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Belkis Unsal

Publications and source records attributed to Belkis Unsal.

12 recordsLinked to original sources
PubMed2006

Jejunogastric intussusception, a rare complication of gastric surgery: report of two cases.

Jejunogastric intussusception is a rare complication of gastric surgery. It usually presents with abdominal pain, nausea, vomiting, and hematemesis. A history of gastric surgery can help in making an accurate diagnosis. An early diagnosis and urgent surgical intervention is mandatory. We herein report two cases of patients with jejunogastric intussusception who presented with acute abdomen and hematemesis.

Adult↗
PubMed2006

Natural coagulation inhibitory proteins and activated protein C resistance in Turkish patients with inflammatory bowel disease.

BACKGROUND/AIMS: Thromboembolic events are a rare but significant complication of inflammatory bowel disease. The aim of this study was to investigate the level of natural coagulation inhibitors and activated protein C resistance in Turkish patients with inflammatory bowel disease. METHODS: Fifty patients (29 male, 21 female) without venous thrombosis history and 37 healthy controls were included in the study. Erythrocyte sedimentation rate, C-reactive protein, thrombocyte count, prothrombin time, activated partial thromboplastin time, fibrinogen concentration, von Willebrand factor antigen, factor VIII activity, activated protein C resistance, functional levels of antithrombin III, protein C and protein S were measured. Patients and controls with activated protein C resistance were further studied using a polymerase chain reaction assay for factor V Leiden mutation. RESULTS: There was no significant difference between patients and the controls in terms of antithrombin III, protein C, protein S, factor (F) VIII and Willebrand factor levels. The mean thrombocyte counts, fibrinogen levels, and Willebrand factor levels were found to be significantly higher in patients who were in the active period of the disease than in controls and patients in remission. No significant difference was observed in those showing activated protein C resistance and factor V Leiden mutation between patients and controls. CONCLUSIONS: The presence of inherited thrombophilic defects, in particular activated protein C resistance and natural coagulation inhibitor deficiency, is uncommon in Turkish patients with inflammatory bowel disease in both active and remission periods. As a result, a controlled study in inflammatory bowel disease patients with thrombosis history is recommended.

Activated Protein C Resistance↗
PubMed2006

Coagulation disorders secondary to acute liver failure in Amanita phalloides poisoning: a case report.

Amanita mushroom poisoning is a serious occurrence. Physicians need to recognize the syndrome promptly and institute effective treatment as soon as possible in order to avoid the often fatal complications. We report a case of a young man with mushroom poisoning of the genus Amanita with a clinical spectrum that ranged from hepatic failure and coagulation disorders to an outcome with a partial recovery. The aim of this report was to emphasize the clinical outcomes and treatment regimens in this type of mushroom poisoning seen with increasing frequency in our region.

Adult↗
PubMed2005

Transanal endoscopic repair of rectal perforation with hemoclips.

A 74-year-old male patient had a full-thickness laceration of the mid-rectum during transurethral urologic surgery. The perforation site was 8-cm above the dentate line and 15 x 6 mm in size. Transanal direct access to the injury site was difficult and endoscopic repair with hemoclips was performed without any further intervention. He was discharged from the hospital uneventfully and complete healing was observed 6 weeks after the procedure. We concluded that endoscopic repair with hemoclips may offer a successful and simple closure method for extraperitoneal high lying rectal lacerations.

Aged↗
PubMed2005

Diagnostic usefulness of carbohydrate antigen-125 in cancerous and noncancerous peritoneal effusions.

