Search

Acute appendicitis (AAp) is the most frequent cause of acute abdominal pain, and appendectomy is the most frequent emergency procedure that is performed worldwide. The coronavirus disease 2019 (COVID-19) pandemic has caused delays in managing diseases requiring emergency approaches such as AAp and trauma.To compare the demographic, clinical, and histopathological outcomes of patients with AAp who underwent appendectomy during pre-COVID-19 and COVID-19 periods.The demographic, clinical, biochemical, and histopathological parameters were evaluated and compared in patients who underwent appendectomy with the presumed diagnosis of AAp in the pre-COVID-19 (October 2018-March 2020) and COVID-19 (March 2020-July 2021) periods.Admissions to our tertiary care hospital for AAp increased 44.8% in the COVID-19 period. Pre-COVID-19 (The present study showed that in the COVID-19 period, the ultrasonographic determination rate of AAp, perforation rate of AAp, and duration of hospital stay increased. On the other hand, negative appendectomy rate decreased. There was no statistically significant delay in hospital admissions that would delay the diagnosis of AAp in the COVID-19 period.

PURPOSE Patient care, newer immunosuppressive medications, and advances in surgical technique, have resulted in significant prolongation of survival after liver transplantation in recent years. However, as life expectancy increased and the early mortality rates have decreased, different problems have evolved due to chronic immunosuppressive therapy. The aim of the present study is to evaluate patients who were transplanted and then developed de novo malignancies, in terms of the type of malignancies and the follow-up period. METHODS The study was conducted on 2814 patients who received liver transplantation between 2008 and 2020 in Inonu University Liver Transplant Institute. In total, the data of 23 patients were evaluated retrospectively. RESULTS Non-melanoma skin cancer was the most common de novo malignancy (21.7%), followed by gynecological cancers (17.3%). The interval between the time of transplantation until the development of de novo malignancy was 36 (6-75) months. The median follow-up period after the diagnoses of the de novo malignancies was 4.11 years. One, 3-, 5-year survival rates of patients after the diagnoses of de novo malignancies were 69.6%, 56.5%, and 41.9%; respectively. CONCLUSION Non-melanotic skin cancers were the most common de novo cancers in liver transplant recipients. A strict surveillance program is very important in the follow-up of liver transplant recipients.

Course of blood procalcitonin levels by days.

Aim: The treatment of end-stage liver disease is liver transplantation. There are studies regarding liver transplantation in patients with colorectal cancer and neuroendocrine tumor liver metastasis indicating comparable results with patients who were transplanted for hepatocellular carcinoma. The aim of the present study is to present a case of a patient with Hepatitis B virus related chronic liver disease and rectal neuroendocrine tumor who underwent concomitant living donor liver transplantation and low anterior resection. Case report: The patients was a 62 years old male patient with hepatitis B virus related end-stage liver failure and a rectal neuroendocrine tumor determined during colonoscopy surveillance. Model for end stage liver disease score was 21 and had two episodes of life-threatening variceal bleeding. We performed living donor liver transplantation and low anterior resection to the patient. Currently patient is doing well 2 years after the operation. Conclusion: Our case is the first in literature showing concomitant liver transplantation for hepatitis B virus related liver failure and rectal resection for neuroendocrine tumor. These procedures can be performed synchronously provided that the etiology of liver failure is unrelated to neuroendocrine tumor and the primary tumor has favorable tumor biologic characteristics. We reviewed the English literature, we did not find any case who underwent rectal NET surgery and HBV-related liver transplantation in the same operation. We wanted to present this first case in the literature.

OBJECTIVES: The majority of HCCs present at an advanced stage in which potentially curative therapies cannot be used. Surveillance ultrasound has been found to increase the numbers of patients diagnosed with small tumors, but it is often not used. We aimed to try to identify widely-available and cheap potential serum markers for use in patients at risk for HCC. MATERIAL AND METHODS: A comparison was made of the complete blood count and liver function tests in a group of patients (n=114) with proven small HCCs (≤ 2 cm) and patients without HCC (n=506), all of whom were treated by liver transplantation in our Liver Transplantation Institute. RESULTS: Significant differences were found for blood levels of WBC, lymphocytes, total bilirubin and transaminases. Several 2-parameter combinations were assessed, but only the combination of total bilirubin and lymphocytes was found to be significantly different between patients with small HCCs and no HCC. Multivariate regression analysis showed significance only for total bilirubin levels and lymphocyte counts. The results were confirmed using a separate small cohort of non-transplant patients. CONCLUSION: The combination of elevated levels of total bilirubin and lymphocyte counts holds promise for identification of patients with chronic liver disease who are at risk for HCC.

