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Öğe Benign pneumoperitoneum: A case report(Ekin Tibbi Yayincilik Ltd Sti-Ekin Medical Publ, 2008) Albayrak, Dogan; Hatipoglu, Ahmet Rahmi; Ibis, Abdil Cem; Polat, Nihat; Coskun, IrfanFlexible colonoscopy is the gold standard in diagnosis, treatment, and follow-up of colonic pathologies. The acute onset of abdominal pain after colonoscopy may be a clinical sign of colonic perforation. Perforation rate after diagnostic colonoscopies varies between 0.01%-0.4%. If the patient develops signs of peritoneal irritation, the surgical intervention is obligatory. According to the literature, early surgical treatment is the best strategic approach that decreases the morbidity and mortality. Nonoperative treatment could be a choice in selected patients without signs of peritoneal irritation. In large colonoscopy series, only 1-5% of the cases with colonic perforation secondary to the colonoscopy were treated conservatively. We reported a case with colonic perforation after diagnostic colonoscopy which we successfully treated nonoperatively without further need of surgery.Öğe Combined Effects of Tauroursodeoxycholic Acid and Glutamine on Bacterial Translocation in Obstructive Jaundiced Rats(Galenos Publ House, 2013) Hatipoglu, Ahmet Rahmi; Oguz, Serhat; Gurcan, Saban; Yalta, Tulin; Albayrak, Dogan; Erenoglu, Cengiz; Sagiroglu, TamerBackground: Bacterial Translocation is believed to be an important factor on mortality and morbidity in Obstructive Jaundiced. Aims: We investigated the probable or estimated positive effects of tauroursodeoxycholic acid, which has antibacterial and regulatory effects on intestinal flora, together with glutamine on BT in an experimental obstructive jaundiced rat model. Study Design: Animal experimentation. Methods: Forty adult, male, Sprague Dawley rats were used in this study. Animals were randomised and divided into five groups of eight each: sham (Sh); control (common bile duct ligation, CBDL); and supplementation groups administered tauroursodeoxycholic acid (CBDL+T), glutamine (CBDL+G), or tauroursodeoxycholic acid plus glutamine (CBDL+TG). Blood and liver, spleen, MLN, and ileal samples were taken via laparotomy under sterile conditions for investigation of bacterial translocation and intestinal mucosal integrity and hepatic function tests on the tenth postoperative day. Results: There were statistically significant differences in BT rates in all samples except the spleen of the CBDL+TG group compared with the CBDL group (p=0.041, p=0.026, and p=0.041, respectively). Conclusion: It is essential to protect hepatic functions besides maintaining intestinal mucosal integrity in the active struggle against BT occurring in obstructive jaundice. The positive effect on intestinal mucosal integrity can be increased if glutamine is used with tauroursodeoxycholic acid, which also has hepatoprotective and immunomodulatory features.Öğe Effects of Intraperitoneal Melatonin on Caustic Sclerosing Cholangitis Due to Scolicidal Solution in a Rat Model(Elsevier, 2010) Sezer, Atakan; Hatipoglu, Ahmet Rahmi; Usta, Ufuk; Altun, Guelay; Sut, NecdetBACKGROUND: Hydatid disease is a worldwide health problem. Treatment is surgical or percutaneous, using scolicidal agents. Caustic sclerosing cholangitis might develop after the contact of scolicidal agents with the biliary ducts. Melatonin, an antioxidant, anti-inflammatory, and anticarcinogenic agent, might be used in the treatment of caustic sclerosing cholangitis due to its possible preventive effects on fibrosis and cell damage. OBJECTIVE: The aim of the study was to investigate the effects of melatonin on an experimentally developed caustic sclerosing cholangitis with scolicidal solution (formalin) in a rat model. METHODS: Forty female Sprague-Dawley rats aged 11 to 13 weeks and weighing 250 +/- 30 g were randomly assigned to 1 of 4 groups of 10: formalin 5% at 0.5 mL/d + melatonin placebo; formalin placebo + intraperitoneal melatonin 10 mg/kg/d; formalin 5% at 0.5 mL/d + melatonin 10 mg/kg/d; and formalin placebo and melatonin placebo (control). Hepatobiliary function was assessed using dynamic scintigraphy with technetium-99m-mebrofenin on study day 60. The histology of the liver and biliary duct specimens was examined on study day 60. In each group, histopathologic alterations were scored as absent, slight, mild, or severe. RESULTS: Mean severity scores for parenchymal necrosis in the liver (P < 0.01), portal fibrosis (P < 0.01), biliary duct