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Öğe Combined Effectiveness of Honey and Immunonutrition on Bacterial Translocation Secondary to Obstructive Jaundice in Rats: Experimental Study(Int Scientific Information, Inc, 2018) Oguz, Serhat; Salt, Omer; Ibis, Abdil C.; Gurcan, Saban; Albayrak, Dogan; Yalta, Tulin; Sagiroglu, TamerBackground: Obstructive jaundice is a serious, life-threatening condition that can lead to death as a result of sepsis and multiorgan failure due to bacterial translocation. Treatment should be started as soon as possible after diagnosis. Material/Methods: Forty 24-week-old male Sprague Dawley rats, with an average weight of 250 g to 300 g, were included in this study. The rats were randomly placed into five groups, each group consisted of eight rats. The sham group underwent only common bile duct (CBD) dissection and no ligation was performed. CBD ligation was applied to the other groups. After the operation, one CBD group was fed with rat chow only, the others were fed with rat chow supplemented with honey, or immunonutrients, or honey plus immunonutrients. After 10 to 12 days, all rats were sacrificed; blood and tissue samples were collected for biochemical, microbiological, and histopathological evaluation. Results: In the groups that were fed with honey and immunonutrients, alanine aminotransferase (ALT) levels were de- creased significantly compared to the other groups. Statistically significant differences were detected in terms of bacterial translocation (BT) rates among liver and spleen samples, and laboratory values of serum, except for MLNs of the BDL+HI group, when compared to other groups. We found mean mucosal thickness of ileum samples have been improved notably in the BDL+HI group compared to the other groups, especially compared to the C/BDL group. Conclusions: Immunonutrition applied with honey had immunostimulant effects, decreased BT due to an additive effect, and had positive effects on intestinal mucosa.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 Effect of Leptin and Apelin Preconditioning on Hepatic Ischemia Reperfusion Injury in Rats(Springer India, 2014) Sagiroglu, Tamer; Aksoy, Mustafa Burak; Sagiroglu, Gonul; Tozkir, Hilmi; Oguz, Serhat; Yalta, Tulin; Yagci, Mehmet A.Leptin and apelin are important adipocytokines involved in a variety of endocrine and paracrine functions. The aim of this study was to evaluate the effect of exogenous leptin and apelin preconditioning on hepatic ischemia reperfusion (I/R) injury in rats. Forty mice were assigned to four groups (n = 10): sham-operated control (sham), I/R injury, I/R + leptin (I/R + L), and I/R + apelin (I/R + A). Leptin 100 mu g/kg/day and apelin 2 mu g/kg/day were delivered intraperitoneally starting 3 days prior to surgical procedure in I/R + L and I/R + A groups, respectively. All I/R groups underwent 45 min of warm ischemia, followed by 30 min of reperfusion. Serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST), liver malondialdehyde (MDA) and glutathione (GSH), and liver histopathology were compared between groups. MDA was elevated in I/R, but stayed similar in I/R + L and I/R + A compared to sham. I/R + A had significantly lower MDA compared to I/R. GSH levels did not differ significantly between the groups. ALT and AST were elevated in all I/R groups, but significant reduction was observed in I/R + L and I/R + A compared to I/R. Liver histopathology was mostly mild in I/R + L and I/R + A, in contrast to severe injury observed in the I/R group. Leptin and apelin preconditioning significantly reduced hepatic I/R injury in rats.Öğe Effects of apelin and leptin on renal functions following renal ischemia/reperfusion: An experimental study(Spandidos Publ Ltd, 2012) Sagiroglu, Tamer; Torun, Nese; Yagci, Mehmet; Yalta, Tulin; Sagiroglu, Gonul; Oguz, SerhatThe present study aimed to investigate the effects of apelin and leptin on renal functions following renal ischemia/reperfusion (I/R). A total of 32 rats were divided into four groups. The control group was not induced with ischemia, but was administered normal saline intraperitoneally. Normal saline, apelin and leptin were administered intraperitoneally to the I/R, ischemia/reperfusion and apelin (I/R+A) and ischemia/reperfusion and leptin (I/R+L) groups, in turn for three days prior to the surgical procedure. Blood and urine samples were obtained after 24 h of reperfusion, and scintigraphic examination