Purpose Patient care, newer immunosuppressive medications, and advances in surgical technique, have resulted in significant prolongation of survival after liver transplantation in recent years. However, as life expectancy increased and the early mortality rates have decreased, different problems have evolved due to chronic immunosuppressive therapy. The aim of the present study is to evaluate patients who were transplanted and then developed de novo malignancies, in terms of the type of malignancies and the follow-up period.MethodsThe study was conducted on 2814 patients who received liver transplantation between 2008 to 2020 in Inonu University Liver Transplant Institute. In total, the data of 23 patients were evaluated retrospectively.ResultsNon-melanoma skin cancer was the most common de-novo malignancy (21.7%), followed by gynecological cancers (17.3%). The interval between the time of transplantation until the development of de novo malignancy was 36 (6-75) months. The median follow-up period after the diagnoses of the de novo malignancies was 4.11 years. One, 3, 5-year survival rates of patients after the diagnoses of de novo malignancies were 69.6%, 56.5% and 41.9%; respectively. ConclusionNon-melanotic skin cancers were the most common de novo cancers in liver transplant recipients. A strict surveillance programs is very important in the follow-up of liver transplant recipients.

Purpose HCC patients typically present at an advanced tumor stage, in which surgical therapies cannot be used. Screening ultrasound exams can increase the numbers of patients diagnosed with small tumors, but are often not used in patients at risk for HCC. We evaluated clinically available and cheap potential blood tests as biomarkers for screening patients at risk for HCC. Methods A comparison was made of commonly used blood count and liver function parameters in a group of patients (n = 101) with small HCCs (≤ 3 cm) or without HCC (n = 275), who presented for liver transplantation in our institute. Results Significant differences were found for blood lymphocytes and AST levels. This 2-parameter combination was found to be significantly different between patients with small HCCs versus no HCC. Using the combination of lymphocytes and AST levels to dichotomize the HCC patients, only blood levels of alpha-fetoprotein among the tumor characteristics were found to be significantly different among the 2 HCC groups, as well as levels of blood total bilirubin, ALKP, and PLR ratio. The results were confirmed using a separate smaller cohort of non-transplanted small size HCC patients. Conclusion The combination of elevated blood levels of lymphocyte counts and AST levels holds promise for screening of patients with chronic liver disease who are at risk for HCC.

Introduction and importance Rectal prolapse is defined as herniation of mucosa or full-thickness of the rectal wall through the anal canal. It has a negative impact on the quality of life and therefore, it should be treated as soon as diagnosis is confirmed. Definitive treatment is surgical and it depends on the clinical characteristics of the patients. We aimed to present the one of the largest rectal prolapse case in the literature. Case presentation A 32- years- old male patient with a history of severe constipation was admitted to our institution with a giant rectal prolapse. The prolapsed segment was incarcerated, and a semi-emergent procedure was performed though a mid-line laparotomy. The sigmoid colon was redundant and therefore sigmoid colon and the upper two thirds of rectum were resected and end to end anastomosis was performed. The patient was discharged postoperative day 7 without any complication. Clinical discussion Rectal prolapse has a negative impact on quality of life and should be operated as soon as the diagnosis is reached. The surgical strategy depends on the compliance of the patient as well as the experience of the surgical team. Conclusion Clinicians should know that chronic constipation together with other factors may result in rectal prolapse which may become disproportionately large in size., Highlights • Rectal prolapse (RP) is herniation of mucosa or full-thickness of the rectal wall through the anal canal. RP is classified in to three clinical subtypes: mucosal invagination, partial; internal, and full-thickness; external. • Prolapsed segment of rectosigmoid larger than 10 cm in length are defined as giant RP