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Öğe A Case of Abdominal Wall Endometriosis Mimicking Strangulated Incisional Hernia(Aves, 2014) Kilic, Murat Ozgur; Degirmencioglu, Gurkan; Dener, CenapIntroduction: 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.Öğe A rare case of Spigelian hernia combined with direct and indirect inguinal hernias(Turkish Surgical Assoc, 2017) Kilic, Murat Ozgur; Degirmencioglu, Gurkan; Dener, CenapSpigelian 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.Öğe 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, SibelIncisional 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.Öğe Acquired Lymphangiectasia of the Breast After Breast Conserving Surgery(Springer India, 2015) Kilic, Murat Ozgur; Dener, CenapLymphangiectasia is characterized by vesicular dilation of lymphatic vessels and is generally a complication of radiotherapy or surgery of various malignant tumors such as breast and cervical cancers. Although it is not a precancerous disease, correct diagnosis is important to rule out Stewart-Treves syndrome which is defined as lymphangiosarcoma that develops in long-standing chronic postmastectomy lymphedema. Observation alone or many therapeutic options including cryosurgery, electrocauterization, sclerotherapy, and excision have been widely used in the management. Herein, a case of breast lymphangiectasia was presented as a late and rare complication of breast cancer-related therapies.Öğe An Unusual Presentation of Lung Cancer Metastasis: Perianal Abscess(Derman Medical Publ, 2014) Kilic, Murat Ozgur; Sen, Meral; Turkan, Ahmet; Yildirim, Umran; Koktener, AsliLung cancer is one of the most commonly diagnosed cancers in both men and women. Although the most frequent sites of distant metastasis of lung cancers are the pleura, liver, adrenal glands, skeletal system and brain, perianal region has been rarely reported as a metastasis site. A male patient was admitted to our emergency room with a long standing perianal abscess. During abscess drainage, a mass was noticed at the base of the abscess pouch, and thus a biopsy was taken. Pathologically, it was reported as a metastasis of squamous cell carcinoma, therefore some radiological investigations and endoscopic procedures were performed to determine the primary focus of cancer. A pulmonary mass was revealed in PET/CT, and was considered as primary tumor. Both primary and metastatic perianal tumors can be rarely presented as an abscess formation. In this situation, a biopsy should be performed from the lesion to avoid misdiagnosis.Öğe Bleeding Caecal Angiodysplasia Diagnosed by CT-Angiography(Derman Medical Publ, 2016) Kilic, Murat Ozgur; Degirmencioglu, Gurkan; Kilic, Yeliz[Abstract Not Available]Öğe Can mastalgia be another somatic symptom in fibromyalgia syndrome?(Hospital Clinicas, Univ Sao Paulo, 2015) Sen, Meral; Kilic, Murat Ozgur; Cemeroglu, Ozlem; Icen, DuyguOBJECTIVE: The purposes of this study were to determine the coexistence of mastalgia and fibromyalgia, to investigate the effects of this combination on pain patterns, and to discuss the status of breast pain in the diagnostic algorithm of fibromyalgia syndrome. METHODS: Sixty-one female patients reporting breast pain during the last three months and 53 female patients diagnosed with fibromyalgia syndrome were enrolled in this study. The Breast Pain Questionnaire was administered to all participants in the mastalgia group and to those in the fibromyalgia syndrome group who had experienced mastalgia during the past three months. The patients in the fibromyalgia syndrome group were evaluated using the 2010 preliminary American College of Rheumatology classification criteria. All of the patients in the mastalgia group were evaluated for the diagnosis of fibromyalgia syndrome by a single physiatrist. The coexistence and pain patterns of mastalgia and fibromyalgia were assessed statistically. RESULTS: Approximately half of the patients with fibromyalgia syndrome (47.2%) reported having mastalgia at the time of admission and 37.7% of the patients with mastalgia met the diagnostic criteria for fibromyalgia syndrome. The patients with mastalgia in the fibromyalgia syndrome group had significantly higher total breast pain scores compared with the women in the mastalgia group. In addition, the patients with fibromyalgia syndrome in the mastalgia group had significantly higher Widespread Pain Index and Symptom Severity Scale scores than the patients with fibromyalgia syndrome. CONCLUSIONS: We suggest that mastalgia can be an aspect of the central sensitivity syndrome and can be added to the somatic symptoms of fibromyalgia.