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Biomedical subjects

A Ozenç

Publications and source records attributed to A Ozenç.

12 recordsLinked to original sources
PubMed2002

Portomesenteric gas due to intestinal obstruction: a case report.

A case of mesenteric vein gas as a nonfatal complication of intestinal obstruction is reported. A 48-year-old woman presented postoperatively signs and symptoms of acute abdomen on the eighth day following a gastric pull-up surgery due to an oesophageal carcinoma. The abdominal tomography findings revealed dilated jejunal segments and free gas in the superior mesenteric vein and end branches of the portal vein in the left hepatic lobe. The patient underwent a second laparotomy with a provisional diagnosis of intestinal ischaemia. Intraoperative gross appearance of the intestines revealed no ischaemic finding, the pathology was the dense adhesions between the jejunal segments and previous incision site. On the basis of these findings, the operation was ended with adhesiolysis. One month after the operation, the patient was well, there were no complications. As the authors, we think that the main reason for portomesenteric gas is mucosal destruction and that these case may be followed conservatively as long as intestinal ischaemia is excluded.

Embolism, Air↗
PubMed1998

Effect of hydrogen peroxide on permeability of the main pancreatic duct and morphology of the pancreas.

BACKGROUND: The direct effect of free oxygen radicals, if any, on the morphology of the pancreas has never been studied in vivo. This study was designed to evaluate the effects of hydrogen peroxide (H2O2) on permeability of the main pancreatic duct (MPD) and morphology of pancreas in cats when administered intraductally or intraarterially. METHODS: Thirty-six mongrel cats were randomly allocated into three groups, and all groups were divided into two subgroups. In group I and III, MPD was perfused with either standard perfusate (group IA and IIIA) or H2O2 at a concentration of 150 microM (group IB and IIIB) for 3 hours. In group II, the splenic artery was infused either with 0.9% sodium chloride (group IIA) or H2O2 (group IIB) for 3 hours. After 3 hours, in group I and II, MPD was perfused with 99mTc labelled dextran, and the percentage of the dextran permeated from the MPD into the portal vein was calculated for the evaluation of the pancreatic duct permeability. Then, tissue samples were obtained for the examination of early histopathological changes in pancreas. In group III, following ductal perfusion studies, the cats were allowed to recover. After 24 hours animals were killed, and samples were taken for the examination of late histological changes in pancreas. In all groups, an inflammatory score was created for each animal based on the pathological changes in pancreas: edema, leukocyte infiltration, parenchymal necrosis, and hemorrhage. RESULTS: Group I: All cats developed acute edematous pancreatitis with significantly higher inflammatory scores than controls (P < 0.01). Desquamation of the single layer of columnar epithelium that normally lined the duct and leukocyte infiltration around the MPD duct were found. Pancreatic duct permeability was found to be increased significantly (P < 0.01). Group II: There were no statistical differences in inflammatory scores and pancreatic duct permeability between experimental and control groups (P > 0.05). Group III: All animals developed gross acute edematous pancreatitis after 3 hours of intraductal H2O2 perfusion. Histopathological changes at 24 hours were much more pronounced in group IIIB than in group IIIA including focal necrosis and hydropic degeneration of acinar cells. CONCLUSION: This study has shown that intraductal H2O2 perfusion induced acute edematous pancreatitis with marked histopathological changes and increased pancreatic duct permeability in cats. Intraarterial H2O2 infusion, however, has no effect on the permeability of the MPD and morphology of pancreas in our model.

Acute Disease↗
PubMed1993

A case of type 3 choledochal cyst masquerading as acute abdominal pain.

A type 3 choledochal cyst, presenting with acute abdominal pain attacks, was diagnosed in a 24-year-old man. Previously he had undergone exploratory laparotomy for acute abdominal pain, which had proved negative. An internal drainage procedure was chosen as the surgical procedure. The patient is under constant follow-up because of the risk of a malignancy developing.

Abdomen, Acute↗
PubMed1992

Bile duct varices or "pseudo-cholangiocarcinoma sign" in portal hypertension due to cavernous transformation of the portal vein.

A total of 832 patients with portal hypertension resulting from different etiology was studied by ultrasonograph as a screening test. In 17 of the 832 patients, cavernous transformation of the portal vein was detected by means of ultrasonography. We have prospectively studied these 17 patients, and the diagnosis of cavernous transformation was confirmed by portography in all patients. To evaluate how much biliary tract has been affected from cavernous transformation of the portal vein, and to explain the cause of mildly increased alkaline phosphatase and serum bilirubin levels, endoscopic retrograde cholangiopancreatography (ERCP) was performed in 16 of the 17 patients. There were narrowing, irregularity, undulation and nodular extrinsic defects resulting from compression of thrombosis of the portal vein and the collateral vessels, mimicking cholangiocarcinoma spreading along the common bile duct on the extrahepatic biliary tract in all 16 patients who underwent ERCP. Similar ERCP findings were not found in six patients with portal hypertension due to liver cirrhosis. The ultrasonographic, portographic, and ERCP findings corresponded to surgical findings in six patients who had undergone splenectomy for either hypersplenism or bleeding from esophageal varices. The results indicate that cavernous transformation of the portal vein cause the above-mentioned radiographic findings that we propose to call "pseudo-cholangiocarcinoma sign."

