DSpace Arşivi :: by Yazar "Dirican, A." değerine göre listeleniyor

Yazar "Dirican, A." seçeneğine göre listele

Listeleniyor 1 - 20 / 21

Aborted donor hepatectomy in living donor liver transplantation: lessons learned
(Sa Medical Assoc, 2020) Kutluturk, K.; Akbulut, S.; Baskiran, A.; Gonultas, F.; Dirican, A.; Isik, B.; Yilmaz, S.
Background: Aborted donor hepatectomy (ADH) during any stage of living donor hepatectomy (LDH) is a rare event. We describe our experience and discuss the lessons from these events. Methods: From September 2005 to January 2019, 77 of 2 031 (3.79%) LDH were aborted at various stages of surgical procedure due to donor or recipient related reasons. Demographic and clinical data of aborted donor candidates and the clinical course of their potential recipients were analysed. Results: LDH of 77 donor candidates was aborted due to donor (n = 53) or recipient (n = 24) related reasons. The most common donor related reason was the quality of liver parenchyma (n = 31). The most common recipient related reason was haemodynamic instability (n = 11). Twenty-three recipients underwent either living donor liver transplantation (LDLT) (n = 21) or deceased donor liver transplantation (DDLT) (n = 2) at a median of 6 days following ADH. In one aborted due to a donor reason and two aborted for recipient reasons, LDLT was performed using the same donor candidates. Thirty-six recipients had no liver transplantation (LT) and died a median of 17.5 days following ADH. Conclusions: We believe that ADH will decrease with experience and meticulous preoperative clinical and radiological evaluations. Abandoning the donor hepatectomy is always a valid option at any stage of the surgery when the unexpected is encountered.
The Alvarado Score is accurate in pregnancy: a retrospective case-control study
(Springer Heidelberg, 2019) Tatli, F.; Yucel, Y.; Gozeneli, O.; Dirican, A.; Uzunkoy, A.; Yalcin, H. C.; Ozgonul, A.
BackgroundAcute appendicitis is the most frequent abdominal condition that requires non-obstetric surgical intervention during pregnancy. This study aims to scan pregnant patients operated on for acute appendicitis to evaluate the efficiency of using the Alvarado Score (AS) for diagnosis.MethodsOur study included 48 pregnant patients who were pre-diagnosed with acute appendicitis and operated on at our department of general surgery from January 2010 to July 2016 and whose files were accessed. Fifty-three non-pregnant female patients of reproductive age who were operated on for appendicitis during the same period were included in the study as the control group. The patients in both groups were divided into two groups based on their AS total score being 7 and 7.ResultsThe mean age of the 48 pregnant patients was 28 (19-42) years, while the mean age of the 53 control patients was 31 (18-45) years. Among pregnant and non-pregnant women, about a third of patients had an AS<7 (16 of 48 versus 18 of 53). There was no significant difference when the AS scores of both groups were compared (p=0.947). Using pathology results as reference test, the sensitivity and specificity of the AS in pregnant women was 79 and 80%.ConclusionsAs a result, when the data collected by our study are evaluated, we see that pregnancy does not have a negative effect on the efficacy of AS. Therefore, the AS system can be an easy, non-invasive auxiliary diagnostic tool with high diagnosis accuracy rates that can be used in pregnant patients suspected of having acute appendicitis.
Donor Complications Among 500 Living Donor Liver Transplantations at a Single Center
(Elsevier Science Inc, 2012) Ozgor, D.; Dirican, A.; Ates, M.; Gonultas, F.; Ara, C.; Yilmaz, S.
Introduction. Living donor liver transplantation (LDLT) has become necessary because of the shortage of cadaveric organs. We retrospectively analyzed 500 living donor hepatectomies using the Clavien classification system for complications to grade their severity. Materials and methods. We retrospectively identified and applied the Clavien clasification to 500 consecutive donors who underwent right for LDLT left hepatectomy between January 2007 and August 2011. Results. The 149 complications were observed in 93 of 500 (18.6%) donors who were followed for a mean 30 months. There wan no donor mortality. Complications developed in 85 (18.6%) right 5 (35.7%) left, and 3 (10%) left lateral segment hepatectomy donors. The overall incidence of reoperations was 7.2%. Seventy-seven of 149 complications were grade I (51.6%) or 9 grade II (6%). The major complications consisted of 27 (18.1%) grade IIIa, 35 (23.4%) grade IIIb, and 1 (0.6%) grade IVa. Grade IVb and grade V complications did not occur. The most common problems were biliary complications in 14 of 181 donors (7.7%). Conclusion. Donors for LDLT experienced a range of complications.