proliferation (P < 0.001), cholangitis/pericholangitis (P < 0.01), hyperemia in the biliary ducts (P < 0.01), and fibrosis (P < 0.01) were significantly lower in rats treated with formalin + melatonin compared with those treated with formalin alone. No significant differences were observed between the 3 treatment groups with respect to t(1/2), a parameter used to assess the secretion function of the hepatocytes. However, the t(1/2) was significantly longer in the treatment groups compared with controls (P < 0.001). CONCLUSION: In this experimental study in a rat model of caustic sclerosing cholangitis, the histopathologic and scintigraphic findings suggested that melatonin is effective in attenuating the damage caused by scolicidal agents on the liver and biliary ducts. (Curr Ther Res Clin Exp. 2010;71:118-128) (C) 2010 Excerpta Medica Inc.Öğe Hemodynamic Instability due to Intratumoral Hemorrhage in Retroperitoneal Alveolar Rhabdomyosarcoma in Adult(Drunpp-Sarajevo, 2010) Sezer, Atakan; Yagci, Mehmet Ali; Hatipoglu, Ahmet Rahmi; Coskun, Irfan; Calta, Fedai; Cicin, Irfan; Usta, UfukBackground: Rhabdomyosarcomas are the most common soft tissue sarcomas in pediatric age and rare in adults. Case Report: A 37-year-old male admitted with abdominal discomfort and mass during the previous 9 months. The patient was hospitalized for the diagnosis of abdominal mass. Initial hemodynamic parameters were stabile. During diagnosis course, hemoglobin level decreased and hemodynamic instability occurred. Abdominal computed tomography revealed a 30x20 cm mass in left retroperitoneal space. The physical examination revealed the enlargement of the mass. The surgical resection of tumor and the adjacent abdominal wall resection were performed. Alveolar rhabdomyosarcoma was diagnosed. The patient received adjuvant chemotherapy and radiotherapy. The patient had 8 mouths follow up without signs of recurrence. Conclusion: The clinical presentation of this tumor with haemodynamic instability due to intra tumoral hemorrhage is a challenging course for physicians and this rare entity must be kept in mind for accurate and urgent treatment.Öğe Hepatic hydatid cyst cases(Aves Yayincilik, Ibrahim Kara, 2008) Albayrak, Dogan; Sezer, Yavuz Atakan; Ibis, Abdil Cem; Yagci, Mehmet Ali; Hatipoglu, Ahmet Rahmi; Coskun, IrfanObjectives: Hydatid cyst is presently a prevalent health problem in our area and country. This study retrospectively reviewed medical records of four patients who underwent urgent surgery due to intraperitoneal rupture and the records of all patients treated for hepatic hydatidosis in the same period. Patients and Methods: Medical records of the 44 patients (24 females, 20 males; mean age 47.5 years; range 16 to 83 years) who were treated in our clinic for hepatic hydatidosis between January 2004 and June 2007 were reviewed retrospectively. The patients were evaluated with respect to age, sex, location of the cyst, surgical method applied, hospital stay duration, pre- and postoperative complications, and treatment methods applied for the complications. Results: Four patients (9%) underwent emergency surgery due to intraperitoneal rupture. Postoperative biliary leakage into the cyst cavity was observed in 15 patients (34%). It was closed spontaneously in 6 patients (40%) without further intervention. In 8 patients (53%) the biliary leakage continued for about 10 days and the daily median drainage was over 100 cc. Endoscopic sphincterotomy was performed in these cases. Mortality rate was 4% (n=2). Conclusion: Rupture of hydatid cyst should be suspected in trauma patients who had hepatic cyst and intraperitoneal free fluid concomitantly. In these patients therapeutic intervention should be quick because of the risk of any anaflactic reaction. Endoscopic sphincterotomy is an effective treatment method for biliary fistula after hydatid cyst surgery.