Adolescent↗
PubMed1990

Pyloric stenosis with esophageal involvement in Behçet's syndrome.

A 43-yr-old man with a diagnosis of Behçet's syndrome since 1977 developed esophageal aphthous ulcerations, duodenal ulcer, and pyloric stenosis. The pyloric stenosis was due to edematous hypertrophy of the pyloric ring. The evidence strongly suggested that these findings were complications of Behçet's syndrome.

Adult↗
PubMedDate not supplied

Factors affecting postoperative mortality in abdominal trauma.

Records of 345 patients in whom laparatomies were performed because of blunt and penetrating abdominal trauma were reviewed retrospectively with respect to factors affecting mortality. One hundred and twenty-eight patients had blunt abdominal trauma (Group I), 114 patients had gunshot wounds of the abdomen (Group II), and 103 patients had stab wounds of the abdomen (Group III). Mortality rates were 14.8%, 12.3% and 1.9% in groups I, II and III respectively. The presence of head trauma especially if accompanied by hypotension in group I, and the presence of chest trauma (hemothorax and/or pneumothorax) and hypotension (less than 90 mmHg) in group II were associated with a high mortality rate (p less than 0.05). Of the two patients who died in group III, one had septic shock due to massive intestinal necrosis and the other had hemorrhagic shock due to multiple organ injury and bleeding from an injured internal thoracic artery as the cause of death.

Abdominal Injuries↗
PubMedDate not supplied

Pylorus preserving pancreaticoduodenectomy.

We have performed 9 pylorus preserving pancreaticoduodenectomies (PPPD) for periampullary malignancies. In these 9 patients, six had been diagnosed as having carcinoma of the ampulla of Vater, two pancreatic carcinoma and one duodenal carcinoma. We have no operative mortality and a 44 per cent rate of morbidity. Complications include wound infections (3), pleural effusion (1), intraabdominal abscess (1), delayed gastric emptying (1). There was neither biliary nor pancreatic leakage in these patients. None of the patients had gastrointestinal haemorrhage and marginal ulceration. We have complete follow-up for all cases. Eight of 9 patients are alive, one patient who had been operated for carcinoma of ampulla of Vater died the 14th month postoperatively. During the follow-up, in 7 patients we have observed neither recurrence nor metastasis but in one patient, who is still alive, operated for carcinoma of the pancreas, recurrence in the pancreatic remnant was detected 27 months after the operation. In four months, all patients regained 90 per cent of the weight lost prior to operation. During the follow-up period no patients had gastrointestinal dumping, diarrhoea, or delayed gastric emptying. We concluded that PPPD, technically easier and faster, can therefore be performed with a much lower morbidity and mortality than the standard Whipple procedure. Preservation of the pylorus reduces the incidence of marginal ulceration, and patients undergoing PPPD are more likely to regain their preoperative weight. The antrum and pylorus were structurally preserved in the first successful radical pancreaticoduodenectomy performed by Kausch in 1912 (13) and Whipple in 1935 (28).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

Biliary enteric fistulas.

Thirty-one patients with biliary enteric fistula who were operated on over a 19-year period (1976-1994) with an incidence of 0.74% in all biliary tract operations were reviewed retrospectively to identify etiologic factors, types of fistulas, signs and symptoms, methods of diagnosis, management and prognosis of the cases. Most common symptoms were abdominal pain, nausea, vomiting and jaundice. Two patients had gallstone ileus. The majority of the patients had severe concomitant medical illnesses. The exact preoperative diagnosis of a biliary enteric fistula was established in only five (16%) patients. In 81% of the cases fistula was secondary to chronic calculous biliary tract disease. Postoperative complications included wound infection in six (19%), biliary fistula in two (6%) and erosive gastritis in one (3%) patient. Two patients died of intra-abdominal sepsis and two of cardiac failure, with an operative mortality of 13%. Early elective cholecystectomy is recommended to avoid complications of chronic calculous cholecystitis such as bilioenteric fistulas and their increased mortality and morbidity.

Adult↗
PubMedDate not supplied

Internal hernia in adults.

BACKGROUND: Congenital bands, congenital anomalies of the intestinal rotation and congenital defects in the mesentery or omentum, postsurgical or traumatic defects of the mesentery and omentum are important factors that predispose to internal herniation. In this retrospective study, 18 cases of internal herniation were evaluated and the factors that effect the prognosis were investigated. METHODS: The records of 609 patients who underwent laparotomy due to acute intestinal obstruction were retrospectively reviewed. The cause of intestinal obstruction was internal herniation in 18 patients. The patients were evaluated with respect to signs and symptoms, radiological findings, time elapsed between the onset of symptoms and surgery, findings, in surgery, type of operation performed, postoperative complications and postoperative stay. RESULTS: Postoperative complications were encountered more frequently in the patients with bowel strangulation (p=0.045) in our series. Time elapsed between the onset of symptoms and laparotomy was found to be significantly longer in the patients with strangulation than in those without strangulation (p=0.046). Additionally, postoperative hospital stay was shorter in the patients without strangulation (p=0.03). CONCLUSIONS: Since preoperative diagnosis of an internal herniation is very difficult because of the lack of specific signs and symptoms, postoperative complications can only be decreased with early surgical intervention in the patients with acute intestinal obstruction.

Acute Disease↗