Publications by authors named "Mustafa Korkut"

37 Publications

Comment on ''Can the neutrophil/lymphocyte ratio (NLR) have a role in the diagnosis of coronavirus 2019 disease (COVID-19)?''.

Rev Assoc Med Bras (1992) 2021 Jul 9. Epub 2021 Jul 9.

Suleyman Demirel University, Faculty of Medicine, Department of Emergency Medicine - Isparta, Turkey.

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http://dx.doi.org/10.1590/1806-9282.67.Suppl1.20200812DOI Listing
July 2021

Mean platelet volume combined red cell distribution width is affected by many conditions.

Clin Respir J 2021 06 5;15(6):702. Epub 2021 Mar 5.

Department of Emergency Medicine, Health Science University Antalya Training and Research Hospital, Antalya, Turkey.

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http://dx.doi.org/10.1111/crj.13343DOI Listing
June 2021

Neutrophil-To-Lymphocyte Ratio And Covid-19.

Shock 2020 Dec 21;Publish Ahead of Print. Epub 2020 Dec 21.

Department of Emergency Medicine, Health Science University Antalya Training And Research Hospital, Antalya,Turkey.

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http://dx.doi.org/10.1097/SHK.0000000000001712DOI Listing
December 2020

NLR, d-NLR and PLR can be affected by many factors.

Int Immunopharmacol 2021 01 21;90:107154. Epub 2020 Nov 21.

Department of Emergency Medicine, Suleyman Demirel University Faculty of Medicine, Isparta, Turkey.

We have read the article by Yang et al, entitled "The diagnostic and predictive role of NLR, d-NLR and PLR in COVID-19 patients" with great interest. The authors emphasized that the NLR (Neutrophil to lymphocyte ratio) is an independent prognostic biomarker for COVID-19 patients. First of all, we congratulate the authors for their valuable contribution to the literature in these difficult conditions. However, we would like to add on a few cases that need more attention.
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http://dx.doi.org/10.1016/j.intimp.2020.107154DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7680208PMC
January 2021

Many conditions may affect mean platelet volume and neutrophil to lymphocyte ratio.

Braz J Otorhinolaryngol 2021 Jan-Feb;87(1):122. Epub 2020 Nov 2.

Health Science University, Antalya Training and Research Hospital, Department of Emergency Medicine, Antalya, Turkey.

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http://dx.doi.org/10.1016/j.bjorl.2020.10.003DOI Listing
May 2021

Red Cell Distribution Width and Hip Fracture.

J Bone Miner Res 2021 Jun 10;36(6):1202. Epub 2020 Nov 10.

Department of Emergency Medicine, Health Science University Antalya Training and Research Hospital, Antalya, Turkey.

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http://dx.doi.org/10.1002/jbmr.4201DOI Listing
June 2021

Can NLR, PLR and LMR be used as prognostic indicators in patients with pulmonary embolism? A commentary.

Bosn J Basic Med Sci 2021 Aug 1;21(4):501. Epub 2021 Aug 1.

Department of Emergency Medicine, Suleyman Demirel University Faculty of Medicine, Isparta, Turkey.

We read with great interest the article "Prognostic role of NLR, PLR, and LMR in patients with pulmonary embolism" by Köse et al.[1]. They found that the neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and lymphocyte-monocyte ratio (LMR) were related to the prognosis and clinical severity of patients with pulmonary embolism (PE). First of all, we congratulate the authors for their invaluable contribution to literature. However, we think that some points should be discussed regarding the use of these laboratory parameters. White blood cell subtypes NLR, PLR, and LMR, have been associated with many inflammatory diseases, including PE [2,3]. These parameters, which can be easily determined by simple and easy measurement of systemic inflammation, maintain their importance today. However, these parameters are affected by many factors such as trauma, local or systemic infection, acute coronary syndromes, and malignancy [3-5]. For these reasons, it would be better for the authors to mention these factors and exclude them from the tables that included malignancy and trauma patients in the study. It is known that drugs, including steroids, can increase neutrophils and decrease lymphocytes and therefore affect NLR, PLR, and LMR values [6]. Consequently, it will be more valuable to exclude patients who use drugs that may affect laboratory parameters. Besides, plasma inflammatory biomarkers are time-dependent variables. The time of sample collection and the time from the onset of the symptom to the sampling may impact the parameters [3-6]. Therefore, it is essential to identify the time from the first symptom to sample collection and the factors that may affect it. In conclusion, because NLR, PLR, and LMR can be affected by many factors, prospective studies with large populations are needed to show the accuracy of use in critically ill patients.
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http://dx.doi.org/10.17305/bjbms.2020.5236DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8292860PMC
August 2021