Öğe Combined procedure of cesarean delivery and preperitoneal mesh repair for inguinal hernia: An initial experience(Elsevier Singapore Pte Ltd, 2017) Surgit, Onder; Gumus, Ilknur Inegol; Kilic, Murat Ozgur; Kaygusuz, IkbalBackground: Combined surgery for cesarean delivery and preperitoneal mesh repair for inguinal hernia has not been previously reported. Objectives: Our aim was to describe the method and to present the results of this simultaneous surgery through a single incision. Methods: From 2012 to 2014, 15 patients underwent cesarean delivery combined with preperitoneal mesh repair for inguinal hernia. All patient characteristics and perioperative findings were recorded. Results: Among 15 patients, 13 had unilateral inguinal hernias and two had bilateral hernias. The mean times spent for unilateral and bilateral hernias were 35.8 minutes (range, 30-45 minutes) and 67.5 minutes (range, 65-70 minutes), respectively. Direct and indirect hernias were present in one and 15 patients, respectively. One patient had mixed hernia. No significant complication was observed perioperatively. Hospital stay ranged from 1 day to 3 days (mean, 1.87 days), and all patients were discharged without any problem. No recurrence was found during the follow-up periods. Conclusion: Single anesthesia, single incisional scar, and single hospitalization are the major advantages of this simultaneous approach of cesarean delivery and preperitoneal mesh repair for inguinal hernia. Our analysis suggests that this combined procedure can be performed safely in selected cases. (C) 2016 Asian Surgical Association and Taiwan Robotic Surgical Association. Publishing services by Elsevier B.V.Öğe Differentially regulated ADAMTS1, 8, 9, and 18 in pancreas adenocarcinoma(Termedia Publishing House Ltd, 2017) Kilic, Murat Ozgur; Aynekin, Busra; Bozer, Mikdat; Kara, Adem; Haltas, Hacer; Icen, Duygu; Demircan, KadirIntroduction: Despite recent diagnostic and therapeutic improvements, pancreas cancer remains one of the highly lethal cancers. The extracellular matrix (ECM) is a physiological barrier that limits the spread of cancer cells into surrounding tissues and distant organs. Disintegrin and metalloprotease with thrombospondin motifs (ADAMTS) is a family of 19 proteases, which is involved in various biological processes such as ECM remodelling and anti-angiogenesis. Aim: To investigate the expression of ADAMTS1, 8, 9, and 18 proteinases in pancreas adenocarcinoma and its nodal metastasis. Material and methods: The immunostaining status of ADAMTS1, 8, 9, and 18 were investigated in formalin-fixed paraffin-embedded samples of 25 patients who underwent pancreaticoduodenectomy for an adenocarcinoma located at the head of the pancreas. Results: In semi-quantitive grading pathologically, ADAMTS1, 8, 9, and 18 were found to be highly stained in all cancerous pancreas samples compared with normal pancreas. In addition, the immune positivity of ADAMTS1, 9, and 18 was found to be higher in metastatic lymph nodes than in non-metastatic lymph tissue. Tumour size was correlated with ADAMTS9 and 18 expressions in cancerous pancreas. Conclusions: According to the data obtained from the study, we suggest that these four ADAMTSs may have significant roles in the tumorigenesis and nodal spread of pancreas adenocarcinoma.Öğe Docetaxel-induced Scleroderma in A Breast Cancer Patient: A Case Report(Aves, 2015) Kilic, Murat Ozgur; Yalaza, Metin; Bilgic, Celal Ismail; Dener, CenapPaclitaxel and docetaxel are antineoplastic drugs derived from the yew tree, Taxus brevifolia. They are the members of the taxane family and act by inhibiting mitotic activity due to the suppression of microtubule depolymerization. They are used in the treatment of ovarian cancer, breast cancer, gastric cancer, small cell lung cancer, and head and neck cancer. In addition to side effects such as cardiotoxicity, neutropenia, arthralgia, and myalgia, they may also cause alopecia, urticaria, mucositis, acral erythema, pustular dermatitis, erythema multiforme, and scleroderma-like mucocutaneous lesions. Scleroderma is among the uncommon side effects of taxane antineoplastic agents. As was the case in few cases in literature, it usually begins with edematous changes in the proximal aspect of the extremities, and subsequently, sclerosis is developed in the skin. Scleroderma, which usually regresses with the discontinuation of the drug and with steroid therapy, may lead to severe contractions that require physical therapy and rehabilitation in some patients. In this paper, we presented a 60-year-old female patient in whom scleroderma developed because docetaxel chemotherapy for breast cancer because it is encountered rarely.