Diseases and tumors of the appendix vermiformis are very rare, except for acute appendicitis. This study aimed to examine rare findings in the histopathologic examinations of specimens of patients undergoing appendectomy due to the diagnosis of acute appendicitis. The files of 1970 patients undergoing appendectomy due to the diagnosis of acute appendicitis between March 2012 and March 2016 were retrospectively investigated. Rare findings were found in 59 (3 %) patients, and these were evaluated in detail. Patients' age, gender, pathology reports, and postoperation follow-ups were recorded. The rare histopathological findings of 59 patients were examined. Of these, 31 were female (52.5 %) and 28 were male (47.5 %). The average age was 33.1 ± 18.2 years. The unusual findings were as follows: 16 fibrous obliteration, 11 , 2 schistosomiasis, 3 appendiceal neuroma, 2 granulomatous appendicitis, 1 Crohn's disease, 3 chronic appendicitis, 1 endometriosis, 2 hyperplastic polyps, 9 mucinous cystadenoma (+mucocele), 8 carcinoid tumors, and 1 lymphoma. All of the malignant tumors were localized in the distal end of the appendix, and all of the patients were treated with appendectomy. Patients with parasitic diseases also underwent anthelmintic treatment, while chemotherapy was administered to the patient with lymphoma. All of the patients diagnosed with malignancy were alive reported no problems at their follow-ups. Although all of the appendectomy samples were normal macroscopically, data from this study suggest that all specimens should be sent for routine investigation.

OBJECTIVES: Our aim was to investigate platelets (PLT) and their indices-mean platelet volume (MPV), platelet distribution width (PDW) and plateletcrit (PCT)-in the differential diagnosis of benign and malignant thyroid disorders. BACKGROUND: Platelet and platelet indices recently started to be defi ned as an useful clinical marker in cancer patients. Their higher reproducibility rates and low cost provide them a wide range of usage. MATERIAL AND METHODS: One-hundred and sixty patients were divided into three groups retrospectively. Group 1: papillary thyroid carcinoma patients (n = 65). Group 2: multi-nodular goiter patients (n = 65). Group 3: normal healthy subjects (n = 30). PLT, MPV, PDW and PCT measurements were compared between groups, and p < 0.05 was accepted as signifi cant. RESULTS: PDW was found to be signifi cantly decreased in Group 1 (p < 0.01), and PCT was observed to be signifi cantly increased in Group 1 (p < 0.01). There were no signifi cant differences in PLT and MPV results. CONCLUSION: Statistically signifi cant increases in PCT and decreases in PDW were observed in papillary thyroid cancer patients when compared with other groups. Platelet indices may be used as useful clinical markers in the differential diagnosis of benign and malignant thyroid disorders (Tab. 1, Fig. 2, Ref.

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Acute gastric dilatation was first described by Duplay in 1833. Since the stomach has rich blood circulation, necrosis and perforation due to dilatation are rarely seen. Clinically, more than 90% of cases have complaints of vomiting. The most useful method to determine diagnosis and etiology is computerized tomography (CT). Medical treatment is suitable for cases that have no necrosis or peritonitis findings. Delay in surgical treatment increases the risk of mortality. The present case is that of a diagnosis of gastric perforation due to acute gastric dilatation in a 24-year-old female patient.

ÖzetAmaç: Otuz beş yaş ve üstü eğitim seviyesi düşük kadınların meme kanseri hakkında bilgilerini ölçmek, risk faktörlerini ortaya koymak ve risk hesaplaması yaparak kadınları bilgilendirmek.Gereç ve Yöntem: Sağlık Bakanlığı meme kanseri risk değerlendirme formu ve Gail modeli ile olguların risk oranları tespit edildi. Ayrıca kadınların meme muayenesi ve tarama hakkındaki bilgileri de kaydedildi. Bulgular:Olguların Gail modeliyle yapılan hesaplamasında yüksek risk saptanmadı. Sağlık Bakanlığı'nın risk değerlen-dirme formuna göre sadece iki olguda orta risk bulundu. Düzenli olarak doktora giden ve muayene olan kadınların sayısı %60'ın altındaydı. Kadınların kendi kendine muayene yapanların oranı %67 idi. Meme kanserinin en sık görüldü-ğünü bilenler %81 oranında olup bilgilerin çoğunluğu televizyondaki sağlık programlarındandır. Sonuç:Meme rahatsızlığı ile başvuran hastaların riskleri ortaya konularak hesaplama yapmanın ve aynı zamanda bilgilendirmenin yararlı olacağı sonucuna varılmıştır.