Evaluation of Potential Donors in Living Donor Liver Transplantation
(Elsevier Science Inc, 2015) Dirican, A.; Baskiran, A.; Dogan, M.; Ates, M.; Soyer, V.; Sarici, B.; Ozdemir, F.
Introduction. Correct donor selection in living donor liver transplantation (LDLT) is essential not only to decrease the risks of complications for the donors but also to increase the survival of both the graft and the recipient. Knowing their most frequent reasons of donor elimination is so important for transplantation centers to gain time. In this study we evaluated the effectiveness of potential donors in LDLT and studied the reasons for nonmaturation of potential liver donors at our transplantation center. Patients and Methods. We studied the outcomes of 342 potential living donor candidates for 161 recipient candidates for liver transplantation between January 2013 and June 2014. Donor candidates' gender, age, body mass index (BMI), relationship with recipient, and causes of exclusion were recorded. Results. Among 161 recipients, 96 had a LDLT and 7 had cadaveric liver transplantation. Twelve of the 342 potential donors did not complete their evaluation; 106 of the remaining 330 donor candidates were accepted as suitable for donation (32%) but 10 of these were excluded preoperatively. The main reasons for unsuitability for liver donation were small remnant liver size (43%) and fatty changes of the liver (38.4%). Other reasons were arterial anatomic variations, ABO incompatibility, and Gilbert syndrome. Only 96 of the candidates (29% of the 330 candidates who completed the evaluation) underwent donation. Effective donors were 29% of potential and 90.5% of suitable donors. Conclusions. In our center, 106 of 330 (32%) donor candidates were suitable for donation and the main reasons for unsuitability for liver donation were small remnant liver size and fatty changes of the liver.
Evaluation of Potential Donors in Living Donor Liver Transplantation (vol 47, pg 1315, 2015)
(Elsevier Science Inc, 2015) Dirican, A.; Baskiran, A.; Dogan, M.; Ates, M.; Soyer, V.; Sarici, B.; Ozdemir, F.
[Abstract Not Available]
The factors affecting development of low anterior resection syndrome (LARS) in patients undergoing sphincter preserving surgery for rectal cancer
(Athens Medical Soc, 2020) Simsek, A.; Bayraktar, H.; Dirican, A.; Ozgor, D.; Ates, M.
OBJECTIVE To investigate the incidence of major low anterior resection syndrome (LARS), using the LARS score, in patients who underwent sphincter-preserving surgery for rectal cancer, and to explore the factors affecting major LARS development. METHOD The medical records were retrospectively reviewed of patients, who were operated for rectal cancer at a tertiary center between January 2009 and October 2017. The inclusion criteria were: The absence of other colorectal or proctologic diseases, the application of anterior resection (high anterior resection, low anterior resection, extremely low anterior resection), follow-up of more than one year after the primary surgery, and follow-up of more than one year after protective ileostomy closure, and the absence of an unreversed stoma, ongoing treatment with chemotherapy or radiotherapy, recurrence, and metastatic disease. LARS was diagnosed using the LARS score developed by Emmertsen and Laurberg. RESULTS For the study period, 81 patients met the inclusion criteria, including 45 (55.5%) men and 36 (44.4%) women, with a mean age of 60.1 years. Of the 81 patients, 56 (69.1%) underwent chemotherapy and 43 (53%) underwent radiotherapy. Major LARS was detected in 29.6% of the patients. Univariate analysis revealed that radiotherapy, lower tumor location and a short interval after ileostomy closure had an effect on LARS development, and multivariate analysis indicated that incidence of LARS was higher in middle and lower rectal cancer. CONCLUSIONS There appears to be no harm in creating a protective ileostomy for LARS development, with regard to anastomosis safety and the planning of the adjuvant therapy. Neither radiotherapy, nor type of surgery had an effect on major LARS. As was expected, a high rate of major LARS was reported in lower rectal tumors.
First laparoscopic totally extraperitoneal repair of Laugier's hernia: a case report
(Springer, 2013) Ates, M.; Dirican, A.; Kose, E.; Isik, B.; Yilmaz, S.
