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Öğe Efficiency of alvarado score in diagnosis of acute appendicitis(Turgut Özal Tıp Merkezi Dergisi, 2016) Tatlı, Faik; Ekici, Uğur; Kanlıöz, Murat; Gözeneli, Orhan; Uzunköy, Ali; Yücel, Yusuf; Dirican, AbuzerAbstract Aim: Acute appendicitis is the most common cause of abdominal pain resulting in surgery. This study aims to investigate the efficiency of Alvarado Score (AS) in diagnosis of acute appendicitis. Materials and Method: The files of 185 patients operated due to acute appendicitis between January 2013 and February 2015 were retrospectively examined. The Alvarado Scores of the patients were calculated. The patients were divided into 2 groups as <7 and ?7 according to their Alvarado Scores and their pathology results were compared. Results: Of the185 patients included in the study, 44.8% (n: 83) were females and 55.2% (n: 102) were males. The average age was 27.12 (10-80) years. In terms of distribution, 63.8% (n: 118) of the patients had an Alvarado score of ?7 and 36.2% (n: 67) had a score of <7. In the study, 16.7% (n: 31) of the patients had normal pathology results and the pathology of 83.2% (n: 154) patients operated with the pre-diagnosis of acute appendicitis were acute appendicitis patients. We also obtained the following results: specificity of Alvarado score: 90.3%; sensitivity: 74.6%; positive predictive value: 97.4%; negative predictive value: 18.1%; and accuracy ratio: 77.2%. Conclusion: Alvarado Scoring is an affordable and effective method that is easy to use in the diagnosis of acute appendicitis. Keywords: Acute Appendicitis; Alvarado Score; Abdominal Pain.Öğe The importance of the structure of pylorus in the success of the gastric botulinum toxin injections(2020) Kanlıöz, Murat; Ekici, Uğur; Tatlı, Faik; Karataş, TurgayAbstract: Introduction: In clinical practices, our success rate proved lower in patients with hypotonic pylorus who underwent gastric botulinum toxin A (GBTA) injection. To analyze this methodologically, we researched how considering the pyloric structure contributes to the treatment success in GBTA injection. Materials and Methods: This study included 196 patients who underwent GBTA injection between 2017 and 2018. We measured their body mass indexes (BMI) before treatment (BT) and six months after treatment (AT). Upon no contraindications in the endoscopy, we applied GBTA 200 U to the patients. During the endoscopy, we named the pylori able to strain & relax spontaneously or by a stimulus and close firmly as normotonic pylorus (NP) and patients unable to close firmly and respond to the stimulus as hypotonic pylorus (HP). The patients were analyzed under three groups: G1, G2 and G3, which included patients with NP, HP and NP (+) HP, respectively. In independent group comparisons, we used the Mann-Whitney U test. Further, we made the dependent group comparisons using the Wilcoxon paired sample test. In all tests, a level of 0.05 was considered significant. Results: Of the patients, 63.8% (125) were female and 36.2% (71) were male. Their mean age was 32.27±9.2 years. 148 and 48 of the patients had NP and HP, respectively. The median BMIs of groups were as follows: 35.5 (27.4–48) kg/m2 BT and 32.55 (24–44.1) kg/m2 AT in G3 with -2.95 kg/m2 variation (p=0.048*), 35.7 (27.4–48) kg/m2 BT and 32.35 (24–42.8) kg/m2 AT in G1 with -3.35 kg/m2 variation (p=0.036*), 35.1 (29– 46.2) kg/m2 BT and 34.15 (27.9–44.1) kg/m2 AT in G2 with -0.95 kg/m2 variation (p=0.098). Conclusion: We recommend administering GBTA injection therapy especially to the patients with NP.Öğe Incarcerated recurrent Amyand’s hernia: a case report(Turgut Özal Tıp Merkezi Dergisi, 2016) Ekici, Uğur; Tatlı, Faik; Kanlıoz, MuratAbstract With this case report, we aimed to discuss clinical presentation and treatment of perforated appendicitis and scrotal abscess in the sac of the recurrent incacerated henia. On 18 May 2014, 49 years old, male, patient applied to the Malatya State Hospital emergency department with right scrotal swelling. The patient had right lower abdomen and right inguinal pain complaints having continued for ten days and increased fewer and vomiting in fecaloid form for the last 48 hours. There was also incarcerated inguinal hernia on the left side. With these findings, patient was emergently operated with the diagnosis of incarcerated inguinal hernia. When the hernia sac was opened, an inflamed and perforated appendix was observed inside. Although, rarely seen and preoperative diagnosis is difficult, in patients coming to the emergency department with high fever, incarcerated hernia, increased scrotal temperature and redness, Amyand’s hernia should be kept in mind. Keywords: Amyand Hernia; Acute Appendicitis; Inguinal Hernia.Öğe Is the appendix length/diameter ratio an early-indicator for the perforation in acute appendicitis?