was performed. Renal damage was evaluated histopathologically. Urea levels of the I/R+L and I/R+A groups were comparable, but were higher compared to that of the control group. The I/R group had the highest urea levels (control, 27 +/- 2; I/R, 120 +/- 15; I/R+A, 75 +/- 10; I/R+L, 80 +/- 11; p<0.001). Creatinine levels were higher in all three ischemic groups compared to the control group. Glomerular filtration rate values of the I/R+A and I/R+L groups were not significantly, but numerically higher compared to that of the I/R group. No pathological damage was observed in any of the animals in the control group. In the I/R group, two animals had moderate and six had severe renal damage, while three had moderate and one had severe renal damage in the I/R+L group. In the I/R+A group, moderate renal damage was found in one animal, while none had severe renal damage. This study demonstrates the functional and histopathological protective effects of leptin and apelin against renal I/R injury.Öğe The Effects of Apelin on Mesenteric Ischemia and Reperfusion Damage in an Experimental Rat Model(Galenos Publ House, 2012) Sagiroglu, Tamer; Oguz, Serhat; Sagiroglu, Gonul; Copuroglu, Elif; Yalta, Tulin; Sayhan, Mustafa Burak; Yagci, Mehmet AliObjective: Intestinal ischemia-reperfusion (I/R) injury is associated with high morbidity and mortality rates. There is ongoing research to find an effective preventive or treatment agent. We aimed to evaluate the effects of apelin 13 (AP) on intestinal I/R injury in a rat model. Material and Methods: Twenty-four male Sprague-Dawley rats aged 6-8 weeks and weighing 280 +/- 20 g were equally divided into three groups (control, I/R and I/R+AP). The control group underwent superior mesenteric artery (SMA) mobilization alone without any clamping. In the I/R and I/R+AP groups, an atraumatic microvascular bulldog clamp was placed across the SMA at its point of origin from the aorta. In the I/R+AP group, 2 mu g/kg/d apelin was administered intraperitoneally. After 60 minutes of ischemia, relaparotomy was performed to remove the microvascular clamp on the SMA for 3 hours of reperfusion. After 3 hours, tissue samples were obtained for biochemical [malondialdehyde (MDA) and glutathione (GSH) levels] and histopathological analyses. Results: MDA levels were significantly higher in the I/R group compared to the control group. Although MDA levels were lower in the I/R+AP group compared to the I/R group, the difference was not statistically significant. There was also no significant difference between the I/R+AP and I/R groups regarding GSH levels. The median histopathological grade was significantly lower in the I/R+AP group compared to the I/R group (p=0.001). Conclusion: Apelin appeared to have a positive effect on oxidative injury; this did not reach statistical significance. Thus, the role of apelin and associated findings in the initial treatment of intestinal ischemia needs further large-scale animal studies before human use.Öğe The Effects of Sirolimus on Target Organs During Mesenteric Ischemia and Reperfusion Damage in an Experimental Rat Model(Elsevier Science Inc, 2011) Sagiroglu, Tamer; Sezer, Atakan; Altaner, Semsi; Umit, Hasan; Yalta, Tulin; Yagci, Mehmet AliBACKGROUND: Mesenteric ischemia and reperfusion (I/R) syndrome (MIRS) has been considered a clinicopathologic entity associated with a variety of clinically severe conditions with decreased intestinal blood flow and has been known to induce I/R damage in various organs. Sirolimus (SRL), a macrolide antibiotic isolated from a strain of Streptomyces hygroscopicus, is a potent and nonnephrotoxic immunosuppressant. OBJECTIVE: This study was designed to investigate the potential impact of sirolimus on MIRS-induced I/R damage in renal, intestinal, pulmonary, and hepatic tissues in an experimental rat model. METHODS: Twenty-four male Sprague-Dawley rats, aged 6 to 8 weeks and weighing 280 (+/- 20 g), were studied. Using computer-generated random numbers, rats were assigned to 1 of the following 3 groups: group 1 (I/R group, n = 8), group 2 (I/R + sirolimus group, n = 8), and group 3 (control group, n = 8). Sirolimus, in a 1 mg/mL (60 mL) solution, was administered intraperitoneally in a dose of 1.5 mg/kg/d to the rats assigned to group 2 starting from 3 days before the surgical procedure. In surgery, a laparotomy was performed to clamp the superior mesenteric artery and, thus, induce bowel ischemia in groups 1 and 