OBJECTIVE:The aim of this study is to evalute risk factors which trigger the development of trocar site hernia after elective laparoscopic cholecystectomy operation and to discuss what needs to be done to prevent it.METHODS:Patients operated with laparoscopic cholecystectomy between 2011 and 2013 were evaluated. Patients were called back for follow-up visit at 12 month after operation. Physical and ultrasonographic examinations were performed at follow-up. Factors that facilitate development of trocar site hernia were investigated.RESULTS:One hundred and ninty patients were operated during the study period. One hundred and thirty-two patients who had been examined at follow-up period were included in the study. Mean age of the patients was 50.64±11.86 (18–76) years and female/male ratio was five. Trocar site hernia was detected in four patients at umblical trocar site. One of these patients had chronic obstructive lung disease, two of them had diabetes and three of them had obesity. Advanced age and obesity were found to be statistically significant in patients having trocar site hernia (p value: 0.007, and 0.008, respectively).CONCLUSION:Development of trocar site hernia after laparoscopic surgery may be prevented by repair of trocar site in patients taken into consideration risk factors such as advanced age and obesity.

During the short follow-up period, this new technique significantly increased the safety of the anastomosis, moreover it did not cause any increase in peritoneal adhesions. This success has most probably occurred as a result of the external mechanical support to the anastomosis.

Laparoscopic cholecystectomy (LC) as a gold standard procedure for treating symptomatic cholelithiasis has certain complications. Some of these complications (e.g., common bile duct injury) have shown lower incidence over time as experience and technology has improved; however, the incidence of gallstone spillage remains unchanged. The incidence of gallbladder perforation during LC has been reported as 18%, and gallstones are spilled in approximately 40% of these cases. Spillage of gallstones has been reported in 6% of all LCs. The incidence of lost gallstones has been reported to be 16%-50% (1, 2).Lost gallstones act as a septic focus and can cause numerous complications. A large number of different presentations have been described after gallstone spillage following LC in the literature; however, late presentation is rare in the literature (3-6). In this study, we present the case of a patient with abdominal and flank abscesses 10 years after LC. Case ReportA 77-year-old man presented with a spontaneously draining right flank abscess. He suffered from vague abdominal pain for a long time. His clinical record showed previous LC 10 years ago. On admission, his white blood cell count was 15,000/µL, C-reactive protein level was 6 mg/L, and other laboratory test results were normal. Abdominal physical examination showed little tenderness in the right upper quadrant. Abdominal computed tomography revealed three abscesses, from the posterior of the liver to the right flank, and an idle metallic clip out of operation area adjacent to the abscess at the posterior of the liver (Figure 1). The abscess in the flank was drained by making an incision at the drainage area, and two gallstones, approximately of 5-8 mm in diameter, were retrieved. The remaining two abdominal abscesses had a connection to each other, and both were percutaneously drained under the guidance of ultrasound two days after the first open drainage (Figure 2). Escherichia coli was isolated through a microbiological examination of the drained material. Antibiotics used for susceptibility testing were ampicillin, ampicillin-sulbactam, cefazolin, cipro oxacin, co-trimoxazole, gentamicin, ceftriaxone, and cefoperazone. The isolated organism was susceptible to all antibiotics. Ampicillin-sulbactam was selected for medical treatment. Complaints and laboratory findings of the patient recovered after the drainage of abscesses and medication. The patient was uneventfully discharged on the 14 th day of hospitalization. No problems were detected in the patient's follow-up after 24 months. Written informed consent was obtained from the patient. DiscussionLaparoscopic cholecystectomy is the gold standard procedure for the management of gallstone disease. Spillage of gallstones during operations is fairly common and occurs in approximately Literatürde safra ve safra taşı dökülmesinin tüm laparoskopik kolesistektomilerin %6'sında görüldüğü bildirilmiştir. Bu dökülme septik odak olarak hareket ve çeşitli komplikasyonlara neden olabilir. Bu çalışmada on yıl önce laparos...