Carbohydrate antigen-125 (CA-125) is a tumor marker that has been used for differential diagnosis of peritoneal malignancies. The aim of the present study was to evaluate the diagnostic usefulness of simultaneous quantification of CA-125 in peritoneal fluid and serum for abdominal cancer cases and noncancer diseases. Noncancer disease group included cirrhotic patients (n=28) and spontaneous bacterial peritonitis (SBP) patients (n=11). Abdominal cancer group was composed of histologically diagnosed various malignancies (n=10), such as gastric cancer. CA-125 levels were quantified by chemiluminescent enzyme immuno-assay. Diagnostic usefulness tests and receiver operating characteristics (ROC) curve analysis were performed for the levels of peritoneal fluid CA-125 (pCA-125) and serum CA-125 (sCA-125), and the ratio of pCA-125 to sCA-125 (p/sCA-125). The sCA-125 levels were significantly higher in noncancer patients than those in the cancer patients, while the pCA-125 levels showed no significant difference between the two groups. Notably, the p/sCA-125 ratio was significantly lower in the noncancer patients than that in the cancer patients. Area under the ROC curve was 0.267 for sCA-125, 0.542 for pCA-125 and 0.831 for p/sCA-125. The accepted cutoff values were the combination of values that gave the greatest diagnostic sensitivity plus specificity. Either sCA-125 or pCA-125 value gave lower diagnostic accuracy, whereas p/sCA-125 value demonstrated a significantly higher diagnostic accuracy (sensitivity-specificity pairs: 0.40-0.33 for sCA-125, 0.60-0.54 for pCA-125, and 0.80-0.72 for p/sCA-125, respectively). Hence, determination of p/sCA-125 improves the biochemical discrimination of abdominal cancerous cases from noncancerous diseases.

Ascitic Fluid↗
PubMed2005

Safety of biopsy in liver hemangiomas.

Hemangiomas are the most common tumors of the liver. Almost all cases are easily detected by ultrasonography, computed tomography, magnetic resonance imaging, and erythrocyte-tagged technetium-99m scintigraphy. In case of inconclusive radiologic features and a history of malignancy or underlying liver disease, liver biopsy is indicated. Bleeding is the most feared complication of biopsy of hemangiomas due to its highly vascular structure. In our clinic, we biopsied seven patients with suspected masses and they were diagnosed histopathologically afterwards as having hemangiomas. We did not observe any complication including bleeding during or after the procedure. Although the case number is too small to reach a definite conclusion, we think that our report deserves attention in showing that concerns about bleeding during biopsy of hemangiomas may be overstated.

Biopsy, Needle↗
PubMed2004

Comparison of cefotaxime and ofloxacin in treatment of spontaneous bacterial peritonitis.

BACKGROUND/AIMS: Gold-standard treatment of spontaneous bacterial peritonitis currently involves 3rd generation cephalosporins. To evaluate the efficacy of ofloxacin in this infection, we compared a combined therapy with intravenous and oral ofloxacin to intravenous cefotaxime. METHODS: Thirty cirrhotic patients with spontaneous bacterial peritonitis were assigned to receive either intravenous (1 g/12 h) cefotaxime for 7 days (n=17) or intravenous (200 mg/12 h) ofloxacin for 2 days followed by oral (200 mg/12 h) ofloxacin for 5 days (n=13). All cases had community-acquired spontaneous bacterial peritonitis. RESULTS: The infection resolution rate on the 7th day of therapy was 82.4% in the cefotaxime group and 92.3% in the ofloxacin group. Hospital survival rates were 82.4% and 100%, respectively. CONCLUSIONS: Oral ofloxacin after a short course of intravenous ofloxacin is effective in the treatment of uncomplicated spontaneous bacterial peritonitis. This regimen may allow physicians to treat these patients as outpatients as soon as their intravenous therapy is completed.

Adult↗
PubMed2004

Adenocarcinoma of the ileocecal valve: report of a case.

Tumors of the ileocecal valve are rarely mentioned, and are mostly defined radiologically. In this manuscript, we report a case of ileocecal valve adenocarcinoma diagnosed endoscopically. The case is a male patient, 78-years-old, with abdominal pain and weight loss in whom a mass was palpated in the lower right quadrant. Abdominal ultrasound examination followed by colonoscopy and pathological diagnosis revealed adenocarcinoma of the ileocecal valve confirmed by surgical diagnosis. We report this case because of its rarity and because there is no endoscopic image in the medical literature.

Adenocarcinoma↗
PubMed2003

Colonoscopy without sedation.