Red blood cell distribution width and mortality in traumatic brain injury.

Acta Neurol Belg 2021 Jun 2;121(3):791-792. Epub 2020 Nov 2.

Department of Emergency Medicine, Faculty of Medicine, Suleyman Demirel University, Isparta, Turkey.

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http://dx.doi.org/10.1007/s13760-020-01539-4DOI Listing
June 2021

Usefulness of Immature Granulocytes to Predict High Coronary SYNTAX Score in Acute Coronary Syndrome; a Cross-sectional Study.

Arch Acad Emerg Med 2020 15;8(1):e73. Epub 2020 Sep 15.

Introduction: Immature granulocytes (IG) in peripheral blood indicate increased bone marrow activation and inflammation, and SYNTAX score (SS) is an anatomical scoring system based on coronary angiogram. This study, aimed to evaluate the relationship between IG and SS, as a new inflammatory marker in patients with acute coronary syndrome (ACS).

Methods: Patients aged >18 years who were diagnosed with ACS in the emergency department were included in this study, which was planned as a cross-sectional study. Patients were divided into two groups of patients with high and low SSs according to coronary angiography results. Demographic and laboratory parameters were compared between the groups.

Results: Our study consisted of 78 patients diagnosed with ACS, who met the inclusion criteria. The average age of the study group was 59 years, and 67.9% of the patients were male. 21 patients (26.9%) had high SSs and 57 patients (73.1%) had low SSs. Mean IG% was significantly higher in high SS group compared to low SS group (0.71±0.25 vs 0.44±0.21 mg/dl, p<0.001). IG% can present a high SS with 76.2% sensitivity and 75.4% specificity at a cut-off value of 0.7.

Conclusion: IG was significantly higher in ACS patients with high SSs. It seems that IG can be used as a parameter, which is quickly accessible and cheap, in order to predict high SS in ACS patients in daily clinical practice.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7587994PMC
September 2020

Immature Granulocyte Count and Percentage as New Predictors of Mortality in Patients with Upper Gastrointestinal Bleeding.

Indian J Crit Care Med 2020 Sep;24(9):794-798

Department of Emergency Medicine, Karabük University Training and Research Hospital, Karabük, Turkey.

Aims: Early identification of patients at risk of adverse outcomes may increase the survival rates in patients with upper gastrointestinal bleeding (UGIB), but this can be difficult to predict in emergencies. The aim of the study is to evaluate immature granulocyte (IG), which can be obtained from simple hemogram tests in patients with UGIB, in terms of clinical use and as a mortality marker.

Materials And Methods: The patients diagnosed with UGIB between March 1, 2019, and September 30, 2019, were evaluated retrospectively. Demographic characteristics, causes of hemorrhage, clinical presentations, hemogram, and biochemistry values at ED admission and 30-day mortality status of the patients were examined. We divided the patients into groups according to their mortality status, and the groups were compared among themselves in terms of parameters.

Results: A total of 213 patients who met the inclusion criteria were included in the study. Of these patients, 139 (65.3%) were male and the mean age was 65.05 ± 16.7 years. Fifteen (7%) of them were in the nonsurvival group, while 198 (93%) were in the survival group. The efficacy of both the IG count (IGC) and IG% in predicting mortality was statistically significant ( = 0.002, = 0.008, respectively). The sensitivity and specificity for the IGC were found as 60% and 84.4; for the IG%, they were found as 66.7% and 75.7%, respectively.