Öğe EVALUATION OF TWENTY-SEVEN PATIENTS WITH TUBERCULOUS PERITONITIS(Carbone Editore, 2016) Kilic, Murat Ozgur; Saglam, Cemile; Caner, Sevkan Sultan; Kilic, Yeliz; Icen, DuyguIntroduction: Tuberculosis (TB) remains a public health problem worldwide. Peritoneal tuberculosis or tuberculous peritonitis (TBP) is an uncommon form of extrapulmonary infection with a proportional increasing of its incidence. This disease is seen most commonly in young adults, and has a highly variable clinical symptomatology. Our aim is to highlight the nonspecific presentation and diagnostic difficulties of the TBP. Materials and methods. We retrospectively reviewed 27 TBP cases diagnosed between 2003 and 2014. Clinical features, all diagnostic methods, and the outcomes of treatment were analyzed in view of literature. Results: Abdominal distension and pain were the most frequent symptoms. A past history of pulmonary TB was obtained in 4 patients. Additionally, concomitant extraperitoneal TB was found in 15 cases. Ascites was the most sonographic finding. Acid-fast staining of ascitic fluid was positive in 1/19. Peritoneal biopsy via laparoscopy or laparotomy was positive for TBP in 13/14. Duration of symptoms prior to diagnosis was found to be associated with prolongation of the treatment (p<0.001). In addition, pretreatment c-reactive protein was found to be significantly different between the patients requiring a standard therapy of 9 months and the patients requiring additional therapy of 3 months (p=0.023). Conclusion: The diagnosis of TBP is often difficult due to diverse presentation. The patient's anamnesis and the presence of ascites are the most significant marks in diagnosis. Laparoscopy with peritoneal biopsy seems to be the gold standard diagnostic method.Öğe Giant gluteal pilomatrixoma: An uncommon tumor in a rare localization(Marmara Univ, Fac Medicine, 2015) Kilic, Murat Ozgur; Sen, MeralPilomatrixoma is an uncommon, benign subcutaneous tumor arising from the hair follicle matrix. This tumor occurs more commonly in children than in adults, and most often originates on the head, neck or upper extremities. Gluteal region is an extremely rare site of pilomatrixoma. Multiple presentation is an unusual condition and often associated with some familial syndromes such as myotonic dystrophy, Gardner syndrome and Turner syndrome. Pilomatrixoma mostly presents as a painless, firm, slow-growing subcutaneous mass, and is usually encapsulated by connective tissue and sharply demarcated from the surrounding normal tissue. Both clinical and radiological findings are non-specific, and therefore histopathology is necessary to reach correct diagnosis. These lesions have very low risk of malignant transformation, and surgical excision with adequate margins is the treatment of choice. Herein, a rare case of gluteal pilomatrixoma with multiple presentation in the upper extremities in a young female patient was presented.Öğe Myofibroblastoma: A rare benign breast tumor in a male case(Yerkure Tanitim & Yayincilik Hizmetleri A S, 2017) Kilic, Murat Ozgur; Sen, Meral; Dener, Cenap; Yenidunya, SibelMyofibroblastoma is a rare benign mesenchymal tumor of the breast. A small number of cases have been reported in the literature. It is often seen in postmenopausal women and older men. In general, MFP occurs slow-growing within months, well-circumscribed, mobile, single-sided and a hard mass. Due to the variety of morphological variants, it is difficult to distinguish from other breast masses by imaging techniques, tru-cut biopsy plays a key role in diagnosis. Local excision of myofibroblastoma as a benign tumor of the breast is curative. Malign transformation and recurrence after surgery have not been reported. Knowing the right approach to this rare breast mass by general surgeons, reduce unnecessary and mistreatments. We presented a new case of myofibroblastoma which is found in a 42 years old male patient's breast, due to its rarity.