SanliUrfa city (3578 cases). Malaria was especially common during 1994 and 1995, with 84 345 and 82 094 cases being diagnosed in these years, respectively. Spontaneous rupture of malarial spleen is rare. We saw two cases during 1998, which are reported herein. Both patients were male, and were receiving chloroquine treatment for an acute attack of malaria. One of the patients had developed abdominal pain and palpitations, followed by fainting. The other patient had abdominal pain and fever. Explorative laparotomy revealed an enlarged spleen in both patients. Splenectomy was performed in both patients. We have identified 15 episodes of spontaneous rupture of the spleen in the English language literature published since 1961. Because of increased travel to endemic areas and resistance to antimalarial drugs, malaria is a major medical problem that is becoming increasingly important to surgeons worldwide. Malaria is a particularly important problem in the southeast Anatolia region of Turkey. Prophylactic precautions should be taken by tourists who travel to this region, especially during the summer.

Introduction: Human hydatid disease is a parasitic infection caused by the larval form of Echinococcus granulosus. It has worldwide distribution and is endemic in many countries, especially the Mediterranean region. It most commonly affects the liver and lungs although multi-organ involvement has been observed in 20-30% of patients. Case report: A 45-year-old woman presented to a gynaecologist because of a mass in the axillary region. Her mother and her two sisters were undergoing treatment for breast cancer. In her examination, a hard, semi-mobile, painless mass was found that was approximately 3 cm in diameter. Axillary ultrasonography showed lymphadenopathy. No abnormality was found in mammographic examination of either breast, or in abdominal ultrasonography and chest X-ray. Occult breast cancer was suspected but when the mass was excised for pathological examination the biopsy showed a hydatid cyst with germinative membranes. Subsequent lung, abdomen and brain tomography scans, whole body bone scintigraphy and hydatid serology, including indirect haemagglutination and enzyme-linked immunosorbent assay, were negative. For these reasons an isolated axillary hydatid cyst was diagnosed. Conclusion: Parasitic cysts should be considered in endemic areas in patients presenting with a soft tissue mass in the axillary region. Imaging methods should be planned to include this possibility.

activities are acceptable. For stage I ingrowing toenails the combination of conservative measures studied was shown t o be successful. In cases of stage I1 ingrowing nails, success can also be achieved but recurrences are frequent in the long term

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The current study shows that MPV is significantly higher in patients with PVT than in the control group.