Rare association of solitary necrotic nodule of the liver with rheumatoid arthritis and systemic lupus erythematosus.

Solitary necrotic nodule of the liver (SNNL) is a rare benign lesion with uncertain etiology characterized by a "completely necrotic core" and a hyalinized capsule containing elastin fibers (Journal of Clinical Pathology 36:1181-1183, 1983). We report herein a 26-year-old woman with a previous diagnosis of rheumatoid arthritis, systemic lupus erythematosus, and Sjögren's syndrome and no history of malignancy who presented with a complaint of diarrhea of 1-year duration. In the abdominal ultrasound, multiple paraaortic, portocaval, and ileal lymphadenopathies (LAPs) have been found with the largest one being 2 cm in size.

Optimizing the Personalized Care for the Management of Rectal Cancer: A Consensus Statement.

Colorectal cancer is the third most common cancer in Turkey. The current guidelines do not provide sufficient information to cover all aspects of the management of rectal cancer. Although treatment has been standardized in terms of the basic principles of neoadjuvant, surgical, and adjuvant therapy, uncertainties in the management of rectal cancer may lead to significant differences in clinical practice.

Circulating interleukin-18 (IL-18) is a predictor of response to gemcitabine based chemotherapy in patients with pancreatic adenocarcinoma.

Background: This study was conducted to investigate the serum levels of interleukin-18 (IL-18) in patients with pancreatic adenocarcinoma (PA) and the relationship with tumor progression and known prognostic parameters.

Methods: Thirty-three patients with PA were studied. Serum samples were obtained on first admission before any treatment.

Prevention of Postoperative Bile Leak in Partial Cystectomy for Hydatid Liver Disease: Tricks of the Trade.

Background: The presence of postoperative bile leak is the major outcome measure for the assessment of operative success in partial cystectomy for hydatid liver disease. However, the optimal operative strategy to reduce the postoperative bile leak rate is yet to be defined.

Methods: Medical records of patients who underwent partial cystectomy for hydatid liver disease between January 2013 and January 2015 were reviewed in this retrospective analysis.

Unusual clinical case: extraluminal manifestation of a tapeworm from the eviscerated midline incision in a post-surgery patient.

Taenia saginata infestation is one of the most common cestode infestations in humans, that may cause gastrointestinal tract related complications as a result of obstruction, perforation or anastomotic leakage. A 55-year-old male patient who was receiving palliative chemotherapy for stage IV gastric cancer was admitted to the emergency department for abdominal pain. A hollow viscus organ perforation was diagnosed and an emergency surgery was performed.

Colonic stent as bridge to surgery in patients with obstructive left-sided colon cancer.

Objective: We assessed the optimal time interval between endoscopic stenting and subsequent surgery in patients with obstructive left-sided colon cancer.

Methods: We reviewed the medical records of patients who underwent endoscopic colonic stenting for obstructive left-sided colon cancer between January 2009 and January 2012. Patients who had successful endoscopic intervention as a bridge to surgery were included in the study.

Minimal invasive endoscopic management of synchronous granular cell tumours in the colon and posterior mediastinum.

Granular cell tumour (GCT), which is a rare benign soft tissue neoplasm, is mostly found in the skin and soft tissue but may develop anywhere in the body. There are less than 10 reported cases of mediastinal GCTs in the current literature. Furthermore, colonic GCTs have recently gained attention due to the increased public awareness on the importance of colonoscopy screening.

The growing role of laparoscopic repair in patients with early diagnosed peptic ulcer perforation.

Objective: Laparoscopy is gaining more importance in emergency abdominal surgery. Peptic ulcer perforation (PUP) constitutes a significant portion of surgical emergencies. The aim of this study was to evaluate the methods and results of patients who underwent surgery due to PUP in our department.

The chain of postoperative complications after laparoscopic cholecystectomy.

Bile duct injuries are among the most dreadful complications of cholecystectomy. As laparoscopic cholecystectomy has become increasingly popular, the incidence of this complication increased and has remained unchanged in spite the learning curve being completed. A 50-year-old female underwent elective laparoscopic cholecystectomy for gallstone disease.

Self-expanding metallic stents in acute mechanical intestinal obstructions resulting from colorectal malignancies.

Endoscopic colonic stenting with self-expanding metallic stents is now widely used to treat malignant large bowel obstruction, where temporary or permanent decompression of the large bowel is desired. The medical records of patients who underwent endoscopic colonic stenting for malignant large bowel obstruction between May 2004 and May 2011 were reviewed. Success rate, morbidity, and mortality rate along with patient characteristics were documented.

Enhanced postoperative recovery pathways in emergency surgery: a randomised controlled clinical trial.

Background: Enhanced recovery pathways are now widely used in elective surgical procedures. The feasibility of enhanced postoperative recovery pathways in emergency surgery for perforated peptic ulcer disease was investigated in this randomized controlled clinical trial.

