Makale Arama

There is no consensus in approach to patients suffered from gunshot injuries since they almost die in scene or on the way to the emegency room. Manegement of the patients with gunshot bullet wounds of thorax is different even among thoracic surgeons. Complication of penetrating chest trauma due to gunshot injuries can occur within days, months even within years. A patient was admitted to the thoracic surgery clinic in bad condition. Foreign body was detected in chest X-ray patient. He had been considered stable and non complicated and discharged from hospital after a penetating gunshot injury of thorax two years ago. We report late presentation of empyema as a late complication of bullet after two years of injury.

Inguinal hernia repair surgery is one of the most common procedures. Strangulated inguinal hernia is one of the most widely performed surgical emergencies dealt with by surgeons worldwide. Uncommonly, strangulation of the contents can occur due to other causes like omental band adhesion. We reported a rare case of strangulated inguinal hernia, brought about by an omental band adhesion, causing closed loop small bowel obstruction and perforation within the hernial sac in the inguinal canal.

Meckel’s diverticulum is a rare cause of mechanical intestinal obstruction in adults. Due to non-specific symptoms and preoperative diagnosis of this rare condition, surgeons should keep in mind. A 28-year-old male patient was admitted to our emergency department with abdominal pain, nausea and vomiting for about 8 hours before onset. The patient was diagnosed as acute small bowel obstruction and underwent emergency surgery. At operation a torsioned ileum due to Meckel’s diverticulum 60 cm proximal to ileocecal valve and small bowel distention proximal to this site was seen. Ileum was detorsioned and Meckel’s diverticulum resection was performed. The patient was discharged on postoperative day 3. Histopathologic specimen were reported as Meckel’s diverticulum in 3x2x1cm size.

Mechanical intestinal obstructions are frequent clinical problems that the surgeons come across in their daily surgical practices. Although the closed segment obstruction is a rare type of the mechanical intestinal obstruction, it is all the more dangerous because of the rapid increase in distension and its entailing strangulation based on the upset circulation in the intestinal wall. In our study we have discussed two closed segment cases related to colon tumor existence along with literature on the subject. The first case is a 38-year-old female patient who underwent only loop ileostomy without a resection because of inoperable rectosigmoid corner tumor 10 months ago at another health center. The patient presented to our clinic with complaints of abdominalgia and distension.The patient was diagnosed with closed segment obstruction based on the infiltration of the cecum by the tumor in the rectosigmoid area. The patient was treated through opening up a colostomy from the transverse colon.The second case was a 50-year-old male patient. The patient, who had undergone left hemicolectomy because of sigmoid colon tumor three years before, presented to the emergency service with a condition of mechanical ileus.The patient was diagnosed with closed segment obstruction in the small intestine related to the metastatic masses in the small intestinal mesentery, intraoperatively. The patient was treated through subtotal small intestinal resection.Closed segment obstructions are rare causes of mechanical intestinal obstructions that need to be treated rapidly. Closed segment obstructions that develop because of the tumor infiltration on both ends are quite rare. Therefore, we aim at discussing the aforementioned cases of closed segment obstruction that developed because of tumor obstruction on both ends and surgically treated in our clinic, along with literature on the subject.

One of the ways for the child to get familiar with its surrounding environment and to build up relations with the same is bringing any possible object to the mouth for tasting. Thus, the children happen to swallow foreign bodies of sorts and sizes unimaginable. A great portion of the grown up children swallowing foreign bodies demonstrate mental deficiencies or psychological problems. The clinic symptoms may be coughing, dyspnoea, hoarseness, breathing difficulty, weakened respiratory sounds and hyper saliva in the mouth. The foreign bodies are usually coins. We want to share an alternative treatment in foreign body aspirations. In this article is demonstrated an alternative approach for foreign body aspiration in four years old patients with down syndrome. The patient developed no complications during the medical intervention and discharged under recommendations. Foreign body aspiration is common in childhood. The majority of foreign bodies are coins. Approach to foreign body aspiration in a patient’s clinical presentation, type of foreign bodies, inserted in the aspiration time and the response shall be decided to treatment according to the conditions. Approaching treatment is endoscopy, observation or operation. In emergency alternative methods can be used such as balloon extraction with foley catheter by experienced surgeons.