An atypical femoral hernia developing through the lacunar ligament is called Laugier's hernia. Preoperative diagnosis of these atypical hernias is very difficult because of their rarity and similar clinical appearance to conventional femoral hernias. A 52-year-old female presented with right groin swelling. During laparoscopic totally extraperitoneal (TEP) inguinal hernia repair, a hernia sac through an opening in the lacunar ligament was diagnosed and repaired with mesh covering the inguinal floor. The surgeon should be alert to the possibility of an atypical femoral hernia when examining patients with inguinal hernias. A laparoscopic approach should be chosen instead of a conventional approach for the treatment of femoral hernias because of its high diagnostic and therapeutic capacity for all types of femoral hernia, including Laugier's.
Incidental Appendectomy in Donors Undergoing Hepatectomy for Living-Donor Liver Transplantation
(Elsevier Science Inc, 2012) Yilmaz, M.; Olmez, A.; Piskin, T.; Unal, B.; Ersan, V.; Sarici, K. B.; Dirican, A.
Background. The aim of this study was to investigate the morbidity associated with appendectomy in living liver donors undergoing hepatectomy. Methods. The medical records of 338 donors who underwent hepatectomies for living-donor liver transplantation between 2008 and 2010 were reviewed retrospectively. The patients were divided into 2 groups on the basis of appendectomy: patients in group A (n = 126) received incidental appendectomies in conjunction with donor hepatectomy, and those in group B (n = 212) underwent hepatectomy alone. Results. No significant difference in age, gender, or body mass index was found between groups. The wound infection rate (P = .037) and length of hospital stay (P = .0038) were higher in group A than in group B. Intraoperative findings in 126 donors in group A were subserosal (n = 4), retrocecal (n = 6), or hard nodular (n = 11) appendix; hyperemic appendix with edema (n = 9); appendix length >= 8 cm (n = 18); and palpable fecalith (n = 78). Histopathologic examination of appendix specimens revealed lymphoid hyperplasia with a fecalith (n = 32), fecalith only (n = 32), acute appendicitis (n = 20), normal anatomy (n = 18), fibrous obliteration (n = 9), lymphoid hyperplasia (n = 9), Enterobius vermicularis (n = 3),appendiceal neuroma (n 1), carcinoid tumor (n = 1), and mucoceles (n = 1). Conclusion. Although incidental appendectomy increased the wound infection rate and length of hospital stay, this procedure is necessary for the prevention of potential complications due to appendicitis when the exploration of the ileocecal region in patients undergoing donor hepatectomy reveals one or more of the following: appendix length >= 8 cm; dropsical, hyperemic, subserosal, nodular, and/or retrocecal appendix; and/or palpable fecaloma.
Liver Transplantation With Livers From Octogenarians and a Nonagenarian
(Elsevier Science Inc, 2015) Dirican, A.; Soyer, V.; Koc, S.; Yagci, M. A.; Sarici, B.; Onur, A.; Unal, B.
Introduction. A shortage of deceased donors has compelled the use of extended-criteria donor organs in liver transplantation. The purpose of this study was to evaluate the impact of using deceased donors older than 80 years. Materials and Methods. We retrospectively evaluated 13 patients who received a liver graft from cadaveric donors older than 80 years between December 2007 and March 2014. We analyzed the donor and their recipient characteristics together with morbidity and mortality of recipients. Results. All 13 donors were older than 80 years (median age, 82.7; range, 80-93). There were 9 male and 4 female recipients with an average age of 50.7 (range, 2-65) years. All of the recipients did not have a living donor for liver transplantation. Recipients' mean model for end-stage liver disease (MELD) score was 14.2 (range, 7-20). Graft with macroscopic steatosis was not accepted. Medium follow-up was 19.5 months. The most frequent cause for liver transplantation (LT) was hepatitis B virus (HBV) cirrhosis (8/13 patients). We had 1 case of primary nonfunction, and 4 patients died in 2 weeks after surgery. Of these patients, 2 of them received a split transplant from an 80-year-old cadaver liver. Overall the survival rate after 1 year was 61.5%. Conclusions. Deceased elderly donor usage in LT could expand the donor pool. Liver grafts from donors older than 80 years can be used in necessity or emergency situations. However, care should be taken to avoid early mortality and primary nonfunction. Procedures extending cold ischemia time such as split liver transplantation may increase the risk of primary nonfunction.