Conclusion: IGC and IG% are independent risk factors for the 30-day mortality status. These measurements are obtained from simple hemogram tests and may be useful for the evaluation of mortality in patients with UGIB.

How To Cite This Article: Bedel C, Korkut M, Avcı A, Uzun A. Immature Granulocyte Count and Percentage as New Predictors of Mortality in Patients with Upper Gastrointestinal Bleeding. Indian J Crit Care Med 2020;24(9):794-798.
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http://dx.doi.org/10.5005/jp-journals-10071-23563DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7584826PMC
September 2020

Comment on: "Neutrophil to lymphocyte ratio is associated with in-hospital mortality in older adults admitted to the emergency department.

Am J Emerg Med 2020 Oct 2. Epub 2020 Oct 2.

Department of Emergency Medicine, Health Science University Antalya Training and Research Hospital, Antalya,Turkey. Electronic address:

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http://dx.doi.org/10.1016/j.ajem.2020.10.001DOI Listing
October 2020

Accuracy of Alvarado, Eskelinen, Ohmann, RIPASA and Tzanakis Scores in Diagnosis of Acute Appendicitis; a Cross-sectional Study.

Arch Acad Emerg Med 2020 13;8(1):e20. Epub 2020 Mar 13.

Department of Emergency Medicine, Health Science University Antalya Training and Research Hospital, Antalya, Turkey.

Introduction: Many scoring systems have been developed to assist in diagnosis of acute appendicitis (AA). This study aimed to compare the screening performance characteristics of Alvarado, Eskelinen, Ohmann, Raja Isteri Pengiran Anak Saleha (RIPASA), and Tzanakis scores in predicting the need for appendectomy in AA patients.

Methods: Our study prospectively evaluated AA patients that were treated in a tertiary hospital's emergency department. The obtained data were used to calculate Alvarado, Tzanakis, RIPASA, Eskelinen and Ohmann scores. Patients were categorized into two groups according to their histopathological results: positive (PA) and negative appendectomy (NA). The accuracy of different scoring systems in diagnosing AA was investigated.

Results: 74 patients suspected to AA with the mean age of 36.68 ± 11.97 years were studied (56.8% male). The diagnosis was histopathologically confirmed in 65 cases (87.8%). Median Alvarado, Tzanakis, RIPASA, Eskelinen and Ohmann scores were significantly higher in patients with positive appendectomy. The area under the curve (AUC), sensitivity, and specificity of Tzanakis score in the cut-off value of 8 were 0.965, 84.4%, and 100%, respectively. For Ohmann and Alvarado scores, these measures were 0.941; 71.9%, 89.9% and 0.938, 60.9%, 89.9%, respectively. Tzanakis scoring system had the best screening performance in detection of cases with AA.

Conclusion: Tzanakis score is more sensitive and specific than Alvarado, RIPASA, Eskelinen and Ohmann scores in identifying AA patients needing appendectomy.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7130437PMC
March 2020

Aortic dissection or spontaneous renal artery dissection, a rare diagnosis?

CEN Case Rep 2020 08 3;9(3):257-259. Epub 2020 Apr 3.

Department of Emergency Medicine, Health Science University Antalya Training and Research Hospital, Kazım Karabekir Street, Muratpaşa, 07100, Antalya, Turkey.

Spontaneous renal artery dissection (SRAD) is a rare entity causing muscle spasm due to acute low back pain, back pain, or flank pain symptoms or misleading clinical diagnosis such as renal colic. A 25-year-old Syrian male refugee presented to the emergency department with sudden onset of left-sided flank pain in the evening. Physical examination results were normal except left-sided costovertebral angle sensitivity. Abdominal, pelvic and thoracic contrast computed tomography angiography (CTA) was performed to evaluate aortic dissection, which was our urgent preliminary diagnosis. Left renal artery dissection was detected in CTA. The patient was treated with medical conservative treatment and spontaneous recovery was observed during the follow-up period. Early detection of SRAD in the emergency department can be difficult due to the fact that the clinical presentation is misleading.
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http://dx.doi.org/10.1007/s13730-020-00469-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7320080PMC
August 2020

Incidental Findings of Computed Tomography Angiography in Patients Suspected to Pulmonary Embolism; a Brief Report.

