Search

Von Hippel--Lindau (VHL) disease is an autosomal dominant syndrome and affects many organs. We aim to report an adult patient with VHL disease having bilateral adrenal pheochromocytoma and multiple neuroendocrine tumors of the pancreas who was successfully treated with simultaneous function-preserving adrenalectomy and pancreatectomy. A 27-year-old woman was admitted to hospital with hypertension. The computed tomography of the abdomen revealed a solid tumor in both adrenal glands with the sizes of 12x7 cm on the right and 4x4 cm on the left. She also had two pancreatic solid masses in the head and three in the tail with varying sizes. The laboratory tests are all within normal limits except elevated 24-hour urinary metanephrine and normetanephrine. I-123 MIBG scanning showed increased uptake in both adrenal glands. Fine needle aspiration biopsy of the tumor on head of pancreas via endoscopic ultrasonography showed neuroendocrine tumor. Those findings were compatible with bilateral pheochromocytoma and multiple pancreatic neuroendocrine tumors and genetic tests revealed the mutation which confirmed the diagnosis of VHL disease. After suppression with alpha-1 inhibitor, right total, left cortical-sparing adrenalectomy, Whipple procedure for the pancreatic head lesions and spleen-preserving distal pancreatectomy were performed and pancreatic corpus was preserved. This case showed that multiple function-preserving procedures can be safely performed with oncological principles in patients with VHL disease. [ABSTRACT FROM AUTHOR]

Introduction: While foreign bodies in the gastrointestinal tract are observed more frequently and accidentally in the childhood age group, they may occur to attract attention, sexual satisfaction, self-harming behavior, abuse, secondary gain, or during self-treatment in young people and adults. In the United States, 1500 people die yearly from ingested foreign bodies. The leading cause of mortality is obstruction and perforation due to impaction in the gastrointestinal system. In this study, we evaluated the clinical findings, risk factors, and clinical output data of foreign bodies in the gastrointestinal tract and presented the most accurate approach considering the literature. Materials and Methods: This is a retrospective and descriptive study analyzing data from a prospective database. Adult patients admitted to the emergency department of our 3rd level university hospital between January 2015 and January 2022 due to foreign bodies in the gastrointestinal tract were included in the study. Results: Transanal rectal body removal in the operating room was performed using the Crede maneuver in seven patients. Laparotomy or thoracotomy was performed in nine patients, and thirty-six patients were treated with endoscopic methods. Endoscopy and laparotomy were performed simultaneously in one patient. It was determined that the foreign body of 29 patients was removed by conservative methods. Conclusion: For treating of foreign bodies, a multidisciplinary approach, including advanced endoscopic and surgery, is required according to the localization and content of the foreign body, underlying cause and patient population. [ABSTRACT FROM AUTHOR]

Introduction: Significant advances in medicine have led to a prolongation of life expectancy and an increase in the rate of operations performed on the elderly. However, despite all these developments, advanced age continues to be one of the factors affecting perioperative and post-operative morbidity and mortality. Considering the increase in elderly population, it is estimated that an increasing number of elderly patients will apply for cholecystectomy in the next decade. Materials and Methods: In this retrospective single-center study, the files of patients over 65 years of age who underwent laparoscopic cholecystectomy (LC) between January 2018 and February 2020 were evaluated. We divided the patients into two groups. Patients aged 65-74 as Group A, and patients aged 75 and over as Group B. Besides the clinical data of the patients, we compared inflammatory markers. Results: Of the 92 patients included in the study, 35 (38.05%) were male, 57 (61.95%) were female, and the mean age was 71.72±5.06. The operation was completed laparoscopically in 85 of the patients who underwent cholecystectomy. The morbidity rate was statistically significantly higher in Group B. Furthermore, Group B stayed in hospitals more than Group A, which was statistically significant. Conclusion: LC is a safe surgical method for elderly patients. However, comorbidity, length of hospital stay, and morbidity seem to be higher with advanced age. This age group should be evaluated with a multidisciplinary approach before and after surgery. [ABSTRACT FROM AUTHOR]

Copyright of Turkish Journal of Trauma & Emergency Surgery / Ulusal Travma ve Acil Cerrahi Dergisi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Surgical Arts / Cerrahi Sanatlar Dergisi is the property of Journal of Surgical Arts / Cerrahi Sanatlar Dergisi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Turkish Journal of Trauma & Emergency Surgery / Ulusal Travma ve Acil Cerrahi Dergisi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Liver is one of the most frequently injured organs in abdominal trauma. However, there are still many controversies in its management. Purpose: We aimed to evaluate the clinical presentation and management of the patients with liver trauma. Methods: This is a retrospective study on patients with liver trauma admitted between 2012 and 2020. Demographic data, vital signs, type of trauma, laboratory findings, imaging findings, grading according to AAST scoring, surgical techniques, morbidity and mortality were evaluated. Results: Of the 100 patients included in the study, 77 (77%) were male and 23 (23%) were female. 51 (51%) of these patients were treated non-operatively and 49 (49%) were treated operatively. While 3.9% of non-operatively managed patients became excitus, 8.1% of operative patients became excitus. Conclusion: As a result; currently, the most effective factor in the decision-making process concerning the management of liver trauma is the patient's hemodynamic status. Although non-operative management is getting widespread in blunt traumas, operative treatment is still more preferred in penetrating traumas. In order to spread non-operative management in liver traumas, in addition to conventional equipment, hybrid operating rooms that allow angiographic and endovascular interventions should be established in regional trauma centers and trauma centers. [ABSTRACT FROM AUTHOR]

Background: Cholecystectomy is one of the most commonly performed surgical procedures. However, it may result in some unpleasant conditions such as bile duct injury (BDI), bile leak, and vessel injury. Subtotal cholecystectomy (SC), which has been introduced as an alternative method for reducing the complication rates, has been reported to have lower risk of BDI when compared to total cholecystectomy. This study aimed to evaluate the indications for SC, its early and late complications and their management, and the risk factors affecting the bile leak. Methods: Fifty‐seven patients who underwent SC were included in the study, and their medical records were retrospectively reviewed. Results: Thirty‐three patients were male (57.9%) and the mean age was 64.84 ± 11.35 (range: 29‐86). All patients had at least one episode of cholecystitis. Forty‐seven (82.5%) patients underwent surgery under emergency conditions. Postoperative bile leak/fistula, surgical site infection, and fluid collection were developed in 12 (21.1%), eight (14%), and six (10.5%) patients, respectively. Leaving the remnant tissue pouch open, presence of comorbidity and emergency operative condition were found to increase the risk of leak development (P <.001). During the average follow‐up of 49 months (range: 13‐98), symptomatic choledocholithiasis, symptomatic gallstones in the remnant tissue, and incisional hernia were detected within the first year of surgery in three (5.3%), four (7%), and seven (12.3%) patients, respectively. Conclusions: Although SC is not an equivalent to total cholecystectomy, its vital benefit of lowering the risk of BDI should be considered in difficult cases. [ABSTRACT FROM AUTHOR]