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Aim:Xanthogranulomatous cholecystitis (XGC) is usually an inflammatory condition due to gallstones and bile stasis. Pathological, radiological and clinical features are similar to gallbladder cancer, leading to erroneous treatments such as excessive or inadequate surgery. The aim of this study was to identify the clinical and surgical characteristics of XGC cases. Materials and Methods:The medical records were reviewed of 55 patients diagnosed as XGC from 4818 patients who underwent cholecystectomy between 2008 and 2015. Results:The most common clinical finding (90%) was right upper quadrant pain, followed by acute cholecystitis (30%). Biliary wall thickening was found in 64% of patients. Conversion to open cholecystectomy rate was 39%, which was significantly higher than that of all cholecystectomies conversion rates 3.4%. Postoperative biliary fistula was determined at 9% and total morbidity at 23%.Conclusion:XGC is a rare form of cholecystitis. Although it is histologically benign, preoperative and intraoperative diagnosis is difficult and complicated due to its aggressive course. Although carcinoma may be suspected during surgery in XGC, the association is not very high. It is quite useful to study frozen samples to avoid extensive surgery. The definitive treatment is surgery, but it should not be forgotten that there are high morbidity rates during and after the operation.

We herein present our first experience obtained by 3D freehand single-photon emission computed tomography (SPECT) (F-SPECT) guidance for sentinel lymph node detection (SLND) in two patients with early stage breast cancer. F-SPECT guidance was carried out using one-day protocol in one case and by the two-day protocol in the other one. SLND was performed successfully in both patients. Histopathologic evaluation showed that the excised nodes were tumor negative. Thus, patients underwent breast-conserving surgery alone.Bu yazıda erken evre meme kanserli iki hastada sentinel lenf nodu tespiti (SLNT) için bilgisayarlı tek foton emisyonlu tomografisi (SPECT) 3D freehand SPECT (F-SPECT) rehberliği yoluyla edinilen ilk deneyimimizi sunuyoruz. F-SPECT rehberliği bu olguların birisinde tek gün protokolü diğerinde iki gün protokolü kullanılarak gerçekleştirildi. SLNT her iki hastada başarı ile gerçekleştirildi. Histopatolojik inceleme çıkarılan nodların tümör negatif olduğunu gösterdi. Hastalar bu sayede sadece meme koruyucu cerrahi geçirdiler.

Intraabdominal hypertension is a common occurrence, especially in intensive care unit patients, and it has high mortality and morbidity rates. The onset is commonly insidious and the poor prognosis is attributed to the long delay in diagnosis. Unfortunately, diagnosis is often delayed until loss of function in the affected tissues has already occurred. The aim of this study was to determine the predictive value of mean platelet volume (MPV) in assessing the risk of intraabdominal hypertension. Materials and methods: Pneumoperitoneum during elective laparoscopic cholecystectomy was used as a model for intraabdominal hypertension. The study included 103 patients who met the inclusion criteria. MPV evaluations were made at 3 distinct times during laparoscopic cholecystectomy based on the actual intraabdominal pressure. Results: MPV values during preinsufflation, insufflation, and desufflation were 8.483 fL (range: 6.7 to 11.1), 8.901 fL (range: 6.8 to 11.9), and 8.538 fL (range: 5.8 to 10.9), respectively. A statistically significant increase in MPV values was found during high intraabdominal pressures (P < 0.001). A significant decrease in MPV values was also detected with desufflation (P < 0.001). Conclusion: Increasing MPV values may reflect increased intraabdominal pressures, which may have a clinical implementation in intraabdominal hypertension.

BACKGROUND Hidradenitis suppurativa (HS) is a chronic suppurative disease of skin with high recurrence. OBJECTIVE To determine factors affecting complications and recurrence of HS in patients who underwent surgery. MATERIALS AND METHODS We operated on 15 patients with HS at 36 sites between 1999 and 2009. The affected areas were classified as groin, axilla, buttocks, nuchae, perianal, and perineal. All patients were treated using wide surgical excision under general anesthesia. The methods of reconstruction varied depending on the size and location of the defect. RESULTS The female:male ratio of patients was 4:11. Mean age was 41.8±10.6. Twenty-eight (77%) of the lesions were Stage III according to Hurley's staging system. Mean follow-up was 42 months. Radical excision was performed on all lesions; 20 were reconstructed with primary closure, nine with fasciocutaneous flaps, and five with split-thickness skin grafts. The overall complication rate was 25% (9/36) and complications occurred mostly in perineal, perianal, and buttocks sites. Two (5.5%) recurrences were seen only in buttocks site. CONCLUSION To prevent complication, avoid recurrence of HS, and improve patients' quality of life, early and wide surgical excision is important and effective. The recurrence and complications are mostly related to the location of the disease. The authors have indicated no significant interest with commercial supporters.

