OBJECTIVE:The present study evaluated effects of incidental parathyroidectomy, surgical technique, and presence of thyroiditis or hyperthyroidism on occurrence of postoperative persistent or transient hypocalcemia.METHODS:Patients who underwent thyroidectomy at İstanbul Medeniyet University between 2013 and 2015 were included in the study. Patient information, postoperative serum calcium levels, and pathology reports were investigated retrospectively. Group 1 was made up of patients who were found to have hypocalcemia (calcium ≤8.5 mg/dL) according to postoperative serum level and normocalcemic patients were placed in Group 2. Groups were compared statistically in terms of rate of incidental parathyroidectomy, surgical technique, and presence of thyroiditis or hyperthyroidism.RESULTS:Mean age was 49.8±12.8 years (range: 20-88). A total of 417 patients were included in the study, 74 (17.7%) were male and 343 (82.3%) were female. Group 1 consisted of 205 (49.2%) patients who had hypocalcemia according to postoperative serum level, and remaining 212 (50.8%) patients were placed in Group 2. In Group 1, 38 (18.5%) patients had incidental parathyroidectomy, and with only 18 (8.5%) patients in Group 2, a statistically significant relationship was found between incidental parathyroidectomy and hypocalcemia (p=0.003). There was no statistically significant difference in terms of presence of thyroiditis or hyperthyroidism between groups. There was statistically significant decrease in postoperative hypocalcemia rate in patients with lobectomy compared to patients with bilateral total thyroidectomy or central neck dissection (p<0.01).CONCLUSION:Risk of postoperative hypocalcemia may be reduced with lobectomy for selected patients. In addition, delicate dissection during thyroidectomy is important in order to protect parathyroid glands and prevent hypocalcemia.
Abstract:Gallbladder agenesis (GA) is a rare congenital anomaly of the biliary system often associated with other congenital abnormalities. Patients become symptomatic in 23% of cases (Richards et al., 1993). GA is often misinterpreted as other diseases, therefore, leading to unnecessary surgery. Many of these patients develop a typical symptomatology of cholelithiasis that leads them to operating theatre. If an operative procedure is done, it is better to remain at the level of laparoscopy because further surgical investigation may lead to detrimental biliary tract injuries (Waisberg et al., 2002). We present a case of GA, diagnosed by magnetic resonance with cholangiopancreatography.
Endometriosis is a disease seen in women at reproductive age, characterized by extrauterine localization of endometrial tissue. Colonic endometriosis rarely causes acute mechanical intestinal obstruction (AMIO). It may also be presented with pelvic pain, dyspareunia, tenesmus, painful defecation related to the menstrual cycle. In the literature, 3-37% of the gastrointestinal location was reported and AMIO was observed in 7-23% of these cases. There are only few cases of mechanical obstruction related to sigmoid endometriosis mimicking colon malignancy. In this study, we aim to report a case of a 40-year-old patient with AMIO developed secondary to colonic endometriosis in light of the literature. The patient was discharged with full surgical recovery after the Hartmann procedure was performed, and the pathological diagnosis was reached as endometriosis. At the post-operative sixth-month colostomy, closure and bilateral oophorectomy were performed with the patient's will. The patient was discharged with surgical recovery and is still being regularly followed up. Endometriosis is a gynecological disease that may occur in all organ systems even though the most common location is the overs. Gastrointestinal located endometriosis should, therefore, be kept in mind in the etiology of AMIO in women at reproductive age and the related symptoms should be questioned in differential diagnosis.
Objective: To find out the outcomes of Fournier's gangrene (FG) patients using clinical data and prognostic biomarkers based on the current literature. Study Design: Descriptive study.
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