Crystallized phenol application is a good alternative to the modified Limberg flap procedure and other surgical procedures, because it has several advantages such as being a minimally invasive procedure performed under local anesthesia with higher success rate after multiple applications, decreased length of stay in hospital, and minimal scar tissue formation.

BackgroundIn this study our aim was to evaluate the diagnostic value of preoperative laboratory and radiological studies for appendicitis.MethodsThe clinical data of 196 patients who have undergone conventional appendectomy between March 2007 and April 2008 were collected retrospectively. Patients were examined for age, sex, white blood cell count, ultrasonography results, histopathological diagnosis and hospital stay.ResultsNegative appendectomy rate was 17.3% (27% for female, 11.5% for male). White blood cell counts were found to be high in 83% for acute appendicitis group and %61 for negative appendectomy group. There were 66 (34%) patients who had negative USG findings for acute appendicitis. Of these patients, histopathological examination revealed acute appendicitis in 46 patients whereas 20 patients had normal appendix. Hospital stays were 2.79 +/- 1.9 and 2.66 +/- 1.7 days for negative and positive appendicectomies respectively.ConclusionsBesides the improvement of diagnostic tests for acute appendicitis, we could not sufficiently reduce the negative appendectomy rate.

Objective: Laparoscopic appendectomy (LA) has been described in 1983, and its superiority over open appendectomy (OA) is still being debated. Currently, there is no agreement on the advantages of LA. Postoperative pain is reported to be lower along with a faster return to normal activities in LA. However, some studies do not support these findings. In our study, we aimed to compare the outcomes and cost effectiveness of LA and OA. Material and Methods:Patients were prospectively randomized into LA (31 patients) and OA (32 patients) groups. Demographic data, pre-and postoperative C-reactive protein (CRP) levels, white blood cell (WBC) count, duration of surgery and hospitalization, complications, and pain scores (VAS) were recorded. Cost was calculated for both groups. Return to normal activities was evaluated by phone calls at the first and second week and 1 month after surgery.Results: There was a significant postoperative decrease in WBC count in the LA group (p<0.01). There were no differences between LA and OA groups in terms of postoperative CRP levels (p>0.05). The rates of wound infection and abscess were similar (p>0.05), while post-operative pain and time to return to normal activities were higher in the OA group (p<0.01). There was a positive correlation between BMI and operative time in the LA group (p<0.01), while BMI and operative time did not show a correlation in the OA group (p>0,05). The average cost in the LA and OA groups were 1960.5±339.05 and 687.115±159.5 TL, respectively. Conclusion:LA is an effective method in the treatment of acute appendicitis due to less pain and faster recovery. LA can be the choice of treatment in acute appendicitis, with utilization of re-useable and cheaper vascular sealing devices.

HighlightsComplete bladder herniation are very rare compared to incomplete bladder herniation.Massive scrotal cystocele is usually defined with voiding symptoms.CT, ultrasonography and retrograde cystogram should be performed to determine the involvement of the bladder in cases of massive inguinoscrotal hernias.In massive scrotal hernia cases, bladder can protrude with the ureter causing hydronephrosis on the affected side.It is necessary to place urinary catheter to empty the urinary bladder to manage the pain and to decrease the risk of injury of bladder during the surgery.

HighlightsCT scan has a great value for retrosternally extended giant goiter cases.If the general status of the patient prevents CT scan, bedside ultrasound can be used instead.Nasal awake intubiation is an appropriate choice for the patients with destructed trachea.Emergency thyroidectomy is a common option for the treatment of giant goiter causing airway obstruction.