2. After 60 minutes of ischemia, the microvascular clamp on the superior mesenteric artery was removed for 3 hours of reperfusion. Soon after experimental induction of MIRS, bowel, lung, kidney, and liver specimens from each animal were harvested for both biochemical and histopathologic analysis. RESULTS: There were statistically significant differences between groups 1 and 3 with regard to degrees of intestinal (P < 0.001), hepatic (P = 0.001), renal (P < 0.001), and pulmonary (P = 0.01) I/R damage. The lung specimens from group 2 had less inflammation and perivascular edema formation compared with specimens from group 1, but no statistical significance was observed between the groups (P < 0.33). There were statistically significant differences between groups 1 and 2 with regard to degrees of intestinal, hepatic, and renal I/R damage (P = 0.001 for all). CONCLUSION: The findings of the present study demonstrate the attenuating effects of sirolimus on I/R damage in the intestine and remote organs, including the liver and kidney in the setting of MIRS in an experimental rat model. As a therapeutic implication, the utility of sirolimus may be of clinical value in procedures associated with a high likelihood of I/R damage, including major abdominal operations and renal transplantation. However, whether these results apply to humans is unclear. Additional experimental and clinical studies are warranted to confirm the clinical utility of sirolimus in conditions potentially associated with I/R damage. (Curr T her Res Clin Exp. 2011;72:79-93) (C) 2011 Elsevier HS Journals, Inc. All rights reserved.Öğe The efficacy of thoracic epidural and paravertebral blocks for post-thoracotomy pain management(Termedia Publishing House Ltd, 2013) Sagiroglu, Gonul; Baysal, Ayse; Copuroglu, Elif; Karamustafaoglu, Yekta Altemur; Sagiroglu, Tamer; Yuksel, Volkan; Huseyin, SerhatIntroduction: The definition of pain focuses mainly on tissue damage and provides information regarding pathophysiological changes in the human being [1]. Patients experience pain as a response to this tissue damage after surgery and the pain intensity after thoracotomies is known to be severe [2]. Aim of the study: Our goal was to investigate the efficacy and adverse effects of thoracic epidural and paravertebral blocks for post-thoracotomy pain management. Material and methods: In a prospective, randomized double blinded study, patients were divided into thoracic epidural (EPI group, n = 30) and paravertebral (PVB group, n = 30) groups. A bolus dose of 10 ml of 0.25% bupivacaine was followed by a continuous infusion of 0.1 ml kg(-1) h(-1) for a total of 24 hours. A visual analog scale (VAS) was used to evaluate pain at rest (VAS-R) and after coughing (VAS-C) at baseline (after extubation), 2, 4, 12 and 24 hours after surgery. The duration of catheter insertion, morphine consumption, complications and side effects were collected. Results: In comparison of EPI and PVB groups, VAS-R and VAS-C scores were similar at baseline and at 2, 4, 12 and 24 hours after surgery (p > 0.05). The incidence of hypotension was higher and the duration of catheter insertion was longer in the EPI group in comparison to the PVB group (p = 0.038, p < 0.0001, respectively). Conclusions: For post-thoracotomy pain, both thoracic epidural analgesia and paravertebral block techniques provide sufficient pain relief. As paravertebral block is an easier and quicker technique with lower incidence of hypotension, it should be considered as a good alternative to thoracic epidural technique to establish postoperative analgesia.Öğe The evaluation of morbidity in gastrointestinal tumor patients underwent cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (HIPEC)(Turkish Surgical Assoc, 2022) Aytin, Yusuf Emre; Cakcak, Ibrahim Ethem; Sagiroglu, TamerObjective: In this study, we aimed to determine the postoperative morbidity rate and identify demographic, clinical, and treatment-related variables that may be potential risk factors for morbidity in gastrointestinal tumor patients undergoing hyperthermic intraperitoneal chemotherapy (HIPEC) with or without cytoreductive surgery (CRS). Material and Methods: In this retrospective study, 60 patients who had undergone HIPEC due to gastrointestinal tumor between October 2017 and December 2019 were included. Systemic toxicities were graded and evaluated according to the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) version 