Methods: Patients with perforated peptic ulcer disease who underwent laparoscopic repair were randomized into 2 groups.

Endobiliary radiofrequency ablation for malignant biliary obstruction.

Background: The cornerstone of palliative treatment for inoperable extrahepatic cholangiocarcinoma is the relief of malignant biliary obstruction. The most commonly applied method is endoscopic stenting. However, the procedure can be complicated with stent obstruction.

Intramural hematomas of the gastrointestinal system: a 5-year single center experience.

Purpose: Although spontaneous intramural hematomas of the gastrointestinal tract are very rare, they may be observed with the use of oral anticoagulant, though less frequently in cases of hematological malignancy and other bleeding disorders. Cases diagnosed as spontaneous intramural hematoma have been assessed in our clinic.

Methods: The cases, which were diagnosed as spontaneous intramural hematoma in the gastrointestinal tract (SIHGT) following anamnesis, physical examination, biochemical, radiological and endoscopic findings from July 2008 to July 2012, have been assessed retrospectively.

Comparison of open and laparoscopic appendectomy in uncomplicated appendicitis: a prospective randomized clinical trial.

Background: In the treatment of a subset of patients with uncomplicated appendicitis, no surgical method has been clearly established as superior.

Methods: The present study was a prospective randomized clinical trial. Patients diagnosed with acute appendicitis were recruited for the study.

Prophylactic injection therapy is necessary for Forrest type 2b duodenal ulcers.

Background: We aimed to assess the effect of prophylactic injection therapy during the index gastroscopy on upper gastrointestinal bleeding due to Forrest type 2b duodenal ulcer.

Methods: The patients who were admitted with upper gastrointestinal bleeding and who underwent emergency gastroscopy between January 2004 and January 2011 were recruited to the study retrospectively. Among those, the patients with Forrest type 2b duodenal ulcer were selected and divided into two groups.

Management of acute appendicitis in pregnancy.

Background: Acute appendicitis is the most common surgical non-obstetric pathology during pregnancy. In this report, pregnant patients operated with a diagnosis of acute appendicitis in the last three years are evaluated retrospectively.

Methods: Between January 2009 and January 2011, 20 pregnant patients were operated for acute appendicitis.

Intracorporeal knotting versus metal endoclip application for the closure of the appendiceal stump during laparoscopic appendectomy in uncomplicated appendicitis.

Purpose: The goal of the study was to compare the efficacy of two methods--intracorporeal knotting and metal endoclip application--for closure of the appendiceal stump during laparoscopic appendectomy in a specific group of patients with uncomplicated appendicitis.

Methods: The patients were randomized into two groups who had their appendiceal stump secured by intracorporeal knotting (Group 1) and metal endoclipping (Group 2). Primary outcome measure was postoperative complications, whereas secondary outcome measures were intraoperative complications, operative time, length of hospital stay, and re-admissions (including rehospitalizations and reoperations).

Endoscopic treatment of a transmigrated intrauterine device to colonic wall: a case report.

We report an asymptomatic 23-year-old female patient who was diagnosed to have a transmigrated intrauterine device (IUD) during a routine gynecological examination. After the IUD had been located within the colonic wall by further investigation, the IUD was successfully extracted via transanal route by colonoscopic intervention.

Acute biliary pancreatitis related with pregnancy: a 5-year single center experience.

Background: Pregnancy-associated acute biliary pancreatitis is a rare but challenging clinical entity in terms of diagnosis and management. We report our institutional medical data of pregnancy-associated acute biliary pancreatitis.

Methods: Medical records of 27 patients admitted to our clinics for pregnancy-associated acute biliary pancreatitis between January 2005 and January 2010 were reviewed.

Wandering spleen: Report of two cases.

Wandering spleen is a rare clinical condition which presents with a variety of symptoms with abdominal pain, abdominal mass, and acute abdomen. It may also remain silent until diagnosed by a routine imaging study. Treatment options may differ depending on the presenting clinical picture.

The effect of halofuginone, a specific inhibitor of collagen type 1 synthesis, in the prevention of pancreatic fibrosis in an experimental model of severe hyperstimulation and obstruction pancreatitis.

Background: The aim of this paper is to assess the effects of halofuginone, a specific inhibitor of synthesis of collagen Type 1, on fibrogenetic process in an experimental model of early pancreatic fibrosis.

Methods: Thirty rats were divided into three equal groups: group 1, sham laparotomy; group 2, severe hyperstimulation and obstruction pancreatitis (SHOP) with no treatment; group 3, SHOP with halofuginone treatment group. SHOP model was induced by complete pancreatic duct obstruction and daily cerulein hyperstimulation (50 microg/kg, intraperitoneally).