Our aim was to review our experience with Fournier’s gangrene in female patients. A retrospective review of ten consecutive female patients with Fournier’s gangrene was performed. Etiological and predisposing factors, causative microbiological organisms, and clinical outcome were investigated. Mean age of the patients was 52.7 years, and the mean duration of hospitalization was 17.6 days. The etiologic origin of the gangrene was anorectal, dermatological, and urogenital infection in 50%, 20%, and 10% of patients, respectively. All patients underwent aggressive surgical debridement and a diverting colostomy. Nine patients survived, and one patient died for an overall mortality rate of 10%. Fournier’s gangrene occurred in females with a pattern similar to that in males. We believe that a colostomy is an integral part of management for patients requiring extensive debridement, especially if the infection arises in the anorectal region.

Background. The purpose of using a whole-body scanning after the radioactive I-131 treatment is to screen functional residual or metastatic thyroid tissues. In whole-body scanning of some patients, false positive radioiodine I-131 uptakes may be seen in physiological uptake regions or atypical localizations. Case report. A 54 year-old woman underwent total thyroidectomy for papillary thyroid carcinoma. A positive appearance seen in the upper postero-lateral part of the right gluteal region was determined by a post-therapy I-131 whole body scan. The colour Doppler ultrasonography, magnetic resonance imaging features and histopathological characteristics of the excised lesion were presented. The lesion was demonstrated to be a foreign body granuloma. Conclusions. Unexpected positive findings in the post-therapy I-131 whole body scan should be confirmed with other imaging modalities in order to avoid unnecessary treatments. In uncertain situations, the diagnosis should be established histopathologically.

Morgagni’s hernia is seen at a rate of 3-4% among all diaphragmatic hernias. It develops from a defect in the pleuroperitoneal membrane. Herniation of the omentum is seen most commonly, that of the colon frequently, and herniation of small bowel and stomach is seen rarely. When being examined due to anemia and dyspnea, a 53-year-old male patient suffered from a respiratory arrest and was hence intubated and placed under treatment at the intensive care unit. On radiological examination, a giant diaphragmatic hernia was observed bilaterally, more marked on the right side. On laparotomy, especially on the right side, the caecum, the ascending colon, the transverse colon, the appendix, the omentum and part of the small bowel was seen to be herniated. Primary diaphragmatic repair + right hemicolectomy + end-to-end ileo-transversostomy was performed. We have reported this case because it was a giant hernia which caused respiratory arrest.

WOS:000284263900006 PubMed: 22933922 Background. The risk of developing a second primary tumour in patients with gastric carcinoma is higher than among the general population. The aim was to investigate the clinicopathological characteristics of the second primary cancers in patients with gastric cancer in this study. Patients and methods. In the retrospective study, patients with gastric cancers were evaluated between 1995 and 2005 for primary tumours according to Warren and Gates' criteria related with the second primary cancers. Results. Nine of the 112 patients with gastric cancer had second primary cancers. Seven of the patients were males and two females. Six patients with gastric cancers had synchronous, and three had metachronous tumours. The age of the patients ranged from 53 to 78 years, and the mean age was 61 +/- 8.3 years. The most frequent site of occurrence of the second tumours was the colo-rectum (33%) followed by the upper respiratory system (22%), and the urogenital system (22%) in descending order of frequency. Conclusions. The incidence of the second primary cancer in gastric cancer patients was 8% in the current report. It is recommended that careful preoperative and postoperative examinations for other primary cancers, as well as for the extent of the primary gastric carcinoma, are carried out. Because colorectal cancer was the most common carcinoma combined with gastric carcinoma, the surveillance for this carcinoma (e.g., colonoscopy, abdominopelvic CT) would be appropriate after the diagnosis of gastric carcinoma.