Arch Acad Emerg Med 2019 22;7(1):e60. Epub 2019 Oct 22.

Department of Radiology, Health Science University, Antalya Training and Research Hospital, Antalya, Turkey.

Introduction: Computed tomography pulmonary angiography (CTPA) scans are increasingly used in emergency department (ED). Therefore, the observation of incidental findings (IFs) has also increased. This study aimed to evaluate the frequency of IFs in patients who underwent CTPA.

Methods: All consecutive patients that underwent CTPA scanning for pulmonary embolism (PE) rule out between January 2017 and June 2018 were analysed. Incidental findings were divided into and reported in three categories: group 1 potentially life-threatening, group 2 required follow up, and group 3 with limited clinical significance.

Results: 151 cases with the mean age of 61.2 ± 17.6 years were studied (54.3% female). PE was documented in 77 cases (50.9%). 448 IFs were detected (3 IFs were found per patient). 60 (13.3%) IFs were classified as group 1, 180 (40.1%) as group 2, and 208 (46.6%) as group 3. Cardiomegaly was the most frequent finding in group 1 (n=32), followed by aortic aneurysm (n=13). In group 2, pleural effusion (n=58) and pneumonia (n=36) were the most frequent incidental findings. Lung structure changes (n=92) and thoracic bone related findings (n=43) were the most common IFs observed in group 3.

Conclusion: IFs were detected in the majority of patients that underwent CTPA. Most of these findings do not require follow-up or treatment. However, more than 50% of cases may require further diagnostic evaluation (40.1%) or immediate treatment (13.3%).
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6905423PMC
October 2019

A dermatologic emergency; Sweet's syndrome.

Authors:
Mustafa Korkut

Am J Emerg Med 2019 09 5;37(9):1807.e1-1807.e3. Epub 2019 Jun 5.

Health Science University Antalya Training and Research Hospital, Emergency Medicine Department, Turkey. Electronic address:

Background: Sweet's syndrome (SS), also known as acute febrile neutrophilic dermatosis, is a rare condition characterized by recurrent erythematous skin lesions. Skin lesions appear as papules, nodules and plaques located on the upper extremity, trunk, neck and face.

Case Report: A 72-year-old male patient presented to the emergency department with a 10-day history of generalized rash, generalized muscle and joint pain and high fever. He had a history of upper respiratory tract infection. He presented with painful erythematous plaques on both lower and upper extremities and the trunk as well as serohemorrhagic bullous lesions on the feet. The laboratory results revealed WBC count of 20.6 × 10/mm (76.9% neutrophils), CRP (c-reactive protein) of 33 mg/L and erythrocyte sedimentation of 110/h. The patient was referred to a dermatologist with prediagnosis of SS due to the presence of typical painful skin lesions, high fever and neutrophilic leukocytosis. A systemic corticosteroid therapy was initiated. The diagnosis for SS was confirmed after the skin biopsy revealed the presence of dense dermal infiltrate of neutrophils and leukocytoclasis in the upper dermis. The patient responded rapidly to corticosteroids and the skin lesions improved.

Conclusion: We reported this case as it was a rare life-threatening dermatosis diagnosed in the emergency department, which is generally difficult to diagnose therein, and the skin lesions appeared on the lower extremities.
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http://dx.doi.org/10.1016/j.ajem.2019.06.012DOI Listing
September 2019

Morgagni Hernia: Is It Just a Congenital Hernia or a Cause of Emergency Surgery?

Am Surg 2016 Nov;82(11):317-319

Ege University School of Medicine, General Surgery Department, Izmir, Turkey.

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November 2016

Unexpected Benefit of the Positron Emission Tomography/Computed Tomography Using F-Fluorodeoxyglucose: Report of a Case.

Indian J Surg 2016 Oct 6;78(5):348-350. Epub 2016 Apr 6.

