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    A Case of Abdominal Wall Endometriosis Mimicking Strangulated Incisional Hernia
    (Aves, 2014) Kilic, Murat Ozgur; Degirmencioglu, Gurkan; Dener, Cenap
    Introduction: Endometriosis is a clinical entity characterized by the presence of functional endometrial tissue outside the uterus. This lesion is often seen in the ovaries, rectovaginal region, and peritoneum of the pelvic floor. Endometriosis, located in the abdominal wall, is quite rare and is usually reported as single cases or small series. Case Report: Herein, a case of abdominal wall endometriosis, mimicking strangulated incisional hernia, is reported. Most cases occur following various obstetric and gynecologic procedures, especially cesarean section. Abdominal wall endometriosis can sometimes lead to acute abdominal findings and may be easily misdiagnosed as subcutaneous abscess, hematoma of the rectus sheath, or strangulated incisional hernia, as in our case. Conclusion: The correct diagnosis of abdominal wall endometriosis is often difficult, but it should be considered, especially in a menstruating woman with cyclic pain. Additionally, the history of obstetrical or gynecological operations should be questioned. Total excision is the treatment of choice.
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    A rare case of Spigelian hernia combined with direct and indirect inguinal hernias
    (Turkish Surgical Assoc, 2017) Kilic, Murat Ozgur; Degirmencioglu, Gurkan; Dener, Cenap
    Spigelian hernia is a rare type of ventral hernias with nonspecific symptoms and signs. Therefore, its diagnosis is often difficult and requires more clinical attention. Although intermittent abdominal swelling and pain are the main symptoms, Spigelian hernias can be sometimes asymptomatic and are discovered incidentally at the operation. In some cases, these hernias can be associated with other abdominal wall hernias, therefore a detailed physical examination of the patients is necessary to avoid mistakes in diagnosis. Herein, we report an interesting and educational case of Spigelian hernia with accompanying ipsilateral both direct and indirect inguinal hernias in a male patient treated by open surgical repair with use of polypropylene mesh.
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    A Rare Case of Strangulated Meckel's Diverticulum in an Incarcerated Ventral Incisional HerniaInkansere
    (Derman Medical Publ, 2014) Kilic, Murat Ozgur; Degirmencioglu, Gurkan; Surgit, Onder; Yenidunya, Sibel
    Incisional or postoperative hernia, one of the most common surgical procedure in general surgery practice, mostly occurs in the first years following abdominal operations. Incarceration or strangulation is a serious complication of these hernias, and mostly requires emergent surgery. Meckel's diverticulum, the most frequent congenital anomaly of the gastrointestinal tract, is rarely found within a hernial sac and this unusual condition is called as Littre's hernia. In addition, preoperative diagnosis of this unusual condition is rather difficult and it is almost always first discovered during operation. A small number of cases of strangulated Meckel's Diverticulum in an incarcerated ventral incisional hernia have been reported in the literature. Herein, we report a strangulated Meckel's Diverticulum through a ventral incisional hernia in a 65 year-old woman who presented with clinical signs of intestinal obstruction.
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    Acute Abdominal Pain with an Unusual Etiology: Splenic Infarction in a Diabetes Patient
    (Aves, 2016) Yalaza, Metin; Kafadar, Mehmet Tolga; Degirmencioglu, Gurkan; Turkan, Ahmet; Sen, Meral
    Splenic infarction is a rare clinical event caused by reduced blood flow to the spleen. Its presentation can mimic other causes of acute abdominal pain. The most frequent causes of splenic infarction include thromboembolic events, malignant hematologic neoplasms, and vasculitides. A few reports of single or multiple cases of diabetes-induced splenic infarction have been published in medical journals. Herein, we report a 67-year-old patient with diabetes-associated splenic infarction who presented to an emergency department with acute abdominal pain.