3.0 criteria. Results: Mean age of the patients was 60.43 +/- 12.83. Primary tumor localization was the stomach in 33 patients (55%), colon in 21 (35%), rectum in five (8.3%), and appendix in one patient (1.7%). PCI mean value was 9.51 +/- 10.92. CC-0 was applied in 37 (61.7%) patients, CC-1 in 11 (18.3%), CC-2 in 6 (10%), and CC-3 in six patients (10%). Morbidity was observed in 50 (83.33%) of the 60 patients participating in the study according to NCI-CTCAE v3.0 classification. Mild morbidity rate was 46.6%, severe morbidity rate was 36.6%, and mortality rate was 11.66%. Enteric diversion application, length of stay in the ICU, and length of hospital stay were shown to have a statistically significant effect on the NCI-CTCAE morbidity score (p= 0.046, p= 0.004, p< 0.001). Conclusion: With proven beneficial effects on survival in patients with locally advanced gastrointestinal tumors, CRC and HIPEC are acceptable in these patients despite their increased morbidity and mortality rate. With new studies on this subject, morbidity and mortality rates may be reduced.Öğe A New Tube Gastrostomy Model in Animal Experiments(Derman Medical Publ, 2013) Sezer, Atakan; Sagiroglu, Tamer; Copuroglu, Elif; Yagci, Mehmet Ali; Oltulu, Cagatay; Sut, NecdetAim: The orogastric route is the most preferred application method in the vast majority of the animal experiments in which application can be achieved by adding the material to the water of the experiment animal, through an orogastric tube or with a surgically managed ostomy. Material and Method: This experiment was constructed with twelve male Sprague-Dawley rats which were randomly assigned to one of two groups consist of control group (group C, n:6) and tube gastrostomy group (group TG, n:6). A novel and simple gastrostomy tube was derivated from a silicone foley catheter. Tube gastrostomy apparatus was constituted with a silicone foley catheter (6 French). In the group TG an incision was performed, and the stomach was visualized. A 1 cm incision was made in the midline and opening of the peritoneum. Anchoring sutures were placed and anterior gastric wall was lifted. The gastric wall is then opened. The apparatus was placed into the stomach and pulled through from a tunnel under the skin and fixed to the lateral abdominal wall with a 2/0 silk suture. Result: The procedure was ended in the 10th day of experiment. No mortality was observed in group C. The rats were monitored daily and no abnormal behavior consists of self harming incision site, resistance to oral intake or attending to displace. There was statistically significant difference in increasing alanine transaminase level (p<0.05) and decrease in the total protein and body weight (p<0.05) at the group TG at the end of experiment. There was significant increase in urea levels in Group C (p<0.05) at the end of experiment. The statistically significant decrease was observed in the same period in group C between aspartate transaminase, albumin, total protein, and body weight (p<0.05). Glucose (p=0.047) and aspartate transaminase (p=0.050) level decrease changes and weight loose (p=0.034) from preoperative period to the end of the experiment between gastrostomy and laparotomy groups were statistically significantly. Discussion: Here in we presented a novel and simple tube gastrostomy model in an experimental rat model in which rats had unrestrained movements. We believe that this new constructed tube gastrostomy model may be an alternative route for the experimental models in which orogastric route is unavailable to use.Öğe Protective effect of curcumin on cyclosporin A-induced endothelial dysfunction, antioxidant capacity, and oxidative damage(Sage Publications Inc, 2014) Sagiroglu, Tamer; Kanter, Mehmet; Yagci, Mehmet Ali; Sezer, Atakan; Erboga, MustafaCyclosporin A (CsA) is the most widely used immunosuppressive drug for preventing graft rejection and autoimmune disease. However, the therapeutic treatment induces several side effects such as nephrotoxicity, cardiotoxicity, hypertension, and hepatotoxicity. Curcumin has been successfully used as a potent antioxidant against many pathophysiological states. This experimental study was performed to test, during CsA treatment, the alterations of curcumin antioxidant properties against CsA-induced endothelial dysfunction. Rats were divided into four groups: control, curcumin alone, CsA, and CsA + curcumin; each group containing eight