Department of General Surgery, Division of Proctology, Ege University School of Medicine, 35100 Bornova, Izmir, Turkey.

The positron emission tomography/computed tomography (PET/CT) has been a new tool utilized in the diagnosis and staging of various cancers. However, common worldwide utilization of the PET/CT includes some economic, legal, and ethic controversies. Although PET/CT scanning can detect colorectal premalignant lesions in an early treatable stage, most governments' health care system does not pay for it as a screening test because of its economic burden. Thus, people are forced to make vital decisions about their health because of health policies of their governments. Here, we present an unusual case and discuss the utilization of PET/CT for detection of incidental neoplasms.
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http://dx.doi.org/10.1007/s12262-016-1477-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5127980PMC
October 2016

A rare cause of colonic obstruction "colonic intussusception": report of two cases.

Case Rep Surg 2015 10;2015:465374. Epub 2015 Mar 10.

Department of General Surgery, Ege University Faculty of Medicine, Izmir, Turkey.

Colocolic intussusceptions are rare clinical entities in adults and almost always caused by a leading lesion which often warrants resection. Mostly being malignant, the leading lesions are rarely benign lesions where intraluminal lipomas are the most frequent among them. Most adult intussusceptions require surgical resection owing to two major reasons: common presence of a leading lesion and significantly high risk of malignancy-reaching as high as 65% regardless of the anatomic site-of the leading lesion. Resection of the affected segment is usually the treatment of choice, since preoperative diagnosis of the lesion is usually ineffective and most leading lesions are malignant. This paper represents two cases of adult colocolic intussusception caused by intraluminal lipomas with a brief review of the literature.
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http://dx.doi.org/10.1155/2015/465374DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4377455PMC
April 2015

Our 'ligation of intersphincteric fistula tract' experience for complex anorectal fistulas: is it a preferable method?

Am Surg 2014 Nov;80(11):E307-8

Department of General Surgery, Ege University, School of Medicine, Izmir, Turkey.

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November 2014

Recurrent pilonidal sinus: lay open or flap closure, does it differ?

Int Surg 2013 Oct-Dec;98(4):319-23

Ege University Faculty of Medicine, General Surgery Department, Izmir, Turkiye.

Treatment options of pilonidal sinus, which has high recurrence rates, is still controversial. In this study, we aimed to analyze for possible factors affecting recurrence. Forty-one patients with recurrent pilonidal sinus were included in this study. Of them, 33 were male and 9 were female (mean age, 24.9 years; age range, 16-42). Factors (i.e., risk factors) were detected in 32 patients. Excision-secondary healing and lay open was performed on 30 of the patients admitted with recurrence. Excision and flap closure was applied on 11 patients. Our recurrence rate was 9.7%. The recurrence rate of our study is compatible with the literature. Comparative studies are needed to determine the appropriate method to decrease recurrence rate.
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http://dx.doi.org/10.9738/INTSURG-D-13-00081.1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3829057PMC
February 2015

Spontaneous intestinal intramural hematoma: What to do and not to do.

Ulus Cerrahi Derg 2013 1;29(2):72-5. Epub 2013 Jun 1.

Department of General Surgery, Ege University Faculty of Medicine, İzmir, Turkey.

Objective: Spontaneous intestinal intramural hematoma is a rare complication of anticoagulant treatment. In this study, we retrospectively evaluated 14 patients with the diagnosis of intramural hematoma of the small intestine who were followed-up and treated in our clinic, and we aimed to determine current approaches in the diagnosis and treatment of intramural hematoma.

Material And Methods: Between February 2010-October 2012, 14 patients diagnosed with small intestinal intramural hematoma were retrospectively analyzed. Nine patients were followed due to clinical findings and 5 patients underwent operation with a histopathological diagnosis of intramural hematoma.

Results: Abdominal computed tomography demonstrated ileal and jejunal wall thickening in 10 patients, while findings were consistent with mesenteric vascular disease in four. Five patients were operated due to mechanical bowel obstruction and acute abdomen. The other 9 patients were followed up with medical treatment and 8 of these patients were already using warfarin due to cardiac bypass and valve replacement.

