Appendiceal anomalies are extremely rare malformations that are usually found in adult populations as an incidental finding. Agenesis and duplication of the appendix have been well documented, but we know of only three reported cases of a horseshoe appendix. A 64-year-old woman admitted to the emergency department. A provisional diagnosis of acute appendicitis was made, and the patient was taken to the operating room. While appendectomy was being performed with a standard approach, the distal tip was seen to communicate with the cecum by another stump, or "horseshoe appendix". The aim of this report is to share our experience with this extraordinary finding.Key Words: Appendix vermiformis; horseshoe; malformation.Apendiks anomalileri çoğunlukla erişkin popülasyonda rastlantı sonucu bulunan çok nadir malformasyonlardır. Apendiks agenezis ve duplikasyonu iyi bilinmesine rağ-men, bildirilmiş sadece üç adet atnalı apendiks olgusu bulunduğunu biliyoruz. Acil servise başvuran 64 yaşında kadın hasta akut apandisit ön tanısı ile ameliyathaneye alındı. Standart yaklaşımla apendektomi uygulanırken, "at nalı apendiks" şeklinde distal ucun ikinci bir güdük ile çekumla bağlantılı olduğu görüldü. Buradaki amacı-mız bu sıra dışı bulguyla ilgili deneyimimizi paylaşmak-tır.Anahtar Sözcükler: Appendiks vermiformis; at nalı; malformasyon.doi: 10.5505/tjtes.2013.67424 Appendiceal anomalies are extremely rare malformations that are usually found in adult populations as an incidental finding. Agenesis and duplication of the appendix have been well documented, and the incidences for these anomalies are 0.008% and 0.004%, respectively.[1] However, we know of only three reported cases of a horseshoe appendix. [2][3][4] In this report, we present the fourth case of a horseshoe appendix. CASE REPORTA 64-year-old woman admitted to the emergency department with a two-day history of right lower abdominal pain, nausea, and loss of appetite. The abdominal examination revealed right lower quadrant tenderness, guarding and rebound tenderness at McBurney's point. All laboratory study results were in normal ranges, and plain chest and abdominal radiographs showed no abnormality. Ultrasonographic examination determined pericecal minimal fluid collection. A provisional diagnosis of acute appendicitis was made, and the patient was taken to the operating room. A standard approach was taken with incision over McBurney's point. The cecum was identified, the taenia coli were followed to their confluence, and an appendiceal stump was found. The distal appendiceal tip was seen to extend to the posteromedial cecum, and there were adhesions that complicated mobilization of the appendix. A decision was made to perform retrograde appendectomy. After appendiceal stump and mesoappendix were ligated and divided, the distal tip was seen to communicate with the cecum by another stump, or "horseshoe appendix" (Figs. 1a, b). Appendectomy was completed. The patient made an uneventful recovery and was discharged two days later.
Background: In this study, we shared the implementation success and clinical results for 38 patients treated with the cleaner™ pharmacomechanical thrombectomy device. Objectives: The impact and results of pharmacomechanical thrombectomy treatment on patients with deep vein thrombosis in the symptomatic acute and subacute phases were assessed. Patients and Methods: Pharmacomechanical thrombectomy treatment was applied in a single session for 38 patients with lower extremity deep vein thrombosis in the acute and subacute phases between May 2012 and June 2014. Venography was performed and each assessment was made based on lysis rates and clinical results. Results: Deep vein thrombosis was found in the left lower extremity in 25 patients (65%) and in the right lower extremity in 13 patients (35%). No patient was found to have bilateral deep vein thrombosis. Thrombus localization was in the iliofemoral area in 17 patients (44%), the iliocaval area in three patients (8%), and the femoropopliteal area in 18 patients (56%). When thrombus resolution was assessed at the end of the process, grade III and grade II lysis was achieved in 36 (94%) out of 38 patients. Complete resolution was achieved in 28 patients (74%) in the acute and subacute groups. Conclusion: Pharmacomechanical thrombectomy provides very satisfactory results in a single procedure, as a new method in the treatment of acute and subacute deep vein thrombosis.
An unscarred uterus rupture is uncommon. It has non-specific symptoms and presentation differs according to the site and time of rupture. It is usually diagnosed intrapartum or shortly after delivery. Here we report a spontaneous rupture of unscarred uterus with delayed presentation and without any usual risk factors. A 33year-old and 38 weeks' pregnant woman presented with regular uterine contractions. The labor was successfully completed vaginally without any augmentation and no intrapartum complications were observed. After 72 hours the patient complained of an abdominal distension and tenderness. She underwent emergency explorative operation. Intraoperative examination revealed a rupture area on the right posterolateral wall of the uterine fundus approximately 5-6 cm in width. The post-operative period was uneventful and the patient was discharged on 5th postoperative day. Spontaneous rupture of unscarred uterus should be kept in mind even though it is rarely seen complication at late postpartum period.
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