Biomedical subjects

Orhan Alimoğlu

Publications and source records attributed to Orhan Alimoğlu.

8 recordsLinked to original sources

PubMed2005

Intermittent pneumatic compression in the prevention of venous thromboembolism in high-risk trauma and surgical ICU patients.

BACKGROUND: Our aim was to evaluate the efficacy and safety of intermittent pneumatic compression methods (IPC) in the prevention of deep venous thrombosis (DVT) and pulmonary embolism (PE) in high-risk patients followed in our intensive care unit (ICU) for whom anticoagulation is contraindicated due to high risk of bleeding. MATERIALS AND METHODS: This prospective study was conducted between October 2001 and June 2002 at the Trauma and Surgical Emergency Service of Istanbul Medical Faculty. Thirty eight surgical ICU patients who used IPC devices for prophylaxis of venous thromboembolisim were evaluated retrospectively. RESULTS: There were 27 male (71%) and 11 female patients (29%) with a mean age of 49.69 +/- 18.61 years. Their diagnoses were as follows; 21 multi-trauma, 11 major abdominal surgery, 11 severe gastrointestinal bleeding. None of the patients had manifested DVT by venous duplex scans. A leg swelling was present in one patient without evidence of DVT by duplex scans. Symptomatic and fatal pulmonary embolism were not detected. Asymptomatic pulmonary embolism was detected by spiral thorax CT examination in one patient (2.6%). CONCLUSIONS: IPC seems to be an effective and a safe modality in preventing both DVT and PE in high-risk ICU patients with severe trauma and for those undergoing major surgery.

Abdominal Injuries↗

PubMed2005

[Approach to the lower gastrointestinal tract bleeding in patients with normal colonoscopic findings.].

BACKGROUND: Lower gastrointestinal bleeding is a commun clinical entity. Although colonoscopic examination is the first choice for diagnosis, it may not be enough to reveal the cause of bleeding in all subjects. METHODS: Eight patients who had massive lower gastrointestinal bleeding having normal colonoscopic findings were retrospectively evaluated at the Department of Trauma and Emergency Surgery, Istanbul University, Faculty of Medicine RESULTS: There were 5 male and 3 female patients with mean age of 51 (28 to 82). Patients received a mean of 13 U (range 2 to 23) with transfused erythrocyte concentrates. Four patients had found to be normal during angiographic, scintigraphy or enterocylytic examinations. Angiography was diagnostic in 4 patients, and identified bleeding from ileocolic pseudoaneurisms (n= 2) branches of jejunal artery (n=2). Embolization procedure were performed in these 4 patients and 3 of them developed intestinal necrosis and underwent surgery. One did not require further treatment. Two of the patients who underwent surgery expired due to sepsis. Patients were hospitalized for a mean of 17 days (range 5 to 37). CONCLUSION: Despite employment of all diagnostic procedures, the cause of bleeding were not detected in half of patients who had normal colonoscopic findings. If angiographic treatment is necessary, superselective arterial embolization should be performed.

Adult↗

PubMed2004

Peutz-Jeghers syndrome: report of 6 cases in a family and management of polyps with intraoperative endoscopy.

BACKGROUND/AIMS: Peutz-Jeghers syndrome is an uncommon, autosomal dominantly inherited disorder characterized by mucocutaneous melanin pigmentation and gastrointestinal hamartomatous polyps. The purpose of this study was to present six cases of Peutz-Jeghers syndrome in a family. METHODS: Enteroclysis, upper and lower gastrointestinal endoscopy, and thyroid, abdominal, and testicular or breast ultrasonography were performed in all subjects. Tumor markers including CEA, alpha-FP, CA 19-9, CA 15-3, and CA 125 were measured. Management of polyps and complications were evaluated. RESULTS: History of the patients were as follows: patient 1 (40-year-old male) underwent surgery 20 years previously; patients 2 and 3 (19-year-old female and 17-year-old male) had undergone surgery three times between the ages of 11 and 18 years, and two times between the ages of 15 and 17 years, respectively; patient 4 (16-year-old male) had undergone surgery three times at the age of 13 years; patients 5 and 6 (14-year-old and 11-year-old males) had no history of surgery. All surgical procedures had been performed due to intestinal obstruction. Hyperpigmentation of the lips and oral mucosa were observed in all patients except patient 1, whose pigmentation disappeared 20 years previously. Patient 2 also had pigmentation of hands and feet. Enteroclysis showed small bowel polyps in all subjects except patients 1 and 6. During colonoscopy, different sizes of polyps were observed at different locations of the colon, and polyps larger than 1 cm were removed. Patients 2 and 3 underwent surgery due to complication of small bowel polyps; 69 polyps in patient 2 and 17 polyps in patient 3 were removed via intraoperative endoscopic procedure. Hamartomatous lesions were confirmed by histopathological examinations. Microscopic study of polyps of patients 2 and 3 revealed dysplastic changes. None of the patients had evidence of malignancy as of June 2003. Peutz-Jeghers syndrome demonstrated autosomal dominant inheritance in this family. CONCLUSIONS: The major problem during follow-up of patients with Peutz-Jeghers syndrome is the management of small bowel polyps. When encountered during surgery, intraoperative enteroscopic polypectomy should be performed.

Adolescent↗

PubMed2004

[A case of Rapunzel syndrome].