Between, 1985 - 1986 150 bronchoscopies were perforıned in our ciinic. 60 cases were diagnosed as bronchus carcinoma. Among 90 cases; 25 cases were diagnosed as tuberculosis, 10 cases lober pneumonie, 39 patients chronic bronchitis, 15 cases lung abcess and in one case foreign material aspiration were diagnosed.

Endometriosis is the presence of normal endometrial tissue outside the uterus. Scar endometriosis is a rare pathology resulting after obstetric and gynecologic surgery procedures on abdominal wall which is not pre-diagnosed in differential diagnosis by general surgeons. Six cases referred to General Surgery outpatient clinic with mass on abdominal wall that have been totally excised and diagnosed as endometriosis in pathology laboratory between 2008-2012 , have been reviewed retrospectively with clinic, radiologic and pathologic findings. The presenting symptoms of six pateints were different; four of them referred with cyclic pain and swelling and two with nonspesific symptoms to general surgery outpatient clinic. All of the masses have been totally excised and diagnosed as endometriosis in pathology laboratory. Scar endometriosis should be considered in differential diagnosis of incisional abdominal wall masses in females referring to General Surgery.

Between 1983 and 1996 splenic surgerv was peıfonned irr a tatar` of 47 .children in the Research Hospital of Medical Faculty of Selçuk Unive•sity. The age• of the patients were betıveen one and 16 vc'ars. Of the patients 38 under•ent splenectomy. of. which 17 were pelforıned general sur.,!:;eons be-Pre 1991_ Pediatric surgeons have been performin these procedures since rhen. When these two periods are coınpared It is frJldlrfl that. the most U)/i dication.v for ,splenectomy are trannut and he-motological diseases before 1991 aml cıfıer tlıen. respectivelv. Wc' suppusod that. the ı-eason of the (lif-frrence between tvı,o periods is the impo•tance of- the jımetions of the spleen is not elem- in adults as iır (.-hildren and therefrre. .fi)r the menagemenı of the trattmatic children, the methocl used hrgenaral sur-geons i.s different from ılıaı (ıf pedian-k:surgeons_

The ideal therapy for sacrococcygeal pilonidal disease (SPD) would be a prompt cure that allowed patients to return quickly to normal activity, with minimal morbidity and a low risk of complications. We report the case operated with excision and primer suture for SPD a month ago had infected and decomposed wound. A 23-year-old male patient was admitted to the emergency room with complaints of intergluteal discharge and pain that last for 10 days. Surgery which was excision and primer suture was applied him in other health center for SPD a month ago. There was infected and decomposed wound and a large cavity under sutured skin on intergluteal area. In the second operation, we excised decomposed wound including cavities and skin as modified equilateral quadrangle shape, a right flap was prepared and rotated to left side for primer suture. Patient was discharged on postoperative 3th day and drain was getting out on postoperative 5th day. Patient recovered completely without any complication on postoperative 20th day. Our case is no not only unique but also rare. However, we think that the most appropriate method for treatment of SPD should be known and applied by all surgeons in our country.

Anorectal malformations occur in an average of 4000-5000 newborns and are more common in males (1). Congenital malformations of the anus, rectum, and urogenital system were often found together. imperforate antisla, enteric urinary fistulas, renal agenesis, irritable-theropelvic obstruction. iireterovesical darhk. The association of structural genitourinary anomalies such as and-zicoureteral reflux, cryptorchidism, ectopic mourning deferens and hypospadias is well known (2, 3). These pathologies are usually detected by pediatric surgeons. However, urologists play the main role in the diagnosis and treatment of these complex and difficult-to-solve clinical problems. Appropriate treatment: depends on the knowledge of normal and abnormal embryology, the presentation of clinical problems associated with these disorders, and the implementation of diagnostic studies that will determine the exact pathology (4).