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Öğe Benign pneumoperitoneum: A case report(Ekin Tibbi Yayincilik Ltd Sti-Ekin Medical Publ, 2008) Albayrak, Dogan; Hatipoglu, Ahmet Rahmi; Ibis, Abdil Cem; Polat, Nihat; Coskun, IrfanFlexible colonoscopy is the gold standard in diagnosis, treatment, and follow-up of colonic pathologies. The acute onset of abdominal pain after colonoscopy may be a clinical sign of colonic perforation. Perforation rate after diagnostic colonoscopies varies between 0.01%-0.4%. If the patient develops signs of peritoneal irritation, the surgical intervention is obligatory. According to the literature, early surgical treatment is the best strategic approach that decreases the morbidity and mortality. Nonoperative treatment could be a choice in selected patients without signs of peritoneal irritation. In large colonoscopy series, only 1-5% of the cases with colonic perforation secondary to the colonoscopy were treated conservatively. We reported a case with colonic perforation after diagnostic colonoscopy which we successfully treated nonoperatively without further need of surgery.Öğe Hemodynamic Instability due to Intratumoral Hemorrhage in Retroperitoneal Alveolar Rhabdomyosarcoma in Adult(Drunpp-Sarajevo, 2010) Sezer, Atakan; Yagci, Mehmet Ali; Hatipoglu, Ahmet Rahmi; Coskun, Irfan; Calta, Fedai; Cicin, Irfan; Usta, UfukBackground: Rhabdomyosarcomas are the most common soft tissue sarcomas in pediatric age and rare in adults. Case Report: A 37-year-old male admitted with abdominal discomfort and mass during the previous 9 months. The patient was hospitalized for the diagnosis of abdominal mass. Initial hemodynamic parameters were stabile. During diagnosis course, hemoglobin level decreased and hemodynamic instability occurred. Abdominal computed tomography revealed a 30x20 cm mass in left retroperitoneal space. The physical examination revealed the enlargement of the mass. The surgical resection of tumor and the adjacent abdominal wall resection were performed. Alveolar rhabdomyosarcoma was diagnosed. The patient received adjuvant chemotherapy and radiotherapy. The patient had 8 mouths follow up without signs of recurrence. Conclusion: The clinical presentation of this tumor with haemodynamic instability due to intra tumoral hemorrhage is a challenging course for physicians and this rare entity must be kept in mind for accurate and urgent treatment.Öğe Hepatic hydatid cyst cases(Aves Yayincilik, Ibrahim Kara, 2008) Albayrak, Dogan; Sezer, Yavuz Atakan; Ibis, Abdil Cem; Yagci, Mehmet Ali; Hatipoglu, Ahmet Rahmi; Coskun, IrfanObjectives: Hydatid cyst is presently a prevalent health problem in our area and country. This study retrospectively reviewed medical records of four patients who underwent urgent surgery due to intraperitoneal rupture and the records of all patients treated for hepatic hydatidosis in the same period. Patients and Methods: Medical records of the 44 patients (24 females, 20 males; mean age 47.5 years; range 16 to 83 years) who were treated in our clinic for hepatic hydatidosis between January 2004 and June 2007 were reviewed retrospectively. The patients were evaluated with respect to age, sex, location of the cyst, surgical method applied, hospital stay duration, pre- and postoperative complications, and treatment methods applied for the complications. Results: Four patients (9%) underwent emergency surgery due to intraperitoneal rupture. Postoperative biliary leakage into the cyst cavity was observed in 15 patients (34%). It was closed spontaneously in 6 patients (40%) without further intervention. In 8 patients (53%) the biliary leakage continued for about 10 days and the daily median drainage was over 100 cc. Endoscopic sphincterotomy was performed in these cases. Mortality rate was 4% (n=2). Conclusion: Rupture of hydatid cyst should be suspected in trauma patients who had hepatic cyst and intraperitoneal free fluid concomitantly. In these patients therapeutic intervention should be quick because of the risk of any anaflactic reaction. Endoscopic sphincterotomy is an effective treatment method for biliary fistula after hydatid cyst surgery.