(2018) Ekici, Uğur; Tatli, Faik; Kanlioz, MuratAim: Acute appendicitis is the most frequent reason for the stomachaches resulting in the surgery. The acute appendicitis perforation might create complications that are of vital importance. In this study, it is aimed to examine the relationship of appendix length/ diameter ratio with acute appendicitis perforation. Material and Methods: Using the pathology results of appendectomy materials of 144 patients that applied to emergency service between March 2013 and May 2014 and were operated due to the suspicion of acute appendicitis, the length/diameter ratios were calculated. The patients were divided into 2 groups as perforated appendicitis and non-perforated appendicitis. The number of patients and the length/diameter ratios were calculated and recorded for both groups. Pearson’s Chi-Square test was used for statistical analysis. Results: In pathological examination of 144 patients involved in this study, non-complicated acute appendicitis was diagnosed in 123 (85.4%) patients, while 21(14.6%) patients were found to have perforation. In present study, the results indicating that the length/ diameter ratio might be used as early indicator for the perforation were achieved. When the appendix length/diameter ratio declined below 10, then the perforation frequency significantly increased (p<0.01). Conclusion: Knowing these rate can help the surgeon in early surgical intervention, so the possible complications of perforated appendicitis might be decreased via early surgical intervention.Öğe Is there any relationship between complicated appendicitis and leucocyte counts?(Turgut Özal Tıp Merkezi Dergisi, 2016) Kanlioz, Murat; Ekici, Uğur; Tatlı, Faik; Karataş, Turgay; İnan, TarıkAbstract Aim: We aim to show the increasing in leucocyte count according to severity of inflammation in complicated appendicitis. Materials and Methods: 174 patients who had appendectomy were included in this prospective study. Patient consents were taken. Types of appendicitis were categorized as negative appendicitis, non-complicated appendicitis, and complicated appendicitis. Groups were formed according to leucocyte count as 6000/uL and below (L1), 6001- 12000/ uL (L2), 12001-16000 /uL (L3), and 16001/ uL and higher (L4). Types of appendicitis were compared with leucocyte counts. P <0,05 value was considered positive. Results: All 174 patients were evaluated prospectively. Number of negative appendicitis was 15 (8,62%), non-complicated appendicitis was 135 (77,58%), and complicated appendicitis was 24 (13,79%). There were 4 patients (2,29%) in L1 group, 78 patients (44,82%) in L2, 43 patients (24,71%) in L3, and 49 patients (28,16%) in L4. The sensitivity and specificity of leucocyte counts were 69,7% and 80% in diagnosis of acute appendicitis. Complicated appendicitis cases were compared with leucocyte groups. Complicated appendicitis count was 0 (0%) in L1 group, 6 (7,69%) in L2, 8 (18,60%) in L3, and 10 (20,40%) in L4. There was a positive relationship between complicated appendicitis and increasing in leucocyte count (P<0,03). Conclusion: We have concluded that leucocyte count can be helpful in detecting severity of appendix inflammation in adults. Keywords: Acute Appendicitis; Complicated Appendicitis; Leucocyte Count.Öğe Komplike apandisitler ile lökosit sayısı arasında herhangi bir ilişki var mı?(2016) Kanlıöz, Murat; Ekici, Uğur; Tatlı, Faik; Karataş, Turgay; İnan, TarıkÖz:Amaç: Komplike apandisitlerde lökosit sayısının inflamasyonun şiddetine göre arttığını göstermeyi amaçladık. Gereç ve Yöntem: Prospektif çalışmaya apandektomi yapılan 174 hasta dahil edildi. Hasta onamları alındı. Apandisit tipleri; apandisit olmayan, non-komplike apandisit ve komplike apandisit şeklinde guruplandırıldı. Lökosit sayısı ise; 6000/uL ve altında olan (L1), 600112000/uL (L2), 12001-16000/uL (L3) ve 16001/uL'den büyük (L4) şeklinde gruplandırıldı. Apandisit tipleri lökosit sayılarıyla karşılaştırıldı. P<0,05 değeri anlamlı kabul edildi. Bulgular: Toplam 174 hasta prospektif olarak değerlendirildi. Hasta sayıları sırasıyla Apandisit olmayan 15 (%8,62), non-komplike apandisit olan 135 (%77,58) ve komplike apandisit olan 24'tü (%13,79). L1'de 4 (%2,29), L2'de 78 (%44,82), L3'de 43 (%24,71) ve L4grubunda 49 (%28,16) hasta bulunuyordu. Akut apandisit tanısında lökosit sayısı duyarlılığı %69,7 ve özgüllüğü %80 idi. Komplike apandisitler ile lökosit grupları karşılaştırıldı. L1grubunda komplike apandisit sayısı 0 (%0) iken, L2'de 6 (%7,69), L3'te 8 (%18,60), L4'te 10 (%20,40) bulundu. Komplike apandisitlerle lökosit sayısı artışı arasında anlamlı bir ilişki vardı (P<0,03). Sonuç: Erişkin hastalardaki apandiks inflamasyon şiddetinin belirlenmesinde, lökosit sayısının da değerli olduğu kanısına vardık.