BACKGROUND/AIMS: In Turkey, colonoscopy is a procedure generally performed with intravenous sedation and analgesia. Most of the complications of colonoscopy are related to sedation. The aims of this study were to determine the percentage of patients who could successfully undergo nonsedated colonoscopy without sedation and to assess patient tolerance and acceptance. METHODS: The study included 120 consecutive patients undergoing colonoscopy by two endoscopists in our endoscopy unit. The procedure routinely began without sedation, which was later given (midazolam and hyoscine butylbromide) only if significant discomfort occurred. Parameters of blood pressure, oxygen saturation and heart rate were measured before and during colonoscopy. After the procedure patients were asked to rate their pain on a four point scale 1=no pain, 2=slight, 3=moderate, 4=severe and they were also asked if they would be willing to undergo colonoscopy again without sedation. RESULTS: Eighty eight percent of all colonoscopies were completed without sedation. Mean PaO2 was 96.46 in nonsedated patients and 93.90 (significant p<0.05) in sedated patients. No difference was found between blood pressure and pulse rate of nonsedated and sedated patients. The mean pain score was 2.0 for the nonsedated patients and 3.8 (significant p<0.05) for the sedated patients. Eighty eight percent of patients stated that they would be willing to undergo colonoscopy without sedation again. CONCLUSIONS: In experienced hands, colonoscopy without sedation can be completed successfully in most patients, without any complications and use of extra instrumentation.

Adolescent↗
PubMed2003

Is prolapse gastropathy a cause of upper gastrointestinal bleeding?

BACKGROUND/AIMS: Prolapse gastropathy is a clinical syndrome involving the invagination of a part of the gastric mucosa into the lower esophagus resulting in well demarcated hemorrhagic mucosa and sometimes bleeding. The importance of this syndrome is that it has been reported as a cause of hematemesis. As this syndrome is considered to be seen in patients with retching and vomiting and to be one of the causes of upper gastrointestinal bleeding, this study was undertaken to evaluate its frequency and importance in our patients. METHODS: The study groups comprised of 941 patients with hematemesis and 54 with recurrent retching and vomiting. Biopsies were obtained from the prolapsing mucosa when detected. Hematoxylin and eosin stained specimens were reviewed by an experienced histopathologist. RESULTS: Prolapse gastropathy was detected in 20 patients (2%), of whom six (0.6%) were in the hematemesis group and 14 (25.9%) in the retching and vomiting group. The location of the lesion was the greater curvature in 10 patients (50%), lesser curvature in seven patients (35%) and anterior wall in three patients (15%). In all six cases from the hematemesis group, bleeding was not related to prolapse gastropathy because other causative lesions were identified. Histologic evaluation of the biopsies revealed acute inflammation, chronic inflammation and submucosal hemorrhage. CONCLUSIONS: According to the results of this study, prolapse gastropathy is not a cause of hematemesis. Other causes should be identified when prolapse gastropathy is detected in a patient with hematemesis.

Adolescent↗
PubMedDate not supplied

A succesfully managed inflammatory pseudotumour of liver without surgery: report of a case.

The inflammatory pseudotumor (IPT) of the liver is an extremely rare focal lesion of the parenchyma with unknown aetiology. It has the appearance of a malignant tumor but has a benign histology and clinical course. Herein, we report a case of IPT in a 55 year-old woman. She had complained of right upper quadrant pain and subfebrile fever. Imaging studies revealed a heterogeneous, solitary mass in right lobe of liver which was 90 x 81 mm in size. Histopathological examination of ultrasonography-guided true-cut biopsy demonstrated IPT. After the initiation of the antibiotic and nonsteroidal anti-inflammatory drugs (NSAID), the size of hepatic pseudotumor decreased (20 x 20 mm) and then completely disappeared. To rule out a malignancy and to reach the diagnosis of IPT, biopsy from the mass is mandatory. After the diagnosis, IPT gave an excellent response to short course of antibiotic and NSAID therapy. To prevent unnecessary resective liver surgery, IPT should be kept in mind in the differential diagnosis of liver mass which can be successfully managed medically.

Anti-Bacterial Agents↗