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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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    Appendix mucinous cystadenoma mimicking a right adnexal mass
    (Cukurova Univ, Fac Medicine, 2016) Kafadar, Mehmet Tolga; Kosem, Bahadir; Kirtis, Emine; Kosus, Nermin; Kosus, Aydin
    Appendix mucocele is a mass formed by the dilatation of appendix lumen due to abnormal mucinous secretions. It develops as a result of epithelial proliferation, mucinous secretion, and luminal dilatation on the background of mucosal hyperplasia, mucinous cystadenoma, or mucinous cystadenocarcinoma. Appendix mucinous cystadenoma is the most common type that may have different clinical presentations. The preoperative diagnosis remains difficult and the pathology is usually detected during laparotomy. Despite concerns about the rupture risk of appendix mucoceles, laparoscopic surgery has been increasingly used for its treatment. Perforation of a lesion and spread of its contents into abdominal cavity produces a condition known as pseudomyxoma peritonei. In this paper we report a case of 75-year-old woman who was taken to the operating room to be operated for a right adnexial mass and but ultimately underwent laparoscopic appendectomy after detecting an appendix mucocele in laparoscopic exploration.
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    Endoscopic and Mucosal Healing in Crohn's Disease with Azathioprine
    (Derman Medical Publ, 2016) Nadir, Isilay; Kafadar, Mehmet Tolga; Kasapoglu, Benan
    [Abstract Not Available]
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    Gastrointestinal stromal Tumor with mesenteric Localization Fistulized to Proximal Jejunum Causing Massive Rectal Bleeding
    (Derman Medical Publ, 2016) Kafadar, Mehmet Tolga; Nadir, Isilay; Bozer, Mikdat
    Gastrointestinal stromal tumors (CISTs) are the most common mesenchymal tumors of the gastrointestinal system. These non-epithelial tumors originate from the muscularispropria layer of the wall of the gastrointestinal tract Their most common locations of origin are the stomach and small intestine Rarely, they may originate from the retroperitoneum or abdomen. and may have no connection with the gastrointestinal system. They are usually incidentally detected in endoscopic and radiological examinations of the gastrointestinal system or during surgical treatment of emergency conditions such as hemorrhage, obstruction, or organ perforation. In this paper, we report a 59-year-old man with GIST located in the proximal jejunum that caused massive bleeding owing to its rarely encountered location. Histopathological examination made the definitive diagnosis, and the patient underwent total excision of the Pass and the resection of a 20-cm jejunal segment.
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    Idiopathic Chronic Cholecystitis with Delayed Diagnosis During the Early Childhood Period
    (Derman Medical Publ, 2016) Kafadar, Mehmet Tolga; Bakan, Vedat; Inan, Aydin
    Today, bile stones are increasingly common in children. Hemolytic disorders and ceftriaxone use are commonly implicated as risk factors, although approximately half of the cases are idiopathic. Patients at risk should be closely followed for bile stones and their complications. The majority of childhood cases are asymptomatic, and most asymptomatic cases are diagnosed by routine ultrasonographic studies. It is, therefore, imperative to perform periodic ultrasonographic studies in cases with hemolytic disorders. In this paper we report the case of a 2.5-year-old child with idiopathic chronic cholecystitis treated with laparoscopic cholecystectomy, who received a delayed diagnosis after a 2-year history of abdominal pain. We also provide a review of the relevant literature. Laparoscopic cholecystectomy should be the first choice in the treatment of pediatric gall bladder diseases as it yields better cosmetic results, is less painful, and patients regain daily activities earlier.
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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.
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    Sub-Diaphragmatic Bronchogenic Cysts: Report of Two Cases
    (Derman Medical Publ, 2016) Nadir, Isilay; Kasapoglu, Benan; Kafadar, Mehmet Tolga; Yildirim, Umran; Nadir, Aydin
    An intra-abdominal tumor originating from a bronchogenic cyst is an extremely rare entity. Although commonly located in the thoracic cavity, these cysts are occasionally present underneath and even within the diaphragm. We report two cases of bronchogenic cysts localized in the extra-thoracic region and treated with surgical therapy, in light of the current literature.