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    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, Seyfi
    Introduction: 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.
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    Type IV Mirizzi Syndrome at the Hepatic Confluence Mimicking a Hilar Cholangiocarcinoma
    (Namık Kemal Üniversitesi, Tıp Fakültesi, 2013) Arslan, Ersoy; Bali, İlhan; Demir, Mete; Görür, Mustafa; Sözen, Selim
    Mirizzi’s syndrome refers to common bile duct obstruction resulting from compression by a gallstone impacted in the cystic duct or neck of the gallbladder. Some cases can not be identified preoperatively, despite modern imaging techniques. Today, treatment of Mirizzi syndrome is surgical. The essential part of the management of patients with Mirizzi syndrome is to determine the best surgical procedure in the preoperative period. In type I patients, simple cholecystectomy is generally enough, but types IIIV require more complex surgical approach, such as cholecystectomy and bilioenteric anastomosis. Here, we presented a 48 year-old man with obstructive jaundice who diagnosed as Mirizzi’s syndrome.