Conclusion: Spontaneous intestinal intramural hematoma is a rare cause of small bowel obstruction due to intramural hematoma, which is encountered even more rarely. An intramural hematoma should be considered among differential diagnosis of patients who present with abdominal pain and symptoms of obstruction with a history of anticoagulant drug use and elevated International Normalized Ratio (INR) levels. Early diagnosis and medical follow-up can provide a good response to treatment in the majority of patients without requiring surgery.
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http://dx.doi.org/10.5152/UCD.2013.41DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4379831PMC
May 2015

Complicated Meckel's diverticulum and therapeutic management.

Ulus Cerrahi Derg 2013 1;29(2):63-6. Epub 2013 Jun 1.

Department of General Surgery, Ege University Faculty of Medicine, İzmir, Turkey.

Objective: This study aimed to investigate the treatment options and compare patient management with the literature for patients operated on for an acute abdomen who had complications due to inflammation of the Meckel's diverticulum at our clinics.

Material And Methods: This study retrospectively evaluated 14 patients who had been operated on for acute abdomen and had been diagnosed with Meckel's diverticulitis (MD) in Ege University Medical Faculty Department of General Surgery, between October 2007 and October 2012.

Results: Fourteen patients with a diagnosis of Meckel's diverticulitis (MD) were retrospectively analyzed. Radiologically, the abdominal computer tomography showed pathologies compatible with mechanical intestinal obstruction, Meckel's diverticulitis and peridiverticular abscess, as well as detection of free air within the abdomen on direct abdominal X-ray. Among patients diagnosed with complicated Meckel's diverticuli (obstruction, diverticulitis, perforation) 10 patients had partial small bowel resection and end-to-end anastomosis (71.5%), three patients underwent diverticulum excision (21.4%), and one patient underwent right hemicolectomy+ileotransversostomy (7.1%).

Conclusion: Meckel's diverticulum is a vestigial remnant of an omphalomesenteric channel in the small bowel. It is a real congenital diverticular abnormality that contains all three layers of the small bowel. Surgical excision should be performed if Meckel's diverticulum is detected in order to avoid incidental complications such as ulceration, bleeding, bowel obstruction, diverticulitis or perforation. Meckel's diverticulitis does not have specific clinical and radiological findings. Delayed diagnosis can lead to lethal septic complications. Complications associated with Meckel's diverticulitis, especially if a definite diagnosis is not made during the preoperative period, should be considered in the differential diagnosis. In the presence of a complicated diverticulum the appropriate treatment should be emergent surgical intervention.
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http://dx.doi.org/10.5152/UCD.2013.36DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4379835PMC
May 2015

Mesenteric fibromatosis of the ileocolic area: a case report.

Indian J Surg 2011 Apr 16;73(2):149-51. Epub 2010 Nov 16.

Ege University, Izmir, Turkey.

Fibromatosis is a kind of spindle cell tumor which is characterized by the remarkable proliferation and invasive growth of fibrous tissue. It often arises from the abdominal wall or the extremities and rarely from the mesentery and abdominal organs. The patient was 35 year old female whose major complaints were an abdominal mass and pain. She underwent a right hemicolectomy after the tumor was confirmed by abdominal ultrasonography and computerized tomography. Hereby the pathophysiology, diagnosis and the treatment of the disease is discussed.
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http://dx.doi.org/10.1007/s12262-010-0202-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3077151PMC
April 2011

Foreign bodies in the rectum: an analysis of 30 patients.

Surg Today 2011 Jun 28;41(6):795-800. Epub 2011 May 28.

Division of Proctology, Department of General Surgery, Ege University School of Medicine, 35100, Bornova, Izmir, Turkey.

Purpose: A foreign body in the rectum is a rare clinical entity. These foreign bodies can be classified under two major groups: the ones that are inserted from the anus and the ones that are swallowed and thereafter become stuck in the rectum.

Methods: Data of patients admitted with a foreign body in the rectum between 1988 and 2008 were retrospectively analyzed. A total of 30 patients were reviewed.

