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Biomedical subjects

Y Akgun

Publications and source records attributed to Y Akgun.

6 recordsLinked to original sources
PubMed1999

Amebic liver abscess: changing trends over 20 years.

Amebiasis and amebic liver abscess (ALA) continue to be a major fatal disease in developing countries where unhygienic environmental conditions prevail. Between January 1975 and December 1984 there were 60 patients and from January 1985 to December 1994 there were 44 patients with ALA who were diagnosed and treated. In the first group, all patients were operated on, and drainage was performed. The morbidity and mortality rates were 53.3% and 23.3%, respectively. Metronidazole was given to all patients in the second group, and in those who did not respond to the metronidazole percutaneous needle aspiration was applied. Surgical treatment was performed in seven patients because four did not respond to metronidazole therapy and percutaneous needle aspiration, and in three the abscess ruptured into the peritoneal cavity. The lesion disappeared ultrasonographically after 4 months in all patients. The morbidity and mortality rates were 4.5% and 2.2%, respectively. The result of this study suggests that uncomplicated ALA can be managed conservatively with metronidazole and needle aspiration of the abscess. Operative therapy should be performed for complications of the abscess and when conservative therapy fails.

Adult↗
PubMed1997

Management of ileosigmoid knotting.

BACKGROUND: Ileosigmoid knotting is a rare cause of intestinal obstruction. METHODS: The clinical records of 16 patients treated for ileosigmoid knotting were evaluated retrospectively. RESULTS: There were 11 men and five women. The mean age was 45 years. The mean duration of symptoms was 4.4 days. Plain abdominal radiographs showed multiple air-fluid levels in the colon and/or small bowel. At operation, ileum and/or sigmoid colon necrosis was observed in 13 patients, both ileum and total colon necrosis in two, while there was no necrosis in one patient. Resection of necrotic bowel was necessary in 15 patients. Intestinal continuity was restored by primary anastomosis in 12; three required a stoma. The patient without necrosis was treated by detorsion and mesosigmoplasty. Three of 16 (19 per cent) patients died; septic shock was the major cause of death. CONCLUSION: Aggressive preoperative resuscitation, appropriate antibiotic therapy, effective surgery and postoperative metabolic support help minimize morbidity and mortality rates.

Adult↗
PubMed1996

Mesosigmoplasty as a definitive operation in treatment of acute sigmoid volvulus.

PURPOSE: The aim of this prospective study was to present our patients with managed mesosigmoplasty as a definitive method and to discuss the efficiency of this operation in the treatment of acute sigmoid volvulus. METHODS: Fifteen patients with acute sigmoid volvulus were treated by mesosigmoplasty between April 1992 and April 1995. RESULTS: Postoperatively, temporary abdominal distention and constipation were seen in two patients, and one patient died of myocardial infarction. Morbidity and mortality rates were 13.3 and 6.6 percent, respectively. The average follow-up was 28.09 +/- 9.60 months, and recurrences and complaints of undue constipation were not seen. CONCLUSIONS: Our results suggest that the mesosigmoplasty is a definitive procedure and that it is the first and most reliable choice that can be easily performed with minimum morbidity and mortality for patients with acute sigmoid colon volvulus who do not have sigmoid necrosis at laparotomy.

Aged↗
PubMed1996

Intestinal obstruction caused by Ascaris lumbricoides.

PURPOSE: The aim of this study is to present patients, to discuss causes of morbidity and mortality, and to ascertain prognostic indexes and therapeutic options influencing outcome of patients with intestinal obstruction caused by Ascaris lumbricoides. MATERIALS AND METHODS: During the past 20 years, between 1975 and 1995, a total of 17 patients with intestinal obstruction attributable to A. lumbricoides underwent surgery. Five were adults, and 12 were children. The most frequent symptoms and physical findings were abdominal pain, distention, nausea, vomiting, and constipation. Enterotomy was performed in ten patients and resection in two patients. Manual exposition and advancement of the parasitic bundle toward the colon was attempted in five patients. Morbidity and mortality rates were 29 and 17 percent, respectively, and septic shock was the major cause of death. RESULTS: This study suggests that simple bowel obstruction is the fatal complication of A. lumbricoides infestation, which is seen particularly in pre-school and young school-aged children living in unhygienic conditions, and illustrates the need for heightened awareness of A. lumbricoides by the emergency physician in the differential diagnosis. CONCLUSIONS: Early diagnosis and surgical intervention are essential to minimize high morbidity and mortality.

Adult↗
PubMed1995

Typhoid enteric perforation.

Of 306 cases of typhoid enteric perforation, 267 were reviewed retrospectively to determine prognostic indices and therapeutic options influencing outcome. The morbidity and mortality rates were 55.4 and 28.5 percent respectively, and the median duration of hospitalization was 18 days. On the basis of these findings, a prospective series of 39 patients was studied. In the preoperative period, aggressive resuscitation and antibiotic therapy with a combination of chloramphenicol, ampicillin/sulbactam and ornidazole were administered. All patients were given total parenteral nutrition to provide adequate metabolic support in the postoperative period. The morbidity and mortality rates decreased to 25 and 10 percent respectively, and the median hospitalization time was 12 days. The results of this study suggest that aggressive resuscitation and a combined antibiotic regimen in the preoperative period, selected operative procedure and metabolic support decrease the morbidity and mortality of typhoid enteric perforation.

Adolescent↗