Living Donor Liver Transplantation for Mushroom Intoxication Caused Acute Liver Failure
(Lippincott Williams & Wilkins, 2017) Dirican, A.; Yilmaz, M.; Baskiran, A.; Ozgor, D.; Ates, M.; Koc, S.; Ince, V
[Abstract Not Available]
Living Donor Re-transplantation for Repeated Acute Liver Failure
(Avicenna Organ Transplant Center, 2018) Ince, V.; Kayaalp, C.; Otan, E.; Ozdemir, F.; Dirican, A.; Toprak, H. I.; Aydin, C.
Emergency liver transplantation (LT) for acute liver failure (ALF) is a life-saving treatment. Occurrence of this situation in the same patient twice is very rare. Herein, we describe a patient who underwent two emergency LTs for ALF, both from living donors. When she was 26 years old, she underwent a right lobe living donor LT (LDLT) from her sister for ALF due to use of herbal weight loss medications. The next 3 years were uneventful but another ALF developed during a terminal stage pregnancy (37th week). Despite medical treatment, her liver functions worsened, and the baby was delivered by caesarean section. The second time, her brother was the donor and she recovered after the emergency right lobe re-LDLT. Both patient and baby were well at the 2-month follow-up. As far as we know, there is no reported similar case, and we concluded that LDLT is a paramount treatment option for both primary and secondary ALFs.
Outcomes of Left-Lobe Donor Hepatectomy for Living-Donor Liver Transplantation: A Single-Center Experience
(Elsevier Science Inc, 2013) Usta, S.; Ates, M.; Dirican, A.; Isik, B.; Yilmaz, S.
Living-donor liver transplantation (LDLT) is an excellent option for patients with end-stage liver disease in situations of donor shortage. The aims of this study were to evaluate our experience with left-lobe donor hepatectomy for LDLT and to grade postoperative complications using the 5-tier Clavien classification system. Data from medical records of 60 adult living liver donors (30 men, 30 women) who underwent left-lobe hepatectomy between November 2006 and April 2012 were reviewed. The median donor age was 31.7 +/- 8.9 (range, 19-63) years. Sixteen complications were observed in 12/60 (20%) donors. Complications developed in 6/15 (40%) donors who underwent left hepatectomy and in 6/45 (13.3%) donors who underwent left lateral segmentectomy. Seven of 16 (43.7%) complications were Grade I and 2 (12.5%) were Grade II. Major complications consisted of 4 (25%) Grade IIIa and 3 (18.7%) Grade IIIb complications; no Grade IVb or V complications occurred. The most common complication was biliary, occurring in 7 (11.6%) donors and comprising 43.7% of all 16 complications. The mean duration of follow-up was 30 +/- 7.1 (range, 2-58) months. No donor mortality occurred. Left-lobe donor hepatectomy for LDLT, which does not benefit the completely healthy donor, was performed safely and with low complication rates, but carries the risk of morbidity. Low morbidity rates following living-donor hepatectomy can be expected when surgical and clinical monitoring and follow-up are adequate and the surgeon has gained increased experience.
Potentially life-threatening complication for living liver donors: Near-Miss Events
(Lippincott Williams & Wilkins, 2018) Onur, A.; Akbulut, S.; Dirican, A.; Yilmaz, S.
[Abstract Not Available]
The predictors of mortality in patients with anogenital necrotizing fasciitis (Fournier's gangrene)
(Athens Medical Soc, 2020) Simsek, A.; Dirican, A.; Gecit, I
OBJECTIVE To evaluate the predictors of mortality in the Fournier's gangrene form of necrotizing fasciitis (NF). METHOD The medical records of patients with anogenital NF who were treated in a tertiary care hospital between January 2010 and December 2018 were reviewed, retrospectively. RESULTS This study included 86 patients, 76 males and 10 females. Perianal abscess (30.2%) was the leading precipitating event causing NF. The scrotum and perineum were the most commonly affected sites, 73.2% and 40.7%, respectively. NF extended beyond the urogenital and or anorectal triangle in 30.2% of cases. Escherichia coli (E. coli) was the most common microorganism isolated in tissue cultures (55.3%), and Klebsiella pneumoniae the second most common (15.3%). Admission to the intensive care unit (ICU) was required for 50 patients (58.1%), and the mortality rate was 23.3%. Older age (>60 years), smoking, and extension of the infection beyond the urogenital and or anorectal triangle were all significantly associated with mortality. CONCLUSIONS Age >60 years, smoking, and extension of the infection beyond urogenital and or anorectal triangle were significantly related with mortality in anogenital NF. Prompt diagnosis and timely intervention are essential to prevent spread of the infection.
