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Öğe Intraabdominal synovial sarcoma, a rare tumour and rare localisation(2018) Uzunoğlu, Mustafa Yener; Altıntoprak, Fatih; Dikicier, Enis; Kahyaoğlu, ZeynepSynovial sarcomas are often seen in the soft tissues, intra-abdominal synovial sarcomas are extremely rare. An intra-abdominal mass starting from the umbilicus and extending into the pelvis was detected in a 53-year-old man admitted with abdominal pain and a palpable mass. Total mass excision surgery was performed and the mass was found to be an intra-abdominal synovial sarcoma arise from small bowel wall histopathologically. Unfortunately, this is a malignancy with a poor prognosis and a short survival despite all therapeutic efforts.Öğe Multiple gastritis cystica profunda in a patient without gastric surgery history(Acad Medical Sciences I R Iran, 2018) Dikicier, Enis; Altıntoprak, FatihGastritis cystica profunda (GCP) is a rare condition characterized by polypoid cystic ectasia of the submucosal layer with cystic dilatation of the glandular structures of the stomach. The probable pathogenesis refers to degradation of the integrity of the muscularis mucosa and migration of epithelial cells to the submucosal layer. The most common cause known in the literature for this occurrence is previous stomach surgery. A case presented with two GCP lesions in different locations in the stomach without any history of previous surgery.Öğe Role of bacteriological agents in idiopathic granulomatous mastitis: real or not ?(Aves, 2019) Kıvılcım, Taner; Altıntoprak, Fatih; Memiş, Bahar; Ferhatoğlu, Murat Ferhat; Kartal, Abdulcabbar; Dikicier, Enis; Dilek, Fatma HüsniyeObjective: Granulomatous mastitis is a rare, benign, chronic inflammatory disease of the breast of unknown etiology. This study evaluated bacteriologic agents that might play a role in the etiology of granulomatous mastitis using a molecular method with a universal primer after isolating deoxyribonucleic acid (DNA) from pathology specimens from patients diagnosed with granulomatous mastitis. Materials and Methods: Breast biopsy material in the pathology department obtained between July 2008 and June 2013 was analyzed. The history of the granulomatous mastitis patients was examined in detail and paraffin block sections of the biopsy material were used to determine the presence of bacteria with a universal DNA primer. Results: This study examined 45 granulomatous mastitis patients who had been diagnosed using excisional, incisional, or core biopsies. We evaluated multiple bacterial taxa, but obtained no positive result using a nucleic-acid-based assay with a universal primer. Conclusion: The etiology of idiopathic granulomatous mastitis remains unclear. Further studies with a large number of patients should aim to identify the causative agent.Öğe Stump appendicitis: a retrospective review of 3130 consecutive appendectomy cases(Biomed Central Ltd, 2018) Dikicier, Enis; Altıntoprak, Fatih; Özdemir, Kayhan; Gündoğdu, Kemal; Uzunoğlu, Mustafa Yener; Çakmak, Güner; Onuray, Feyyaz; Çapoğlu, RecaiBackground: Stump appendicitis is inflammation of remnant appendix tissue due to incomplete removal of the appendix. Due to appendectomy history, stump appendicitis diagnosis is usually delay and that can cause increase morbidity. Methods: Medical records of patients who had surgery for acute appendicitis at a single center from 2008 to 2017 were retrospectively reviewed. During the evaluation of medical records, patients that had a previous operation for acute appendicitis or had "stump appendicitis" as an exploratory finding in operation notes were included. Results: Appendectomy was performed in 3130 patients (2630 open surgeries and 380 laparoscopic surgeries). Stump appendicitis was diagnosed in five patients (0.15%). The appendectomies had been performed 4, 5, 7, 7, and 11 years previously. Mean time taken for surgery was 36 h after symptoms began. Open surgery was performed in three patients, laparoscopic procedures in others. Conclusion: Awareness of stump appendicitis before radiological examinations may facilitate accurate diagnosis and decrease the duration of the decision-making process, leading to decreased morbidity.