Results: The most common reason for a foreign body in the rectum was insertion for erotic purposes, which was seen in 19 of the 30 patients. All these patients were male. The remaining 11 patients reported nonerotic causes. The most efficient and implemented therapeutic method was simple extraction during the first examination.

Conclusions: The most common reason for a foreign body in the rectum is insertion for erotic purposes. The first target of therapy should be extraction of the foreign body using the simplest method possible. Meanwhile, protecting the integrity of the intestine is of the utmost importance. The care for maintaining the integrity of the rectum should include an evaluation of the patient's psychological status.
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http://dx.doi.org/10.1007/s00595-009-4362-5DOI Listing
June 2011

Negative prognostic factors in colorectal carcinoma: An analysis of 448 patients.

Indian J Surg 2010 Jun 26;72(3):243-8. Epub 2010 Aug 26.

Department of General Surgery/Division of Proctology, School of Medicine, Ege University, Turkey Izmir.

Background And Aims: Colorectal carcinoma (CRC) is the most frequent malignancy of the gastrointestinal tract. Prognostic researches are carried out for choosing the optimum therapy, evaluating therapy results and comparing multicentre results for better qualification in the therapy of the disease.

Patients And Methods: In this study, 448 patients, whose surgery and follow-up was performed by the same correspondent surgeon between the years 1995 and 2003, were retrospectively analyzed.

Results: Age, presence of comorbidity, weight loss, emergency admission, high serum CEA and CA 19-9 levels, neighboring organ invasion, operation type, major morbidity, tumor size and type, lymph node metastases, venous and perineural invasion, Dukes' classification and local recurrence and distant metastasis during follow-up are found to be significant negative factors affecting prognosis of the CRC patient.

Conclusion: Therapy results of the CRC are evaluated by survival times regardless of the therapy method selected for each individual. In our study we tried to find out negative prognostic factors by researching possible factors affecting disease free survival time for CRC. Since our understanding of factors that have an impact on prognosis increases, we are hoping to improve survival.
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http://dx.doi.org/10.1007/s12262-010-0052-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3452660PMC
June 2010

A new extraction technique for rectal foreign bodies with a rubber band ligation device.

Surg Today 2010 Jun 23;40(6):583-5. Epub 2010 May 23.

Division of Proctology, Department of General Surgery, Ege University School of Medicine, 35100, Bornova, Izmir, Turkey.

Foreign bodies in the rectum are a rare clinical condition that should be noted. The most frequently encountered cause is erotic activity. The first goal of the therapy is extraction of the foreign body using the simplest method possible while protecting the integrity of the intestine. Many instruments and methods have been suggested for this purpose. This report discusses a new management strategy for these patients along with a review of the literature.
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http://dx.doi.org/10.1007/s00595-009-4095-5DOI Listing
June 2010

Rectosigmoid endometriosis.

Turk J Gastroenterol 2008 Dec;19(4):294-6

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December 2008

Dieulafoy's lesion of the anal canal: report of a case.

Turk J Gastroenterol 2007 Dec;18(4):265-7

Department of General Surgery, Ege University, Faculty of Medicine, Izmir, Turkey.

Background/aims: Dieulafoy's lesion of the anal canal is a very rare clinical case. Although it was first described in the stomach, there has been an increasing frequency, especially in the last decade, of reports of the lesion in the colorectal region.

Methods: Herein, we report one case presenting with massive hematochezia requiring multiple blood transfusions due to a Dieulafoy's lesion in the anal canal. To our knowledge, this is the fourth case in Medline. Surgical oversewing was attempted twice but rebleeding occurred, and local excision through the anal canal was performed.

Results: The patient was treated successfully with mucosectomy including the lesion.

Conclusions: Sclerotherapy, alcohol and epinephrine injection, thermocoagulation and selective arterial embolization are the options of therapeutic endoscopy and interventional radiology. As for surgical management, oversewing is an alternative technique. However, in our opinion, because of the recurrent and life-threatening manner of this arterial bleeding pattern, local excision, if possible, is the most reliable management of the disease.
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December 2007
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