Pulmonary Complications After 1150 Living Donor Hepatectomies
(Elsevier Science Inc, 2015) Ates, M.; Kinaci, E.; Dirican, A.; Sarici, B.; Soyer, V.; Koc, S.; Yilmaz, S.
Aim. Donor safety is the major concern in living-donor liver transplantation. Studies in literature related to donor hepatectomy (DH) have generally considered intra-abdominal complications. The aim of this study is to specifically evaluate pulmonary complications (PCs) after DH. Materials and Methods. We evaluated retrospectively 1150 living donors who underwent to DH between January 2007 and July 2014. Patients with PCs, such as pneumonia, pleural effusion, pneumothorax, and respiratory insufficiency, were considered. A complication was considered only when it was clinically apparent and/or requiring interventions. Any special diagnostic tool was used to expose the clinically silent pathologies. Results. A total of 986 right hepatectomies (RH) and 164 left hepatectomies (LH) (left lobectomy or left lateral segmentectomy) were performed in the study interval. There were 18 (1.6%) donors with PCs (15 males and 3 females). Mean age was 33.8 +/- 9.3 years (18-51). Mean hospital stay was 23.8 +/- 13.5 days (5-62). Presented PCs were pleural effusion (n = 5, 0.4%), pneumonia (n = 4, 0.3%), combinations (n = 2, 0.2%), pneumothorax (n = 2, 0.2%), and acute respiratory insufficiency (n = 5, 0.4%). Sixteen cases (1.7%) were seen after RH, whereas 2 cases (1.2%) were seen after LH (P = 1.000). Conclusion. The most common PCs after living donor hepatectomy were pleural effusion and acute respiratory insufficiency. There was no significant difference between RH and LH. It is possible to overcome those PCs with careful monitoring and timely and appropriate treatment.
Right Lobe Living Donor Liver Transplantation for Adult Patients with Acute Liver Failure: A Single-Center Experience in Turkey
(Lippincott Williams & Wilkins, 2012) Ates, M.; Dirican, A.; Hatipoglu, S.; Ince, V; Isik, B.; Yilmaz, M.; Cemallettin, A.
[Abstract Not Available]
Right-Lobe Living-Donor Liver Transplantation in Adult Patients With Acute Liver Failure
(Elsevier Science Inc, 2013) Ates, M.; Hatipoglu, S.; Dirican, A.; Isik, B.; Ince, V.; Yilmaz, M.; Aydin, C.
Background. Right-lobe living-donor liver transplantation (RLDLT) is an excellent option to reduce donor shortages for adult patients with acute liver failure (ALF). The aim of this study was to evaluate the etiologies and outcomes of 30 consecutive adult patients who underwent emergency RLDLT for ALP. Methods. Between January 2007 and September 2011, we examined data from medical records of patients with ALF who underwent RLDLT. Results. Their mean age was 32.2 +/- 13.05 years. The etiologies of ALP were acute hepatitis B (n = 11; 36.6%), hepatitis A (n = 4; 13.3%), drug intoxication (n = 4; 13.3%), pregnancy (n = 2; 6.7%), hepatitis B with pregnancy (n = 1; 3.3%), mushroom intoxication (n = 1; 3.3%), and unknown (n = 7; 23.3%). The mean hepatic coma grade (Model for End-Stage Liver Disease score) was 34.13 +/- 8.72. The 43 (48.7%) postoperative complications were minor (grades I-II) and 44 (51.3%) were major (grades III-V). Reoperation was required in 14 of 30 (47%) recipients (grades IIIb-IVa). Deaths occurred owing to pulmonary (n = 2), cardiac (n = 1), septic (n = 2), or encephalopathic (n = 4) complications. The mean durations of intensive care unit stay and postoperative hospitalization were 3.2 +/- 2.3 and 29.5 +/- 23 days, respectively. The survival rate was 70%. The mean follow-up duration was 305 days (range, 1-1582). Conclusion. Liver transplantation is potentially the only curative modality, markedly improving the prognosis of patients with ALP. The interval between ALF onset and death is short and crucial because of the rapid, progressive multiorgan failure. Thus, RLDLT should be considered to be a life-saving procedure for adult patients with ALF, requiring quicker access to a deceased-donor liver graft and a short ischemia time.