animals. The animals in the CsA + curcumin group were treated with CsA (10 days, 25 mg/kg, orally) and curcumin (15 days, 200 mg/kg, orally, starting 5 days before CsA administration). At the end of the treatments, the animals were killed; serum and aorta tissue were treated for biochemical and morphological analyses. The results indicate that CsA-induced aortic endothelial dysfunction was characterized by morphological and ultrastructural alterations in tissue architecture, changes in malondialdehyde and ferric reducing/antioxidant power levels, and increase in endothelial nitric oxide synthase and terminal-deoxynucleotidyl-transferase mediated dUTP nick end labeling (TUNEL) expression. In conclusion, our data suggest that the imbalance between production of free oxygen radicals and antioxidant defence systems, due to CsA administration, is a mechanism responsible for oxidative stress. Moreover, we show that curcumin plays a protective action against CsA-induced endothelial dysfunction and oxidative stress, as supported by biochemical, ultrastructural, immunohistochemical, and TUNEL results.Öğe Protective Effect of Curcumin on Liver Damage Induced by Biliary Obstruction in Rats(Galenos Publ House, 2011) Erenoglu, Cengiz; Kanter, Mehmet; Aksu, Burhan; Sagiroglu, Tamer; Ayvaz, Suleyman; Aktas, Cevat; Erboga, MustafaObjective: The aim of this study is to evaluate the possible protective effects of curcumin against cholestatic oxidative stress and liver damage in common bile duct ligated rats. Material and Methods: A total of 18 male Wistar albino rats were divided into three groups: control, common bile duct ligation (BDL) and BDL+curcumin. Each group contained 6 animals. The rats in the curcumin treated group were given curcumin (100 mg/kg) once a day orally for 14 days, starting 3 days prior to BDL operation. Following 14 days of treatment, all the animals were decapitated and liver tissue samples were obtained for histopathological investigation. Results: The changes demonstrating the bile duct proliferation and fibrosis in expanded portal tracts, including the extension of proliferated bile ducts into lobules, mononuclear cells, and neutrophil infiltration into the widened portal areas, were observed in BDL group. Treatment of BDL with curcumin attenuated liver damage. Both the elevated alpha smooth muscle actin (alpha-SMA), and the activity of TUNEL in the BDL were observed to be reduced with the curcumin treatment. Conclusion: Our data indicate that curcumin reduced BDL-induced cholestatic liver injury, bile duct proliferation, fibrosis.Öğe Protective effect of everolimus on renal ischemia reperfusion injury in rats(Medknow Publications & Media Pvt Ltd, 2014) Sagiroglu, Tamer; Sezer, Atakan; Torun, Nese; Yalta, Tulin; Yagci, Mehmet Ali; Sagiroglu, Gonul; Copuroglu, ElifThe aim of this study was to determine the effect of everolimus and tacrolimus pretreatments on renal morphology and function in a rat ischemia reperfusion (I/R) model. Twenty-eight male Sprague-Dawley rats were randomly assigned to saline sham operation, saline I/R (IR), tacrolimus I/R (TRL I/R) and everolimus I/R (ERL I/R) groups. Saline and active treatments were administered intraperitoneally for seven consecutive days before the surgery. The suprarenal aorta was clamped to achieve warm ischemia, except in the sham group. Right nephrectomy was performed in all animals and histology was examined. Renal function was assessed on post-operative Day 7 by Tc-99m dimercaptosuccinic acid (DMSA) scintigraphy, glomerular filtration rate (GFR) and serum biochemistry. Both everolimus and tacrolimus preserved serum creatinine and blood urea nitrogen levels, but only everolimus preserved GFR (0.74 +/- 0.36, 1.20 +/- 0.37 and 2.24 +/- 0.32 mL/min for I/R, TRL I/R and ERL I/R, respectively, P < 0.001). %ID values for sham, I/R, TRL I/R and ERL I/R were 55 +/- 3, 47 +/- 4, 45 +/- 6 and 62 +/- 7 (P < 0.001). On histologic evaluation, ERL I/R showed less tubular damage and necrosis than I/R, as well as TRL I/R. Within the confines of this rat warm ischemia model, everolimus pre-treatment was useful in preserving renal function following I/R injury. The possibility of using everolimus as a pre-conditioning agent for I/R injury in kidney transplantation should be further explored.