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    Acute Appendicitis in Pregnant Women: Our Clinical Experience
    (Canadian Soc Clinical Investigation, 2016) Turkan, Ahmet; Yalaza, Metin; Kafadar, Mehmet Tolga; Degirmencioglu, Gurkan
    Purpose: The purpose of this study was to analyse 13 patients who were treated in our clinic due to acute appendicitis during pregnancy. Methods: Records of the patients who received appendectomy with appendicitis diagnosis in our Turgut Ozal University Research and Application Hospital between January 2007 and December 2015 have been analyzed retrospectively. Results: Appendectomies were performed on 13 pregnant patients with an acute appendicitis diagnosis. Average age of the patients was 27.69 years (between 22-37 years). Most frequent complaint of the patients was abdominal pain and most frequent examination finding was tenderness at right lower quadrant. Ultrasonography was used in all cases for diagnosis. Surgery was decided with clinical diagnosis for five cases (38.5%) where appendix had not been identified with ultrasonography. While laparoscopic appendectomy was applied in one case (7.7%) and open appendectomy was applied using a McBurney incision in 12 cases (92.3%). Average hospitalization duration was 1.69 days. All patients were tracked together through the Gynaecology Department for two weeks after they had been discharged from the hospital. Preterm delivery, maternal and fetal loss did not occur. Conclusion: It is considered appropriate to apply ultrasonography routinely to all pregnant patients in whom acute appendicitis is suspected. Concern for maternal or fetal complication that may occur in consequence of an unnecessary surgery should not be at a level that will delay surgical treatment needed by the patient.
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    Bleeding Caecal Angiodysplasia Diagnosed by CT-Angiography
    (Derman Medical Publ, 2016) Kilic, Murat Ozgur; Degirmencioglu, Gurkan; Kilic, Yeliz
    [Abstract Not Available]
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    Isolated Jejunal Angiodysplasia: A Rare Cause of Massive Lower Gastrointestinal Bleeding Requiring Surgical Resection with an Unexpected Localization
    (Aves, 2016) Kafadar, Mehmet Tolga; Yalaza, Metin; Degirmencioglu, Gurkan; Inan, Aydin
    Angiodysplasias are most commonly observed in the cecum and ascending colon. The number of cases with angiodysplasias in the jejunum is very few. The endovascular transcatheter embolization method can be used in cases of lower gastrointestinal tract bleeding when endoscopy is not effective. According to the nature of lesion and source of bleeding, embolization is performed using the appropriate embolic agent. A surgical approach is used when endoscopic treatment methods and mesenteric angiography attempts fail. Here we present a rare case of jejunal anjiodysplasia with massive lower gastrointestinal bleeding treated with selective arterial embolization followed by urgent surgery because of a failed attempt to gain hemodynamic stability using both conservative and endoscopic methods.
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    Laparoscopic Nissen fundoplication with mesh-hiatoplasty: Single center experience and early-term results
    (Canadian Soc Clinical Investigation, 2016) Kafadar, Mehmet Tolga; Yalaza, Metin; Turkan, Ahmet; Surgit, Onder; Degirmencioglu, Gurkan; Nadir, Isilay
    Purpose: In this study we report early-term results of laparoscopic Nissen fundoplication with mesh hiatoplasty that we perform to treat gastroesophageal reflux disease. Methods: We retrospectively reviewed the medical records of 68 patients who underwent laparoscopic Nissen fundoplication with mesh hiatoplasty at our clinic. Thirty-six (53%) patients were male and 32 (47%) were female. The mean age of the study population was 46.1 (25-72) years. All patients underwent endoscopy, esophagus pH metry and manometry before the operation. All operations were performed under general anesthesia using five ports. In addition to Nissen fundoplication, all patients also underwent polypropylene mesh placement. Results: Preoperatively, all patients reported a burning sensation in the chest and regurgitation of the stomach contents up into the mouth. The mean time from symptom onset to operation was 28 (6-84) months. All patients were diagnosed with esophagitis in the preoperative endoscopic examination. The mean operative time was 80 (40-125) minutes, the median duration of hospital stay was 1.2 (1-4) days and the median follow- up time was 12 (2-30) months. Functional outcome was excellent in 65% of patients, good in 24.5%, moderately good in 7% and poor in 3.5%. Conclusion: Fundoplication with mesh hiatoplasty is a surgical procedure performed for the traetment of gastroesophageal reflux disease and hiatal hernia. Surgery can be safely carried out with low morbidity and mortality rates and constitutes an alternative to long-term drug therapy. We believe that this operation is beneficial since it reduces the rate of recurrences to a significant degree.