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Biomedical subjects

E Parlak

Publications and source records attributed to E Parlak.

15 recordsLinked to original sources
PubMed2006

Endoscopic treatment of pancreatic fistulas.

BACKGROUND: Pancreatic fistulas are managed primarily by conservative treatment. Surgery is performed in cases of conservative treatment failure. Endoscopic treatment is reported to be both effective and safe as an alternative treatment method. METHODS: A total of 26 patients underwent endoscopic treatment after failure of conservative treatment between January 2002 and November 2004. The mean time between the onset of fistula and the endoscopic retrograde cholangiopancreatography (ERCP) procedure was 95 days. The mean fistula output volume was 400 ml per day. Four patients had pancreatic ascites. The aim of the endoscopic treatment was to bypass the ductal disruption by placing stents or drains where the origin of fistulous tract could be identified, and to lower the pancreatic duct pressure by performing pancreatic sphincterotomy or by placing stents where the site of the leak could not be identified. RESULTS: Pancreatography could be performed in all the patients except one. Partial duct disruption occurred in 16 patients. All of the fistulas closed after the ductal disruption was bypassed. Pancreatic sphincterotomy or endoprothesis placement was effective for eight of the remaining nine patients in whom the ductal disruption originated from the tail of the pancreas and hence could not be bypassed. The overall success rate was 94% for the patients with partial duct disruption. Four patients had side branch leaks. All of them closed after placement of an endoprothesis. Fistulas closed in only one (20%) of the five patients with complete duct disruption. Pancreatic ascites resolved in two of the four patients after endoscopic treatment. No serious complications resulted from endoscopic treatment other than proximally migrated stents in two patients. CONCLUSIONS: Endoscopic treatment is an effective and safe method for patients with pancreatic fistulas unresponsive to conservative treatment. The success rate is very high, especially for patients with partial and side branch duct disruption.

Adolescent↗
PubMed2001

Effectiveness of endoscopic treatment modalities in complicated hepatic hydatid disease after surgical intervention.

BACKGROUND AND STUDY AIMS: Hepatic hydatid cyst is a common disease in Turkey and the rupture of the cyst into the biliary tract is the most common complication which is difficult to detect and to manage. The aim of this study was to investigate the effectiveness of endoscopic treatment modalities in hydatid cyst patients with biliary complications who had previously undergone surgery. PATIENTS AND METHODS: Over the last 8 years, by means of endoscopic retrograde cholangiopancreatography (ERCP), we have examined 87 patients with postoperative biliary symptoms who had previously undergone surgery for hepatic hydatid disease of the liver. Endoscopic treatment modalities were as follows: endoscopic sphincterotomy (ES) and nasobiliary drainage in patients with biliary fistula; balloon and or bougie dilation and stenting in patients with biliary stricture; and ES and balloon extraction in patients with residual hydatid material within the bile duct. RESULTS: Findings from ERCP included biliary fistula in 55 patients (63.2 %), biliary stricture in 16 (18.4 %), and residual hydatid material within the bile duct in 14 (16.1 %). Two patients had normal findings on ERCP. In total, 85 patients were treated by means of endoscopic modalities. The time to closure of fistula was 17.8 +/- 5 days and the rate of fistula closure was 81 %. Biliary stenting was performed in 13 patients with biliary stricture. Endoscopic removal of hydatid material was achieved in 14 patients. The overall success rate of endoscopic treatment was 86 %, and a second surgical intervention was required only in six patients. No serious complication was encountered after endoscopic procedures. CONCLUSIONS: Endoscopic treatment modalities are safe and helpful methods for the treatment of biliary complications of hepatic hydatid cyst in the postoperative period.

Adolescent↗
PubMed2001

Primary sclerosing cholangitis in patients with inflammatory bowel disease in Turkey.

BACKGROUND: Primary sclerosing cholangitis (PSC), which is a progressive cholestatic liver disease of unknown etiology, is strongly correlated with inflammatory bowel disease (IBD). GOALS: To determine the prevalence and describe the characteristics of PSC in patients with IBD in Turkey. STUDY: We determined the prevalence of PSC in patients with IBD admitted to our department during a 6-year period. Also, patients with PSC were investigated from an IBD aspect. Regardless of whether the patient had symptoms such as itching, jaundice, and abdominal pain, endoscopic retrograde cholangiopancreatography was performed on those with elevated alkaline phosphatase, and liver biopsy was done if endoscopic retrograde cholangiopancreatography failed to bring about the diagnosis. RESULTS: Overall prevalence of PSC was 9 of 386 (2.3%) patients with ulcerative colitis (UC) and 4 of 110 (3.6%) patients with Crohn's disease (CD). Inflammatory bowel disease was established in 13 of 18 (72.2%; UC, 50.0%; CD, 22.2%) patients who were being observed for PSC. The male-to-female ratio was 5:4 in UC and 3:1 in CD patients with PSC. The mean age at diagnosis of PSC was 43.6 years (range, 30-54 years) in patients with UC and 30.5 years (range, 26-41 years) in patients with CD. In patients with UC, the extension of colitis was total in seven patients (7/110, 6.3%) and left-sided in two patients (2/142, 1.4%). In patients with CD, the disease was located in the ileum and colon in one patient (1/47, 2.1%) and in colon alone in three patients (3/21, 14.2%). CONCLUSIONS: Prevalence of PSC-associated IBD in the Turkish community appear to be similar to the results of western origin studies.

Adult↗
PubMed2001

Ornidazole-induced autoimmune hepatitis.

Ornidazole is a commonly prescribed antiparasitic drug for parasitic infestations, including amoebiasis, giardiasis and Trichomonas vaginalis. Several cases of antibiotic-induced autoimmune hepatitis (AIH) or AIH-like syndrome have been reported recently. In this report, we describe a 35-year-old woman with two relapses of AIH induced by ornidazole prescribed for diarrhoea and vaginal infection.

Adrenal Cortex Hormones↗
PubMed2000

Sonographic diagnosis of recurrent ulcer penetrating the anterior abdominal wall.

Penetration of a recurrent ulcer into the anterior abdominal wall after surgical treatment of peptic ulcer disease is a rare surgical emergency. Early diagnosis is essential, but there are no specific radiographic or endoscopic features. We report 2 cases of recurrent ulcer penetration into the anterior abdominal wall diagnosed preoperatively with transabdominal sonography. The ulcers appeared as cavity lesions, with hyperechoic bases that had destroyed the continuity of the stomach wall. Associated findings were a minimal amount of fluid around the ulcer cavity and a hypoechoic area considered secondary to inflammation or edema. The diagnoses were confirmed at laparotomy.

Abdominal Muscles↗