Sacrococcygeal foreign body progressing with pilonidal sinus clinical picture: report of a case.

BACKGROUND: Pilonidal sinus is a benign anorectal disease that is frequently seen in the sacrococcygeal area when a foreign body reaction develops after the invasion of hair follicles. OBJECTIVES: Trauma in this region and clinical abscesses that recur after trauma due to foreign bodies are not frequently observed. CASE REPORT: This study presents the case of a patient with chronic leakage who had a history of three surgical procedures due to recurrent pilonidal abscesses and the presence of a foreign body in the sacrococcygeal area. CONCLUSION: The presence of a foreign body in cases progressing with a single and wide inlet and frequently recurring abscess formation is a condition of which to be aware.

The importance of serum intestinal fatty acid-binding protein for the early diagnosis of acute mesenteric ischemia.

BACKGROUND: Acute mesenteric ischemia (AMI), although relatively rare, is an emergency condition with high mortality rates (60-80%) attributed to lack of early diagnosis. The aim of this experimental study was to observe the changes in serum intestinal fatty acid-binding protein (I-FABP) levels over time in the AMI model by ligating superior mesenteric artery (SMA) in rats and to compare with the serum I-FABP levels of the rats in the control group. METHODS: Twenty rats were randomly allocated into two groups as control and ischemia group. The basal serum I-FABP levels were determined. SMA was isolated by laparotomy in all animals. In the ischemia group, SMA was ligated and intestinal ischemia was formed. Blood was taken from each rat in both groups at 30th, 60th, and 90th min to determine the serum I-FABP levels. The blood results were compared between two groups and were also compared by time in each group. RESULTS: In the ischemia group, serum I-FABP levels were significantly higher than the control group at post-operative 30th, 60th, and 90th min (p<0.01). In comparison with pre-operative serum I-FABP levels, remarkable increases were observed statistically at post-operative 30th, 60th, and 90th min in the ischemia group (p<0.01). In contrast, there was no statistically significant difference within the serum I-FABP levels over time in the control group. The increases of serum I-FABP levels in the ischemia group were directly correlated with the time of ischemia. CONCLUSION: Serum I-FABP levels have increased significantly in the intestinal ischemia and these values have risen progressively over time. Serum I-FABP may be a useful and promising biomarker for the early diagnosis of AMI.

Cyanoacrylate application on colonic anastomosis: is it safe or not?

INTRODUCTION: Major complications of colonic anastomosis include fistula, bleeding, and anastomotic stricture, and the most common one is anastomotic leakage. Many organic or inorganic tissue adhesives are being used such as fibrin glue or cyanoacrylate to strengthen or protect colonic anastomosis. Up to now, a great number of studies have been carried out to investigate the effects of these biomaterials. AIM: To determine the effect of cyanoacrylate application on anastomosis safety. MATERIAL AND METHODS: In this experimental study, rats were divided into two groups; a control group and an experimental group. Full-thickness incisions were done on the left colon of the rats, and then end-to-end anastomosis was performed by using 5/0 silk separated sutures. In the experimental group we applied cyanoacrylate over the sutures. The samples were taken on the 7th day. RESULTS: In the control group the average tissue hydroxyproline levels and the average bursting pressures were significantly higher than in the experimental group. CONCLUSIONS: The purpose of all the experimental studies is to prevent and reduce anastomotic complications. Despite all the studies that have been done, colonic anastomosis complications continue to be a problem. As a result, we suggest that cyanoacrylate has a negative effect on the healing process of colonic anastomosis.

Diagnostic Value of Hook Wire Localization Technique for Non-Palpable Breast Lesions.

BACKGROUND: The aim of this study was to investigate the validity of hook wire localization biopsy for non-palpable breast lesions which were detected by ultrasonography (USG) or mammography (MMG). METHODS: In this retrospective study, USG or MMG-guided hook wire localization technique was performed on 83 patients who had non-palpable breast lesions. Then histopathological examination was performed on surgically removed specimens. All patients' mammograms or ultrasonograms were categorized using Breast Imaging-Reporting and Data System (BI-RADS) classification. RESULTS: Radiologically, 27 (32.53%) patients were classified as BI-RADS 3, 49 (59.04%) BI-RADS 4, one (1.2%) BIRADS 5 and six (7.23%) BI-RADS 0. Histopathological results were benign in 68 (81.9%) and malignant in 15 (18.1%) patients. Twenty-seven patients were classified as BI-RADS 3 and definitive diagnoses for all were benign. Besides, 49 patients were classified as BI-RADS 4 and histopathologically 14 of them were reported as malignant, and 35 as benign. Sensitivity of MMG was 93% and specificity was 55%. For USG, the sensitivity was 100% and the specificity was 73%. CONCLUSION: In early diagnosis of breast cancer, the validity of the imaging-guided hook wire localization biopsy of non-palpable breast lesions has been proved. The cooperation of surgeon, radiologist and pathologist increases the successfull results of hook wire localization technique.

Intestinal Obstruction due to Colonic Lithobezoar: A Case Report and a Review of the Literature.

Bezoar is defined as the accumulation of undigested foreign bodies or nutrients in the gastrointestinal tract. These foreign bodies can be hair (trichobezoar), fibers or seeds of vegetables and fruits (phytobezoar), or remnants of milk (lactobezoar) and stones (lithobezoar). Lithobezoar, the accumulation of stones in the digestive tract, is commonly seen in stomach. In this paper, a 7-year-old girl with colonic lithobezoar who presented with constipation, abdominal pain, and the history of pica was successfully treated by the extraction of the stones under general anesthesia.

The effect of fibrin glue on the intensity of colonic anastomosis in the presence and absence of peritonitis: an experimental randomized controlled trial on rats.

Aim. Anastomotic leakage after colon anastomosis is the most frequent and most feared complication with its highest mortality rate. In this study, we aimed to expose the impact of performing fibrin glue on sutured colocolic anastomosis, in the presence of experimental peritonitis, on anastomosis safety. Method. In this experimental study, the rats were divided into two groups as control group (Groups 1 and 3) and experimental group (Groups 2 and 4). They were also divided as clean abdomen (Groups 1 and 2) and infected abdomen (3 and 4) groups. Full-thickness incisions were made on the proximal colon of both groups of rats. The control group's anastomoses were conducted only with sutures, whereas in experimental group, fibrin glue was applied over the sutures. The samples were taken on the 10th day. Results. Highest values for average levels of hydroxyproline in the tissues and anastomotic bursting pressures were detected when fibrin glue was applied on sutured anastomosis in clean abdomen. In the histopathological staging performed in line with Ehrlich-Hunt model, lowest values were detected during the presence of peritonitis. Conclusion. As a result, it has been established that the use of fibrin glue over sutured colocolic anastomosis, both in clean abdomen and in the presence of peritonitis, had increased anastomosis safety.

Rapunzel Syndrome Case Report: A 13-year-old Girl.

Bezoars are masses, which are commonly encountered in patients after stomach surgery or in those with psychiatric problems, formed by the accumulation of intraluminal nondigestible substances that can lead to obstruction of the stomach and the small intestine. The anatomical changes in the gastrointestinal tract are known to cause bezoar formation. In the absence of an anatomical change, psychiatric disorders such as trichotillomania may lead to the formation of trichobezoars in the stomach. The so-called Rapunzel syndrome is the extension of the bezoars down to the duodenum and the jejunum, which is a rare condition. In this paper, a 13-year-old patient with trichotillomania is reported, who was admitted to our clinic with nausea, vomiting, and fatigue complaints, in whom a giant trichobezoar was identified, which completely filled the stomach and duodenum, without causing obstruction.