Öğe Treatment results of small bowel perforations due to unusual causes(Professional Medical Publications, 2018) Uzunoğlu, Mustafa Yener; Altıntoprak, Fatih; Dikicier, Enis; Zengin, İsmailObjectives: Although non-traumatic Small Bowel Perforations (SBPs) are rare, they have high rates of morbidity and mortality in case of late presentation. Aetiological factors vary across different geographical regions. In this paper, SBPs caused by anything other than trauma and other well-known causes are presented and the current literature is reviewed. Methods: The study was conducted at General Surgery Clinics of two different tertiary university hospitals between January 2008 and September 2016. The authors directly involved in managing the patients. This study was approved by the ethical institutional board and was performed at the Department of General Surgery, School of Medicine, Sakarya University. The medical records of patients retained in both hospitals are electronic. Medical records of subjects who had undergone emergency operations with a prediagnosis of acute abdomen in single center, and were determined to have SBPs due to unusual causes, were investigated retrospectively. Patients with aetiological factors such as trauma, mesenteric vascular disease, internal and external hernias, intra abdominal adhesions, inflammatory bowel diseases, and iatrogenic causes were excluded. Results: In total, 35 patients were evaluated, 20 (57.1%) males and 15 (42.9%) females. The mean age of the cases was 51.6 (18-88) years. Mean time until admission at the hospital was 1.4 days (range 0.25-7 days). The most frequent aetiological factors were various malignancies (10 cases, 28.5%) and perforation of Meckel's diverticulum (8 cases, 22.8%). It was surprising to detect a considerable rate of perforation due to bezoars (6 patients, 17.1%). Conclusions: Post-operative consequences of SBPs due to unusual causes are similar with those related to common, known causes. Factors affecting the clinical course are presentation time and patients' clinical status in admission, not aetiology.Öğe Ultrasonographic Evaluation of Flap Thickness In Patients with Pilonidal Sinus-Original Article(2018) Asil, Kıyasettin; Uzunoğlu, Mustafa Yener; Dikicier, Enis; Zengin, İsmail; Altıntoprak, Fatih; Arslan, YusufAim Various risk factors have been defi ned for recurrence in pilonidal disease. This study was designed to investigate the local subcutaneoustissue thickness in patients who were operated on for sacrococcygeal pilonidal disease. ( Sakarya Med J 2018, 8(3):505-510)Methods Ninety-eight patients who had been operated in General Surgery Clinics of Sakarya University Research and Educational Hospital on withthe diagnosis of pilonidal sinus were retrospectively evaluated between January 2008 and January 2014. In evaluation of the fl ap thickness,the nearest and farthest margins were measured by ultrasonography between the skin and sacrum.This is a cross-sectional and descriptivestudy and local ethics approval was obtained from Sakarya University Medical SchoolResults Resection and primary closure and Limberg fl ap transposition were performed in 46 (46.9%) and 52 (53.1%) patients, respectively. Meanfl ap thickness was found to be 17.2 mm (range: 3.9 - 36.4) and 20.5 mm (range: 4.0 - 42.3) in the primary repair group and the Limberggroup, respectively. The recurrence rate was 10.8% in the primary repair group, 3.8% in the Limberg group at a mean of 27.1 months(range: 12-54 months) of follow-up.Conclusion Subcutaneous tissue thickness in the place of surgery was greater in patients with the Limberg fl ap procedure compared to the patientswith primary closure in pilonidal sinus disease. Flap thickness may be a parameter that can be used to predict the possibilty of recurrenceÖğe Ultrasonographic evaluation of flap thickness in patients with pilonidal sinus-original article(2018) Dikicier, Enis; Altıntoprak, Fatih; Uzunoğlu, Mustafa Yener; Arslan, Yusuf; Asil, Kıyasettin; Zengin, İsmailAim Various risk factors have been defi ned for recurrence in pilonidal disease. This study was designed to investigate the local subcutaneous tissue thickness in patients who were operated on for sacrococcygeal pilonidal disease. ( Sakarya Med J 2018, 8(3):505-510) Methods Ninety-eight patients who had been operated in General Surgery Clinics of Sakarya University Research and Educational Hospital on with the diagnosis of pilonidal sinus were retrospectively evaluated between January 2008 and January 2014. In evaluation of the fl ap thickness, the nearest and farthest margins were measured by ultrasonography between the skin and sacrum.This is a cross-sectional and descriptive study and local ethics approval was obtained from Sakarya University Medical School Results Resection and primary closure and Limberg fl ap transposition were performed in 46 (46.9%) and 52 (53.1%) patients, respectively. Mean fl ap thickness was found to be 17.2 mm (range: 3.9 - 36.4) and 20.5 mm (range: 4.0 - 42.3) in the primary repair group and the Limberg group, respectively. The recurrence rate was 10.8% in the primary repair group, 3.8% in the Limberg group at a mean of 27.1 months (range: 12-54 months) of follow-up. Conclusion Subcutaneous tissue thickness in the place of surgery was greater in patients with the Limberg fl ap procedure compared to the patients with primary closure in pilonidal sinus disease. Flap thickness may be a parameter that can be used to predict the possibilty of recurrence