Öğe Hepatic Hydatid Cyst Cases Reply(Ekin Tibbi Yayincilik Ltd Sti-Ekin Medical Publ, 2008) Albayrak, Dogan; Sezer, Yavuz Atakan; Ibis, Abdil Cem; Yagci, Mehmet Ali; Hatipoglu, Ahmet Rahmi; Coskun, Irfan[Abstract Not Available]Öğe Inflammatory myofibroblastic tumor presenting as an abdominal wall mass in an adult patient(Wolters Kluwer Medknow Publications, 2010) Yagci, Mehmet Ali; Sezer, Atakan; Yeldan, Eyup; Coskun, Irfan; Usta, Ufuk; Cicin, Irfan; Temizoz, OsmanInflammatory myofibroblastic tumor of the abdominal wall is a rare soft-tissue tumor presentation in adults. A 50-year-old woman was referred with abdominal pain and a palpable mass in the left lower quadrant. Computed tomography scan and magnetic resonance investigation revealed an 8-cm heterogeneous abdominal wall mass. Tumor markers were within normal limits. Fine-needle aspiration cytology and tru-cut biopsies yielded necrotic material. A preoperative diagnosis of a resectable rhabdomyosarcoma was suggested. On exploration a tumor measuring 8 x 8 x 6 cm was resected along with the involved structures. Histopathologic examination of specimen revealed an inflammatory myofibroblastic tumor of the abdominal wall. The patient has been followed up for the last 12 months without clinical or radiographic evidence of recurrence. Inflammatory myofibroblastic tumor arising from the anterior abdominal wall in adults is an unusual manifestation of soft-tissue tumors, which can be managed by a multidisciplinary team of surgeons, oncologists, radiologists and pathologists.Öğe Intussusception due to fibroid polyp: case report(Yerkure Tanitim & Yayincilik Hizmetleri A S, 2008) Ibis, Abdil Cem; Albayrak, Dogan; Sezer, Yavuz Atakan; Polat, Nihat; Coskun, IrfanIntusussusception is a clinical aspect characterized by the entrance of proximal intestinal segments into distal part. Ileal intussusception is a disease for child age group. Only 5% of all intussusception is seen in adults. Contrary to child age group in many of the adult patients, there is a lesion causing intussusception. Therefore, a surgical cure is necessary for most of the patients. Although the type of surgical treatment is still controversial, partial resection rather than reduction and primary anastomosis are commonly recommended especially for adults. In this article, an adult patient diagnosed as ileo-ileal intussusception during surgery for mechanical intestinal obstruction and treated by small bowel resection and primary anastomosis is presented.Öğe A rare cause of intestinal obstruction due to an exophytic gastrointestinal stromal tumor of the small bowel(Pharmamed Mado Ltd, 2009) Sezer, Atakan; Yagci, Mehmet Ali; Hatipoglu, Ahmet Rahmi; Coskun, Irfan; Cicin, Irfan; Usta, Ufuk; Temizoz, OsmanIntroduction: Gastrointestinal stromal tumors constitute a distinct group of rare gastrointestinal tract tumors that originate from the interstitial cells of Cajal. These jejunoileal lesions are a rare cause of obstruction but can be associated with substantial morbidity. Case: A 59-year-old woman presented to the emergency department with abdominal pain and distention. Physical examination revealed tenderness and rebound in right lower quadrant. Computed tomography revealed a mass in lower right quadrant. A 9x9x4 cm exophytic ileal mass was observed at exploration. Preoperative diagnose was a small bowel tumor and then segmental resection and primary anastomosis were performed. Histopathological investigation revealed spindle cells that stained strongly for C-117, consistent with a diagnosis of a malign gastrointestinal stromal tumor. Conclusion: We conclude that exophytic small bowel gastrointestinal stromal tumors are rare lesions, which should be kept in mind by physicians among the diagnosis of small bowel obstructions in order to reduce substantial morbidity and mortality.Öğe Response of a finite beam on a tensionless Pasternak foundation under symmetric and asymmetric loading(Techno-Press, 2008) Coskun, Irfan; Engin, Hasan; Oezmutlu, AydinThe static response of a finite beam resting on a tensionless Pasternak foundation and subjected to a concentrated vertical load is assessed in this study. The concentrated vertical load may be applied at the center of the beam, or it may be offset from the center. The tensionless character of the foundation results in the creation of lift-off regions between the beam and the foundation. An analytical/ numerical solution is obtained from the governing equations of the contact and lift-off regions to determine the extent of the contact region. Although there is no nonlinear term in the equations, the problem shows a nonlinear character since the contact region is not known in advance. Due to that nonlinearity, the essentials of the problem (the coordinates of the lift-off points) are calculated numerically using the Newton-Raphson technique. The numerical results are presented in figures to illustrate the behaviours of the free-free and pinned-pinned beams under symmetric or asymmetric loading. The figures illustrate the effects of the shear foundation parameter and the symmetric and asymmetric loading options on the variation of the contact lengths and the displacement of the beam.