Trichobezoars are concretions of hair casts in the stomach associated with trichotillomania and trichophagia. The condition is termed Rapunzel syndrome when formation of a huge trichobezoar extends to the small bowel, resulting in gastrointestinal obstruction. We present a 19-year-old girl who had complaints of colicky abdominal pain, nausea and vomiting seven years after surgical treatment for a gastric trichobezoar. Gastric endoscopy was performed with an initial diagnosis of recurrent trichobezoar, which revealed a huge one. The patient underwent laparotomy, during which a huge trichobezoar with a long tail was totally removed by an anterior gastrotomy. Following removal of the lesion, the antrum was observed with multiple ulcers secondary to extensive pressure. Postoperative period was uneventful. A subsequent psychiatric consultation revealed depressive personality disorder.

Adult↗

PubMed2003

[Evaluation of severe burns managed in intensive care unit].

BACKGROUND: This study designed to evaluate the results of the patients with severe burns treated in the intensive care unit. METHODS: Between May 1997 and May 2002, fifty-four patients who had thermal and electrical burns managed at the Intensive Care Unit of General Surgery of Istanbul University Medical Faculty. RESULTS: Forty-five of patients were males and nine were females with mean age of 39 years. The mean hospital stay was 26 days. The mean total body surface area burns was 60%. Pseudomonas aeruginosa was detected in wound cultures at the 68% of patients. 83% of cases died. Mortality was due to sepsis in 66% of patients. CONCLUSION: Besides early debridmant, early enteral feeding, woundcare and intensive care unit support, establishing of specific burncenters may reduce morbidity and mortality rates in severe burns.

Adolescent↗

PubMed2003

The late outcomes of vena cava filters in the prevention of pulmonary embolism.

BACKGROUND: Pulmonary embolism (PE) is the most serious complication of deep venous thrombosis (DVT) resulting in high morbidity and mortality rate. The purpose of this study is to evaluate the long-term results of vena cava filters (VCFs) placement for prevention of PE in high- risk patients. METHODS: Between June 1999 and March 2002, at the Trauma and Surgical Emergency Service of Istanbul Medical Faculty, 15 high-risk patients who underwent placement of filters were evaluated. RESULTS: There were eleven males (73%) and four females (27%) with mean age of 50 years (range 14 to 76). Eleven of VCFs were placed for prophylactic and four for therapeutic purposes. The indications of VCFs placement are as follows: Spinal cord injury with life-long paraplegia in eight and quadriplegia in two patients, venous thromboembolism while on anticoagulation in two patients, contraindications to anticoagulation in three patients. The mean duration of follow-up was 17 months (range 3-32 months). No patients developed DVT and recurrent DVT. No patients clinically had signs or symptoms of PE. There was one insertion site thrombosis that related to VCF complications, which resolved with medical therapy. Four patients died during the study period. Medical records revealed no evidence of PE. CONCLUSION: Although VCF placement seems to prevent PE in high- risk patients, prospective randomized trials with larger patient groups and longer-term follow up period are necessary to evaluate efficacy and safety of VCF in prevention of PE before making definitive conclusion.

Adolescent↗

PubMed2003

[The comparison of incision and drainage with skin excision and curettage in the treatment of acute pilonidal abscess].

BACKGROUND: To compare therapeutic values of incision and drainage, with skin excision and curettage in surgical treatment of the patients with acute pilonidal abscess. METHODS: In this prospective study, patients with acute pilonidal abscess were divided into two groups. The first group of patients were treated with incision and drainage and the second with skin excision and curettage. Two treatment modalities were compared in terms of healing time, time of returning to active work and development of chronic pilonidal sinus rates with chi-square and student-t test. RESULTS: Development of chronic pilonidal sinus rate was 76% in incision and drainage group and 24% in skin excision and curettage group (p<0.001). Healing time and time of returning to active work were 27 and 35 days in skin excision and curettage group, 19 and 26 days in incision and drainage group, respectively (p<0.001). CONCLUSION: Skin excision and curettage, which is associated with lower rates of development of chronic pilonidal sinus, may be the treatment of choice in acute pilonidal abscess.

Abscess↗

PubMed2003

[Complicated Meckel's diverticulum].

BACKGROUND: In this study we present our experience in the surgical treatment of complicated Meckel's diverticulum. METHODS: The data of eight patients who underwent surgery due to complications of Meckel's diverticulum between 1994-2001 was retrospectively assessed. RESULTS: There were six males and two females with a mean age of 31 years (range 13 to 65). Preoperative diagnoses were acute surgical abdomen in six and incarcerated inguinal hernias in two patients. Intraoperative diagnoses were as follows; Littre's hernia in two, diverticulitis in two, perforation of the diverticulum in one and intestinal obstruction in three patients (there was a band extending from diverticulum to the umbilicus in two patients and a mesodiverticular band in the remaining one). While diverticulectomies were performed in five patients, three had small bowel resections. The mean diameter of the diverticula was 2.3 cm (range 2 to 4) and the mean length was 3.5 cm (range 3 to 8). Postoperative intestinal obstruction was observed in one patient who had underwent diverticulectomy and subsequently a small bowel resection was performed. CONCLUSION: Being aware of the complications of the Meckel's diverticulum is necessary in correct timing of the surgery and selecting the proper incision in patients with acute abdomen. This will result in decreased morbidity.

Abdomen, Acute↗