Scar endometriosis, also referred to as abdominal wall endometriosis (AWE), is a rare form of endometriosis that usually develops in the scar after obstetric or gynecological surgeries, including cesarean section (CS). Recently, the occurrence of scar endometriosis has been increasing together with the increase of CS incidence. Scar endometriosis can be clinically misdiagnosed as hernia, lipoma, or hematoma. Here we retrospectively analyzed the clinical aspects of scar endometriosis and surgical approach in 14 patients from a tertiary hospital, who were treated by surgery, between 2012 and 2017. The mean age was 32.71 ± 8.61 years (range: 19-45). Palpable mass and cyclic pain at the scar site were the most common complaints. Twelve patients had previously undergone CS, and two patients had undergone a surgery of ovarian endometrioma. The preoperative diagnosis was determined with ultrasonography (US), magnetic resonance imaging (MRI), or computed tomography (CT). Preoperatively, scar endometriosis was diagnosed in 12/14 patients (85.7%), while 2 patients (14.3%) were diagnosed with inguinal hernia. The treatment was surgical excision in all patients; in addition, mesh repair surgery was performed in 1 patient with recurrent scar endometriosis. Postoperatively, endometriosis was confirmed by histology in all patients. The average size of endometriomas was 24.71 ± 6.67 mm (range: 11-35). No woman had concurrent pelvic endometriosis. In the follow-up period (mean: 9 months) the recurrence of endometriosis was not observed. Scar endometriosis should be considered in all women of reproductive age presenting with cyclic pain and swelling in their abdominal incision sites.
As a result, when the data collected by our study are evaluated, we see that pregnancy does not have a negative effect on the efficacy of AS. Therefore, the AS system can be an easy, non-invasive auxiliary diagnostic tool with high diagnosis accuracy rates that can be used in pregnant patients suspected of having acute appendicitis.
Thymoquinone and curcumin both have known positive effects on the organism. Histological and biochemical tests showed that thymoquinone is more effective than curcumin.
Acute appendicitis (AA) is the most common cause of acute abdominal surgeries, accounting for 15% of all emergency visits due to acute abdominal pain in patients aged over 60 years. Appendicitis is reported as the third most common cause of abdominal surgery in geriatric patients. In this current retrospective study, the records of 68 patients aged over 65 years, who were treated by surgical resection in our clinic diagnosed for AA between February 2015 and February 2020, were analyzed. The age, gender, duration of hospital stay of the patients and, histopathological results of appendectomy specimens were recorded. The Raja Isteri Pengrian Anak Saleha Appendicitis (RIPASA) Score of the patients was calculated according to the clinical history, physical examination, and laboratory parameters of the patients. According to the RIPASA scores, the patients were divided into three groups as the low-score group (4 to 7), the intermediate-score group (7.5 to 11.5), and the high-score group (≥ 12). The groups were compared on the basis of the microscopic diagnosis. According to the calculated RIPASA score, there were 12 patients in the low-score group, 44 patients in the intermediate-score group, and 12 patients in the high-score group. When the results were classified based on the pathology, we detected non-complicated conditions such as a normal appendix or reactive lymphoid hyperplasia in ten patients and catarrhal stage appendicitis in 38 patients along with complicated (gangrenous or perforated) appendicitis in 20 patients. In conclusion, the RIPASA score can be used in elderly patients considering its high accuracy rate. In elderly patients with a high RIPASA score, the pathological stage of the appendectomy specimen may also be complicated (perforated or gangrenous) appendicitis. Therefore, the mortality and morbidity rates may increase with increased complication rates.
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Background: Injuries to the recurrent inferior laryngeal nerve (RLN) remain one of the major post-operative complications after thyroid surgery. In studies, temporary RLN damage during thyroidectomy is %2-11, and the rate of permanent RLN damage is %0.6-1.6. Complementary thyroidectomies have a higher complication rate compared to the first surgical procedure. In the last two decades, intraoperative neural monitoring has become a powerful tool for risk minimization. In our study, we aimed to retrospectively examine the pa-tients who underwent complementary thyroidectomy and intraoperative nerve monitoring. Materials and Methods: Between January 2016 and February 2020, the files of 54 patients, who underwent complementary thyroidectomy and nerve monitoring in our clinic, were analyzed retrospectively.Patients who did not undergo nerve monitoring were not included in the study. The age, gender, pathology and indication, first surgery type, and the length of hospital stay of the patients, the reason for undergoing complementary thyroidectomy, and whether or not postoperative complications developed in the patients, were all recorded. Results: The mean age of the patients was 44.4 (16-82 years). The average length of hospital stay of the patients was 2.37 (1-5 days). According to the initial pathology results of the patients who underwent comp-lementary thyroidectomy, 34 had papillary thyroid cancer, 6 had follicular thyroid carcinoma or suspicion, 1 had medullary thyroid carcinoma, 1 patient had Anaplastic thyroid carcinoma suspicion and 12 patients had Multinodular Goiter recurrence. Conclusions: As a result, complementary thyroid surgery poses an important problem for surgeons. It has a high rate of complications due to the formation of scar and loss of normal tissue planes. Therefore, we think that the use of intraoperative nerve monitoring during complementary thyroidectomy surgery may be helpful in reducing the occurrence of permanent or temporary recurrent laryngeal nerve damage. Key Words: Intraoperative Nerve Monitoring Complementary Thyroidectomy, Complication
Background: Peptic ulcer disease (PUD) is an ulcerative lesion that extends to the submucosa or muscularis propria in the acid-induced stomach and duodenum. Peptic ulcer perforation (PUP) is the second-most common complication observed in 2%-10% of PUD cases. Materials and Methods: The records of 70 patients who were operated with a diagnosis of PUP between January 2010 and December 2018 were reviewed retrospectively. The mean platelet volume (MPV), platelet distribution width (PDW), white blood cell (WBC) count, and platelet count in the preoperative blood tests and at mortality were recorded in the patients. The patients were divided into two groups: those who did not develop mortality (Group 1) and those who developed mortality (Group 2). Results: Mortality was seen in 10 (14.2%) patients, of which five each were male and female. All patients who developed mortality did so in the early postoperative period (6th hour and 2nd day). There was a statistically significant difference in MPV and PDW values (p < 0.015 and p < 0.015, respectively). Conclusions: As a result, in our study, we think that preoperative high MPV and PDW values can be used to predict mortality in patients who will be operated for PUP. We anticipate that changes in MPV and PDW may be due to sepsis developed secondary to peritonitis due to perforation.
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