Analysis of appendiceal neoplasms in 1,423 appendectomy specimens: a 10-year retrospective cohort study from a single institution.

OBJECTIVE: This study aimed to reveal the incidence, clinicopathological, and oncological outcomes of appendiceal neoplasms. METHODS: This is a retrospective cohort study from a single institution. Patients with a pathological diagnosis of malignancy who underwent appendectomy between January 2011 and 2021 were included in the study, and groups were formed according to pathological type. Clinical, pathological, and oncological results were compared in these groups. RESULTS: The incidence of neoplasia was 2.38% (n=34) in a cohort of 1,423 appendectomy cases. Of the cases, 56% (n=19) were female. The median age in the entire cohort was 55.5 (range: 13-106) years. In the cohort, the rate of neuroendocrine tumor mucinous cystadenoma adenocarcinoma, and low-grade appendiceal mucinous neoplasm, according to the American Joint Committee on Cancer classification of appendiceal neoplasms, was 32.3% (n=11), 26.4% (n=9), 26.4% (n=9), and 14.7% (n=5), respectively. Neuroendocrine tumor patients (median age: 35 years) were younger than the other groups (p=0.021). Secondary complementary surgery was performed in 66.7% (n=6) of adenocarcinoma patients and 27.3% (n=3) of neuroendocrine tumor patients. Right hemicolectomy was performed in all neuroendocrine tumor patients requiring secondary surgery, while right hemicolectomy was performed in three adenocarcinoma patients and cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in three adenocarcinoma patients. After a median follow-up of 44.4 months (95% confidence interval: 18.6-70.1), the mean survival rate was 55% in appendiceal adenocarcinoma patients compared to 100% in neuroendocrine tumor patients. CONCLUSION: Appendiceal neoplasms are rare but remain an important cause of mortality. Appendiceal adenocarcinomas are associated with poorer oncological outcomes compared to other neoplasms.

Hemosuccus pancreaticus A case report and review of the literature.

Hemosuccus pancreaticus is a rare clinical condition, defined as a bleeding from an artery around the pancreas or a lesion on the pancreas, to the pancreatic duct. The intensity of bleeding can vary from occult bleeding to life threatening massive acute bleeding. In this article, we aimed to present a 68-year-old man who presented to our clinic with recurrent upper gastrointestinal bleeding and abdominal pain. Endoscopy revealed hemorrhage from ampulla vateri, CT angiographic examination showed an aneurysm of the splenic artery and that the splenic artery was connected to the pancreatic duct.Splenectomy and subtotal pancreatectomy was performed on the patient. The patient was discharged with healing. Hemosuccus pancreaticus should be kept in mind in patients with a history of pancreatitis and peripancreatic aneurysm and upper gastrointestinal bleeding.The early diagnosis and treatment of HP is life-saving. In this study, we aimed to review the basic symptoms and clinical findings, along with the diagnosis and treatment methods of HP. KEY WORDS: Gastrointestinal bleeding, Pancreas, Splenic Artery.