Öğe Spleen rupture due to brucellosis(Turkish Surgical Assoc, 2021) Yagmurkaya, Orhan; Oguz, Serhat; Kahya, Eyilp; Aksoy, Huseyin; Albayrak, Dogan; Sagiroglu, TamerBrucellosis is a common zoonotic infection worldwide; it is caused by infection with the bacterial species Brucella and leads to severe diseases in humans and animals. In Turkey, this bacterial species has not been completely eradicated and is commonly found in animals (such as goats or sheep). Brucellosis can lead to various symptoms, affect multiple systems, and cause splenomegaly in the case of spleen involvement. In contrast to traumatic spleen ruptures, spontaneous spleen ruptures are rare and most commonly occur because of infectious causes. A 52-year-old man was treated at our infectious diseases clinic for Brucella endocarditis. Due to sudden abdominal pain, nausea, vomiting, and vertigo, the patient was evaluated by our team of doctors at the same clinic. The patient had widespread sensitivity in the abdominal region, as well as defense and rebound symptoms. Emergency abdominal tomography revealed a ruptured spleen and widespread hemorrhagic fluid in the abdomen. Exploration revealed multiple ruptures in the spleen capsule. The patient underwent splenectomy and did not experience any complications during the postoperative period. Spontaneous spleen rupture is a rare clinical condition that should be considered in patients who are hospitalized at internal medicine clinics for infectious, hematogenic, and metabolic causes, as well as in those who have sudden abdominal pain and hypovolemia.Öğe Spontaneous Fistulization of a Pancreatic Abscess to Colon and Duodenum Treated With Percutaneous Drainage(Lippincott Williams & Wilkins, 2011) Sezer, Atakan; Sagiroglu, Tamer; Temizoz, Osman; Yagci, Mehmet Ali; Umit, Gulsum Elif; Umit, HasanPancreatic fistulas are rare clinical entities associated with severe pancreatitis. A 39-year-old man who had been diagnosed and treated for severe pancreatitis 2 months ago presented with abdominal pain, fever, and vomiting. The abdominal computed tomography (CT) demonstrated a peripancreatic abscess and a duodenal fistula communicating the first part of duodenum, which was also verified with fluoroscopy. A size 14-French catheter with pig-tail tip was inserted primarily with a Seldinger 2-step technique through percutaneous route under CT-guidance to avoid intervening bowels or solid organs. The patient's clinic improved and treatment was stopped on the 18th day. On the 26th day of the first intervention, the patient had fever and abdominal pain and his clinic was deteriorated. A second fluoroscopic examination revealed that the duodeno pancreatic fistula was closed while a new 1 has developed into the ascending colon. With aggressive nutrition support, antibiotics and repeated drainage of the abscess pouch a dramatic clinical improvement was observed. Control abdominal CT demonstrated the resolution of pancreatic abscess on the 62nd day.Öğe Surgical Treatment of Patients with Tracheal Rupture Following Endotracheal Intubation(Galenos Publ House, 2011) Sagiroglu, Gonul; Sagiroglu, Tamer; Meydan, Burhan; Tezel, CagatayObjective: We aimed to present clinical features and treatment outcomes of patients who had tracheal rupture following intubation due to surgical interventions. Material and Methods: Five patients (M/F, 1/4; Mean age, 53.8 +/- 10.9 years) who were diagnosed as having tracheal rupture during or soon after surgery were included in the study and evaluated retrospectively. History, clinical features, patient characteristics, and localizations of rupture, diagnostic modalities, and treatment outcomes were reported. Results: Two of the patients were intubated with a single-lumen tube, whereas 3 patients were intubated by using a double-lumen tube. The most common symptom that led to diagnosis was subcutaneous emphysema. One patient was diagnosed during stump control before the occurrence of symptoms. It is considered that using a stylet during intubation might be a risk factor, as four of our patients were intubated with the help of a stylet. Only one patient had a difficult intubation. Conclusion: Close postoperative monitorization of patients intubated due to surgical interventions, may enable us to determine tracheal ruptute cases in the early period before symptoms occur. The most common symptom was subcutaneous emphysema in the present case series. Thus, it is considered as the most effective warning symptom. In the light of the above findings, it is suggested that difficult intubation may not add to the risk of tracheal rupture.