Öğe Non-Operative Management of Isolated Pneumoperitoneum Due to Severe Blunt Abdominal Trauma(Derman Medical Publ, 2015) Kilic, Murat Ozgur; Bozer, Mikdat; Turkan, Ahmet; Kilic, YelizNonperative management of blunt abdominal trauma is the treatment of choice for hemodynamically stable patients. The results of nonoperative management are more successful in isolated solid organ injuries such as the liver and spleen than hollow viscus injury. In this approach, both the clinical course of the patient and the computed tomography findings play an important role. Isolated pneumoperitoneum in blunt abdominal trauma may be a surgical challenge for clinicians because it is usually a significant radiological sign for hallow viscus perforations. Here, we report a case of isolated pneumoperitoneum detected on computed tomography and managed non-surgically, in a young man suffered from a severe blunt abdominal trauma. Our aim is to attract the attention of surgeons to the management problems of the presence of pneumoperitoneum in the absence of other radiological findings in blunt abdominal trauma.Öğe The Clinicopathological Factors Associated with Multicentricity in Papillary Thyroid Cancer(Derman Medical Publ, 2016) Kilic, Murat Ozgur; Bilgic, Celal Ismail; Dener, Cenap; Icen, DuyguAim: Multicentricity is a frequent feature of papillary thyroid cancer, and is generally associated with advanced stage, increased risk of regional and distant metastasis. In this study, we aimed to determine the associated clinicopathological factors on multicentricity in papillary thyroid cancer. Material and Method: One hundred and thirty patients with papillary thyroid cancer were included in this retrospective study. The affecting clinical and histopathological factors on multicentricity were investigated. Results: Total thyroidectomy with or without central/lateral neck dissection was performed in 130 patients (101, 77.7% were female and 29, 22.3% were male) with a mean age of 43.03 years. The diagnosis of papillary thyroid cancer was confirmed by final histopathology in all cases. Multicentricity and bilaterality were detected in 54 (41.5%) and 16 (12.3%) patients, respectively. Tumor size (p= 0.046) and perineural invasion (p= 0.020) were significantly different between the patients with multicentric cancer and those with solitary cancer. Discussion: According to the findings obtained from this study, tumor size and perineural invasion were the affecting factors on multicentricity in papillary thyroid cancer. However, large-scale, multicenter clinical and genetic studies are needed to clearly determine the affecting factors on multicentricity of these cancers.Öğe Use of fibrin glue in preventing pseudorecurrence after laparoscopic total extraperitoneal repair of large indirect inguinal hernia(Korean Surgical Society, 2016) Surgit, Onder; Cavusoglu, Nadir Turgut; Kilic, Murat Ozgur; Unal, Yilmaz; Kosar, Pinar Nergis; Icen, DuyguPurpose: Seroma is among the most common complicatidns of laparoscopic total extraperitoneal (TEP) for especially large indirect inguinal hernia, and may be regarded as a recurrence by some patients. A potential area localized behind the mesh and extending from the inguinal cord into the scrotum may be one of the major etiological factors of this complication. Our aim is to describe a novel technique in preventing pseudorecurrence by using fibrin sealant to close that potential dead space. Methods: Forty male patients who underwent laparoscopic TEP for indirect inguinal hernia with at least 100-mL volume were included in this prospective clinical study. While fibrin sealant was used to close the potential dead space in the study group, nothing was used in the control group. The volume of postoperative fluid collection on ultrasound was compared between the groups. Results: Patient characteristics and the volumes of hernia sac were similar between the 2 groups. The mean volume of postoperative fluid collection was found as 120.2 mL in the control group and 53.7 mL in the study group, indicating a statistical significance (P < 0.001). Conclusion: Minimizing the potential dead space with a fibrin sealant can reduce the amount of postoperative fluid collection, namely the incidence of pseudorecurrence.