Öğe Hepatic Hydatid Cyst Cases Reply(Ekin Tibbi Yayincilik Ltd Sti-Ekin Medical Publ, 2008) Albayrak, Dogan; Sezer, Yavuz Atakan; Ibis, Abdil Cem; Yagci, Mehmet Ali; Hatipoglu, Ahmet Rahmi; Coskun, Irfan[Abstract Not Available]Öğe Lymphangiomatosis of the colon mimicking acute appendicitis(Wolters Kluwer Medknow Publications, 2011) Yagci, Mehmet Ali; Sezer, Atakan; Yeldan, Eyup; Coskun, I; Hatipoglu, Ahmet Rahmi; Altaner, Semsi; Umit, Hasan[Abstract Not Available]Öğe The management of gastric perforation in a girl with Rett syndrome: Report of a case(Elsevier Science Bv, 2011) Sezer, Atakan; Yagci, Mehmet Ali; Hatipoglu, Ahmet RahmiIntroduction: Rett syndrome is a neurologically disorder that affects approximately one in 10,000 females. Case report: A 21-year-old girl with Rett syndrome was hospitalized for abdominal distention and pain. Physical examination revealed abdominal tenderness. Radiology investigation revealed bilateral free air in subdiaphragmatic area. Gastric perforation observed at laparotomy. Primary suturing and omentoplasty were performed. In the follow-up, the symptoms of intestinal obstruction occurred. Conservative treatment failed and second intervention was performed. At laparotomy severe gastric and intestinal dilatation and bowel adhesions were detected. Adhesiolysis, tube gastrostomy, and feeding jejunostomy performed. Discussion: Rett syndrome and associated gastric complications are uncommon. These pathologic disorders may cause gastric, intestinal necrosis, intestinal obstructions. Because of the late occurring of physical findings and insidious presentation of the gastrointestinal perforations in Rett syndrome, physicians should keep in mind this rare entity to reduce morbidity and mortality. (C) 2010 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.Öğe Perforated primary small bowel lymphoma: A case report(Ekin Tibbi Yayincilik Ltd Sti-Ekin Medical Publ, 2008) Albayrak, Dogan; Ibis, Abdil Cem; Hatipoglu, Ahmet Rahmi; Polat, Nihat; Hoscoskun, ZekiMalignant tumors of the small bowel are rarely seen and are usually diagnosed in advanced stages because of the difficulties in diagnosis. Lymphomas account for %1 of malignant gastrointestinal system tumors. Primary gastrointestinal lymphoma is very rare and its preoperative diagnosis is difficult. Its diagnosis is usually made through laparotomy. A 77-year-old male patient developed acute abdomen during observation for partial mechanic intestinal obstruction. Emergent explorative laparotomy revealed perforation of a small bowel tumor. A wide small bowel resection was performed with a double-layer end-to-end anastomosis. Histopathological examination of the surgical specimen was reported as indolent B-cell non-Hodgkin's lymphoma. It should be kept in mind that small bowel tumors can present as mechanic intestinal obstruction, resulting in delayed diagnosis.Öğe A rare cause of intestinal obstruction due to an exophytic gastrointestinal stromal tumor of the small bowel(Pharmamed Mado Ltd, 2009) Sezer, Atakan; Yagci, Mehmet Ali; Hatipoglu, Ahmet Rahmi; Coskun, Irfan; Cicin, Irfan; Usta, Ufuk; Temizoz, OsmanIntroduction: Gastrointestinal stromal tumors constitute a distinct group of rare gastrointestinal tract tumors that originate from the interstitial cells of Cajal. These jejunoileal lesions are a rare cause of obstruction but can be associated with substantial morbidity. Case: A 59-year-old woman presented to the emergency department with abdominal pain and distention. Physical examination revealed tenderness and rebound in right lower quadrant. Computed tomography revealed a mass in lower right quadrant. A 9x9x4 cm exophytic ileal mass was observed at exploration. Preoperative diagnose was a small bowel tumor and then segmental resection and primary anastomosis were performed. Histopathological investigation revealed spindle cells that stained strongly for C-117, consistent with a diagnosis of a malign gastrointestinal stromal tumor. Conclusion: We conclude that exophytic small bowel gastrointestinal stromal tumors are rare lesions, which should be kept in mind by physicians among the diagnosis of small bowel obstructions in order to reduce substantial morbidity and mortality.Öğe Rectal foreign bodies: A report of three cases(Ekin Tibbi Yayincilik Ltd Sti-Ekin Medical Publ, 2007) Albayrak, Dogan; Ibis, Abdil Cem; Hatipoglu, Ahmet Rahmi; Irfanoglu, Mehinet EminDifferent foreign bodies were found in rectum in three male patients, whose ages were 25, 66 and 67. These foreign materials were iron stick, special wooden stick and tea cup. In two patients, materials were taken out under general anesthesia in lithotomy position and the other one in knee-elbow position by anal dilatation under local anesthesia with sedation. In two patients there were not any complications related with the treatment method but one of them had superficial lacerations on rectal mucosa. All of the patients were discharged after 24 hours observation. Foreign bodies in rectum and sigmoid colon is increasingly being seen recently and is one of the significant surgical emergency problems due to the complications it may cause.