Significance and Outcome of Living-donor Liver Transplantation in Acute Mushroom Intoxication
(Wolters Kluwer Medknow Publications, 2018) Baskiran, A.; Dirican, A.; Ozgor, D.; Kement, M.; Koc, S.; Sahin, T. T.; Ates, M.
Introduction: Mushroom intoxication ( MT) can lead to acute liver injury which may result in Mushroom intoxication-related liver failure ( M-ALF) requiring liver transplantation ( LT). In the present study, we want to share the experience of our institute regarding living-donor LT ( LDLT) due to mushroom poisoning. Aim: The aim of this study is to identify the predictors of poor prognosis in patients with ALF secondary to mushroom intoxication requiring LDLT. Materials and Methods: All patients with MT between 2008 and 2016 were evaluated. Demographics, symptoms, interval between symptoms and admission to our institute, laboratory data, model for end-stage liver disease ( MELD)/ pediatric end-stage liver disease ( PELD) scores, clinical course, and outcomes of supportive therapy and LT were evaluated. There were two groups in the study: Group A = responsive to supportive therapy ( n = 9) versus Group B = unresponsive to supportive therapy ( n = 9). Results: During the study, a total of 18 patients were admitted with M-ALF. Twelve ( 66.7%) of them were female, and the mean age was 39.9 +/- 18.2 years. All of the nine patients in Group A fully recovered with supportive therapy. In Group B, one patient died during waiting period for LT and 8 patients received LDLT LDLT. Three of the eight patients who were transplanted died in the postoperative early period within postoperative 5 days. The patients in Group B had significantly higher MELD/ PELD scores and encephalopathy rate than in Group A ( P < 0.05). International normalized ratio ( INR), bilirubin, ammonium levels, and platelet count were significantly different between groups ( P < 0.05). The patients in Group B had significantly longer interval before admission to our institute ( P < 0.05). Conclusion: The presence of encephalopathy, higher MELD/ PELD, INR, bilirubin, ammonium levels, and lower platelet count was related to poor prognosis in MT. LDLT provides a good therapeutic option in patients with M-ALF. The time is a crucial factor in successful treatment of MT. Early admission to a tertiary referral center with expertise in LT results in a better prognosis and increased survival following M-ALF.
The simple suture laparoscopic repair of peptic ulcer perforation without an omental patch
(Springer, 2012) Ates, M.; Dirican, A.
[Abstract Not Available]
Surgical treatment of phytobezoars causes acute small intestinal obstruction
(Comenius Univ, 2009) Dirican, A.; Unal, B.; Tatli, F.; Sofotli, I; Ozgor, D.; Piskin, T.; Kayaalp, C.
Purpose: Our aim was to perform a clinical analysis of small intestinal obstructions caused by surgically treated phytobezoars. Methods: Twenty-four patients, with small intestinal obstructions caused by phytobezoars, underwent surgery in our department between 1998 to 2008, were reviewed retrospectively. Results: Twenty (83.3 %) of 24 patients had previous gastric surgery. Preoperative computed tomography (CT) was performed in nine patients and seven (77.8 %) patients, showed results consistent with a bezoar and subsequently, underwent surgery on the same day. The remaining patients had no preoperative diagnosis of a phytobezoar were typically followed-up for postoperative adhesion intestinal obstruction. Only those patients who showed no response to nonoperative treatment options underwent surgery. The phytobezoar was fragmented and milked into the cecum in 11 (45.8 %) patients or extracted via longitudinal enterotomy in 12 (50 %) patients; the remaining patient (4.2 %) was treated via laparoscopy. Three patients had gastric phytobezoars, which were extracted via gastrotomy. There was no postoperative mortality. Two patients with previous enterotomy had either postoperative wound infection or wound infection and evisceration. Conclusions: Phytobezoars should be considered in the differential diagnosis of acute small yntestinal obstruction in patients with prior gastric surgery, poor dentition, or consume fiber-rich foods. Abdominal CT is useful for both diagnosis and for the decision to perform emergency surgery. When possible, the phytobezoar should be fragmented and milked into the cecum. Laparoscopic fragmentation may be useful in such cases (Tab. 3, Ref. 28). Full Text (Free, PDF) www.bmj.sk.

Yazar "Dirican, A." seçeneğine göre listele

Sayfa Başına Sonuç

Sıralama seçenekleri