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Öğe A Rare Complication of Incisional Hernia Repair: Gastric Obstruction Due to Mesh Migration on Gastroenterostomy Line(Namık Kemal Üniversitesi, Tıp Fakültesi, 2014) Erdem, Hasan; Sözen, Selim; Çetinkünar, Süleyman; Bali, İlhan; İrkörücü, OktayHernia repair is one of the most common elective procedures in general surgery. Agreement has been achieved that tension-free hernia repair using prostheses reducesrecurrence rates significantly. Approximately 60% of prosthetic repairs of the inguinal flor are believed to use a flat mesh of some type, and 90% of incisional and ventral herniarepairs incorporate the use of a synthetic prosthesis. However, the use of prosthetic mesh for hernia repair can cause serious complicationssuch as infection, seroma formation, fistulae formation, adhesion, biomaterial-related intestinal obstructions, and other miscellaneous complications. Mesh migration is dangerous and rare complication after hernia repair. Hereby, reporting a rare case of intra-peritoneal migration of polypropylene mesh and its adhesion to stomach wall following onlay mesh repair of incisional hernia.Öğe Basal Cell Carcinoma Appearing As a Suture Reaction Along The Incision Line(Namık Kemal Üniversitesi, Tıp Fakültesi, 2014) Aziret, Mehmet; Erdem, Hasan; Çetinkünar, Süleyman; Yaycıoğlu, İsmail Bülent; İrkörücü, Oktay; Emir, SeyfiThe most frequently occurring malignant neoplasm of the skin is basal cell carcinoma (BCC). It is seen most often around the head and neck area. Predisposing factors include exposure to ultraviolet radiation (UV) and inorganic arsenic, trauma, chronic wounds, immune dysfunction and plaques, such as sebaceous nevus.While squamous cell carcinoma is frequently encountered as a result of chronic wounds, silk fistulas and scar formation, cases of BCC are very rare. In incidences of BCC developing along the incision line, the treatment involves making a large surgical excision. Problems related to the incision site are most often observed in operations conducted at surgical clinics, with the most common cause being suture reactions. In cases of chronic ulceration and discharge, a diagnosis of BCC should be considered and a biopsy should be conducted.Öğe Can isolated pancreaticojejunostomy reduce pancreas fistula after pancreaticoduodenectomy with Roux-en-Y reconstruction?(2016) Erdem, Hasan; Çetinkünar, Süleyman; Aziret, Mehmet; Reyhan, Enver; Sözütek, Alper; Sözen, Selim; İrkörücü, OktayAmaç: Pankreatikoduodenektomi ampulla Vateri, pankreas başı, distal koledok tümörleri ve bazı kronik pankreatit olgularında yaygın kabul gören cerrahi prosedürdür. Rekonstrüksiyon sonrası pankreatik fistül halen ciddi bir problemdir. Rekonstrüksiyon yöntemleri hususunda üzerinde fikir birliği sağlanmış bir yöntem henüz yoktur.Gereç ve Yöntemler: Pankreas tümörü nedeniyle pankreatikoduodenektomi uygulanan hastalarda yapılan rekonstrüksiyon yöntemleri ve sonuçları retrospektif olarak araştırılmıştır. Tüm hastalardaki anastomoz Roux-en-Y şeklinde yapılmış olup birbirinden farkları ise şöyledir; Tip 1: Y bacağı ile sadece pankreatik anastomoz, Tip 2: Y bacağı ile pankreas ve hepatik kanal anastomozu birlikte yapılmıştır.Bulgular: Çalışmaya 31 hasta dahil edilmiştir. Hastaların 21'i erkek, 10'u kadındı. Çalışmamızda pankreatik fistül, kanama, abse, yara yeri enfeksiyonu ve akciğer enfeksiyonu postoperatif dönemde gözlenen komplikasyonlardı. Her ne kadar grup 2'de komplikasyonların sayısı grup 1'e kıyasla daha fazla gözlense de istatistiksel olarak anlamlı fark tespit edilmedi. Mortalite her iki grupta da birer hastada gelişti.Sonuç: Kaçağın sebeplerinden birinin aynı ans üzerine yapılan pankreas ve safra kanalı anastomozlarının birlikte debiyi yükseltmesi ve anastomoz basıncını arttırarak fistül oluşumuna neden olması olduğunu düşünüyoruz. Çalışmamızın dezavantajı ise hasta sayısının az olmasıdır. Pankreatik sıvı ile safranın ayrı anastomozlarla rekonstüksiyonu kronik pankreatik fistülleri azaltabilir.Öğe IMPORTANCE OF TOGETHER USE OF ENDOSCOPIC AND INTRAOPERATIVE ULTRASONOGRAPHY IN THE DIAGNOSIS AND TREATMENT OF INSULINOMA(Namık Kemal Üniversitesi, Tıp Fakültesi, 2016) Arslan, Ersoy; Aziret, Mehmet; Akgündüz, Fatih; İrkörücü, Oktay; Reyhan, Enver; Adamhasan, Fulya; Bali, İlhan; Emir, SeyfiIntroduction: Insulinoma is a usually benign tumor of pancreas. It is seen rarely and incidence of insulinoma is 1 in 250,000 patient-years. We present a rare case with insulinoma which well diagnosed and treated with aid of endoscopic and intraoperative ultrasonography. Case Report: A patient involving a 39-year-old woman with complaints of cold sweats, weakness, syncope attacks, palpitations was evaluated in polyclinic. She was hospitalized with the diagnosis of pancreatic insulinoma after abdominal computer tomography(CT), magnetic resonance imaging(MRI) endoscopic ultrasonography(EUS), and biochemical parameters. The patient was well treated with enucleation and after imaging aid of endoscopic and intraoperative ultrasound(IOUS). Discussion: In patients with insulinoma, preoperative localization of tumor is most important for diagnosis and treatment. Therefore; CT scanning, MRI, EUS and SPECT / CT are used for diagnosis of insulinoma. Together use of endoscopic and intraoperatively ultrasonography are increasing recently. Enucleation is a curative treatment approach in insulinoma. Conclusion: Together using of preoperative endoscopic and intraoperative ultrasound is quite helpful in the diagnosis and treatment of insulinoma.Öğe Primary Thyroid Lymphoma Causing Progressive Respiratory Distress: A Case Report(Namık Kemal Üniversitesi, Tıp Fakültesi, 2014) Erdem, Hasan; Çetinkunar, Süleyman; Bali, İlhan; Demirtürk, Pelin; Gökler, Cihan; Sözen, Selim; İrkörücü, OktayPrimary thyroid lymphoma (PTL) is a rare malignancy of the thyroid gland. It usually presents itself as a very rapidly growing mass, and respiratory distress is commonly the first finding. Ultrasound guided fine needle aspiration biopsy and surgical biopsy can help with its diagnosis. The treatment is radiotherapy and chemotherapy. Surgical treatment is only indicated in cases which tracheal compression is severe. In this report, we present a primary thyroid lymphoma case, which presented with progressive respiratory distress, and dramatically went into remission with medical therapy, along with a literature review.
